Journal of the American Medical Directors Association
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Comparative Study
Has the prevalence of disability increased over the past decade (2000-2007) in elderly people? A Spanish population-based survey.
The main objectives of the current study were (1) to describe the prevalence of disability according to sociodemographic features, self-perceived health status, comorbidity, and lifestyle habits; (2) to determine factors associated with disability in men and women; and (3) to study the time trends prevalence of disability in the period 2000 to 2007. ⋯ The current study revealed an increase in disability from 2000 to 2007 in the older Spanish population. We found that age older than 84 years, lower education levels, obesity, not practicing physical activity and sleeping more than 8 hours per day were associated with higher disability. Individuals with disability reported a worse self-perceived health status and a greater number of comorbid conditions.
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Multicenter Study Comparative Study
Prevalence of psychotropic medication use among German and Austrian nursing home residents: a comparison of 3 cohorts.
Despite increasing knowledge about the limited effectiveness and severe adverse effects, the prescription rate of psychotropic medications in frail elderly persons remains high. Prescriptions are mainly made to control behavioral and psychological symptoms of dementia, although factors associated with prescriptions are rarely reported. However, such information is a prerequisite to develop intervention programs aiming to safely reduce psychotropic medication in nursing home residents. ⋯ Frequency of psychotropic and especially antipsychotic medication is substantial in nursing home residents in Germany and Austria. The high number of prescriptions is likely to be an indicator for a perceived or actual lack of strategies to handle behavioral and psychological symptoms of dementia.
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Comparative Study
The influence of hospice use on nursing home and hospital use in assisted living among dual-eligible enrollees.
This study examined the impact of hospice enrollment on the probabilities of hospital and nursing home admissions among a sample of frail dual-eligible assisted living (AL) residents. ⋯ Hospice enrollment was associated with a lower likelihood of hospital and nursing home admissions, and, thus, may have allowed AL residents in need of palliative care to remain in the AL community. AL providers should support and facilitate hospice care among older frail dual-eligible AL residents. More research is needed to examine the impact of hospice care on resident quality of life and total health care expenditures among AL residents.
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Comparative Study
A survey of emergency department staff about challenges and recommendations for emergency department care of extended care facility patients.
Extended care facility (ECF) patients who transfer to emergency departments (EDs) can pose problems when complicated health problems require extra resources. Higher numbers of older patients are projected to use EDs, so we aimed to identify problems now to implement solutions before they worsen in the future. ⋯ Because population projections predict an increasing trend of older adults, health care providers must think ahead and prepare for future medical needs. This survey was an inexpensive and effective way to identify next steps. We plan to use the survey results to initiate collaboration with ED staff, EMS providers, and ECF staff to identify specific actions to improve acute care for elderly patients--for the present and the future.
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To compare the chronic kidney disease (CKD) stages derived from GFR estimates using 3 different formulae in a sample of older adults from the community and long term care settings. ⋯ The Cockcroft-Gault equation systematically provides lower (more severe) estimates of renal function than the Modification of Diet in Renal Disease Study and Chronic Kidney Disease Epidemiology Collaboration equation in patients older than 70 years. However, significant differences in CKD staging derived from estimate of glomerular filtration rate or creatinine clearance were not observed in adults from 59 to 69 years of age. These findings do not validate one formula over the others, but demonstrate that disparities exist; it may be prudent to use the same formula over time in a given patient to monitor changes in renal function.