Abstract：
OBJECTIVES:To determine the prevalence, rate of underdiagnosis and undertreatment, and association with activities of daily living dependency of spasticity in a nursing home setting. DESIGN:Cross-sectional study. SETTING AND PARTICIPANTS:This study is an analysis of a deidentified data set generated by a prior quality improvement project at a 240-bed nursing home for residents receiving long-term care or skilled nursing care services. METHODS:Each resident was examined by a movement disorders specialist neurologist to determine whether spasticity was present and, if so, the total number of spastic postures present in upper and lower limbs was recorded. Medical records, including the Minimum Data Set, were reviewed for neurologic diagnoses associated with spasticity, activities of daily living (ADL) dependency, and prior documentation of diagnosis and past or current treatments. Ordinary least squares linear regression models were used to evaluate the association between spasticity and ADL dependency. RESULTS:Two hundred nine residents (154 women, 81.9 ± 10.9 years) were included in this analysis. Spasticity was present in 22% (45/209) of residents examined by the neurologist. Only 11% of residents (5/45) had a prior diagnosis of spasticity and were receiving treatment. Presence of spasticity was associated with greater ADL dependency (χ2 = 51.72, P < .001), which was driven by lower limb spasticity (χ2 = 14.56, P = .006). CONCLUSIONS AND IMPLICATIONS:These results suggest that spasticity (1) is common in nursing homes (1 of 5 residents), (2) is often not diagnosed or adequately treated, and (3) is associated with worse ADL dependency. Further research is needed to enhance the rates of diagnosis and treatment of spasticity in long-term care facilities.
journal_name
J Am Med Dir Assocjournal_title
Journal of the American Medical Directors Associationauthors
Gill CE,Hacker ML,Meystedt J,Turchan M,Schnelle JF,Simmons SF,Habermann R,Phibbs FT,Charles Ddoi
10.1016/j.jamda.2020.01.005subject
Has Abstractpub_date
2020-08-01 00:00:00pages
1157-1160issue
8eissn
1525-8610issn
1538-9375pii
S1525-8610(20)30030-Xjournal_volume
21pub_type
杂志文章abstract：OBJECTIVE:To identify predictors of adverse outcomes (nursing home placement and hospital length of stay) in a cohort of older hospitalized patients. DESIGN:Prospective cohort study. SETTING:A suburban medical center in the New York City metropolitan area. PARTICIPANTS:Patients aged 65 years and older admitted from ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：
更新日期：2000-09-01 00:00:00
abstract：BACKGROUND:An estimated 1.5 million residents of nursing homes (NH) in the United States were prescribed an average of 7 to 8 medications each month. However, it is unknown which of these prescribed drugs and nutritional supplements have been tested for use among NH residents who often have distinct and complex needs c...
journal_title：Journal of the American Medical Directors Association
pub_type： 历史文章,杂志文章
doi：10.1016/j.jamda.2008.06.005
更新日期：2009-01-01 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：: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：:Diabetes mellitus (DM) is a major health problem for the aging population. Glycemic control is fundamental to the management of diabetes, as glycemic levels are closely linked to development of diabetes-related complications. Measurement of the hemoglobin A1c (A1c) to assess chronic glycemic control is an integral com...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2005.03.012
更新日期：2005-05-01 00:00:00
abstract：OBJECTIVES:To determine what factors contribute to successful appeals of nursing home deficiencies in the Informal Dispute Resolution (IDR) process. DESIGN:We merged Centers for Medicare and Medicaid Services' data about IDRs with Online Survey, Certification, and Reporting data about nursing home characteristics. We ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2012.09.015
更新日期：2013-02-01 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：BACKGROUND:Nursing home residents' repeated transfers to hospital are costly and can lead to in-hospital complications and high mortality for frail residents. However, no research has examined the trajectory of residents' symptoms over their nursing home residency and its relationship to hospital transfer. AIM:The pur...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2016.06.019
更新日期：2016-11-01 00:00:00
abstract：OBJECTIVE:To report on the process and effect of a quality improvement project on end-of-life (EOL) care in a state veterans' home. DESIGN:The design uses survey data from representatives of the deceased, continuous quality improvement (QI) techniques, and interdisciplinary team activities. Representatives of the dece...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2005.12.020
更新日期：2006-03-01 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：:While federal law establishes guidelines that designated facilities must follow in providing information about a patient's rights regarding self-determination in the health care decision-making process, state law determines the decision-making process and the legal requirements pertaining thereto. A person's capacity ...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2006.01.001
更新日期：2006-06-01 00:00:00
abstract：OBJECTIVES:The number of older people dying in long-term care facilities (LTCFs) is increasing globally, but care quality may be variable. A framework was developed drawing on empirical research findings from the Palliative Care for Older People (PACE) study and a scoping review of literature on the implementation of p...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2020.01.009
更新日期：2020-08-01 00:00:00
abstract：OBJECTIVES:To investigate the effects of light therapy on cognition, depression, sleep, and circadian rhythms in a general, nonselected population of seniors living in a long term care facility. DESIGN:A double-blind, placebo-controlled trial. SETTING:The experiment took place at a long term care facility in Pennsylv...
