Abstract:
OBJECTIVES:To compare self-reporting of pain by cognitively impaired (CI) older adults living in the community with reports of their caregivers; to identify the factors associated with differences in agreement; and to identify those pain assessment tools that are most useful to nonprofessional caregivers. DESIGN:Prospective observational cohort of patients with dementia and their caregivers. SETTING:In-home assessments of community-dwelling CI older adults and family members, adult foster care providers, or aides in residential care facilities. All CI subjects were enrolled in a Program for All-inclusive Care of the Elderly program (ElderPlace) in Portland, Oregon. PARTICIPANTS:A total of 156 CI adults and their caregivers. METHODS:Standardized pain assessment instruments were administered to the CI subjects and their caregivers in the subject's home by trained research assistants between June and October 1998. CI subjects were assessed with the Nonverbal Visual Analog scale ("line"), the Faces Pain Scale ("faces"), and the Philadelphia Pain Intensity Scale (PIS). Research assistants observed pain behaviors in the CI subjects using the Hospice Approach Discomfort Scale. The CI subject's caregivers completed the "line," "faces," PIS, and Cornell Scale for Depression in Dementia. A baseline Mini-Mental State Exam, Functional Assessment Stage Test, and Geriatric Depression Scale were performed on all CI subjects by ElderPlace medical, nursing, or social work staff. RESULTS:The mean age of the CI subjects was 83, and 83% were women. The mean Mini-Mental State Exam score was 15.7. One-third of the CI subjects were unable to complete any of the three pain assessment tools. Of the 104 subjects completing at least one tool, 13 (12.5%) reported no pain and 91 (87.5%) reported some pain. Sixteen (10%) of the subjects were depressed as measured with the GDS or Cornell instrument. In 70 of the 104 subjects (67%) able to complete any tool, the caregiver and CI subject agreed as to the level of pain experienced by the CI subject. The number of tools completed by the CI subjects decreased with increased cognitive impairment. The Pain Intensity Scale was the tool most likely to be completed by both CI subjects and caregivers. The means of test scores were not significantly different for the paired groups of CI subject and caregiver, and the nonparametric correlation of each tool was significant: "faces" (Spearman's rho (p) = .417); "line" (p = .420); and PIS (p = .452). The Hospice Approach Discomfort Scale did not correlate well with other tools. The Pain Intensity Scale seems to be more useful than other pain assessment tools in assessing pain in cognitively impaired patients and can be used by nonprofessional caregivers in a community-based care setting.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Krulewitch H,London MR,Skakel VJ,Lundstedt GJ,Thomason H,Brummel-Smith Kdoi
10.1111/j.1532-5415.2000.tb03871.xsubject
Has Abstractpub_date
2000-12-01 00:00:00pages
1607-11issue
12eissn
0002-8614issn
1532-5415journal_volume
48pub_type
杂志文章abstract:OBJECTIVES:To compare the epidemiological and microbiological characteristics of bloodstream infection (BSI) between the young old (65-75), old (76-85), and old old (>85). DESIGN:Retrospective study. SETTING:Forty-six hospitals in southeast France. PARTICIPANTS:One thousand seven hundred forty patients aged 65 and o...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50458.x
更新日期:2002-10-01 00:00:00
abstract::A study was made of 50 patients drawn at random from a Skilled Nursing Facility (SNF) attended by seven physicians. For 59 percent of these patients, polypharmacy was practiced but no substantiating diagnoses were recorded. Approximately half of the drugs were administered pro re nata. More drugs were prescribed in po...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1979.tb04139.x
更新日期:1979-03-01 00:00:00
abstract::The objectives of this study were to examine the prevalence of assistive technology (AT) use, type of assistance used for each activity of daily living (ADL) limitation, and correlates of AT use among Native Indian aged 55 and older. Data were collected as part of a cross-sectional study of disability with 505 members...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.03140.x
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVES:To assess 1-week prevalence of International Classification of Disease, Tenth Edition (ICD-10) current depression, physical comorbidity, associated disability, and healthcare utilization in older primary care patients. Comparisons with younger patients are also reported. DESIGN:Cross-sectional, two-phase ep...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50011.x
