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 clinics. PARTICIPANTS:Two hundred forty-two patients (aged>or=65, mean+/-standard deviation=79+/-7, range 65-98) consecutively referred for evaluation of transient loss of consciousness to any of six clinical centers participating in the study. Of these, 11 had a syncope-like condition (5 transient ischemic attack; 6 seizures), and 231 had syncope (aged 65-74, n=71; aged>or=75, n=160). MEASUREMENTS:Protocol designed to define etiology and clinical characteristics of syncope derived from European Society of Cardiology Guidelines on syncope. RESULTS:No major complication occurred with use of the protocol. Neurally mediated was the more prevalent form of syncope in this population (66.6%). Cardiac causes accounted for 14.7% of all cases. The neuroreflex form of syncope (vasovagal, situational, and carotid sinus syndrome) was more common in younger than in older patients (62.3% vs 36.2%; P=.001), whereas orthostatic syncope was more frequent in the older than in the younger group (30.5% vs 4.2%; P<.001). In only 10.4% of cases, syncope remained of unexplained origin. After initial evaluation, a definite diagnosis was possible in 40.1% of the cases, and a suspected diagnosis was obtained in 57.9%. Syncope of suspected cardiac origin after initial evaluation was confirmed in 43.7% of cases, and neuromediated causes were confirmed in 83.5% of the cases. CONCLUSION:The protocol is applicable even beyond the age of 90 in geriatric departments. The standardized protocol is associated with a reduction in the frequency of unexplained syncope to about 10%.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Ungar A,Mussi C,Del Rosso A,Noro G,Abete P,Ghirelli L,Cellai T,Landi A,Salvioli G,Rengo F,Marchionni N,Masotti G,Italian Group for the Study of Syncope in the Elderly.doi
10.1111/j.1532-5415.2006.00891.xsubject
Has Abstractpub_date
2006-10-01 00:00:00pages
1531-6issue
10eissn
0002-8614issn
1532-5415pii
JGS891journal_volume
54pub_type
杂志文章,多中心研究abstract:OBJECTIVE:Recent studies have suggested that vascular dementia in older persons is more common than previously hypothesized. A substantial proportion of dementia in old age may be an early manifestation of cerebrovascular disease (CVD), that eventually becomes clinically evident as an acute cerebrovascular accident. Th...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb00908.x
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abstract:OBJECTIVES:Only limited data are available regarding smoking and health in later life and, in particular, in the older Chinese population. This paper reports the relationship between smoking and mortality in a Chinese cohort aged 70 years and older. SETTING:A population-based study conducted in Hong Kong. PARTICIPANT...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1999.tb01565.x
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abstract:BACKGROUND:Elderly adults (65 years of age and older) are of particular concern for traumatic amputations due to age-related changes in vision and coordination, making them more susceptible to injury. OBJECTIVES:The objective of this study is to describe the epidemiology of traumatic amputations in the elderly adults ...
journal_title:Journal of the American Geriatrics Society
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abstract:OBJECTIVES:To review the epidemiology, pathophysiology, and etiology of congestive heart failure (CHF) in older adults. METHODS:Published reports relevant to the epidemiology, pathophysiology, and etiology of CHF were systematically reviewed. Studies involving older adults and more recent studies were emphasized. RES...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1997.tb02968.x
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abstract:OBJECTIVES:Poor diet due to poor oral health was proposed as a potential mediator of the association between poor oral health and frailty. This study explores the cross-sectional associations between poor oral health, poor diet, and frailty in Canadian adults, aged 45 to 85 years, and then tests whether the expected or...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16377
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abstract::Older driver safety is a growing public health concern for which interventions are currently being sought. Statistics show that older drivers suffer a disproportionately high rate of motor vehicle fatalities compared with other adult drivers. This disproportion is due to two factors: an increased crash rate per vehicl...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.2004.52025.x
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abstract:OBJECTIVES:To examine the effect of obesity (body mass index (BMI)≥30.0 kg/m2 ) on outcomes of older adults admitted to skilled nursing facilities (SNFs) for hip fracture postacute care (PAC). DESIGN:Retrospective cohort study. SETTING:U.S. Medicare- and Medicaid-certified SNFs from 2008 to 2015. PARTICIPANTS:Medica...
