Abstract:
OBJECTIVE:To evaluate the efficacy of Simulated Presence, a personalized approach to enhance well-being among nursing home residents with Alzheimer's disease and related dementia's (ADRD). DESIGN:Latin-Square, double blinded, 3-factor design with restrictive randomization of three treatments (the study intervention, a placebo audio tape of a person reading the newspaper, and usual care). The three factors were treatment, time, and facility type. SETTING:Nine nursing homes in Eastern Massachusetts and Southern New Hampshire. PARTICIPANTS:Fifty-four subjects with documented ADRD who were aged 50 years or older, medically stable, had resided in their current nursing home for at least 3 months, and who had no planned discharge. All subjects had a history of agitated or withdrawn behaviors. INTERVENTION:The purpose of Simulated Presence is to provide a personalized intervention for persons with moderate to severe cognitive impairment. Through a unique testing process, some of the best loved memories of the ADRD person's lifetime are identified and then those memories are introduced to the patient in the format of a telephone conversation using a continuous play audio tape system. The intervention may be used for extended periods of time because each repetition is viewed as a fresh, live telephone call as a result of the short-term memory deficit of the person with ADRD. MEASUREMENTS:Direct observations of outcomes included using a newly developed scale, the Scale for the Observation of Agitation in Persons with Dementia, an agitation visual analog scale, the Positive Affect Rating Scale (mood and "interest"), a withdrawal visual analog scale, and facial diagrams of mood. Reported measures included daily staff observation logs of responses to interventions offered, and weekly staff surveys using the short-form Cohen-Mansfield Agitation Inventory and the Multidimensional Observation Scale for Elderly Subjects (mood and "interest"). Severity of dementia was assessed by the Mini-Mental State Exam, the Test for Severe Impairment, the Bedford Alzheimer's Nursing Scale, and the ADL Self-Performance Scale. RESULTS:Chi-square analysis of direct observations, using facial diagrams, revealed that Simulated Presence was equivalent to usual care (P = .141) and superior to placebo for producing a happy facial expression (P = .001). A positive effect was also documented in nursing staff observation logs using Analysis of Variance techniques (ANOVA) for subjects during Simulated Presence phases compared with the placebo phases (P < .001) and usual care phases (P < .001). According to ANOVA analyses of "interest" from weekly surveys, Simulated Presence was superior to both usual care (P = .001) and placebo (P = .008). We were unable to find evidence of significant differences (P < .05) among interventions for other direct observations and weekly reports of overall agitation or mood aspects of withdrawal. Subjects accepted the intervention most of the time, except for five subjects who refused it more than 50% of the time. CONCLUSION:This study provided evidence that Simulated Presence can be effective in enhancing well-being and decreasing problem behaviors in the nursing home setting as a substitute for or complement to usual care.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Camberg L,Woods P,Ooi WL,Hurley A,Volicer L,Ashley J,Odenheimer G,McIntyre Kdoi
10.1111/j.1532-5415.1999.tb07237.xsubject
Has Abstractpub_date
1999-04-01 00:00:00pages
446-52issue
4eissn
0002-8614issn
1532-5415journal_volume
47pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract:OBJECTIVES:To examine the influence of age on the value of four techniques for diagnosing Alzheimer's disease (AD). DESIGN:Observational cohort study. SETTING:Alzheimer's Disease Neuroimaging Initiative. PARTICIPANTS:Individuals with mild cognitive impairment (MCI; n = 179), individuals with AD (n = 91), and normal ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03539.x
更新日期:2011-09-01 00:00:00
abstract:OBJECTIVES:To assess the relative independent contribution of changes in executive control function (ECF) and memory to changes in functional status. DESIGN:Three-year longitudinal cohort study. SETTING:A comprehensive care retirement community. PARTICIPANTS:Five hundred forty-seven noninstitutionalized people aged ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53004.x
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVES:To determine the association between multiple chronic conditions and risk of incident mild cognitive impairment (MCI) and dementia. DESIGN:Prospective cohort study. SETTING:Olmsted County, Minnesota. PARTICIPANTS:Cognitively normal individuals (N = 2,176) enrolled in the Mayo Clinic Study of Aging (MCSA)....