更新日期:2002-01-01 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:OBJECTIVES:To assess what screening practices agencies use in hiring caregivers and how caregiver competency is measured before assigning responsibilities in caring for older adults. DESIGN:One-to-one phone interviews in which interviewers posed as prospective clients seeking a caregiver for an older adult relative. ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2012.04047.x
更新日期:2012-07-01 00:00:00
abstract::Thyroid disease in the aged, both hypothyroidism and hyperthyroidism, may be subtle or may be present with no clinical symptoms and signs, and is therefore difficult to diagnose on the basis of clinical evaluation. The help of the laboratory is essential in making the diagnosis of disease of the thyroid. Therapeutic s...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1993.tb06488.x
更新日期:1993-12-01 00:00:00
abstract:OBJECTIVES:To examine whether arterial stiffness is a risk factor for falls in community-dwelling older people. DESIGN:Prospective cohort study. SETTING:Community population, Sydney, Australia. PARTICIPANTS:Community-dwelling older adults (mean age 79.8±4.4, 52.2% female; N=481). MEASUREMENTS:Carotid-femoral pulse ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12931
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:To identify presenting characteristics of older patients with subdural hematoma who are unlikely to survive hospitalization. DESIGN:A retrospective cohort. PATIENTS:All patients > or = 65 years of age hospitalized at a tertiary care center from 1985-1990 with the primary diagnosis of subdural hematoma. MEA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb07329.x
更新日期:1995-03-01 00:00:00
abstract::Optimizing the management of antibiotic resistance is an important strategy in improving outcomes for infectious diseases in older persons. Strategies that manage antibiotic resistance must take into account all clinical settings, because resistant pathogens previously seen only in acute care facilities are becoming i...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1046/j.1532-5415.50.7s.5.x
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVES:To examine the relationship between total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) and the incidence of coronary heart disease (CHD) in elderly men. DESIGN:Prospective. SETTING:Population based. PARTICIPANTS:A sample of 2,424, Japanese-American men aged 71 to 93 was used. MEASUREM...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52551.x
更新日期:2004-12-01 00:00:00
abstract::This study was undertaken to identify the demographic characteristics of patients aged 55 or older in a drug-overdose group admitted to the Emergency Department of Arizona Health Sciences Center during the 3-year period, August 1975-July 1978. Of the 646 overdose patients observed, 60 (9.5 percent) were aged 55 or old...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb00004.x
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVE:To assess the validity of the Neurobehavioral Rating Scale (NRS) in patients with Alzheimer's disease (AD) or multi-infarct dementia (MID) and to characterize the cognitive, psychiatric, and behavioral disturbances that occur in these patients. DESIGN:Cross-sectional evaluation. SETTING:West Los Angeles VAM...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1992.tb02101.x
更新日期:1992-06-01 00:00:00
abstract:OBJECTIVES:To determine the prognostic value of apathy for mortality in patients of somatic (SC) and dementia special care (DSC) nursing home (NH) units. DESIGN:Longitudinal design, secondary analyses of a 2-year, cluster-randomized trial with six measurements, approximately 4 months in between. SETTING:SC and DSC-un...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/jgs.15007
更新日期:2017-10-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,meta分析,评审
doi:10.1111/jgs.13835
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVES:To determine the association between interleukin-6 (IL-6), IL-6 soluble receptor (sR), and soluble tumor necrosis factor receptor-1 (sTNF-R1) and cognitive status in the oldest-old women. DESIGN:Twenty-year longitudinal cohort study. SETTING:Four clinical sites in the United States. PARTICIPANTS:Women fro...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/jgs.12739
更新日期:2014-04-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2003.51356.x
更新日期:2003-08-01 00:00:00
abstract:OBJECTIVES:To investigate the natural history, cause of death, and end-of-life experiences of individuals diagnosed with dementia with Lewy bodies (DLB). DESIGN:Twenty-question online survey administered through the Lewy Body Dementia Association. SETTING:United States. PARTICIPANTS:Caregivers, family, and friends o...
