Journal of the American Medical Directors Association
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Observational Study
One-year stability of care dependency in patients with advanced chronic organ failure.
Care dependency is a determinant of quality of life and survival among patients with advanced chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF), or chronic renal failure (CRF). The objectives of this study were to explore the profiles of care dependency in patients with advanced COPD, CHF, or CRF; to study the changes in care dependency during 1-year follow-up; and to study whether 1-year changes in care dependency are comparable between patients with advanced COPD, CHF, or CRF. ⋯ Care dependency profiles differ between patients with COPD, CHF, or CRF. Patients with advanced COPD are at risk for a 1-year increase in care dependency. Regular assessment of care dependency and addressing care dependency in palliative care programs for patients with advanced COPD, CHF, or CRF are needed.
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To compare the costs of care for community-dwelling dementia patients with the costs of care for dementia patients living in nursing homes from the societal perspective. ⋯ From the societal perspective care for dementia patients living in the community tends to cost more than care in nursing homes when functional impairment is controlled for.
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To identify risk factors for back pain leading to restricted activity (restricting back pain) in older persons. ⋯ In this prospective study, several factors were independently associated with restricting back pain, including some that may be modifiable and therefore potential targets for interventions to reduce this common and often recurrent condition in older persons.
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To explore how quality of life (QoL) and quality of care (QoC) for people with dementia (PwD) vary across 8 European countries; to explore how QoL and QoC for PwD vary across living arrangements; and to assess the association between QoL and QoC. ⋯ There is great variation in QoL and QoC scores among European countries and settings. To gain insight into the underlying causes of these differences, more knowledge is needed about the effect of different national health care systems and dementia strategies on QoL and QoC indicators. Depressive symptoms were associated with QoL, and executing longitudinal studies investigating which factors are associated with change in QoL is highly recommended.
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Observational Study
Impact of polypharmacy on occurrence of delirium in elderly emergency patients.
To examine associations between polypharmacy and delirium diagnosed in elderly patients hospitalized in geriatric acute care unit after emergency hospital admission. ⋯ In our study, polypharmacy is an independent risk factor for delirium in a population of elderly patients after emergency admission. In the geriatric population, delirium is an underestimated scourge and because of its medicosocial and economic consequences and its impact on morbidity and mortality, we need to give increased attention to the prevention and control of polypharmacy, which is a predisposing factor for delirium.