Abstract:
OBJECTIVES:Gastrointestinal (GI) complications are the most-common serious adverse reactions associated with nonsteroidal anti-inflammatory drugs (NSAIDs). We quantified the effect of specific NSAIDs on the rate of GI hospitalizations among older people living in long-term care. DESIGN:Retrospective cohort study. SETTING:All Medicare/Medicaid certified nursing homes in four states (Maine, Minnesota, New York, and South Dakota). PARTICIPANTS:We identified 125,516 newly admitted residents from a database of all residents (1992-1996) of all Medicare/Medicaid certified nursing homes in four states. Using the federally mandated Minimum Data Set, which includes information on all drugs received (prescription and over-the-counter), we identified patients who received at least one prescription for aspirin (n = 19,101) or NSAIDs (n = 9,777). The control population consisted of all institutionalized persons who did not receive these drugs. MEASUREMENTS:From Health Care Financing Administration inpatient claims, we identified the first hospitalization for GI perforation, ulcer, or hemorrhage that occurred during the year of follow up (ICD9-CM discharge codes: 531-534, 578). Cox proportional hazards models provided adjusted estimates of rate ratios. RESULTS:NSAID exposure increased the GI-event-related hospitalization rate in both men (rate ratios (RR) = 2.64; 95% confidence interval (CI) = 1.17-5.99) and women (RR = 3.23; 95% CI = 1.85-5.65). The rate of GI hospitalizations for both men and women taking sulindac, naproxen, or indomethacin was higher than for nonusers. The risk of GI-event-related hospitalizations was greatest among women exposed to diflunisal (RR = 6.08; 95% CI = 2.27-16.26) or oxaprozin (RR = 6.03; 95% CI = 2.49-14.58). CONCLUSIONS:Despite the high background rate of GI events, most NSAIDs increased the risk of GI hospitalization. Careful attention to choice of agent and dosing is needed in prescribing NSAIDs in this frail, older population.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Lapane KL,Spooner JJ,Mucha L,Straus WLdoi
10.1046/j.1532-5415.2001.49117.xsubject
Has Abstractpub_date
2001-05-01 00:00:00pages
577-84issue
5eissn
0002-8614issn
1532-5415pii
jgs49117journal_volume
49pub_type
杂志文章abstract:OBJECTIVES:To identify specific care management activities within a dementia care management intervention that are associated with 18-month change in caregiver mastery and relationship strain. DESIGN:Exploratory analysis, using secondary data (care management processes and caregiver outcomes) from the intervention arm...
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/j.1532-5415.2008.01643.x
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVE:The literature suggests that Medicare health maintenance organization (HMO) patients may have poorer outcomes with formal home-health care than do fee-for-service (FFS) patients, but it is unclear whether this is related to case-mix or quality. Our objective was to compare the home-health care outcomes for HM...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb01083.x
更新日期:1998-05-01 00:00:00
abstract:OBJECTIVES:To assess the efficacy of a leg exercise performed in supine position to prevent orthostatic hypotension (OH) in older adults. DESIGN:Case-control study. SETTING:Division of Physical Medicine and Rehabilitation, Salvatore Maugeri Foundation, Scientific Institute of Veruno, Veruno, Italy. PARTICIPANTS:Indi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12313
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVES:To describe the features of community-acquired pneumonia (CAP) requiring hospitalization in subjects receiving home care. DESIGN:Prospective study from November 15, 2000, to November 14, 2002. SETTING:Six hospitals in the Edmonton, Canada, area. PARTICIPANTS:Two thousand four hundred sixty-four subjects a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53264.x
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVES:To examine the relationship between cognitive function and self-reported oral health-related quality of life (HRQoL) in community-dwelling older adults. DESIGN:Cross-sectional. SETTING:Community in West Virginia. PARTICIPANTS:Two hundred twenty-six community-dwelling older adults. MEASUREMENTS:Oral HRQoL...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12402
更新日期:2013-09-01 00:00:00
abstract:OBJECTIVES:Older black patients are at risk for underutilization of preventive services. Our objectives were to assess the delivery of five preventive services in Title 330-funded health centers in low income neighborhoods in Cleveland, Ohio, and to determine the association of health system factors and health status w...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb03902.x
更新日期:2000-02-01 00:00:00
