Abstract:
OBJECTIVES:To compare the effectiveness of acute geriatric unit care, based on all or part of the Acute Care for Elders (ACE) model and introduced in the acute phase of illness or injury, with that of usual care. DESIGN:Systematic review and meta-analysis of 13 randomized controlled and quasi-experimental trials with parallel comparison groups retrieved from multiple sources. SETTING:Acute care geriatric and nongeriatric hospital units. PARTICIPANTS:Acutely ill or injured adults (N = 6,839) with an average age of 81. INTERVENTIONS:Acute geriatric unit care characterized by one or more ACE components: patient-centered care, frequent medical review, early rehabilitation, early discharge planning, prepared environment. MEASUREMENTS:Falls, pressure ulcers, delirium, functional decline at discharge from baseline 2-week prehospital and hospital admission statuses, length of hospital stay, discharge destination (home or nursing home), mortality, costs, and hospital readmissions. RESULTS:Acute geriatric unit care was associated with fewer falls (risk ratio (RR) = 0.51, 95% confidence interval (CI) = 0.29-0.88), less delirium (RR = 0.73, 95% CI = 0.61-0.88), less functional decline at discharge from baseline 2-week prehospital admission status (RR = 0.87, 95% CI = 0.78-0.97), shorter length of hospital stay (weighted mean difference (WMD) = -0.61, 95% CI = -1.16 to -0.05), fewer discharges to a nursing home (RR = 0.82, 95% CI = 0.68-0.99), lower costs (WMD = -$245.80, 95% CI = -$446.23 to -$45.38), and more discharges to home (RR = 1.05, 95% CI = 1.01-1.10). A nonsignificant trend toward fewer pressure ulcers was observed. No differences were found in functional decline between baseline hospital admission status and discharge, mortality, or hospital readmissions. CONCLUSION:Acute geriatric unit care, based on all or part of the ACE model and introduced during the acute phase of older adults' illness or injury, improves patient- and system-level outcomes.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Fox MT,Persaud M,Maimets I,O'Brien K,Brooks D,Tregunno D,Schraa Edoi
10.1111/jgs.12028subject
Has Abstractpub_date
2012-12-01 00:00:00pages
2237-45issue
12eissn
0002-8614issn
1532-5415journal_volume
60pub_type
杂志文章,meta分析,评审abstract::In response to the needs and demands of an aging population, geriatric medicine has grown rapidly during the past 3 decades. The discipline has defined its core values as well as the knowledge base and clinical skills needed to improve the health, functioning, and well-being of older persons and to provide appropriate...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2005.53350.x
更新日期:2005-06-01 00:00:00
abstract:OBJECTIVES:To compare longitudinal changes in healthcare costs between fallers admitted to the hospital at the time of the fall (admitted), those not admitted to the hospital (nonadmitted), and nonfaller controls; test hypotheses related to differences in mean costs between and within these groups over time; and estima...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02816.x
更新日期:2010-05-01 00:00:00
abstract::Capitated or salaried managed care systems offer an important opportunity to provide high quality, cost-effective end-of-life care. However, capitated healthcare delivery systems have strong incentives to avoid patient populations in need of such care. Care currently provided at the end of life in fee-for-service prac...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb01047.x
更新日期:1998-03-01 00:00:00
abstract::Two concurrent studies of geriatric outpatients who received diagnoses of depression were conducted. In the first, patients were treated with one of two tricyclic antidepressants or with a placebo. In the second, patients were assigned to groups receiving either psychodynamic group therapy or cognitive-behavioral grou...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb01987.x
更新日期:1982-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of pentoxifylline to treat impotence in men with mild to moderate penile vascular insufficiency. DESIGN:Double-blind randomized clinical trial. SETTING:Sexual Dysfunction Clinic at VA Medical Center, Sepulveda, CA. PARTICIPANTS:Convenience sample of couples. INTERVENTION:Twelve weeks o...
