Abstract：
OBJECTIVE:Prognostic information is important for guiding palliative care planning for patients with dementia. We aim to validate a risk score that uses Minimum Data Set (MDS) to estimate 6-month mortality for nursing home residents with advanced dementia. DESIGN:Two cohort studies. SETTING:Six nursing homes in The Netherlands, and 35 nursing homes in Missouri. PARTICIPANTS:Long-term stay residents with advanced dementia: 288 Dutch residents and 269 residents from Missouri who also had a lower respiratory tract infection (LRI). MEASUREMENTS:Patient risk factors and 6-month mortality. RESULTS:Six-month mortality rates were 24.3% for Dutch residents, and 36.8% for US residents. The risk score's AUROC was 0.65 (CI 0.58-0.72), and 0.64 (CI 0.58-0.71), respectively. For the large majority of residents, observed mortality in the 2 validation cohorts were comparable to the development cohort. Among the few residents identified as at very high risk according to the risk score, observed mortality was lower than expected. CONCLUSION:The original mortality risk score predicted 6-month mortality with reasonable accuracy in 2 validation cohorts of nursing home residents with advanced dementia. Thus, the performance of the risk score, at least over the range of low to moderate risk (up to around 40% risk of mortality), can be generalized to long-stay (versus recently admitted) residents with advanced dementia, and to those with LRI.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
van der Steen JT,Mitchell SL,Frijters DH,Kruse RL,Ribbe MWdoi
10.1016/j.jamda.2007.05.004subject
Has Abstractpub_date
2007-09-01 00:00:00pages
464-8issue
7eissn
1525-8610issn
1538-9375pii
S1525-8610(07)00256-3journal_volume
8pub_type
杂志文章,多中心研究abstract：OBJECTIVES:To identify patient characteristics associated with higher numbers of prescribed drugs or risk of receiving one or more inappropriate medications. DESIGN:A cross-sectional survey using chart reviews. PARTICIPANTS:A total of 414 long-stay residents of 20 nursing homes in three states MEASUREMENTS:Current m...
journal_title：Journal of the American Medical Directors Association
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abstract：OBJECTIVES:Patients discharged to a skilled nursing facility (SNF) for post-acute care have a high risk of hospital readmission. We aimed to develop and validate a risk-prediction model to prospectively quantify the risk of 30-day hospital readmission at the time of discharge to a SNF. DESIGN:Retrospective cohort stud...
journal_title：Journal of the American Medical Directors Association
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doi：10.1016/j.jamda.2019.01.137
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abstract：OBJECTIVE:With advancing age, the prevalence of vitamin D deficiency and musculoskeletal pain increases. However, published data on the effectiveness of vitamin D supplementation in reducing chronic pain are inconclusive. The purpose of this study was to test the effect of 3 different monthly doses of vitamin D on chro...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2018.09.004
更新日期：2019-03-01 00:00:00
abstract：OBJECTIVES:Coronavirus disease 2019 (COVID-19) has caused many nursing homes to prohibit resident visits to prevent viral spread. Although visiting restrictions are instituted to prolong the life of nursing home residents, they may detrimentally affect their quality of life. The aim of this study was to capture perspec...
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更新日期：2020-12-01 00:00:00
abstract：OBJECTIVE:To compare the immunogenicity and safety between full-dose (15 μg) intramuscular (i.m.) and full-dose (15 μg) intradermal (i.d.) immunization of the trivalent influenza vaccine in nursing home older adults. DESIGN:A single-center, randomized, controlled, open-label, parallel group trial from October 2013 to ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2014.05.002
更新日期：2014-08-01 00:00:00
abstract：BACKGROUND:Co-prescribing of scheduled drugs is endemic in the United Sates, increasing health risks to patients and the burden on healthcare systems. PURPOSE:We conducted a pragmatic historical cohort study to measure the effect of enrollment in a state-authorized United States' Medical Cannabis Program (MCP) on sche...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2017.07.017
更新日期：2018-01-01 00:00:00
abstract：OBJECTIVE:To identify the differences of incidence of disability between frail older persons with and without slow walking speed. DESIGN:Prospective cohort study. SETTING:Japanese community. PARTICIPANTS:A total of l4,081 older adults aged ≥65 years living in the community, participated in a baseline assessment and ...
