Abstract:
OBJECTIVES:We investigated whether there was a higher prevalence of cognitive impairment (CI) and/or physical frailty (PF) in persons with diabetes compared to their non-diabetic counterparts, and the individual and combined impact of CI and PF on functional and mortality outcomes among diabetic older persons. METHOD:Community-living diabetic and non-diabetic participants (N = 2696) aged 55 and above were assessed on CI (MMSE) and PF (CHS criteria) status. Among 486 diabetic persons, we estimated the odds ratio and 95% confidence intervals (OR, 95% CI) of association of CI and/or PF with prevalent IADL and ADL disability and mortality from 11 years of follow up. RESULTS:Diabetes was associated with significantly higher prevalence of CI and/or PF. Adjusted for sex, age, education, smoking, alcohol intake, physical activity, and BMI, diabetes was associated with higher prevalence of PF alone (OR = 2.24, 1.16-4.34) and PF with CI (OR = 2.01, 1.12-3.60), but not with CI alone (OR = 1.02, 0.73-1.44). In multivariable analyses of 486 diabetic older adults, compared to non-frail (NF) and cognitive normal (CN), CI alone was not significantly associated with IADL (OR = 1.06, 0.53-2.10), but PF alone was associated with considerably higher prevalence of IADL (OR = 6.72, 1.84-24.5). PF with CI was associated with the highest prevalence of IADL (OR = 17.8, 3.66-8.68) and ADL disability (OR = 93.8, 23.6-372.4). Whether singly or in combination, PF and/or CI were associated with worse hazard (HR) ratio for mortality outcomes: CI alone (HR = 2.72, 1.48-5.01), PF alone (HR = 4.30, 1.88-9.82) and CI with PF (HR = 8.41, 3.95-17.9). CONCLUSION:Cognitive impairment and/or physical frailty are powerful prognostic factors identifying people with diabetes at high risk of mortality.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Thein FS,Li Y,Nyunt MSZ,Gao Q,Wee SL,Ng TPdoi
10.1080/00325481.2018.1491779subject
Has Abstractpub_date
2018-08-01 00:00:00pages
561-567issue
6eissn
0032-5481issn
1941-9260journal_volume
130pub_type
杂志文章abstract::Part 1, which begins on page 64, discusses diagnosis of rheumatic disease by radiography. The most popular laboratory tests in rheumatic disease are nonspecific and include those based on the formation of autoantibodies. Rheumatoid factor assays actually are of little diagnostic help in rheumatoid arthritis, but antin...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1979.11715082
更新日期:1979-03-01 00:00:00
abstract::In most cases, patients presenting with "the worst headache ever" are found to have a benign condition, notably migraine, toxic vascular headache, or exertion-induced headache. However, ominous causes first must be excluded by appropriate investigation, such as computed tomographic or magnetic resonance imaging scans ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1989.11704328
更新日期:1989-07-01 00:00:00
abstract::Why do some people spend most of the night tossing and turning while others drop off as quickly as a cat in the sun? There are many possible explanations for problems with falling and staying asleep and, sometimes, patients actually get a lot more sleep than they think they do. Each type of insomnia has its own set of...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.03.935
更新日期:2000-03-01 00:00:00
abstract::The maximal exercise stress test continues to be an important diagnostic and prognostic tool in the primary care office setting. But are you getting the most accurate information possible? Drs Driggers and Marchant discuss several factors that are crucial to the test's validity--and thus to its usefulness in your clin...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.05.1.737
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVE:To identify attitudes and practices of endocrinologists (ENDOs), family practitioners (FPs), internists (IMs), primary care nurse practitioners (NPs), physician assistants (PAs), certified diabetes educators (CDEs), retail pharmacists (R-PHs), and hospital pharmacists (H-PHs) with respect to type 2 diabetes m...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2014.05.2764
更新日期:2014-05-01 00:00:00
abstract::A patient's history usually contains key information regarding the type of dizziness and the best way to direct diagnostic workup. In dizziness with a vestibular cause (benign positional vertigo, vestibular neuritis, Meniere's disease, migraine, vertebrobasilar insufficiency), patients often describe their world as sp...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.1999.02.555
更新日期:1999-02-01 00:00:00
abstract::Pregnancy is an important risk factor for venous thrombosis, and venous thromboembolism is a leading cause of preventable death in pregnancy. Diagnosis of venous thromboembolism is complicated in that the symptoms of dyspnea and lower extremity edema are relatively common complaints of pregnant patients. Physicians sh...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2000.09.15.1238
更新日期:2000-09-15 00:00:00
abstract::Preview The number of cardiac drugs is growing every day, and their indications are changing as more is learned about each one. Choosing the appropriate drug for each patient is made difficult by these complexities, especially when a patient has already had a heart attack. The authors review the latest trials of the m...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1993.11945746
更新日期:1993-11-01 00:00:00
abstract:OBJECTIVES:There is evidence that increasing severity of hypertriglyceridemia increases the risk of acute pancreatitis. There is a debate about superiority of treatment methods and previous works have specifically called for direct comparison between IV insulin and apheresis techniques. Identify patient characteristics...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2018.1470439
