The journals of gerontology. Series A, Biological sciences and medical sciences
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J. Gerontol. A Biol. Sci. Med. Sci. · Jul 2003
Randomized Controlled Trial Clinical TrialEffects of an exercise intervention on immunologic parameters in frail elderly nursing home residents.
Aging is associated with decline in both cell-mediated and humoral immunity and may contribute to increased incidence and severity of infections in frail elderly. Exercise, depending on intensity, has significant effects on the immune system. We conducted a randomized, controlled clinical trial of a 32-week functionally oriented exercise program in frail elderly living in nursing homes and determined whether the exercise intervention was associated with a change in immune parameters in this frail elderly nursing home population. ⋯ A 32-week exercise intervention did not bring about beneficial or detrimental effects on immune parameters in the frail elderly nursing home population and may explain why the intervention was not associated with a change in the incidence of infections in the intervention group compared with the control group.
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J. Gerontol. A Biol. Sci. Med. Sci. · Jun 2003
Comparative StudyA comparative study of rehabilitation outcomes of elderly hip fracture patients: the advantage of a comprehensive orthogeriatric approach.
The optimal setting and design of a comprehensive treatment for elderly hip fracture patients is unknown. The aims of this study were to compare the functional outcomes associated with an innovative comprehensive single-step (geriatric-based) and classic double-step (orthopedic-based) treatment of such patients. ⋯ The functional outcome of elderly hip fracture patients is better for those treated in the orthogeriatric setting, as compared with the common two-steps model of orthopedic surgery followed by transfer to a geriatric rehabilitation facility.
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J. Gerontol. A Biol. Sci. Med. Sci. · May 2003
Delirium among newly admitted postacute facility patients: prevalence, symptoms, and severity.
Delirium may persist for weeks or months, and discharging elderly patients quickly from acute care facilities is not uncommon. Therefore, the adverse impact of delirium on loss of independence may occur in the postacute setting rather than in the hospital. The purpose of this study is to describe the prevalence of delirium, delirium symptoms, and severity assessed at admission to postacute facilities. ⋯ Results indicate that 16% of admissions to postacute facilities have CAM-defined delirium, and over two thirds had at least one delirium symptom. It is not known whether or not postacute staff have the training necessary to detect or manage delirium. Managing delirium may require different strategies and techniques in a postacute setting, thereby requiring further research.
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J. Gerontol. A Biol. Sci. Med. Sci. · Feb 2003
Comparative StudyLifestyle intervention of hypocaloric dieting and walking reduces abdominal obesity and improves coronary heart disease risk factors in obese, postmenopausal, African-American and Caucasian women.
There are few empirical data to support the claim that weight loss improves coronary heart disease (CHD) risk factors in postmenopausal women; nor is it known if there are racial differences in changes of body fat distribution, lipids, glucose tolerance, and blood pressure with weight loss. This study determined the efficacy of a lifestyle weight loss intervention in reducing total and abdominal obesity and improving CHD risk factors in obese Caucasian and African-American postmenopausal women. ⋯ Weight loss achieved through a lifestyle intervention of energy restriction and increased physical activity is an equally effective therapy in African-American and Caucasian obese, postmenopausal women for improving glucose and lipid CHD risk factors.
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J. Gerontol. A Biol. Sci. Med. Sci. · Jan 2003
Comparative StudyRelationship between pain and opioid analgesics on the development of delirium following hip fracture.
Delirium and pain are common following hip fracture. Untreated pain has been shown to increase the risk of delirium in older adults undergoing elective surgery. This study was performed to examine the relationship among pain, analgesics, and other factors on delirium in hip fracture patients. ⋯ Using admission data, clinicians can identify patients at high risk for delirium following hip fracture. Avoiding opioids or using very low doses of opioids increased the risk of delirium. Cognitively intact patients with undertreated pain were nine times more likely to develop delirium than patients whose pain was adequately treated. Undertreated pain and inadequate analgesia appear to be risk factors for delirium in frail older adults.