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 States. PARTICIPANTS:Two hundred eight nursing home patients with a diagnosis of probable or possible AD, or AD with cerebrovascular disease; mean Mini-Mental State Examination (MMSE) score 14.4; mean age 85.7. MEASUREMENTS:The primary outcome measure was the Neuropsychiatric Inventory-Nursing Home Version (NPI-NH). Secondary efficacy measures were the Clinical Dementia Rating (Nursing Home Version)-Sum of the Boxes (CDR-SB), MMSE, and the Physical Self-Maintenance Scale (PSMS). Safety was monitored by physical examinations, vital signs, clinical laboratory tests, electrocardiograms (ECGs), and treatment-emergent adverse events (AEs). RESULTS:Eighty-two percent of donepezil- and 74% of placebo-treated patients completed the trial. Eleven percent of donepezil- and 18% of placebo-treated patients withdrew because of AEs. Mean NPI-NH 12-item total scores improved relative to baseline for both groups, with no significant differences observed between the groups at any assessment. Mean change from baseline CDR-SB total score improved significantly with donepezil compared with placebo at Week 24 (P < .05). The change in CDR-SB total score was not influenced by age. Differences in mean change from baseline on the MMSE favored donepezil over placebo at Weeks 8, 16, and 20 (P < .05). No significant differences were observed between the groups on the PSMS. Overall rates of occurrence and severity of AEs were similar between the two groups (97% placebo, 96% donepezil). Gastrointestinal AEs occurred more frequently in donepezil-treated patients. In general, AEs were similar in older and younger donepezil-treated patients, with the majority of patients experiencing only AEs that were transient and mild or moderate in severity. Weight loss was reported as an AE more frequently in older patients, although a loss at last visit of >or=7% of screening weight occurred at the same rate in older and younger patients (9% of donepezil- and 6% of placebo-treated patients). No significant differences between groups in vital sign changes, bradycardia, or rates of clinically significant laboratory or ECG abnormalities were observed. CONCLUSION:Patients treated with donepezil maintained or improved in cognition and overall dementia severity in contrast to placebo-treated patients who declined during the 6-month treatment period. The safety and tolerability profile was comparable with that reported in outpatient studies of donepezil. These findings also suggest that advanced age, comorbid illnesses, and high concomitant medication usage should not be barriers to donepezil treatment. Given the apparent improvement in behavior in the placebo group, and the high use of concomitant medications in both groups, the impact of donepezil on behavior in the nursing home setting is unresolved and merits further investigation. In summary, effects on cognition, overall dementia severity, and safety and tolerability findings are consistent with previous findings in outpatients and support the use of donepezil in patients with AD who reside in nursing homes.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Tariot PN,Cummings JL,Katz IR,Mintzer J,Perdomo CA,Schwam EM,Whalen Esubject
Has Abstractpub_date
2001-12-01 00:00:00pages
1590-9issue
12eissn
0002-8614issn
1532-5415pii
49266journal_volume
49pub_type
临床试验,杂志文章,多中心研究,随机对照试验abstract:BACKGROUND:The serum concentration of interleukin 6 (IL-6), a cytokine that plays a central role in inflammation, increases with age. Because inflammation is a component of many age-associated chronic diseases, which often cause disability, high circulating levels of IL-6 may contribute to functional decline in old age...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb01583.x
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVES:To design a value-driven, interprofessional inpatient geriatric consultation program coordinated with systems-level changes and studied outcomes and costs. DESIGN:Propensity-matched case-control study of older adults hospitalized at an academic medical center (AMC) who did or did not receive geriatric consu...