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.2011.05.006
更新日期：2012-02-01 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：OBJECTIVES:To determine the effect of a Social Health Maintenance Organization (S/HMO) on diverting older adults admitted into a nursing facility from converting to long-stay placement. DESIGN:Members of the SCAN S/HMO and those in Medicare Fee-For-Service were compared on successful discharge to the community after b...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2009.10.009
更新日期：2010-06-01 00:00:00
abstract：BACKGROUND/OBJECTIVES:Polypharmacy and multimorbidity is a threat to older people; hence, listing approaches should support physicians to optimize medication. The FORTA (Fit fOR The Aged) classification of drug appropriateness for older people provides positive or negative labels: A (A-bsolutely), B (B-eneficial), C (C...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2019.07.023
更新日期：2020-03-01 00:00:00
abstract：OBJECTIVES:The aim of this study was to examine the effects of a home-based and volunteer-administered physical training and nutritional intervention program compared with social support intervention on nutritional and frailty status in prefrail and frail community-dwelling older persons. DESIGN:This was a randomized ...
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.2016.04.018
更新日期：2016-07-01 00:00:00
abstract：OBJECTIVE:To evaluate whether botulinum toxin can decrease the burden for caregivers of long term care patients with severe upper limb spasticity. METHOD:This was a double-blind placebo-controlled trial with a 24-week follow-up period. SETTING:A 250-bed long term care hospital, the infirmary units of 3 regional hospi...
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.2012.03.005
更新日期：2012-06-01 00:00:00
abstract：BACKGROUND:Health care-related adverse events (HCRAEs), which should not be confused with (blameworthy) medical errors, are common; they can lead to hospital admissions and can have grave consequences. Although they are sometimes potentially preventable, information is lacking on HCRAEs leading to admission to differen...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2015.06.019
更新日期：2015-12-01 00:00:00
abstract：OBJECTIVE:To examine whether reduced ability to self-administer medication can accurately classify living placement (independent or assisted living) in a continuing care retirement community (CCRC). DESIGN:Convenience sample of consecutive patients seen in a medical clinic. SETTING:An outpatient medical clinic at a C...
journal_title：Journal of the American Medical Directors Association
pub_type： 临床试验,杂志文章
doi：10.1016/j.jamda.2005.04.002
更新日期：2005-07-01 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...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2016.08.019
更新日期：2016-11-01 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：PURPOSE:To describe a feasible quality improvement system to manage feeding assistance care processes in an assisted living facility (ALF) that provides dementia care and the use of these data to maintain the quality of daily care provision and prevent unintentional weight loss. DESIGN AND METHODS:Supervisory ALF staf...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2017.12.012
更新日期：2018-03-01 00:00:00
abstract：:Singapore faces a rapidly aging population. By 2030, 19% of her population will be aged 65 years and above. Other Asian countries face similar problems, with South Korea having the fastest aging population worldwide, followed by China and Thailand. With Singapore possessing an advanced aging population, its policy pro...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2013.12.082
更新日期：2014-06-01 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：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：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：:Currently, the Agency for Healthcare Research and Quality (AHRQ) Common Format for nursing homes (NHs) accommodates voluntary reporting for 4 adverse events: falls with injury, pressure ulcers, medication errors, and infections. In 2015, AHRQ funded a technical brief to describe the state of the science related to saf...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章,评审
doi：10.1016/j.jamda.2016.03.005
更新日期：2016-06-01 00:00:00
abstract：OBJECTIVE:To cross-culturally adapt and test the FRAIL scale in Chinese community-dwelling older adults. DESIGN:Cross-sectional study. METHODS:The Chinese FRAIL scale was generated by translation and back-translation. An urban sample of 1235 Chinese community-dwelling older adults was enrolled to test its psychometri...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：10.1016/j.jamda.2017.06.011
更新日期：2018-01-01 00:00:00
abstract：:In long-term care facilities, 5 to 15% of residents have chronic urinary catheters in place. Catheters are commonly used for urinary retention, incontinence control, wound management, and patient comfort. The appropriate use and management of these devices continues to be studied and debated. Transurethral catheters a...
journal_title：Journal of the American Medical Directors Association
pub_type： 杂志文章
doi：
更新日期：2002-05-01 00:00:00
