The journals of gerontology. Series A, Biological sciences and medical sciences
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J. Gerontol. A Biol. Sci. Med. Sci. · Sep 2005
Comparative StudySex differences in the emergency department evaluation of elderly patients with syncope.
Current data suggest that 30%-50% of patients with syncope leave the hospital without a defined etiology of their syncopal event. Recent studies have shown significant differences in both presentation and therapy in women with coronary disease and congestive heart failure. ⋯ Considerable numbers of patients presenting to EDs with syncope remain without a diagnosis. Women, despite being less likely to have concomitant coronary artery disease or diabetes, are significantly more likely to present to an ED with syncope, yet less likely to be discharged with a defined etiology.
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J. Gerontol. A Biol. Sci. Med. Sci. · Aug 2005
Neglect assessment in urban emergency departments and confirmation by an expert clinical team.
Elder neglect accounts for over 70% of all adult protective services reports in the nation annually, and it has been estimated that there are over 70,000 new cases each year. The purpose of this study was to conduct elder neglect research in the emergency department (ED), using a dyadic vulnerability/risk-profiling framework for elder neglect. ⋯ This study documents the underreporting of cases of neglect as evidenced by differences in diagnoses by screeners versus experts. The research assistants screened positive for neglect in 5% (N=22) of the 405 cases. The NAT made the diagnosis of neglect in 22% (86/389) of the cases. This markedly different rate of neglect may mean that ED screens are important but may underestimate the true number of cases. Conversely, an NAT may make the diagnosis of neglect in an older adult more often given a higher sensitivity and a more robust knowledge base of the problem.
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J. Gerontol. A Biol. Sci. Med. Sci. · Jul 2005
Comparative StudyHospitalization and development of dependence in activities of daily living in a cohort of disabled older women: the Women's Health and Aging Study I.
Changes in self-reported function in older adults are known to occur in the 2 weeks prior to, during, and in the first few months after hospitalization. The long-term outcome of hospitalization on functional status in disabled older adults is not known. The objective of this study was to determine whether hospitalization predicts long-term Activities of Daily Living (ADL) dependence in previously ADL independent, although disabled, older women. ⋯ These results suggest that hospitalization has an independent and dose-response effect on loss of ADL independence in disabled older women over an 18-month period.
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J. Gerontol. A Biol. Sci. Med. Sci. · Jun 2005
Delirium superimposed on dementia in a community-dwelling managed care population: a 3-year retrospective study of occurrence, costs, and utilization.
Dementia is a growing public health problem and a well-described risk factor for delirium. Yet little is known about delirium superimposed on dementia in community-dwelling populations. The purpose of this study was to examine the 3-year occurrence, healthcare utilization, and costs associated with delirium superimposed on dementia in community-dwelling persons. ⋯ This study is the first to report the occurrence rate of DSD in a community-dwelling population, and to demonstrate the substantial health care costs and utilization associated with DSD.
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J. Gerontol. A Biol. Sci. Med. Sci. · Jun 2005
Back pain and decline in lower extremity physical function among community-dwelling older persons.
Little is known regarding the longitudinal effects of back pain on physical function among older persons. We sought to determine whether back pain leading to activity restriction (i.e., restricting back pain) is associated with decline in lower extremity physical function among community-dwelling older persons. ⋯ Restricting back pain is independently associated with decline in lower extremity physical function among community-dwelling older persons. Treatment of restricting back pain may help to decrease functional decline in this population.