Abstract:
OBJECTIVES:Dysphagia is a major healthcare problem as it increases the risk of malnutrition, dehydration, aspiration pneumonia, and death. The aims of this analysis of data from nursing homes (NHs) worldwide were to examine prevalence rates of dysphagia, to identify characteristics of residents with dysphagia, and to describe which type of nutrition residents with dysphagia receive. DESIGN:One-day cross-sectional study, repeated in yearly intervals since 2007. SETTING:926 NH units from 19 countries. PARTICIPANTS:NH residents participating in the nutritionDay between 2007 and 2014, aged 65 years or older, from Europe and North America, and with available information on dysphagia. MEASUREMENTS:Data on resident and unit level were collected on nutritionDay by local nursing staff using standardized questionnaires. Residents' nutritional status, nutritional intake, general residents' characteristics, and unit characteristics were of interest as potential predictors of dysphagia (no vs yes). Univariable generalized estimating equations were performed for all variables, and significant predictors (P < .01) included in a multivariable analysis. Nutritional strategies (type of diet, use of oral nutritional supplements, tube feeding, and parenteral nutrition) are described for residents with and without dysphagia. RESULTS:Dysphagia was reported in 13.4% of the 23,549 residents included, with great variation in the prevalence rates between participating countries. Twelve variables of 23 remained in the multivariable model [area under the receiver operating curve = 0.898; 95% confidence interval (CI) 0.892-0.904; P < .001]. Residents who were not able to eat lunch orally on nutritionDay were 14.90 [odds ratio (OR); 95% CI 9.61-23.11] times more likely to have dysphagia compared with residents who ate everything. ORs of dysphagia were higher for residents with chewing problems (OR 10.48; 95% CI 8.98-12.23), immobile (OR 5.10, 95% CI 4.25-6.11) and partially mobile residents (OR 1.94; 95% CI 1.64-2.29) compared to mobile residents, and residents with severe cognitive impairment (OR 1.99; 95% CI 1.64-2.42). Poor nutritional status, digestive diseases, neurologic diseases, dehydration, and use of antibiotics were also related to a higher risk of dysphagia. The most common nutritional strategy for residents with dysphagia was providing texture-modified diet (42.5%) followed by normal diet (28.2%). One-quarter of residents with dysphagia received oral nutritional supplements additionally, 7.4% of residents with dysphagia received tube feeding exclusively, and 8.0% in combination with oral nutrition. CONCLUSIONS:This analysis of NHs participating in the nutritionDay provides important insight into the current awareness of dysphagia, associated factors, and nutritional strategies. Residents who were unable to eat orally, malnourished, or dehydrated suffered more often from dysphagia, which substantiates the challenges of providing safe and adequate nutrition for residents with dysphagia. Adequacy and efficiency of different nutritional strategies need to be clarified in future studies.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Streicher M,Wirth R,Schindler K,Sieber CC,Hiesmayr M,Volkert Ddoi
10.1016/j.jamda.2017.08.015subject
Has Abstractpub_date
2018-02-01 00:00:00pages
141-147.e2issue
2eissn
1525-8610issn
1538-9375pii
S1525-8610(17)30482-6journal_volume
19pub_type
杂志文章,多中心研究abstract:RATIONALE:Malnutrition screening among nursing home residents is often performed with tools developed for use among older subjects, and sometimes with tools designed for an adult population. Only a few tools have been designed specifically for the nursing home setting. This systematic review assesses the criterion and ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2013.10.006
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:The association between frailty and malnutrition is widely noted, but the common and distinct aspects of this relationship are not well understood. We investigated the prevalence of prefrailty/frailty and malnutrition/nutritional risk; their overlapping prevalence; compared their sociodemographic, physical, a...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.06.017
更新日期:2017-12-01 00:00:00
abstract:PURPOSE:The purpose of this study was to explore approaches used by administrators to respond to grief and bereavement among staff after the death of a resident. METHODS:Continuing care retirement community (CCRC) facilities (n = 10) were randomly selected from a larger study of 31 facilities. Open-ended interviews we...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.06.013
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:To examine the predictive validity of a quick frailty screening tool, the FRAIL-NH, for adverse health outcomes in nursing home residents, using variables from the Minimum Data Set (MDS). The screening items were compiled from the MDS for potential direct application in long-term care facilities using this h...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2015.09.006
更新日期:2015-12-01 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 identify the impact of the regulations implemented in Maryland in 2001, related to nursing home attending physicians and medical directors, and nursing home quality assurance requirements, on Maryland nursing homes, administrators, and physicians. DESIGN:Two surveys were mailed to all nursing home admini...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1097/01.JAM.0000066022.74526.CF
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVES:The aim of this study was to create a screening tool to predict first-time injurious falls in community-living older men and women. DESIGN:Longitudinal cohort study between 2001 and 2009. SETTING:The Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), Sweden. PARTICIPANTS:Community-living ol...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.02.023
更新日期:2019-09-01 00:00:00
abstract:OBJECTIVES:To compare survival rates of hip fracture patients treated within a comprehensive geriatric hip fracture unit (CGHFU) with those undergoing a standard of care treatment (SOCT) in general orthopedic wards. DESIGN:Retrospective chart review. SETTING:A geriatric hip fracture unit of a division of geriatric me...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2010.09.003
更新日期:2011-07-01 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: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:OBJECTIVES:To enable prevention of poor outcome in elderly people, a valid instrument is required to detect individuals at high risk. The concept of frailty is a better predictor than age alone. The Groningen Frailty Indicator (GFI) has been developed to identify frailty. We assessed feasibility, reliability, and const...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2012.04.007
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:To evaluate the impact of a multicenter intervention to reduce potentially inappropriate antipsychotic use in Canadian nursing homes at the individual and facility levels. DESIGN:Longitudinal, population-based cohort study to evaluate the Canadian Foundation for Healthcare Improvement's Spreading Healthcare...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.04.004
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND:Cognitive impairment is common in people living with chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF); however, accurate estimates of prevalence are lacking. To date, there are no meta-analyses that have specifically investigated prevalence of mild cognitive impairment (MCI) in th...
