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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Falls and fall-related injuries are leading problems in residential aged care facilities. The objective of this study was to provide descriptive data about falls in nursing homes. ⋯ The differing fall risk patterns in specific subgroups may help to target preventive measures.
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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.
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Despite serious safety concerns, prescription rates of antipsychotics for the treatment of the behavioral and psychological symptoms of dementia remain high, especially in nursing homes. This high prevalence of antipsychotic use cannot be explained by the modest success rate reported in the literature. In this study, we aim at clarifying the reasons for prescribing an antipsychotic drug in behavioral and psychological symptoms of dementia and look at the role of nurses and family caregivers in the decision-making process that precedes the prescription of an antipsychotic drug. ⋯ The interviewed nursing home physicians and nurses expect almost half of their patients with dementia and behavioral disturbances to benefit from antipsychotic therapy. Serious side effects were expected to occur only sporadically. These expectations may contribute to the high rate of antipsychotic use among these patients.
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Improve the safety of methotrexate use in nursing home residents by reducing methotrexate errors. ⋯ Implementation of intensification of dispensing practices, mandatory training, and measurement eradicated sentinel events associated with methotrexate in nursing homes.