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13612
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVES:To investigate whether atherosclerosis of the ascending aorta, internal carotid arteries, and coronary arteries is predictive of postoperative delirium in subjects undergoing coronary artery bypass graft (CABG) surgery. DESIGN:Prospective cohort study. SETTING:Boston Veterans Affairs Healthcare System. PA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53165.x
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVES:To investigate whether anticholinergic burden scores from nine published anticholinergic scales are associated with adverse health outcomes, including hospital admissions, hospitalizations for falls, hospital length of stay (LOS), and more visits to general practitioners (GPs). DESIGN:Pharmacoepidemiologica...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13206
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVES:Patients undergoing hip fracture surgery have a 10 times increased risk of stroke compared with the general population. We aimed to evaluate the association between the CHA2 DS2 -VASc (congestive heart failure, hypertension, age ≥75 years, diabetes, previous stroke/TIA [transient ischemic attack]/systemic em...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16452
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:To verify the change in health variables and parameters of health service utilization in a group of active caregivers for older persons with dementia in comparison with former caregivers who had ceased to provide home care for at least 6 months (death of the patient or institutionalized care). DESIGN:A pros...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50209.x
更新日期:2002-05-01 00:00:00
abstract::When medical schools change their curricula, this opens up opportunities for the development of new material and often eliminates previously designed courses. Emory University's School of Medicine revised its curriculum in 2007, combining clinical medicine and basic sciences in the first 18 months. As part of its firs...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02363.x
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVES:To examine whether hearing acuity correlates with walking ability and whether impaired hearing at baseline predicts new self-reported walking difficulties after 3 years. DESIGN:Prospective follow-up. SETTING:Research laboratory and community. PARTICIPANTS:Four hundred thirty-four women aged 63 to 76. MEA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02553.x
更新日期:2009-12-01 00:00:00
abstract::Because the value of calcium supplementation in age-related bone loss is controversial, we conducted a study to examine the effects of six months of calcium supplementation on parathyroid hormone (PTH) and other indices of bone metabolism. Calcium carbonate (1.2 grams elemental calcium/day) or placebo was administered...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1532-5415.1991.tb01625.x
更新日期:1991-02-01 00:00:00
abstract:OBJECTIVES:To clarify the effect of tooth loss on development of all-cause dementia and its subtypes in an elderly Japanese population. DESIGN:Prospective cohort study. SETTING:The Hisayama Study, Japan. PARTICIPANTS:Community-dwelling Japanese adults without dementia aged 60 and older (N = 1,566) were followed for ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14791
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVES:To compare the diagnosis and management of urinary tract infection (UTI) in hospitalized older people with clinical criteria and therapeutic guidelines. DESIGN:A retrospective case series of emergency hospital admissions collected over an 18-month period. SETTING:An acute general hospital in northwest Engl...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.02073.x
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:To compare the risk of serious hypoglycemia associated with the use of individual sulfonylureas in older people. DESIGN:A retrospective cohort study. SETTING:The Tennessee Medicaid Program. PATIENTS:A total of 13,963 Medicaid enrollees, aged 65 years or older, who were prescribed one of six sulfonylureas f...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb03729.x
更新日期:1996-07-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that mild cognitive impairment (MCI) is associated with poorer financial and healthcare decision-making. DESIGN:Community-based epidemiological cohort study. SETTING:Communities throughout northeastern Illinois. PARTICIPANTS:Older persons without dementia from the Rush Memory and Agi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13346
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:To describe a broad range of physical disability by examining the association between a four-level measure of disability, based on self-report of difficulty in performing functional activities, and previously identified risk factors for disability. DESIGN:Cross-sectional. SETTING:Community-based. PARTICIPA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb04065.x
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVES:To assess whether the relationship between antidepressant adherence and coronary artery disease (CAD) hospitalizations varied between older and younger adults with depression. DESIGN:Retrospective cohort study. SETTING:Department of Veterans Affairs outpatient clinics nationwide. PARTICIPANTS:Chronically ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12849
更新日期:2014-07-01 00:00:00
abstract::Eighty-seven community-dwelling nonagenarians provided with extensive medical and social services as needed were followed for two years. Fifty-one subjects were admitted to an acute care hospital at least once. Total durations of hospitalization for those who required it averaged 44 days per individual over the two ye...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1984.tb02038.x
