Journal of gerontology
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Journal of gerontology · Mar 1989
Age- and sex-related changes of the lymphocyte subsets in healthy individuals: an analysis by two-dimensional flow cytometry.
The relative and absolute numbers of the peripheral blood lymphocyte (PBL) subpopulations from 156 healthy men and women of different ages (20-99 years old) were studied by the use of monoclonal antibodies (MoAbs) and two-dimensional flow cytometry. The percentage of pan-T MoAb-positive cells decreased with age, which was attributable to a relative decline in the CD8+ suppressor/cytotoxic T cells, more precisely in the CD8+ CD11- cytotoxic T cells. ⋯ The absolute numbers of most of the lymphocyte subsets examined declined with age except that those of natural killer cell subsets and helper T cells remained unchanged. It should be noted that the PBL subsets differed markedly according to age and sex, the changes being more evident among women.
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Journal of gerontology · Sep 1988
Comparative StudyPhysicians' and spouses' predictions of elderly patients' resuscitation preferences.
"Substituted judgment," in which surrogate decisionmakers approximate patients' wishes, has been recommended for decision making for mentally incapacitated patients. To test understanding of patients' preferences by potential surrogate decisionmakers, we studied primary care physicians' (n = 105) and spouses' (n = 90) predictions of elderly outpatients' (n = 258) preferences for cardiopulmonary resuscitation (CPR) and CPR plus ventilator (CPR + V), assuming three baseline health states: current health, stroke, and chronic lung disease. Although more than three-quarters of physicians and spouses surveyed believed their predictions of patients' preferences were accurate, the accuracy of physicians' and spouses' predictions did not exceed that expected due to chance alone in 5 of 6, and 3 of 6 decisions, respectively. ⋯ Spouses overestimated patients' preferences for resuscitation in all decisions, significantly so in the three CPR + V decisions (p less than .05). These results suggest physicians and spouses often do not understand elderly outpatients' resuscitation preferences. Under these circumstances they are unlikely to provide accurate substituted judgments.
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Journal of gerontology · Mar 1988
Comparative StudyThe relationships of coping responses to physical health status and life satisfaction among older women.
This study examined a model specifying the causal links between the physical, functional, and subjective components of physical health status and life satisfaction among older women, and assessed the effects of three coping responses (direct-action, positive-cognitive, and passive-cognitive coping) at each point in the process. Based on interview data with 281 older women, a series of regression analyses indicated that, before the inclusion of the coping variables, physical conditions directly contributed to functional impairment, and both indirectly lowered life satisfaction through their direct negative effects on subjective health assessments. Further analyses indicated that positive-cognitive coping buffered the effects of physical conditions at each point in the model, that passive-cognitive coping generally had deleterious effects on health status, although it prevented negative health assessments from lowering life satisfaction, and that direct-action coping had little effect. These findings emphasize the importance of a multidimensional conceptualization of physical health status in understanding its relationship with life satisfaction as well as the specific functions of coping at different points in the process for older women.
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Journal of gerontology · Nov 1987
Comparative StudyPatterns of use of the emergency department by elderly patients.
The spectrum of illness and use patterns of 540 elderly patients (greater than or equal to 65 years) admitted to an emergency department (ED) were compared to an equal number of nonelderly patients. The proportion of visits by the elderly group to the ED was similar to the proportion of elderly residents in the area surrounding the hospital. Elderly patients were more likely than nonelderly patients to have an emergent diagnosis (34.4 vs. 8.3%), to arrive by ambulance (54.6 vs. 23.5%), to be admitted to the hospital (51.1 vs. 14.4%), and to have a medical (as opposed to a surgical) illness (75.0 vs. 53.2%). ⋯ Elderly patients had a significantly lower proportion of nonurgent diagnoses (19.4 vs. 32.0%) than the nonelderly patients. Use of the ED by elderly patients is different from nonelderly patients in that they are more likely to have a serious medical illness. There is little evidence that elderly persons use the ED for primary self-care or social problems.