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pub_type: 杂志文章
doi:10.1111/jgs.15608
更新日期:2019-01-01 00:00:00
abstract::The reported prevalence of depressive symptomatology among the elderly ranges from 5 to 65 percent in hospital and community populations. Depression is considered the most common emotional disorder of advanced age. One of the chief diagnostic problems has been the lack of differentiation between disorders manifested b...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb00205.x
更新日期:1980-02-01 00:00:00
abstract:OBJECTIVES:To elucidate the relationship between stroke and depressive symptoms and to determine whether disability or cerebrovascular risk factors mediate that relationship. DESIGN:A prospective longitudinal epidemiological survey. SETTING:The mid-Monongahela Valley, a rural, nonfarm, low-socioeconomic-status commun...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52217.x
更新日期:2004-05-01 00:00:00
abstract::The relation of serum albumin concentration to age was assessed in a series of hospitalized medical patients. Those with disease states (e.g., dysproteinemia, renal insufficiency, hepatic dysfunction, malnutrition) potentially associated with abnormal serum albumin levels were excluded, leaving a study population of 1...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1979.tb01715.x
更新日期:1979-01-01 00:00:00
abstract:OBJECTIVES:To evaluate effects of health status on word-finding difficulty in aging, adjusting for the known contributors of education, sex, and ethnicity. DESIGN:Cross-sectional. SETTING:Community. PARTICIPANTS:Two hundred eighty-four adults aged 55 to 85 (48.6% female) participating in an ongoing longitudinal stud...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02559.x
更新日期:2009-12-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15473
更新日期:2018-09-01 00:00:00
abstract:OBJECTIVES:To estimate in a community-dwelling elderly population the magnitude of renal function misclassification, occurring when persons with normal serum creatinine have reduced glomerular filtration rate (GFR), and to describe the participant characteristics related to misclassification. DESIGN:Cross-sectional. ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01196.x
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:To clarify the neuropsychological function in patients with Charles Bonnet Syndrome. DESIGN:Control group comparison study. SETTING:University of Chicago Hospitals. PARTICIPANTS:The neuropsychological function of 15 older adults with presenting complaints of visual hallucinations who met criteria for Charl...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1996.tb02937.x
更新日期:1996-09-01 00:00:00
abstract:OBJECTIVE:Traditional mental status and psychometric assessments bottom out in the late stages of Alzheimer disease (AD). A method adapted from cognitive testing in infants, the Ordinal Scales of Psychological Development was modified (M-OSPD) and applied to a severely demented population. The concurrent validity of th...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章
doi:10.1111/j.1532-5415.1994.tb06509.x
更新日期:1994-12-01 00:00:00
abstract::In experience with total joint replacement in the lower extremity, to date, total hip arthroplasty has been the most successful. Total arthroplasty operations as applied to the knee and ankle are giving promising results. These methods offer new avenues for relief of pain and deformity and stabilization of arthritic j...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1977.tb00232.x
更新日期:1977-02-01 00:00:00
abstract:OBJECTIVES:To compare the association between a restrictive transfusion strategy and cardiovascular complications during hospitalization for hip fracture with the association between a liberal transfusion strategy and cardiovascular complications, accounting for all transfusions from the emergency department to postacu...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15371
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:To determine whether a home-based multicomponent physical activity counseling (PAC) intervention is effective in reducing glycemic measures in older outpatients with prediabetes mellitus. DESIGN:Controlled clinical trial. SETTING:Primary care clinics of the Durham Veterans Affairs (VA) Medical Center betwe...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2012.04119.x
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVES:Measurements of health-related quality of life (HRQL) are an essential component in overall assessment of health status, particularly in older patients. Nevertheless, how measures of HRQL relate to measures of disease severity is largely unexplored. This study was carried out to explore the relationship betw...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:
更新日期:2000-11-01 00:00:00