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doi：10.1016/j.jamda.2015.03.019
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVES:The objective of this study was to evaluate the benefits of influenza vaccination against hospitalization and mortality on frail elderly people. DESIGN:The design was a population-based retrospective cohort study. SETTING:Taiwan's National Health Insurance claims data. PARTICIPANTS:Participants were 5063 ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.12.003
更新日期：2014-04-01 00:00:00
abstract：OBJECTIVES:To evaluate the effectiveness of (1) dissemination strategies to improve clinical practice behaviors (eg, frequency and documentation of pain assessments, use of pain medication) among health care team members, and (2) the implementation of the pain protocol in reducing pain in long term care (LTC) residents...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2012.05.013
更新日期：2012-09-01 00:00:00
abstract：OBJECTIVES:Little is known about the relationship between how medical care is organized and delivered in nursing homes. Taking a lead from the acute care arena, we hypothesize that nursing home medical staff organization (NHMSO) is an important predictor of clinical outcomes in the nursing home. METHODS:A total of 202...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2010.06.004
更新日期：2011-11-01 00:00:00
abstract：OBJECTIVE:Older adults receiving Medicare home health services who experience undernutrition may be at increased risk of experiencing adverse outcomes. We sought to identify the association between baseline nutritional status and subsequent health service utilization and mortality over a 1-year period in older adults r...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2010.08.017
更新日期：2011-05-01 00:00:00
abstract：:Recent research has shown that while Lewy body dementia. (LBD) may be the second most common form of dementia, it is difficult to confirm the disease before autopsy. Patients with LBD share many clinical signs and symptoms with patients diagnosed with Alzheimer's disease (AD), making it difficult to differentiate betw...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：
更新日期：2001-07-01 00:00:00
abstract：OBJECTIVES:To test whether coordination of discharge from hospital reduces hospitalizations in patients with chronic obstructive pulmonary disease (COPD). DESIGN:Randomized controlled clinical trial. SETTING:Specialized pulmonary hospital. PARTICIPANTS:Patients hospitalized for an acute exacerbation of COPD. INTERV...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2013.03.003
更新日期：2013-06-01 00:00:00
abstract：:Sexuality is an important component of emotional and physical intimacy that men and women experience throughout their lives. Research suggesting that a high proportion of men and women remain sexually active well into later life refutes the prevailing myth that aging and sexual dysfunction are inexorably linked. Age-r...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2013.01.022
更新日期：2013-08-01 00:00:00
abstract：OBJECTIVES:The objective of this study was to measure the level of lighting in nursing homes in a variety of areas to determine its adequacy in meeting the visual needs of elderly residents. DESIGN:Observational study PARTICIPANTS:Eight nursing homes cooperating in an intervention study designed to prevent accidental...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2007.01.003
更新日期：2007-06-01 00:00:00
abstract：BACKGROUND:Exercise tolerance is an important clinical aspect of chronic obstructive pulmonary disease that can be easily and reliably measured with the 6-minute walking test (6MWT). To improve the utility of the 6MWT for patient and health care system management, the interpretation of the functional status measure in ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamda.2011.06.009
更新日期：2012-03-01 00:00:00
abstract：BACKGROUND:Little research has explored racial and socioeconomic differences in the presence, detection, and treatment of neuropsychiatric symptoms in nursing home residents. OBJECTIVE:To evaluate racial and socioeconomic differences on mood and behavior Minimum Data Set (MDS) recorded symptoms, MDS recorded psychiatr...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2005.06.011
更新日期：2006-01-01 00:00:00
abstract：:Unintentional weight loss is a common problem among nursing home residents and one that can lead to adverse and costly clinical outcomes. Observational studies have shown that residents often receive inadequate and poor-quality feeding assistance during meals, and residents consume few calories between meals from oral...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2006.12.003
更新日期：2007-03-01 00:00:00
abstract：OBJECTIVES:To describe the clinical characteristics, 30-day mortality, and associated factors of patients living in nursing homes (NH) with COVID-19, from March 20 to June 1, 2020. DESIGN:This is a retrospective study. A geriatric hospital-based team acted as a consultant and coordinated the care of older people livin...
