Abstract:
OBJECTIVES:To assess whether older age is independently associated with hemorrhage risk in patients with atrial fibrillation, whether or not they are taking warfarin therapy. DESIGN:Cohort study. SETTING:Integrated healthcare delivery system. Thirteen thousand five hundred fifty-nine adults with nonvalvular atrial fibrillation. MEASUREMENTS:Patient data were collected from automated clinical and administrative databases using previously validated search algorithms. Medical charts were reviewed from patients hospitalized were for major hemorrhage (intracranial, fatal, requiring >or=2 units of transfused blood, or involving a critical anatomic site). Age was categorized into four categories (<60, 60-69, 70-79, and >or=80), and multivariable Poisson regression was used to assess whether major hemorrhage rates increased with age, stratified by warfarin use and adjusted for other clinical risk factors for hemorrhage. RESULTS:A total of 170 major hemorrhages were identified during 15,300 person-years of warfarin therapy and 162 major hemorrhages during 15,530 person-years off warfarin therapy. Hemorrhage rates rose with older age, with an average increase in hemorrhage rate of 1.2 (95% confidence interval (CI) 1.0-1.4) per older age category in patients taking warfarin and 1.5 (95% CI=1.3-1.8) in those not taking warfarin. Intracranial hemorrhage rates were significantly higher in those aged 80 and older (adjusted rate ratio=1.8, 95% CI=1.1-3.1 for those taking warfarin, adjusted rate ratio=4.7, 95% CI=2.4-9.2 for those not taking warfarin) than in those younger than 80. CONCLUSION:Older age increases the risk of major hemorrhage, particularly intracranial hemorrhage, in patients with atrial fibrillation, whether or not they are taking warfarin. Hemorrhage rates were generally comparable with those reported in previous randomized trials, indicating that carefully monitored warfarin therapy can be used with reasonable safety in older patients.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Fang MC,Go AS,Hylek EM,Chang Y,Henault LE,Jensvold NG,Singer DEdoi
10.1111/j.1532-5415.2006.00828.xsubject
Has Abstractpub_date
2006-08-01 00:00:00pages
1231-6issue
8eissn
0002-8614issn
1532-5415pii
JGS828journal_volume
54pub_type
杂志文章abstract::Close to 6 million Americans have Alzheimer's disease (AD) or Alzheimer's disease and related dementia (AD/ADRD). These high-need, high-cost patients are vulnerable to receiving poor quality uncoordinated care, ultimately leading to adverse health outcomes, poor quality of life, and misuse of resources. Improving the ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16621
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVES:To perform an economic evaluation of a primary care-based physical activity counseling intervention that improved physical activity levels and rapid gait speed in older veterans. DESIGN:Secondary objective of randomized trial that assessed the effect of exercise counseling (relative to usual care) on physic...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.14567
更新日期:2017-03-01 00:00:00
abstract::Among 35 elderly patients with transtracheal aspirate (TTA)-documented nosocomial pneumonia, 7 (20 percent) had Streptococcus pneumoniae infection. Clinical and epidemiologic data are reported on these 7 patients and on 2 others with nosocomial pneumococcal pneumonia documented by bacteremia. Malignancy and chronic ob...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1981.tb01272.x
更新日期:1981-07-01 00:00:00
abstract::(-)Deprenyl (Selegiline, Jumex, Eldepryl, Movergan), a close structural relative to phenylethylamine (PEA), is a drug with a unique pharmacological spectrum. (1) It is a highly potent and selective, irreversible inhibitor of B-type monoamine oxidase (MAO), a predominantly glial enzyme in the brain. The activity of thi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1992.tb01860.x
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVES:To assess the relationship between alcohol intake and mortality in a cohort of women aged 70 and older and to explore the relationship between level of alcohol use and changes in physical and mental health-related quality of life. DESIGN:National longitudinal surveys from 1996 to 2002. SETTING:Community ba...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2006.00837.x
更新日期:2006-09-01 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::The Acute Care for Elders (ACE) model of care is a multicomponent intervention that improves outcomes for older patients hospitalized for acute medical illnesses. Likewise, stroke units improve outcomes for patients with acute stroke, yet the descriptions of their structure and approach to stroke management are hetero...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1046/j.1532-5415.2003.51521.x
更新日期:2003-11-01 00:00:00
abstract::The characteristic morphologic changes frequently observed in the brain of an old adult include a decrease in weight and volume, a change in the pattern of cerebral cortical convolutions, and an increase in ventricular size. Cell loss varies from region to region in the brain, and may be intensified in Alzheimer's dis...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1976.tb03246.x
更新日期:1976-01-01 00:00:00
abstract:OBJECTIVES:To examine cross-national care and outcomes related to end-of-life experiences. DESIGN:Postdeath interviews and self-administered questionnaires completed with family caregivers of residents with dementia who died in long-term care settings or shortly after transfer. SETTING:One hundred eighty-three nursin...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03816.x
更新日期:2012-02-01 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::Leaders of geriatric programs at academic health centers (AHCs) face several challenges in seeking support for clinical program development. These challenges relate to how revenues from Medicare activities flow within AHCs. Typically, clinical departments such as the Department of Medicine see a very small proportion ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50174.x
