Journal of the American Medical Directors Association
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Review Meta Analysis
Efficacy of physical exercise in preventing falls in older adults with cognitive impairment: a systematic review and meta-analysis.
Numerous studies have reported the prevention of falls through exercise among cognitively healthy older people. This study aimed to determine whether the current evidence supports that physical exercise is also efficacious in preventing falls in older adults with cognitive impairment. ⋯ The present analysis suggests that physical exercise has a positive effect on preventing falls in older adults with cognitive impairment. Further studies will be required to determine the modality and frequency of exercise that are optimal for the prevention of falls in this population.
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Comparative Study
The effect of hospice on hospitalizations of nursing home residents.
Hospice enrollment is known to reduce risk of hospitalizations for nursing home residents who use it. We examined whether residing in facilities with a higher hospice penetration: (1) reduces hospitalization risk for nonhospice residents; and (2) decreases hospice-enrolled residents' hospitalization risk relative to hospice-enrolled residents in facilities with a lower hospice penetration. ⋯ Higher facility-level hospice penetration reduces hospitalization risk for both nonhospice and hospice-enrolled residents. The findings shed light on nursing home end-of-life care delivery, collaboration among providers, and cost benefit analysis of hospice care.
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Comparative Study
International variation in place of death of older people who died from dementia in 14 European and non-European countries.
The objective of this study was to examine variation in place of death of older people dying from dementia in countries across 4 continents. ⋯ Place of death of older people who died from a dementia-related disease differs substantially between countries, which might point to organizational differences in end-of-life care provision. Increasing the availability of long-term care beds might be important to reduce the number of hospital deaths, while focusing specialized end-of-life care services on married people or those aged 65 to 79 might be crucial for achieving home death. However, proper end-of-life care needs to be ensured in hospitals, should this be the most appropriate end-of-life care setting.
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Comparative Study
Differential association of frailty with cognitive decline and sarcopenia in community-dwelling older adults.
Frailty in older adults is a serious problem because of various adverse health outcomes in many countries with aging populations, such as Japan. The purpose of this study was to determine whether frailty and pre-frailty are associated with cognitive decline and sarcopenia in community-dwelling older adults. ⋯ Sarcopenia was associated with pre-frailty and frailty, whereas cognitive decline was associated only with frailty.
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Randomized Controlled Trial Clinical Trial
Economic evaluation of a multifactorial, interdisciplinary intervention versus usual care to reduce frailty in frail older people.
To compare the costs and cost-effectiveness of a multifactorial interdisciplinary intervention versus usual care for older people who are frail. ⋯ For frail older people residing in the community, a 12-month multifactorial intervention provided better value for money than usual care, particularly for the very frail, in whom it has a high probability of being cost saving, as well as effective. Trial registration: ACTRN12608000250336.