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.2017.01.014
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVES:To compare clinical outcomes in older patients with acute medical crises attended by a geriatrician-led home hospitalization unit (HHU) vs an inpatient intermediate-care geriatric unit (ICGU) in a post-acute care setting. DESIGN:Quasi-experimental longitudinal study, with 30-day follow-up. PARTICIPANTS:Old...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.06.013
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To investigate the ability of nurses to recognize delirium and its symptoms and to investigate the factors associated with undetected delirium. DESIGN:A prospective, observational study with repeated measurements over a 6-month period. SETTING:Seven long term care settings in Montreal and Quebec City, Canad...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2010.11.002
更新日期:2012-03-01 00:00:00
abstract::Throughout the millennia, the cannabis plant has been utilized as a recognized therapy for pain relief and symptom management. Following the Prohibition-era stigmatization and criminalization of all forms of cannabis of the early 20th century, there has been a recent nationwide and worldwide resurgence in interest and...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.11.013
更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Long-term care (LTC) homes expressed concern that patients had experienced medication incidents after hospital discharge as a result of poor coordination of care. OBJECTIVE:The London Transfer Project aimed to reduce LTC medication incidents by 50% within 48 hours of discharge from general medicine units at...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2018.09.037
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVES:While various short variants of the Montreal Cognitive Assessment (MoCA) have been developed, they have not been compared among each other to determine the most optimal variant for routine use. This study evaluated the comparative performance of the short variants in identifying mild cognitive impairment or ...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.02.004
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVES:Paratonia, a form of hypertonia typically seen in dementia, is often associated with difficulties in positioning and daily care. No evidence-based therapy or clinical guideline for management is available. In this study, the short-term effect of harmonic techniques (HT) and supporting cushions (SC) on parato...
journal_title:Journal of the American Medical Directors Association
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jamda.2019.04.031
更新日期:2019-12-01 00:00:00
abstract:BACKGROUND:More than one-half of nursing home residents experience a complex mix of pain. Despite this, assessment and treatment of pain remain inadequate. METHODS:Using techniques of the Cochrane Collaboration and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we assessed effi...
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.2016.09.016
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:Medical students often lack training in complex geriatric medical decision making. We therefore developed the serious game, GeriatriX, for training medical decision making with weighing patient preferences, and appropriateness and costs of medical care. We hypothesized that education with GeriatriX would impr...
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.2014.04.011
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:To examine the bidirectional temporal relationship between depressive symptoms and cognition in relation to risk, reaction, and prodrome. DESIGN:Cross-lag analysis of longitudinal data collected online at baseline and 12-month follow-up. SETTING AND PARTICIPANTS:A United Kingdom population cohort of 11,855...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2020.01.106
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:To describe end-of-life care in Japanese nursing homes by comparing facility and characteristics of residents dying in nursing homes with those who had been transferred and had died in hospitals, and by comparing the quality of end-of-life care with hospitals and with their respective counterparts in the Uni...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2013.02.008
更新日期:2013-10-01 00:00:00
abstract::Loneliness is a common experience within long-term care and, to promote well-being and quality of life among people with dementia, it is important to draw upon a repertoire of strategies that provide social stimulation, companionship, and enjoyment. This paper describes and reflects on a program of co-operative social...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2017.01.013
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVE:Young-onset dementia (YOD) is defined as dementia that develops before the age of 65. Neuropsychiatric symptoms (NPS) have important clinical consequences for patients and their family members. To date, knowledge about the prevalence and correlates of NPS in YOD is limited, but essential to establish specific...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章
doi:10.1016/j.jamda.2016.01.002
更新日期:2016-06-01 00:00:00
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
pub_type: 杂志文章
doi:10.1016/j.jamda.2019.01.137
更新日期:2019-04-01 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: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:OBJECTIVE:To determine the effects of dopaminergic medication withdrawal in an elderly, demented and minimally ambulatory nursing home population with parkinsonism in New York City. METHODS:In our double-blind, randomized study, 11 patients (7 males, 4 females) were randomized into 2 groups: one group underwent levodo...
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.2008.07.001
更新日期:2008-11-01 00:00:00
abstract::Vitamin D deficiency is a common finding in institutionalized older persons. Vitamin D-deficient elderly persons are at higher risk of falls and fractures. Long-term care residents should be considered at high risk of vitamin D deficiency and therefore vitamin D supplementation is highly recommended in this population...
journal_title:Journal of the American Medical Directors Association
pub_type: 杂志文章,评审
doi:10.1016/j.jamda.2010.09.013
更新日期:2011-03-01 00:00:00