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 thousand six hundred ninety-two veterans aged 65 and older admitted between January 1, 2004, and June 3, 2005, with long stays (≥ 90 days). MEASUREMENTS:Prevalence of potential underuse, inappropriate use, and overuse of antidepressants in residents with and without depression (as documented according to International Classification of Diseases, Ninth Revision, Clinical Modification, codes or Depression Rating Scale). RESULTS:Selective serotonin reuptake inhibitors were the most commonly prescribed antidepressant. Of the 877 residents with depression, 25.4% did not receive an antidepressant, suggesting potential underuse. Of residents with depression who received antidepressants, 57.5% had potential inappropriate use due primarily to problems seen with drug-drug and drug-disease interactions. Of the 2,815 residents who did not have depression, 1,190 (42.3%) were prescribed one or more antidepressants; only 48 (4.0%) of these had a Food and Drug Administration-approved labeled indication, suggesting potential overuse. Overall, only 17.6% of antidepressant use was appropriate (324/1,844). The only consistent resident factor associated with potential underuse and overuse use was taking an antipsychotic without evidence of schizophrenia (underuse: adjusted relative risk ratio (ARRR)=0.56, 95% confidence interval (CI)=0.33-0.94; overuse: adjusted odds ratio=1.52, 95% CI=1.21-1.91). Having moderate to severe pain (ARRR=1.54, 95% CI=1.08-2.20) and the prescribing of an anxiolytic or hypnotic (ARRR=1.33, 95% CI=1.02-1.74) increased the risk of potential inappropriate antidepressant use. CONCLUSION:Potential problems with the use of antidepressants were frequently observed in older U.S. veteran CLC residents. Future studies are needed to examine the true risks and benefits of antidepressant use in CLC and non-VA nursing homes.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Hanlon JT,Wang X,Castle NG,Stone RA,Handler SM,Semla TP,Pugh MJ,Berlowitz DR,Dysken MWdoi
10.1111/j.1532-5415.2011.03522.xsubject
Has Abstractpub_date
2011-08-01 00:00:00pages
1412-20issue
8eissn
0002-8614issn
1532-5415journal_volume
59pub_type
杂志文章abstract:OBJECTIVE:The impact of cognitive function and decline on political ideology is unknown. We studied the relationship between cognition and both political orientation and political policy choices in a population of older persons. DESIGN:Longitudinal investigation. SETTING:A retirement community and its surroundings in...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16935
更新日期:2020-10-31 00:00:00
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
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1993.tb01893.x
更新日期:1993-05-01 00:00:00
abstract:OBJECTIVES:To test the hypothesis that a micronutrient supplement can improve seroconversion after influenza immunization in older institutionalized people. DESIGN:: Randomized, double-blind, placebo-controlled study. SETTING:Nursing and residential homes in Liverpool, United Kingdom. PARTICIPANTS:One hundred sixty-...
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.1532-5415.2004.52005.x
更新日期:2004-01-01 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::Evidence of poor performance in the evaluation and management of common geriatric conditions suggests the need for changing physician behavior in these areas. Traditional lecture-style continuing medical education (CME) has not been shown to be effective. Expert faculty initially trained 60 nonexpert peer educators to...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01205.x
更新日期:2007-08-01 00:00:00
abstract:OBJECTIVES:To compare the prevalence and predictors of caregiver esteem and burden during two different stages of care recipients' illnesses-advanced chronic illness and the last year of life. DESIGN:Longitudinal, observational cohort study. SETTING:Community sample recruited from outpatient clinics at Duke Universit...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12841
更新日期:2014-06-01 00:00:00
abstract:OBJECTIVES:To determine the cross-sectional and longitudinal associations between 25-hydroxyvitamin D (25(OH)D) levels and frailty status in older men. DESIGN:Prospective cohort study. SETTING:Six U.S. community-based centers. PARTICIPANTS:One thousand six hundred six men aged 65 and older. MEASUREMENTS:25(OH)D (li...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2010.03201.x
更新日期:2011-01-01 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::Despite concerted effort to rehabilitate and return patients to their homes, the majority of nursing home patients are destined to spend the remainder of their days in institutional settings. These custodial care patients are elderly, have many functional disabilities, and are often demented. The traditional medical a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1985.tb05442.x
更新日期:1985-12-01 00:00:00
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:OBJECTIVES:To examine the associations between typology of family relationship and risk of elder mistreatment (EM). DESIGN:Population-based epidemiological cross-sectional study. SETTING:Community-dwelling older adults in the greater Chicago area. PARTICIPANTS:A total of 3157 US older Chinese immigrants. MEASUREMEN...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15892
更新日期:2019-08-01 00:00:00
abstract::A trial by any means that can possibly prevent or retard the development of arteriosclerosis is to be recommended. Arteriosclerosis is the chief cause of strokes and heart attacks. The heavy evening meal now in vogue is characteristically rich in animal fats. Normal digestion is at its peak at about the seventh hour, ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1978.tb02404.x
更新日期:1978-06-01 00:00:00
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:As a person's age increases and his/her health status declines, new challenges arise that may lead physicians to consider deprescribing statins. We aimed to provide insight into recommendations available in international cardiovascular disease prevention guidelines regarding discontinuation of statin treatme...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16219
