Abstract:
:Uncertainty appears to typify the experience of living with dementia. With an uncertain illness trajectory and unpredictable levels of deterioration and stability in symptoms, people with a diagnosis of dementia may live with uncertainty and anxiety and find it hard to make plans or decisions for their future. People with memory problems and caregivers seeking a diagnosis of dementia may also potentially find themselves navigating a labyrinth-like maze of services, practitioners, assessments, and memory tests, with limited understanding of test scores and little information about what support is available. In this context of uncertainty, the apparent clarity and certainty of a "dementia care pathway" may be attractive. However, the term "dementia care pathway" has multiple and overlapping meanings, which can potentially give rise to further confusion if these are ill-defined or a false consensus is presumed. This review distinguishes four meanings: 1) a mechanism for the management and containment of uncertainty and confusion, useful for the professional as well as the person with dementia; 2) a manual for sequencing care activities; 3) a guide to consumers, indicating eligibility for care activities, or a guide to self-management for dementia dyads, indicating the appropriateness of care activities; and 4) a manual for "walking with" the person. Examples of these approaches are presented from UK dementia services with illustrations of existing care pathways and associated time points, specifically focusing on: 1) early symptom identification and first service encounters, 2) assessment process, 3) diagnostic disclosure, 4) postdiagnostic support, and 5) appropriate interventions. We review the evidence around these themes, as well as discuss service pathways and referral routes used by some services in England and internationally. We conclude that the attraction of the term "care pathway" is seductive, but caution is needed in taking shared understandings for granted.
journal_name
Clin Interv Agingjournal_title
Clinical interventions in agingauthors
Samsi K,Manthorpe Jdoi
10.2147/CIA.S70628subject
Has Abstractpub_date
2014-11-27 00:00:00pages
2055-63eissn
1176-9092issn
1178-1998pii
cia-9-2055journal_volume
9pub_type
杂志文章,评审abstract:OBJECTIVE:We studied the effect of sustained virologic response (SVR) after treatment with pegylated-interferon (PEG-IFN) plus ribavirin on the development of liver cirrhosis in elderly patients with chronic hepatitis C (CHC). PATIENTS AND METHODS:This retrospective study enrolled 145 elderly CHC patients (aged ≥65 ye...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S97242
更新日期:2016-03-17 00:00:00
abstract::Sensorimotor functions decrease in old age. The well-documented loss of tactile acuity in elderly is accompanied by deterioration ofhaptic performance and fine manipulative movements. Physical training and exercise can maintain sensorimotor fitness into high age. However, regular schedules of training require discipli...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/cia.s3174
更新日期:2008-01-01 00:00:00
abstract::In this case study of an unique instance, effects of medium-energy, high-focused extracorporeal generated shock waves (ESW) onto the skin and the underlying fat tissue of a cellulite afflicted, 50-year-old woman were investigated. The treatment consisted of four ESW applications within 21 days. Diagnostic high-resolut...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/cia.s2334
更新日期:2008-01-01 00:00:00
abstract:Objective:The aim of this study was to compare the perceived oral health of elderly persons and the clinical reality of their oral status. Background:Persons aged over 60 have considerable need for oral health care; a need that increases over time. However, this population appears to be unaware of their state of oral ...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S204533
更新日期:2019-06-28 00:00:00
abstract:Aim:To contribute to the knowledge about the mechanisms involved in aortic stiffness due to ageing. Materials and Methods:Aortic rings from young (1.5±0.5 months, 0.8±0.2 kg), adult (6±0.5 months, 2.7±0.5 kg) and old (28±8 months, 3.2±0.8 kg) male New Zealand rabbits were used to evaluate: 1) intima-media thickness by...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S236173
更新日期:2020-04-20 00:00:00
abstract::Pharmacologic management of infections in elderly patients presents multiple challenges to health care professionals due to variable pharmacokinetics, pharmacodynamics, and immune function. Age is a well-established risk factor for infection, but furthermore is a risk factor for prolonged length of hospital stay, incr...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S133640
更新日期:2018-04-17 00:00:00