更新日期:1984-05-01 00:00:00
abstract:BACKGROUND:Pain is a multidimensional experience that should be evaluated beyond an estimate of intensity. A multidimensional pain measure has not been developed for older persons undergoing comprehensive geriatric assessment. OBJECTIVE:To develop and evaluate validity and reliability of a multidimensional pain assess...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb03881.x
更新日期:2000-12-01 00:00:00
abstract::There are over 2.5 million black Americans aged 65 and over living in the United States today, including some 258,000 persons aged 85 years and over. The post-World War II baby boom within the US black population should ensure that the numbers of persons aged 65 and over will increase into the 21st Century. If present...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1992.tb04485.x
更新日期:1992-10-01 00:00:00
abstract:OBJECTIVES:To investigate the effect of eicosapentaenoic acid (EPA) plus docosahexaenoic acid (DHA) supplementation on quality of life (QOL). DESIGN:Randomized, double-blind, placebo-controlled trial. SETTING:Independently living individuals from the general older Dutch population. PARTICIPANTS:Three hundred two ind...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2009.02361.x
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVES:To compare the risk of congestive heart failure (CHF) in elderly individuals treated with any peripheral alpha-1 antagonist for hypertension with any thiazide, test whether the risk persists in subjects without cardiovascular disease (CVD) at baseline, and examine CHF risk in normotensive men with prostatism...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52456.x
更新日期:2004-10-01 00:00:00
abstract::The current literature on suicide by medicinal overdose among the elderly population of the United States and Britain is discussed. The older white male is a high risk in this regard. Physical and mental illnesses contribute to the problem of suicide among the aged, and some of the drugs prescribed for treatment (e.g....
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1975.tb00218.x
更新日期:1975-07-01 00:00:00
abstract::Differing concepts of aging, i.e., a normative versus a pathologic process, are presented in historical perspective and are traced through selected writings from ancient China, India, Egypt, and Greece into more modern times. These is no consistent shift across epochs from one to the other perspective, and mixed persp...
journal_title:Journal of the American Geriatrics Society
pub_type: 历史文章,杂志文章
doi:10.1111/j.1532-5415.1982.tb07104.x
更新日期:1982-04-01 00:00:00
abstract:OBJECTIVE:To examine physician use of stool guaiac testing in order to determine indications for testing, how the test was used, and the consequences of a particular test result. DESIGN:Retrospective case series. SETTING:Large midwestern inpatient nursing home facility. PATIENTS:All patients with positive fecal occu...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1991.tb03569.x
更新日期:1991-12-01 00:00:00
abstract:OBJECTIVES:To describe the circumstances of falls resulting in hip fractures among older people and to determine whether the circumstances differ by gender, age, and residential status. DESIGN:Cross-sectional study. SETTING:Two hospitals in Auckland, New Zealand, in which all individuals aged 60 years or older with a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1997.tb05975.x
更新日期:1997-09-01 00:00:00
abstract::Little is known about the unmet mental health needs of minority older adults. Racial and ethnic differences in the prevalence rates of psychological distress and reported need and use of mental health services were examined in a population-based sample of older adults using the 2005 California Health Interview Survey....
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02573.x
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVE:To describe the evaluation of an interdisciplinary comprehensive geriatric assessment (CGA) consultation program for targeted hospitalized patients. DESIGN:Multi-center randomized clinical trial (RCT) at four hospitals where patients were randomly assigned to CGA consultation or usual care by the attending p...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1532-5415.1994.tb04977.x
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVES:To assess the prevalence of protocols or guidelines for selected domains of inpatient care for older adults; to explore associations between hospital characteristics and adoption of these guidelines or protocols. DESIGN:Telephone- and Web-based questionnaire. SETTING:General acute care hospitals in Pennsyl...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2010.03056.x
更新日期:2010-10-01 00:00:00
abstract::The literature has identified significant successes in cardiac resuscitation with the use of automated external defibrillators (AEDs) in public areas. As of September 2004, the Food and Drug Administration has authorized the purchase of these devices by the general public without a prescription. For the practicing ger...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2005.00569.x
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVES:To estimate outcomes according to attained blood pressure (BP) in the oldest adults treated for hypertension in routine family practice. DESIGN:Cohort analysis of primary care inpatient and death certificate data for individuals with hypertension. SETTING:Primary care practices in England (Clinical Practic...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14712
更新日期:2017-05-01 00:00:00