abstract:OBJECTIVES:To examine racial differences in readmissions of older adults undergoing elective total hip and knee replacement, to determine the relationship between nurse staffing and readmission, and to study whether the relationship between staffing and readmission differs for older black and white adults. DESIGN:Cros...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/jgs.14367
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:The benefits and harms of screening of Alzheimer disease and related dementias (ADRDs) are unknown. This study addressed the question of whether the benefits outweigh the harms of screening for ADRDs among older adults in primary care. DESIGN, SETTING, AND PARTICIPANTS:Single-blinded, two-arm, ran...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.16247
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:To test the effects of a modified Hospital Elder Life Program (mHELP) on frailty. DESIGN:Matched and unmatched analyses of data from a before-and-after study. SETTING:Hospital, inpatient. PARTICIPANTS:Participants aged 65 and older (n = 189) undergoing major elective abdominal surgery at a medical center ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12651
更新日期:2014-02-01 00:00:00
abstract::The initial assessments of cognitive, psychologic, and behavioral functioning of 17 adults enrolled in a day care program for victims of Alzheimer's disease are described. These evaluations by the staff, the patients themselves, and their primary caregivers made use of standardized quantitative measures, thus permitti...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1983.tb03398.x
更新日期:1983-12-01 00:00:00
abstract::Patients with diabetes mellitus and an underlying mixed axonal and demyelinating polyneuropathy are particularly prone to compression neuropathies with consequent axonal degeneration and a poor prognosis for recovery. This hazard should be taken into account whenever a prolonged surgical procedure is contemplated. An ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb00515.x
更新日期:1980-04-01 00:00:00
abstract:BACKROUND:Baseline depressive symptoms have been consistently associated with the onset of cardiovascular disease (CVD). OBJECTIVES:Since depressive symptoms vary over time in elderly persons, and to help clarify whether or not depression is an etiological factor for CVD, we quantified the association between the cour...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/jgs.13872
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVES:To examine the cost-effectiveness of a randomized, clinical trial of a home-based intervention for caregivers of people with dementia. DESIGN:This cost-effectiveness analysis examined Resources for Enhancing Alzheimer's Caregivers Health (REACH II), a multisite, randomized, clinical trial, from June 2002 th...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2007.01569.x
更新日期:2008-03-01 00:00:00
abstract::Physicians caring for individuals with life-altering, incurable illnesses often have a desire to convey a sense of hope while also helping their patients prepare for the end of life to minimize unnecessary suffering and grief. Unfortunately, in the United States, most people receive more-aggressive treatments toward t...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13392
更新日期:2015-05-01 00:00:00
abstract::Diastolic left ventricular function was comparatively assessed in 19 healthy elderly individuals (mean age 71 years) and in 20 young normal subjects (mean age 26 years), using digitized echocardiograms. Peak and average filling rates were slower in the group of elderly subjects than in the younger population (128 +/- ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1985.tb04186.x
更新日期:1985-11-01 00:00:00
abstract::The primary and secondary diagnoses for 100 geriatric patients consecutively admitted to a nursing home were reviewed for accuracy and omissions. Primary diagnoses were identified as the direct basis for nursing home admission. Other physical, biochemical or behavioral disorders requiring continued therapeutic care we...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1976.tb04281.x
更新日期:1976-03-01 00:00:00
abstract:OBJECTIVES:To apply diagnostic criteria for mild cognitive impairment (MCI) to a geographically representative sample, to estimate the prevalence of MCI, and to estimate 10-year trajectories of incident disability for cognitively intact participants and subgroups with MCI. DESIGN:Prospective cohort; 10 years of follow...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53566.x
更新日期:2005-11-01 00:00:00
abstract::Contemporary, systematic approaches to injury prevention are presented as guides for considering needless death and disability of older people because of falls, burns, and vehicular crashes. Injury results from an unfavorable relationship between etiologic agent and host within a particular environment setting. Abnorm...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb07102.x
更新日期:1982-04-01 00:00:00