abstract:BACKGROUND:Exercise has been shown to be effective in cardiovascular endurance in the elderly. We studied the effect of Thai dancing on physical performance of Thai elderly. METHODS:This was an open-labeled, randomized intervention study. The Thai dancing group exercised for 40 minutes three times a week for 6 weeks. ...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,随机对照试验
doi:10.2147/CIA.S41076
更新日期:2013-01-01 00:00:00
abstract::Heart failure is a common and disabling condition with morbidity and mortality that increase dramatically with advancing age. Large observational studies, retrospective subgroup analyses and meta-analyses of clinical trials in systolic heart failure, and recently published randomized studies have provided data support...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S4482
更新日期:2010-12-03 00:00:00
abstract:OBJECTIVE:To evaluate the impact of chronic obstructive pulmonary disease (COPD) on left ventricular (LV) diastolic function in hospitalized elderly patients. METHODS:This was a case-control observational study of 148 consecutive hospitalized elderly patients (≥65 years old): 73 subjects without COPD as controls and 7...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S71878
更新日期:2014-12-19 00:00:00
abstract:Background:When considering the "joint as an organ", the tissues in a joint act as complementary components of an organ, and the "set point" is the cellular activity for homeostasis of the joint tissues. Even in the absence of injury, joint tissues have adaptive responses to processes, like aging and menopause, which r...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S151453
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) is the most common arrhythmia in patients with chronic kidney disease (CKD), and the combined prevalence of these two disorders increases as the population ages. Both AF and CKD have risk factors for development of each other and eventual mortality. However, the relationship between ...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S55972
更新日期:2014-02-14 00:00:00
abstract:BACKGROUND:Endovascular option has been proposed for a very limited and selected number of Stanford type A aortic dissection (TAAD) patients. We have performed a computed tomography (CT)-based TAAD study to explore appropriate endograft configurations for the ascending aortic pathology. METHODS:TAAD patients treated w...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S104961
更新日期:2016-07-14 00:00:00
abstract:Purpose:The post-stroke elderly was increased caused by increasing stroke and advanced medical. However, ankle-foot orthoses (AFOs) can be uncomfortable for hemiplegic patients; therefore, the usability is not good. In this study, we analyzed ankle and knee joint angles in post-stroke elderly patients to assess the fun...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S222087
更新日期:2019-12-05 00:00:00
abstract::Osteoporosis and fragility fractures are relevant health issues because of their impact in terms of morbidity, mortality, and socioeconomic burden. Despite this alarming scenario, both underdiagnosis and undertreatment are common features of osteoporotic patients, particularly those who have already sustained a fragil...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S242038
更新日期:2020-03-26 00:00:00
abstract:PURPOSE:Patients leaving the hospital are at increased risk of functional decline and hospital readmission. The Employee and Community Health service at Mayo Clinic in Rochester developed a care transition program (CTP) to provide home-based care services for medically complex patients. The study objective was to deter...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S44390
更新日期:2013-01-01 00:00:00
abstract:PURPOSE:We evaluated the short- to midterm outcomes of metatarsal head-resurfacing hemiarthroplasty and total metatarsophalangeal joint arthroplasty (total joint replacement [TJR]) as surgical treatments for advanced-stage hallux rigidus (HR). PATIENTS AND METHODS:From 2012 to 2014, all data from patients who underwen...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S110865
更新日期:2016-12-13 00:00:00
abstract:Background:Postoperative functional training for fracture or osteoarthritis is mainly focused on functional self-exercise, which aims to recover the function of the lower limbs. Purpose:To compare the function and life quality recovery in patients with fracture or arthritis treated with novel muscle training device (N...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S277118
更新日期:2020-11-18 00:00:00
abstract:BACKGROUND:No conventional creatinine- or cystatin C-based glomerular filtration rate (GFR) estimation equation performed consistently outstandingly in elderly Chinese in our previous studies. This research aimed to further evaluate the performance of some recently proposed estimation equations based on creatinine and ...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S68801
更新日期:2014-09-11 00:00:00
