Abstract:
OBJECTIVES:The primary objective was to evaluate the risk of fractures associated with use of zopiclone, a new Z-hypnotic, in a population-based cohort of older people in New Zealand (NZ) in a real-world setting. The secondary objective was to examine a nonlinear relationship with age and risk for fractures in zopiclone users. DESIGN:Population-based cohort study with a case-crossover design. SETTING:A nationwide representative sample of New Zealanders aged 65 years and older sourced from the pharmaceutical collections and hospital discharges. PARTICIPANTS:74,787 older individuals with a first-time fracture between January 1, 2005, and December 31, 2015, were analyzed using a case-crossover design for fracture risk with zopiclone use. MEASUREMENTS:Prescription records (2005-2014) of zopiclone were sourced from NZ Pharmaceutical Collections (Pharms). The first-time coded diagnosis of fracture was extracted from the National Minimal Datasets. Datasets were linked by a unique patient identifier to set up case-crossover designs. Relative risks (RRs) of fracture associated with zopiclone was calculated using conditional logistic regression. A varying-coefficient conditional logistic model was employed to examine the influence of age as a risk factor for fractures. RESULTS:The risk of fracture associated with zopiclone is higher [RR = 1.45, 95% confidence interval (CI) = 1.37-1.55], compared to non-use. The increased risk of fracture associated with zopiclone [adjusted relative risk (ARR) = 1.36, 95% CI = 1.28-1.45] remained significant after adjusting for concomitant use of alpha blockers, antipsychotics, beta blockers, benzodiazepines, and tricyclic antidepressants. The varying coefficient model showed that the risk of fracture increases significantly and monotonically with age. CONCLUSION:The results support that the magnitude of the risk of fracture is higher with use of zopiclone compared to non-use. Prescribers must be aware that the relationship between age and fracture risk is nonlinear, and the oldest old are highly vulnerable to fractures with zopiclone use.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Nishtala PS,Chyou TYdoi
10.1016/j.jamda.2016.12.085subject
Has Abstractpub_date
2017-04-01 00:00:00pages
368.e1-368.e8issue
4eissn
1525-8610issn
1538-9375pii
S1525-8610(17)30008-7journal_volume
18pub_type
杂志文章abstract::Osteoporosis is expected to increase as our population pyramid shifts toward old age. It is associated with increased risk of fractures, leading to complications of limitation of ambulation, loss of independence, and chronic pain. Depression is also a common occurrence in the elderly population. Currently, up to 35% o...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2011.09.003
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVES:Evidence on associations between marital status and frailty is limited. The objectives of this study were to perform a systematic review for associations between marital status and physical frailty and to perform a meta-analysis to combine findings. DESIGN:Systematic review and meta-analysis. SETTING AND P...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2019.09.017
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVE:To assess the proposed prevalence of unresponsiveness of older men and women to augment lean body mass, muscle fiber size, muscle strength, and/or physical function following prolonged resistance-type exercise training. DESIGN/SETTING/PARTICIPANTS:A retrospective analysis of the adaptive response to 12 (n = ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.01.071
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVES:Psychotropic drugs are usually prescribed to deal with behavioral and psychological symptoms of dementia, especially when nonpharmacologic approaches are not available or have limited efficacy. Poor outcomes and serious adverse events of the drugs used must be addressed, and risk-benefit ratios need to be co...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.02.003
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVES:In nursing home settings, providers often think that most percutaneous endoscopic gastrostomy (PEG) tubes are placed in older people, some perhaps inappropriately. We sought to describe the relationships between patient age and the indications for, the decision making behind, and the outcomes of gastrostomy ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2005.05.010
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVES:Nursing home (NH) residents receiving texture-modified diet (TMD) are at risk of inadequate nutritional intake and subsequent malnutrition. It is essential to monitor dietary intake to take corrective actions, if necessary. Plate diagrams (PDs) are widely used to assess dietary intake in institutions but lit...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.12.014
更新日期:2020-01-27 00:00:00
abstract::Managing Alzheimer's disease (AD) continues to challenge long-term care physicians and administrators. Although pharmacologic treatment can substantially benefit AD patients in the nursing home setting, common misconceptions and skepticism about its value are barriers to treatment use. Aggressive treatment for AD maxi...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2005.09.010
更新日期:2006-02-01 00:00:00
abstract::Long term care facilities are important sites of care for elderly adults. Despite a growing need and interest in medical direction in nursing homes, there have been limited educational opportunities in this area for geriatric medicine fellows. This article describes a novel medical director's curriculum for first-year...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2012.10.008
更新日期:2013-03-01 00:00:00
abstract::Community care provision for older Australians is growing in places and options, based on older people's preference to stay in their own homes, coupled with its cost efficiency compared to long-term residential care. Australia's aging population, cultural diversity, and dispersed population in rural and remote areas p...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2007.11.010
更新日期:2008-02-01 00:00:00
abstract:OBJECTIVES:Existing studies have indicated that caring for a person with disabilities in a family could result in strong adverse impacts on the health of his or her spouse. However, little is known about the potential joint burden and interactive patterns in a family when both spouses are in poor health. The objective ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2016.01.006
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVE:To identify nursing home standards related to items brought in from the community for residents through a nationwide survey of directors of nursing. Specifically we examined the policies with regard to food, cigarettes, alcoholic beverages, and over-the-counter medications. METHODS:A national survey was dist...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2009.03.003