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.tb06941.x
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVES:To determine factors that predict site of death (hospital vs nursing home (NH)), related costs, and geographic variation in site of death of NH residents admitted under the Medicare Part A Benefit. DESIGN:Retrospective cohort study. SETTING:NHs located in the United States (N=13,146). PARTICIPANTS:All per...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52352.x
更新日期:2004-08-01 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:OBJECTIVES:To assess the effect of cardiovascular diseases and risk factors on mortality in individuals with dementia. DESIGN:Systematic review and meta-analysis. English- and Dutch-language studies in PubMed, EMBASE, and PsycINFO databases were searched in April 2014 with hand-searching of in-text citations and no pu...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,meta分析,评审
doi:10.1111/jgs.13835
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:Traditional mental status and psychometric assessments bottom out in the late stages of Alzheimer disease (AD). A method adapted from cognitive testing in infants, the Ordinal Scales of Psychological Development was modified (M-OSPD) and applied to a severely demented population. The concurrent validity of th...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章
doi:10.1111/j.1532-5415.1994.tb06509.x
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of influenza vaccine, rapid influenza testing, and influenza antiviral medication in nursing homes in the US to prevent and control outbreaks. METHODS:Survey questionnaires were sent to 1017 randomly selected nursing homes in nine states. Information was collected on influenza prevention,...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb02606.x
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVES:Heart failure is a major health care burden among older adults, but information on recent trends has not been available. We compare rates, sociodemographic characteristics, and discharge outcomes of the initial hospitalization for heart failure in the Medicare populations of 1986 and 1993. DESIGN:Informatio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1997.tb00939.x
更新日期:1997-03-01 00:00:00
abstract:OBJECTIVES:To determine whether genetic variants in the ciliary neurotrophic factor (CNTF) gene are associated with muscle strength in older women. DESIGN:Cross-sectional analysis of baseline data from the Women's Health and Aging Studies I (1992) and II (1994), complementary population-based studies. SETTING:Twelve ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2006.00693.x
更新日期:2006-05-01 00:00:00
abstract::In experience with total joint replacement in the lower extremity, to date, total hip arthroplasty has been the most successful. Total arthroplasty operations as applied to the knee and ankle are giving promising results. These methods offer new avenues for relief of pain and deformity and stabilization of arthritic j...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1977.tb00232.x
更新日期:1977-02-01 00:00:00
abstract::The case report presented is clinically compatible with late onset HD. The diagnosis was initially obscured by a lack of family history due to the early death of both parents and siblings. The presence of symptoms at the age of 59 in one offspring is consistent with the intrafamilial transmission of late onset HD dise...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1988.tb01807.x
更新日期:1988-03-01 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 estimate the prevalence of obesity in elderly Americans in 2010 and to discuss the health and economic implications of these estimates. DESIGN:Three methods of generating future point-prevalence estimates using data from consecutive cross-sectional studies. SETTING:All regions of the United States. PAR...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52517.x
更新日期:2004-11-01 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:OBJECTIVE:Attention has recently been drawn to the potential dangers of firearm use among patients with dementia. However, little is known about the actual prevalence of firearms in households with demented family members. This study seeks to determine the prevalence and loaded status of firearms in households with a d...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb05197.x
更新日期:1999-10-01 00:00:00
abstract:OBJECTIVE:To evaluate the usefulness of standardized neuropsychological tests in the psychometric differentiation of patients with very mild or mild Alzheimer's Disease (AD) and/or major depression presenting in a tertiary clinic with memory/attention complaints. DESIGN:Controlled prospective clinicoexperimental desig...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章
doi:10.1111/j.1532-5415.1995.tb07402.x
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:To determine how physical activity at various ages over the life course is associated with cognitive impairment in late life. DESIGN:Cross-sectional study. SETTING:Four U.S. sites. PARTICIPANTS:Nine thousand three hundred forty-four women aged 65 and older (mean 71.6) who self-reported teenage, age 30, age...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2010.02903.x
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVES:To examine concerns that vulnerable populations, such as depressed or cognitively impaired beneficiaries would have challenges accessing Part D coverage. DESIGN:Logistic regression analysis was used to assess whether elderly Medicare beneficiaries with depression or cognitive impairment differentially plann...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02348.x
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVES:To evaluate the effectiveness of exercise and amino acid supplementation in enhancing muscle mass and strength in community-dwelling elderly sarcopenic women. DESIGN:Randomized controlled trial. SETTING:Urban community in Tokyo, Japan. PARTICIPANTS:One hundred fifty-five women aged 75 and older were defin...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2011.03776.x
更新日期:2012-01-01 00:00:00
abstract:OBJECTIVES:To examine the effects of caring for a spouse with dementia on the caregiver's risk for incident dementia. DESIGN:Population-based study of incident dementia in spouses of persons with dementia. SETTING:Rural county in northern Utah. PARTICIPANTS:Two thousand four hundred forty-two subjects (1,221 married...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02806.x
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVES:Older people approaching end of life are commonly prescribed multiple medications, many of which may be inappropriate or futile. Our objective was to examine the effect of applying the STOPPFrail, a recently developed deprescribing tool, to the medication regimens of older patients with advanced frailty. DE...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16278
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to report on the prevalence, incidence and prognosis of left ventricular hypertrophy (LVH) on the electrocardiogram (ECG) in a cohort of ambulatory older men and women. DESIGN:A prospective, longitudinal study of 10 years duration with ECGs obtained at baseline and on an annua...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb01437.x
更新日期:1996-05-01 00:00:00
abstract:OBJECTIVES:To measure end-of-life (EOL) care preferences and advance care planning (ACP) in older Latinos and to examine the relationship between culture-based attitudes and extent of ACP. DESIGN:Cross-sectional interview. SETTING:Twenty-two senior centers in greater Los Angeles. PARTICIPANTS:One hundred forty-seven...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02853.x
更新日期:2010-06-01 00:00:00
abstract::After a 2-week washout period, 30 elderly hypertensive patients were treated with pindolol (a beta-adrenergic blocker) for 3 weeks. In 13 patients the reduction in blood pressure was satisfactory and treatment with pindolol was continued for another 4 weeks. In 17 patients the subsequent treatment was supplemented wit...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1978.tb03680.x
更新日期:1978-08-01 00:00:00
abstract:OBJECTIVES:To determine whether body mass index (BMI) is independently associated with cognitive function in postmenopausal women and the relationship between body fat distribution as estimated by waist-hip ratio (WHR). DESIGN:Cross-sectional data analysis. SETTING:Baseline data from the Women's Health Initiative (WH...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02969.x
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of dental problems in Paget's patients and in a control population without Paget's disease. The relationship of localization of bony involvement of Paget's disease with the prevalence of dental, auditory, visual, and smell changes is examined. DESIGN:Cross-sectional national surve...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb06618.x
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVES:To evaluate whether age, sex, depression, dementia disorder, nutritional status, or level of functional balance capacity influences the effect of a high-intensity functional weight-bearing exercise program on functional balance. DESIGN:Preplanned subgroup analyses of a randomized controlled trial. SETTING:...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2011.03484.x
更新日期:2011-07-01 00:00:00