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abstract:OBJECTIVES:To describe the prevalence of and characteristics associated with major and minor depression in older medical inpatients and to compare associated characteristics by sex and history of depression. DESIGN:Cross-sectional study of two patient samples, with and without a screening diagnosis of major or minor d...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.2005.53404.x
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abstract::Contrary to earlier findings, elderly patients are not at significantly greater risk of perioperative morbidity or mortality than younger patients simply because of advanced age. Increased risk, when present, is attributable to pathologic changes that are not uniformly seen in all geriatric patients. Most perioperativ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1983.tb04606.x
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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
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abstract:OBJECTIVE:To investigate the prevalence of hypoalbuminemia and hypoprealbuminemia in hospitalized, elderly, skilled nursing facility residents and to correlate these findings with clinical outcomes. DESIGN:Prospective cohort study. SETTING:A 300-bed community hospital. PARTICIPANTS:Eighty-one hospitalized, skilled n...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1993.tb01893.x
更新日期:1993-05-01 00:00:00
abstract::Prescription drugs are not always taken as directed. When there is a discrepancy between the use of a drug and the prescription directions, the drug-taking behavior is considered "nonadherent." To determine the extent of prescription non adherence by old persons and the reasons for nonadherence, an in-home survey was ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb05623.x
更新日期:1982-05-01 00:00:00
abstract::The coming decades will see a dramatic rise in the number of homebound adults. These individuals will have multiple medical conditions requiring a team of caregivers to provide adequate care. Home-based primary care (HBPC) programs can coordinate and provide such multidisciplinary care. Traditionally, though, HBPC pro...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2006.00835.x
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abstract:OBJECTIVES:To determine whether obese older adults who qualify for nursing home (NH) placement are as likely as nonobese adults to be admitted to NHs that provide adequate quality of care. DESIGN:Retrospective study. SETTING:NHs in New York State. PARTICIPANTS:Individuals aged 65 and older newly admitted to a NH in ...
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abstract::Seventy consecutive patients receiving warfarin as an anticoagulant were evaluated for the relationship between the response to the loading dose of warfarin and the response to the maintenance dose. No patients were excluded because of complicating diseases or the concurrent use of other drugs. There was a moderate co...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1980.tb00116.x
更新日期:1980-01-01 00:00:00
abstract::The effect of age on glucose tolerance, insulin secretion, and in vivo insulin action (insulin clamp) was studied in 48 nonobese subjects, all of whom were fully ambulatory and in good general health. The observed age-related increase in fasting plasma glucose (r = 0.35, P less than 0.01) was not due to an increase in...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb05662.x
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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
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doi:10.1111/j.1532-5415.1983.tb03398.x
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abstract:OBJECTIVES:To investigate the relationship between total estradiol (E2) levels and 9-year mortality in older postmenopausal women not taking hormone replacement therapy (HRT). DESIGN:Population-based study of persons living in the Chianti geographic area (Tuscany, Italy). SETTING:Community. PARTICIPANTS:A representa...
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abstract:OBJECTIVES:Most clinico-neuropathological correlative studies of Alzheimer's Disease (AD) are based on research cohorts that are not necessarily generalizable to patients seen in the general medical community. In this study, we examine the accuracy of the criteria used in diagnosing AD in a community-based case series ...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1999.tb02571.x
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journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1981.tb01757.x
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abstract::The incidence, ecology, and mortality of gram-negative bacillary bacteremia in elderly patients were studied in an analysis of 334 episodes over a four-year-period in a 489-bed North Carolina community teaching hospital, 135 (40.4%) of which occurred in patients 70 years of age or older. The bacteremia rate per 1000 h...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.1987.tb02311.x
更新日期:1987-03-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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更新日期:2004-10-01 00:00:00
abstract:OBJECTIVES:To assess the feasibility of cognitive screening in older veterans presenting for routine primary care. DESIGN:Quality improvement initiative. SETTING:Seven Veterans Affairs Medical Centers. PARTICIPANTS:Veterans aged 70 and older without a prior diagnosis of cognitive impairment. MEASUREMENTS:Scores fro...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
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更新日期:2011-02-01 00:00:00
abstract:OBJECTIVES:To determine the relationship between frailty and overall and cardiovascular mortality. DESIGN:Longitudinal mortality analysis. SETTING:National Health and Nutrition Examination Survey (NHANES) 1999-2004. PARTICIPANTS:Community-dwelling older adults aged 60 and older (N = 4,984; mean age 71.1 ± 0.19, 56% ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:To compare clinical and economic outcomes of early insulin initiation with those of delayed initiation in older adults with type 2 diabetes mellitus (T2DM). DESIGN:Retrospective cohort study. SETTING:Humana Medicare Advantage health insurance plan. PARTICIPANTS:Older (≥65) Medicare beneficiaries with T2DM...
journal_title:Journal of the American Geriatrics Society
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更新日期:2015-05-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2003.51468.x
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVES:To examine recent trends in discharge disposition after hospitalization for hip fracture. DESIGN:Retrospective observational study using data from the 5% random sample of Medicare claims data from 2001 to 2005 that the Centers for Medicare and Medicaid Services makes available for research purposes. SETTIN...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.01688.x
更新日期:2008-06-01 00:00:00
abstract::Mortality in 159 patients who sustained 163 hip fractures in a single geriatric hospital and residential health facility in a ten-year period was studied. This study confirms the major problem of mortality associated with hip fractures in the very elderly. Factors that seemed associated with mortality were preoperativ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1983.tb05119.x
更新日期:1983-08-01 00:00:00
abstract:OBJECTIVES:To model the relative contributions of driver data and clinical judgments to clinical ratings of driver capability for a state licensing authority and to compare ratings with on-road test results. DESIGN:Retrospective, logistic regression. SETTING:Missouri Driver License Bureau. PARTICIPANTS:Adults aged 6...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14022
更新日期:2016-04-01 00:00:00