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVES:To study whether subjective memory deterioration is associated with future dementia in older people. DESIGN:A population-based prospective cohort study begun in 1994 with biennial follow-up interviews. SETTING:Community-based members of Group Health Cooperative, a large health maintenance organization in t...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52568.x
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVE:To determine the association between kyphosis (degree of forward curvature of the thoracic spine) and measures of spinal osteoporosis (height loss and vertebral fractures) and chronic back pain and disability in older women. DESIGN:A cross-sectional study. SETTING:Eleven clinical centers in the United State...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1997.tb01470.x
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVES:Evidence suggests inflammation is associated with cognitive impairment, but previous epidemiological studies have reported conflicting results. DESIGN:Prospective population-based cohort. SETTING:Epidemiology of Hearing Loss Study participants. PARTICIPANTS:Individuals without cognitive impairment in 1998...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12994
更新日期:2014-09-01 00:00:00
abstract::Ethical issues surrounding decisions to limit treatment often focus on dramatic and highly technical interventions, such as mechanical ventilation. Many less dramatic forms of therapy are considered routine, and ethical aspects of their use may be less closely examined. Nutritional support can be crucially important i...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1984.tb02009.x
更新日期:1984-03-01 00:00:00
abstract:OBJECTIVES:To examine whether hearing acuity correlates with walking ability and whether impaired hearing at baseline predicts new self-reported walking difficulties after 3 years. DESIGN:Prospective follow-up. SETTING:Research laboratory and community. PARTICIPANTS:Four hundred thirty-four women aged 63 to 76. MEA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02553.x
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVES:To investigate the association between blood pressure and mortality in very old people. DESIGN:Population-based cohort study. SETTING:County of Västerbotten, Sweden. PARTICIPANTS:Half of all subjects aged 85 and all of those aged 90 and 95 and older (N=348) in one urban and five rural municipalities in th...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.01948.x
更新日期:2008-10-01 00:00:00
abstract:OBJECTIVES:To estimate lifetime morbidity, mortality, and costs from hip fracture incorporating the effect of deficits in activities of daily living. DESIGN:Markov computer cohort simulation considering short- and long-term outcomes attributable to hip fractures. Data estimates were based on published literature, and ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1046/j.1532-5415.2003.51110.x
更新日期:2003-03-01 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:OBJECTIVES:The specific goals of the study were to compare three health status measures among older adults for their correlations with similar scales and to examine whether extreme (positive) health states might lead to measurement problems. We also report on practical administration and response problems among older a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb05569.x
更新日期:1995-09-01 00:00:00
abstract::Thirty-two patients entered a simple-blind, cross-over study on the action of tocopherol in osteoarthritis; only 3 did not complete the course. Each patient was randomly assigned either to the tocopherol group (600 mg/day for 10 days) or to the placebo group. After 10 days the groups were transposed. The analgesic and...
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.1532-5415.1978.tb01345.x
更新日期:1978-07-01 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::A study was made of the effects of community nutrition services on 234 noninstitutional elderly aged 65 or older. Many of the problems were related to overweight and longstanding inappropriate food habits. The results indicated that counselling can stimulate an increased awareness of nutrition and improvement in the k...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1978.tb01223.x
更新日期:1978-03-01 00:00:00
abstract:OBJECTIVES:To examine the association between usual sleep duration and mortality according to physical and mental health status in older adults. DESIGN:Prospective study conducted from 2001 to 2008. SETTING:Community-based study. PARTICIPANTS:Cohort study of 3,820 persons representative of the noninstitutionalized p...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.03071.x
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVES:To analyze the association between chronic kidney disease (CKD) and mild cognitive impairment (MCI) in Mexican Americans and to determine whether there is a blood-based proteomic profile linking CKD to MCI. DESIGN:Retrospective analysis of cohort study. SETTING:Health and Aging Brain among Latino Elders st...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13665
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:To analyze the preferences of people with amnestic mild cognitive impairment (aMCI) and mild dementia in Alzheimer's disease (AD) regarding different aspects of healthcare-related decisions, to correlate these findings with different measures of decision-making capacity, and to explore the views of relatives...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03661.x
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVES:To determine the effect of four vitamin D supplement doses on falls risk in elderly nursing home residents. DESIGN:Secondary data analysis of a previously conducted randomized clinical trial. SETTING:Seven hundred twenty-five-bed long-term care facility. PARTICIPANTS:One hundred twenty-four nursing home r...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2007.01048.x
更新日期:2007-02-01 00:00:00