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doi：10.1016/j.jamda.2020.12.003
更新日期：2020-12-11 00:00:00
abstract：:Internists and family physicians are trained in evidence-based medicine (EBM). The philosophy of incorporating clinical research "evidence" into medical practice is taught at the undergraduate and graduate levels of medical training. Practicing physicians incorporate EBM into their practices in variable degrees depend...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：
更新日期：2004-09-01 00:00:00
abstract：OBJECTIVES:Pneumonia is a frequent condition in older people. Our aim was to examine the total healthcare cost related to pneumonia in nursing home (NH) residents over a 1-year follow-up period. DESIGN:This was a prospective, longitudinal, observational, and multicenter study that was a part of the Incidence of Pneumo...
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pub_type： 杂志文章,多中心研究
doi：10.1016/j.jamda.2017.01.021
更新日期：2017-05-01 00:00:00
abstract：:Up to 80% of nursing home residents are affected by pain. Pain assessment aims to determine pain intensity, quality, and course of pain to underpin diagnostic decision making. In the nursing home population, pain assessment is frequently compromised by cognitive impairment. Characteristics of the nursing home setting,...
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更新日期：2020-02-01 00:00:00
abstract：OBJECTIVE:New guidelines recommend a target glycated hemoglobin (HbA1c) of 7.5% to 8.0% in elderly persons with type 2 diabetes mellitus (T2DM), but real-world data regarding outcomes associated with different HbA1c levels in the elderly are limited. This study assessed outcomes and their association with defined HbA1c...
journal_title：Journal of the American Medical Directors Association
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更新日期：2014-10-01 00:00:00
abstract：OBJECTIVES:Long-term care (LTC) is an important setting for goals of care (GoC) discussions. Understanding clinician barriers to GoC discussions could identify opportunities for LTC-specific interventions to improve quantity and quality of GoC discussions in the context of serious illness. DESIGN:A multicenter, cross-...
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更新日期：2020-05-01 00:00:00
abstract：OBJECTIVES:Sarcopenia is a common geriatric syndrome, whose diagnosis implies the assessment of muscle mass. Dual-energy x-ray absorptiometry (DXA) is the reference method for clinical practice, but it is not universally available. We compared DXA with 2 anthropometry-based methods to assess muscle mass in older adults...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2018.05.016
更新日期：2018-09-01 00:00:00
abstract：BACKGROUND:Both anemia and blood transfusion could be precipitating factors for delirium; hence in postoperative patients with anemia at high risk for delirium, it is controversial whether transfusion is the best option. The aim of this study is to investigate the association of anemia and delirium and the role of bloo...
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pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.jamda.2016.04.008
更新日期：2016-08-01 00:00:00
abstract：OBJECTIVE:Sex-specific impact of frailty on all-cause mortality in older age population remains controversial. This meta-analysis aimed to evaluate the association between frailty and all-cause mortality in older age women vs men from the general population. DESIGN:Meta-analysis. SETTING AND PARTICIPANTS:PubMed and E...
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更新日期：2020-07-15 00:00:00
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journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.jamda.2010.02.010
更新日期：2011-01-01 00:00:00
abstract：:Pressure ulcers remain problematic across health care settings, with prevalence and incidence changing little over the past 2 decades. Because external pressure is viewed as the chief factor in the development of pressure ulcers, considerable research has focused on pressure relief. Because relief of external pressure...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
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更新日期：2010-07-01 00:00:00
abstract：OBJECTIVES:To investigate the association between polypharmacy and medication regimen complexity with time to first hospitalization, number of hospitalizations, and number of hospital days over a 12-month period. DESIGN:A 12-month prospective cohort study. PARTICIPANTS AND SETTING:A total of 383 residents of 6 Austra...
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更新日期：2016-11-01 00:00:00