更新日期:2009-07-01 00:00:00
abstract::The prevalence of malnutrition ranges up to 50% among patients in hospitals worldwide, and disease-related malnutrition is all too common in long-term and other health care settings as well. Regrettably, the numbers have not improved over the past decade. The consequences of malnutrition are serious, including increas...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.05.011
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Informal caregivers of patients with a cognitive impairment may face exhaustion while taking care of their relatives, and are themselves at higher risk of disease. The objective was to assess the relationship between patients' comorbidities evaluated with the Charlson index, and the caregiver burd...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.10.011
更新日期:2016-03-01 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::Chronic indwelling catheters are used to manage urinary retention, especially in the presence of urethral obstruction, and to facilitate healing of incontinence-related skin breakdown. These indwelling foreign bodies become coated and sometimes obstructed by biofilm laden with bacteria and struvite crystals. Bacteria ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2006.01.020
更新日期:2006-07-01 00:00:00
abstract:CONTEXT:Home Hospital is a worldwide phenomenon that provides acute and subacute medical care in the home in an attempt to reduce the need for hospitalization. OBJECTIVE:To evaluate the clinical parameters of a home hospitalization program operating in Jerusalem for 8 years. DESIGN:The Jerusalem Home Hospitalization ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:Influenza vaccination coverage among nursing home residents has consistently been reported well below the Healthy People goals. We sought to determine if standing order programs (SOPs) in long-term care facilities are associated with greater influenza vaccination coverage among residents. METHODS:The Nation...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2009.12.091
更新日期:2010-11-01 00:00:00
abstract::Sexuality is a basic human need that begins at birth and continues throughout life. The sexual needs of the elderly are similar to those of the young, but with variations in frequency, intensity, and mode of expression. Regardless of age, every individual has a need for love, intimacy, and companionship. Unfortunately...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1097/10.1097/01.JAM.0000061465.00838.57
更新日期:2004-03-01 00:00:00
abstract:OBJECTIVES:Rehabilitation plays a vital role in the mitigation and improvement of functional limitations associated with aging and chronic conditions. Moderating factors such as sex, age, the medical diagnosis, and rehabilitation timing for admission status, as well as the expected change related to inpatient rehabilit...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.05.034
更新日期:2020-12-01 00:00:00
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:BACKGROUND:Poor gait performance predicts risk of developing dementia. No structured critical evaluation has been conducted to study this association yet. The aim of this meta-analysis was to systematically examine the association of poor gait performance with incidence of dementia. METHODS:An English and French Medli...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jamda.2015.12.092
更新日期:2016-06-01 00:00:00
abstract:OBJECTIVES:To examine the independent associations between atrial fibrillation (AF) and objectively measured mobility in a nationally representative cohort. DESIGN:Wave 1 of The Irish Longitudinal Study on Ageing (TILDA), a population-based study assessing health, economic, and social aspects of ageing. SETTING:Commu...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.08.005
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:To describe the recruitment strategy and association between facility and staff characteristics and success of resident recruitment for the Promoting Independence in Residential Care (PIRC) trial. DESIGN:Cross-sectional study of staff and facility characteristics and recruitment rates within facilities with...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jamda.2007.11.008
更新日期:2008-05-01 00:00:00
abstract:PURPOSE:Long-term care facilities have lagged heavily behind other health providers in adopting health information technology (IT). This article examines the facility characteristics that are associated with health IT adoption. DESIGN AND METHODS:This study is a secondary data analysis of information gathered between ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2016.02.028
更新日期:2016-05-01 00:00:00
abstract:OBJECTIVE:Delirium superimposed on dementia (DSD) is common, morbid, and costly, yet frequently undiagnosed. Our study aimed to develop a brief screening test to improve health care worker recognition of DSD. DESIGN/SETTING/PARTICIPANTS:Older hospitalized adults with dementia were prospectively enrolled from medical a...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.05.011
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVES:To explore determinants of behavior change maintenance of a physically active lifestyle in patients with chronic obstructive pulmonary disease (COPD) 8-11 months after completion of a 4-month outpatient pulmonary rehabilitation program. DESIGN:A qualitative descriptive study of semistructured interviews. S...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2014.05.003
更新日期:2014-09-01 00:00:00
abstract::The phenomenon of elderly sexual offenders is poorly catalogued, and is especially complex. In institutions, elderly people are often unrecognized victims of sexual abuse but are also at great risk for doing abuse toward vulnerable victims like children. The lack of attention to an elder's basic needs can endanger or ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2012.05.012
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVES:Immigrants often face many unique cultural and logistical challenges in their health care that differ from nonimmigrants. We sought to describe and compare characteristics and the time to placement between recent immigrants and long-standing residents waiting for long-term care (LTC). DESIGN:Population-base...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.07.018
更新日期:2020-08-25 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...
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.2017.01.021
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:Good scientific evidence indicates that calcium and vitamin D supplementation decrease the incidence of osteoporosis-related fractures among institutionalized elderly. OBJECTIVE:The objective was to study the frequency of prescribing calcium and vitamin D supplements in elderly institutionalized individuals...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1097/01.JAM.0000110649.22467.B4
更新日期:2004-03-01 00:00:00