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 identify fracture types in a series of older adults with pelvic fractures and to determine whether the type of pelvic fracture affected short-term outcomes and morbidity. DESIGN:Retrospective chart review. SETTING:Teaching hospital. PARTICIPANTS:One hundred eighty-one individuals aged 65 and older with...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03455.x
更新日期:2011-07-01 00:00:00
abstract::Older adults with advanced chronic kidney disease (CKD) experience functional impairment that can complicate CKD management. Failure to recognize functional impairment may put these individuals at risk of further functional decline, nursing home placement, and missed opportunities for timely goals-of-care conversation...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14262
更新日期:2016-10-01 00:00:00
abstract::By 2050, the European population of 720 million will include 187 million (one quarter) octogenarians. Although living longer is a true privilege, care for the graying population suffering from chronic and disabling diseases will raise enormous challenges to healthcare systems and geriatric education. Are European coun...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.01788.x
更新日期:2008-08-01 00:00:00
abstract::Falls are a leading cause of fatal and nonfatal injuries among the elderly in the United States. Despite the importance of fall injuries, epidemiological studies of falls among the elderly have identified neither their causes nor the methods to prevent them. Therefore, we established a community-based surveillance sys...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1988.tb04371.x
更新日期:1988-11-01 00:00:00
abstract::Hip fractures in older adults are a common event, leading to substantial morbidity and mortality. Hip fractures have been previously described as a "geriatric, rather than orthopedic disease." Patients with this condition have a high prevalence of comorbidity and a high risk of complications from surgery, and for this...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.01770.x
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVE:To compare the sensitivity to atrial natriuretic peptide (ANP) in young and elderly subjects. DESIGN:Double-blind, random-order, placebo-controlled study using two different rates of ANP infusion. SUBJECTS:Eight healthy young (23 +/- 3 years, mean +/- SD) and eight healthy elderly (76 +/- 4 years) subjects ...
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.1532-5415.1993.tb07309.x
更新日期:1993-11-01 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 examine prevalence and resident- and site-level factors associated with potential underuse, overuse, and inappropriate use of antidepressants in older Veterans Affairs (VA) Community Living Center (CLC) residents. DESIGN:Longitudinal study. SETTING:One hundred thirty-three VA CLCs. PARTICIPANTS:Three t...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03522.x
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVES:To determine whether older adults with the hepatitis C virus (HCV) achieve a sustained viral response (SVR) after treatment with direct-acting antiviral therapy. PARTICIPANTS:Individuals aged 80 and older with chronic HCV infection (N = 253; n = 213 with cirrhosis, n = 40 with advanced fibrosis). MEASUREME...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15140
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVES:To determine the utility of hypodermoclysis in the management of dehydration in nursing home residents and to review the recent literature on the use of clysis in older adults. DESIGN:A retrospective chart review. SETTING:Two continuing care retirement community nursing home units in Cincinnati. PARTICIPA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1996.tb01870.x
更新日期:1996-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:To explore the opinion of the Dutch general public and of physicians regarding euthanasia in patients with advanced dementia. DESIGN:A cross-sectional survey. SETTING:The Netherlands. PARTICIPANTS:Random samples of 1,965 citizens (response = 1,965/2,641 [75%]) and 1,147 physicians (response = 1...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16692
更新日期:2020-10-01 00:00:00
abstract:OBJECTIVES:To identify patient factors that influence physicians' decisions to recommend screening mammograms for older women. DESIGN:A cross-sectional survey including clinical case vignettes. PARTICIPANTS:Random sample of Massachusetts internists, obstetrician/gynecologists, family/general practice physicians, and ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb01371.x
更新日期:1996-10-01 00:00:00
abstract:OBJECTIVES:To alert persons in the public and private healthcare professions to the increasing trends in higher proportions of persons aged 50 and older who are newly diagnosed with human immunodeficiency virus (HIV) and who are living with HIV and acquired immunodeficiency syndrome (AIDS). DESIGN:Data from the period...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01295.x
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVES:To provide estimates of change in depressive symptoms and determine how changes in depressive symptom influence recovery of functional status. DESIGN:Prospective cohort study. SETTING:Eleven inpatient medical rehabilitation facilities located across the United States. PARTICIPANTS:Five hundred forty-four ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2010.03266.x