abstract:Purpose:The study aimed to investigate the association between body composition and frailty in elder inpatients. Patients and Methods:This is a cross-sectional study including 656 elder inpatients (275 females and 381 males) aged ≥65 years, from department of geriatrics of Zhejiang Hospital between January 2018 and Ma...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S243211
更新日期:2020-03-04 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) disproportionately affects older adults. However, direct comparison of clinical features, medical therapy, and outcomes in AF patients aged 65-74 and ≥ 75 years is rare. The objective of the present study was to evaluate the differences in clinical characteristics and prognosis in th...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,多中心研究
doi:10.2147/CIA.S67123
更新日期:2014-08-12 00:00:00
abstract::Numerous randomized, double-blind, placebo-controlled studies and observational studies have demonstrated that statins decrease mortality and major cardiovascular events in older high-risk persons with hypercholesterolemia. The Heart Protection Study found that statins decreased mortality and major cardiovascular even...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/ciia.2006.1.4.433
更新日期:2006-01-01 00:00:00
abstract::Idiopathic normal pressure hydrocephalus (iNPH) is a rare neurological disorder with no clear prevalence factors and is a significant danger to the elderly. The intracranial glymphatic system is the internal environment that maintains brain survival and metabolism, and thus fluid exchange changes in the glymphatic sys...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S290709
更新日期:2021-01-15 00:00:00
abstract:BACKGROUND:Older patients with acute myocardial infarction (AMI) usually have a poor prognosis, but whether this poor prognosis leads to high hospital costs remains unclear. This study investigated the clinical outcomes of and costs incurred by older patients with AMI and metabolic syndrome (MS) in hospital. METHODS A...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S70372
更新日期:2015-01-23 00:00:00
abstract::Most patients with myelodysplastic syndromes (MDS) are elderly (median age range 65 to 70 years); as a consequence, the incidence and prevalence of these diseases are rising as the population ages. Physicians are often uncertain about how to identify patients who may benefit from specific treatment strategies. The Int...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/cia.s5203
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this work was to analyze and compare the movement kinematics of sit-to-stand (STS) and back-to-sit (BTS) transfers between frail aged adults and young subjects, as well as to determine the relationship between kinematic changes and functional capacities. METHODS:We analyzed the Timed Up and Go...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S74755
更新日期:2015-02-26 00:00:00
abstract:BACKGROUND:The purpose of this study was to determine the relationship between hypothesized pain behaviors in the elderly and a measurement model of pain derived from the Minimum Data Set-Resident Assessment Instrument (MDS-RAI) 2.0 items. METHODS:This work included a longitudinal cohort recruited from Medicare-certif...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S29656
更新日期:2012-01-01 00:00:00
abstract:Background/Objective:One of the problems associated with aging is the development of apoptosis in different tissues. There is evidence that physical activity and herbal remedies can be useful. This study aimed to determine the effect of swimming training (SW) alone or combined with garlic extract on renal and hepatic c...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S250321
更新日期:2020-08-18 00:00:00
abstract:BACKGROUND:The modifications of cholesterol metabolism associated with aging are ill-defined. The objective of this study was to define age-associated alterations of the different metabolic pathways controlling cholesterol homeostasis by analyzing circulating sterols. METHODS:We analyzed serum samples collected from 2...
journal_title:Clinical interventions in aging
pub_type: 杂志文章
doi:10.2147/CIA.S57714
更新日期:2014-03-17 00:00:00
abstract::Data on the oral health of the elderly depict a worrying situation, with an elevated prevalence of caries and moderate periodontal disease, frequent edentulism, and numerous cases of dry mouth and oral cancer. There is wide evidence that periodontitis is a risk factor for certain systemic diseases, and impaired oral h...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S54630
更新日期:2015-02-11 00:00:00
abstract::Taken once a year, intravenous zoledronic acid (Zol) (Reclast® or Aclasta®) is a third-generation nitrogen-containing bisphosphonate that is effective compared with placebo in reducing the risk of fractures in patients with postmenopausal osteoporosis and recent low-trauma hip fracture. In glucocorticoid-induced osteo...
journal_title:Clinical interventions in aging
pub_type: 杂志文章,评审
doi:10.2147/CIA.S7282
更新日期:2011-01-01 00:00:00