The journals of gerontology. Series A, Biological sciences and medical sciences
-
The Patient Self-Determination Act of 1991 requires that nursing homes reimbursed by Medicare or Medicaid inform all residents upon admission of their rights to enact care directives in the event of terminal illness. This study investigated the relationship between care directive use and resident functional status. ⋯ Care directive use is influenced by a number of sociodemographic and functional characteristics.
-
J. Gerontol. A Biol. Sci. Med. Sci. · May 1999
Differential effects of aging on heart rate variability and blood pressure variability.
Previous studies investigating autonomic cardiovascular control in elderly persons usually included analysis of R-R interval but not of blood pressure variability. "Physiological" blood pressure rise during the aging process was not accounted for as a possible confounding factor. This study was designed to characterize the relationship between age and short-term heart rate (HR) and blood pressure (BP) variability, independently of the "physiological" rise in BP associated to aging. The study was carried out in 65 "normotensive" (BP< or =140/80 mm Hg) healthy subjects, ranging in age from 18 to 80 years. ⋯ The baroreflex gain was negatively correlated with age. The effect of aging on autonomic nervous system cardiac control is progressive and continuous throughout an 18-80 years age range. Although the aging process diminished HR variability and diastolic BP variability, it had no influence on systolic BP variability.
-
J. Gerontol. A Biol. Sci. Med. Sci. · Jan 1999
Serum anticholinergic activity changes with acute illness in elderly medical patients.
Elevated serum anticholinergic activity levels have been associated with delirium in cross-sectional studies of ill older persons. This study used serial measures of serum anticholinergic activity levels to determine whether these levels change following illness resolution, and if such changes are specific to those with delirium. ⋯ In older nursing home residents with a fever, serum anticholinergic activity appears to be elevated during illness, and declines following recovery from illness. This effect does not seem to be specific to those residents with delirium, nor does it seem related to medication changes.
-
J. Gerontol. A Biol. Sci. Med. Sci. · Jan 1999
Effects of age and gender on cardiovascular responses to phenylephrine.
The age-associated impairment in left ventricular (LV) systolic function appears to be mostly detectable during exercise or sympathetic stimulation. We hypothesized that the decline in cardiac function could be unmasked by an acute increase in afterload induced by phenylephrine. We further sought to examine whether the deterioration in cardiac function is influenced by gender. ⋯ This study's findings suggest that age can significantly influence the cardiovascular responses to alpha-adrenergic stimulation and that phenylephrine, by acutely increasing afterload, is effective in unmasking the age-associated deterioration in left ventricular systolic function. Further, it appears that the increase in systolic blood pressure in response to an alpha-adrenergic challenge is significantly influenced not only by age but also by gender.
-
J. Gerontol. A Biol. Sci. Med. Sci. · Jul 1998
A two-year longitudinal study of falls in 482 community-dwelling elderly adults.
Falls are a common occurrence in elderly persons, including relatively healthy, community-dwelling men and women. A significant percentage of falls result in soft-tissue injuries. Although some risk factors for falls have been identified, more research is needed on risk factors for injurious falls. In addition, there is little information from prospective studies on the long-term consequences of falls other than injury. ⋯ Falls and injurious falls without fracture are frequent events for healthy elderly people and may be associated with morbid changes in cognitive status, physical health, and mobility.