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVES:To examine current utilization patterns of cholinesterase inhibitor (ChEI) therapy for dementia to determine treatment duration, use in long-term care, how often patients receive these drugs until death, and frequency of switching between the available ChEIs. DESIGN:A population-based healthcare administrat...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2007.01377.x
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVES:To analyze the costs for long-stay (>90 days) nursing home (NH) decedents with and without hospice care. DESIGN:Retrospective cohort study using a 1999-2009 data set of linked Medicare and Medicaid claims and minimum data set (MDS) assessments. SETTING:Indiana NHs. PARTICIPANTS:Long-stay NH decedents (N =...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14070
更新日期:2016-04-01 00:00:00
abstract::It has long been thought that demographic aging and its attendant implications for health and social services is primarily a problem for industrialized wealthy countries. Nothing could be further from the truth since most older persons (and an increasingly higher number) reside in low-income countries. Through a descr...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.16191
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVES:To estimate prescribing tends of and correlates independently associated with high-risk anticholinergic prescriptions in adults aged 65 and older in office-based outpatient visits. DESIGN:Repeated cross-sectional analysis. SETTING:National Ambulatory Medical Care Survey (NAMCS). PARTICIPANTS:A national sa...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15357
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:To describe decade- long trends (1999-2009) in the rates of not undergoing cardiac catheterization and percutaneous coronary intervention (PCI) in individuals aged 65 and older presenting with an ST-segment elevation acute myocardial infarction (STEMI) and factors associated with not undergoing these procedu...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/jgs.13399
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:To compare the diagnoses, psychiatric and medical comorbidities, and prior and current treatment received by late-middle-aged and older affective disorder patients in mental health and medical service settings and to identify predictors of these patients' length of inpatient care. DESIGN:Department of Vetera...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb01832.x
更新日期:1996-06-01 00:00:00
abstract::Various biological aspects of the aging process are reviewed. Aging has multiple causes. First, there is the initial genetic variability in the organism. Second, there is the destructive effect of the environment. Third, there is an accumulation in the somatic cells of changes, mutations or local chemical damage. Thes...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1966.tb03069.x
更新日期:1966-05-01 00:00:00
abstract::The United States Senator from Maryland, as speaker at the Awards luncheon of the American Geriatrics Society (Washington meeting), presented his views on priorities in various health programs for the elderly, and asked for the Society's cooperation in making some of the difficult decisions that lie ahead. An importan...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1979.tb01672.x
更新日期:1979-09-01 00:00:00
abstract:OBJECTIVES:To validate the Harmful Behaviors Scale (HBS) as a measure of direct and indirect self-destructive behaviors in nursing home residents and to determine the prevalence of self-destructive behaviors and their relationship to other variables. DESIGN:A cross-sectional study. SETTING:Eleven nursing homes in the...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1532-5415.2002.50070.x
更新日期:2002-02-01 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:OBJECTIVES:To compare the frequency and characteristics of septic arthritis in patients younger than 80 and aged 80 and older. DESIGN:Retrospective. SETTING:Single hospital center. PARTICIPANTS:Patients admitted between 1979 and 2002 for septic arthritis. MEASUREMENTS:Age, sex, time to diagnosis, predisposing facto...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53373.x
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:To determine if family members perceive that hospice improves the care of dying nursing home residents during the last 3 months of life. DESIGN:Mailed survey. PARTICIPANTS:Family members for all nursing home hospice enrollees in North Carolina during a 6-month period. MEASUREMENTS:After residents' deaths, ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb06883.x
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVES:To test the effect of an adapted U.S. model of pharmaceutical care on prescribing of inappropriate psychoactive (anxiolytic, hypnotic, and antipsychotic) medications and falls in nursing homes for older people in Northern Ireland (NI). DESIGN:Cluster randomized controlled trial. SETTING:Nursing homes rando...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2009.02617.x
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVES:To demonstrate reliability and feasibility of a standardized protocol to assess and score quality indicators relevant to pressure ulcer (PU) care processes in nursing homes (NHs). DESIGN:Descriptive. SETTING:Eight NHs. PARTICIPANTS:One hundred ninety-one NH residents for whom the PU Resident Assessment Pr...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2003.51402.x
更新日期:2003-09-01 00:00:00