abstract::Although the field of frailty research has expanded rapidly, it is still a nascent concept within the clinical specialties. Frailty, conceptualized as greater vulnerability to stressors because of significant depletion of physiological reserves, predicts poorer outcomes in several medical specialties, including cardio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14902
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:To determine the independent prognostic effect of seven potential frailty criteria, including five from the Fried phenotype, on several adverse outcomes. DESIGN:Prospective cohort study. SETTING:Greater New Haven, Connecticut. PARTICIPANTS:Seven hundred fifty-four initially nondisabled, community-living p...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.02008.x
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVES:To determine whether glycosylated hemoglobin (HbA1c) levels predict functional decline in older adults. DESIGN:Longitudinal cohort study. PARTICIPANTS:Community-dwelling, nursing home (NH)-eligible individuals with diabetes mellitus enrolled at On Lok between October 2002 and December 2008 (367 participant...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.04041.x
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVES:To develop and evaluate a model to estimate inpatient resource utilization for seriously ill patients using periodic medical record abstraction and hospital length of stay. DESIGN:A prospective cohort study of prognoses and preferences and outcomes of seriously ill hospitalized adults. The predictive model ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb03127.x
更新日期:2000-05-01 00:00:00
abstract::Cognitive impairment in old age is one of the most important topics in modern geriatrics. This article discusses the historical dimensions of this phenomenon. To this end, a number of primary sources ranging from antiquity to the modern era are evaluated. Although a physiology and pathology of old age were conceptuali...
journal_title:Journal of the American Geriatrics Society
pub_type: 历史文章,杂志文章
doi:10.1111/j.1532-5415.2005.53558.x
更新日期:2005-11-01 00:00:00
abstract:OBJECTIVES:To test whether Stepping On, a multifaceted community-based program using a small-group learning environment, is effective in reducing falls in at-risk people living at home. DESIGN:A randomized trial with subjects followed for 14 months. SETTING:The interventions were conducted in community venues, with a...
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.1532-5415.2004.52411.x
更新日期:2004-09-01 00:00:00
abstract:OBJECTIVES:To evaluate the safety and efficacy of donepezil in the management of patients with Alzheimer's disease (AD) residing in nursing home facilities. DESIGN:Twenty-four-week, randomized, multicenter, parallel-group, double-blind, placebo-controlled trial. SETTING:Twenty-seven nursing homes across the United St...
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:
更新日期:2001-12-01 00:00:00
abstract:OBJECTIVE:To determine if pre-complication nutrient intake can be predicted based on an admission assessment. DESIGN:Survey (cross-sectional study). SETTING:Geriatric Rehabilitation Unit (GRU) of a Veterans Administration hospital. PATIENTS:Three-hundred-twelve randomly selected admissions to the GRU. MEASUREMENTS:...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb04967.x
更新日期:1994-05-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Patient activation encompasses the knowledge, skills, and confidence that equip adults to participate actively in their healthcare. Patients with hearing loss may be less able to participate due to poor aural communication. We examined whether difficulty hearing is associated with lower patient ac...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15833
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Delirium is common in older adults, especially following hospitalization. Because low vitamin D levels may be associated with increased delirium risk, we aimed to determine the prognostic value of blood vitamin D levels, extending our previous genetic analyses of this relationship. DESIGN:Prospec...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16853
更新日期:2020-10-05 00:00:00
abstract::Forty-three elderly patients with massive bleeding of hemorrhoidal varices were treated by cryosurgery at a single outpatient session, using nitrous oxide gas, without premedication or anesthesia. The results were excellent in all but one patient, who had ulcerative colitis and required another session of cryotherapy ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1984.tb05152.x
更新日期:1984-01-01 00:00:00
abstract:OBJECTIVE:To study the association of two well known risk factors for breast cancer and the association of knowledge of those risk factors with mammography utilization. DESIGN:Cross sectional: two independent random telephone surveys. SETTING:Two Northeastern metropolitan communities surveyed in 1987 and in 1989. PA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1992.tb01848.x
更新日期:1992-08-01 00:00:00