更新日期:2002-04-01 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::Because of changes that occur with aging, older people with any other risk factors for vitamin D deficiency are likely to have inadequate stores of this vitamin. The consequences of vitamin D deficiency are likely to be losses in bone, strength, and function and the development of pain. Many questions remain regarding...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1995.tb07059.x
更新日期:1995-07-01 00:00:00
abstract::What ethical concerns regarding the application of new antidementia compounds are pertinent to the best interests of patients with Alzheimer's disease and their caregivers? Based on collected preliminary anecdotal accounts, these concerns are important and should be considered carefully by clinicians, researchers, and...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb03819.x
更新日期:1998-06-01 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 applicability and safety of a standardized diagnostic algorithm in geriatric departments and to define the prevalence of different causes of syncope in older patients. DESIGN:Multicenter cross-sectional observational study. SETTING:In-hospital geriatric acute care departments and outpatient cli...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2006.00891.x
更新日期:2006-10-01 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::In 1976, 130 patients aged 70 or older were admitted to the Coronary Care Unit (CCU) at Toronto Western Hospital. Arrhythmias were noted in all but 24 percent. Digoxin was given to 53 patients, lidocaine to 24, propranolol to 28, and quinidine to 11. In 2 patients, cardioversion by direct current was required for supr...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1979.tb06032.x
更新日期:1979-05-01 00:00:00
abstract::Circadian changes of the blood pressure and heart rate in elderly normotensive bedridden patients with severe dementia of the Alzheimer type (group D) were compared with those in elderly normotensive bedridden patients without dementia (group R), normotensive subjects with normal daily activity (group N), and hyperten...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1990.tb04418.x
更新日期:1990-09-01 00:00:00
abstract:OBJECTIVE:(1) To establish the range of cerebral atrophy across the adult age spectrum in optimally healthy, rigorously evaluated individuals. (2) To determine, across the age spectrum, the relation of gender and cerebral atrophy (as measured by ventricular enlargement) to cognitive function. DESIGN:Cross-sectional co...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1992.tb02073.x
更新日期:1992-03-01 00:00:00
abstract::The necessity and safety of an oral calcium (Ca) and vitamin D regimen was evaluated in a population of 66 independently living and 73 institutionalized elderly women over an 11-week winter period. The members of both groups were randomly assigned into trial and control groups. Serum Ca, creatinine, and calcidiol leve...
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.1532-5415.1990.tb05700.x
更新日期:1990-08-01 00:00:00
abstract:OBJECTIVES:To examine the relationship between baseline hypertension, blood pressure, and the development of cognitive decline in participants in the Women's Health Initiative Memory Study (WHIMS). DESIGN:Prospective analyses. SETTING:Thirty-nine centers. PARTICIPANTS:Seven thousand one hundred forty-nine women aged...
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.1532-5415.2008.01806.x
更新日期:2008-08-01 00:00:00
abstract::To prevent falls effectively, one must first understand the underlying reasons. Although environmental factors are sometimes to blame, the fundamental cause is a decline in postural control which is partly age-related and partly due to pathologic changes in the central nervous system. Dizziness is a common complaint a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb01125.x
更新日期:1980-11-01 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:OBJECTIVES:To explore the associations between self-reported hearing problems and physical performance and self-reported difficulties in mobility and activities of daily living (ADLs) in community-dwelling older adults. DESIGN:Cross-sectional cohort study. SETTING:Community. PARTICIPANTS:Men and women aged 75 to 90 ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13381
更新日期:2015-06-01 00:00:00
abstract::This clinical, practice-based study explores the research question: Is there a relationship between hearing loss and functional disturbance in elderly patients? We analyzed the impact of hearing impairment on 153 patients over 65 years of age screened in primary care practice. Functional and psychosocial impairment we...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1989.tb05870.x
更新日期:1989-02-01 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
abstract:OBJECTIVES:To characterize rehabilitation services use of older adults according to fall-risk classification based on screening guidelines. DESIGN:Cross-sectional analysis of 2015 National Health and Aging Trends Study. SETTING:Study participants' homes. PARTICIPANTS:National sample of 7,440 community-dwelling Medic...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15625
更新日期:2019-01-01 00:00:00
abstract::Chronic atrial fibrillation is generally thought to cause stroke by atrial thrombus formation with subsequent embolization. Rheumatic heart disease previously led to most cases of atrial fibrillation, but recent substantial declines in the incidence of rheumatic fever have changed the distribution of causes of atrial ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1985.tb07121.x
更新日期:1985-04-01 00:00:00
abstract:BACKGROUND:Healthcare providers may not offer patient portal (PP) access to electronic health records (EHRs) to their patients older than 85 years, due to the false impression that they do not utilize technology. It is imperative that older adults be given equal opportunity to use technology in regard to their healthca...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16393
更新日期:2020-05-01 00:00:00