更新日期:2018-06-01 00:00:00
abstract::While a wide variety of thyroid function tests are currently available, all are sometimes abnormal in patients without thyroid disease. To interpret test results properly, the clinician needs to be aware of factors altering thyroid function tests. In every instance, the clinician needs to begin by asking whether the p...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1989-04-01 00:00:00
abstract::In scarcely more than 30 years, the People's Republic of China has progressed from limited health care available only to a privileged few to a countrywide system providing basic services to one fifth of the world's population. The author gives his impressions of the current situation, based on a recent visit. :There ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1981.11715824
更新日期:1981-08-01 00:00:00
abstract::Primary aldosteronism is a potentially curable cause of hypertension; it occurs in about 1% of hypertensive patients. In the case reported here, persistent hypokalemia developed in a 72-year-old man who had been treated for 13 years for essential hypertension. Investigation revealed elevated aldosterone level and redu...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1984-08-01 00:00:00
abstract::In this review, we focus on current trends in the management of male lower urinary tract symptoms (LUTS), defined here as LUTS, namely, storage, voiding, and post-micturition symptoms presumed secondary to benign prostatic hyperplasia (BPH), and discuss possible novel approaches toward better care. According to result...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.2018.1487238
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Binge eating disorder (BED) is now a formal diagnosis in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). However, post-DSM-5 patient profiles and viewpoints on BED diagnosis and treatment remain unclear. This study used a focus group methodology to examine demographic and cl...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2014.09.2800
更新日期:2014-09-01 00:00:00
abstract::In the next 30 years, the average age of the population will continue to increase, as will the prevalence of dementia. The management of advanced dementia requires the careful orchestration of communication, prognostication, patient care, and caregiver education. Understanding the specific tools available to establish...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2014.10.2826
更新日期:2014-10-01 00:00:00
abstract::The mere presence of uterine fibroids is not, since qua non, an indication for their surgical removal. Knowing when not to operate is probably more important for the physician than knowing when to operate. It is easy to fall into diagnostic and therapeutic traps when uterine fibroids are known to be present, especiall...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1976-09-01 00:00:00
abstract::Measurement of cerebrospinal fluid (CSF) lactate is a useful test when properly applied to the appropriate clinical situation and can offer information other CSF parameters cannot provide. Except for Gram's stain of CSF, lactate level is the most important CSF parameter in the early differentiation of viral (aseptic) ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.1080/00325481.1990.11716403
更新日期:1990-10-01 00:00:00
abstract::Chronic stable angina (CSA) impairs patient quality of life, is associated with increased patient mortality, and is a prominent symptom of coronary artery disease (CAD), the latter being prevalent worldwide in patients. Currently, therapeutic options for patients with CSA include β-blockers, calcium channel blockers, ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2013.11.2711
更新日期:2013-11-01 00:00:00
abstract::The cultural drive to be thin can lead to eating disorders in many women and girls. In adolescent females with diabetes, the increased focus on eating and the weight gain associated with good glycemic control likely increase their susceptibility to abnormal eating. It is clear that nonspecified and subthreshold eating...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2001.04.910
更新日期:2001-04-01 00:00:00
abstract::Triglyceride (TG) levels can increase for numerous reasons, including a sedentary lifestyle, an unhealthy diet, especially one rich in refined carbohydrates, and comorbidities. According to the National Cholesterol Education Program (NCEP), the normal TG level is < 150 mg/dL. Patients with very high TG (VHTG) levels (...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2009.07.2020
更新日期:2009-07-01 00:00:00
abstract:AIM:To demonstrate the impact of the parathyroid hormone-related peptide (PTHrP) on the large conductance calcium-activated potassium (BKCa) channels in vascular smooth muscle cells (VSMC) and hyperpolarization of the cell membrane and its dependence on calcium. MATERIALS AND METHODS:VSMC were isolated from rat aorta ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.2014.03.2742
更新日期:2014-03-01 00:00:00
abstract::With use of the International Normalized Ratio (INR), physicians can accurately assess the intensity of anticoagulation in treatment programs and trials. Bleeding is the major complication of oral anticoagulant therapy, and its incidence can be lessened, with no loss of efficacy, by using less intense therapy (INR, 2 ...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:
更新日期:1995-09-01 00:00:00
abstract::Whether preparticipation sports examinations are necessary and what they should include are matters of debate, especially in the young because of the low yield of new medical diagnoses. The goal of the examining physician is to determine whether the athlete is mentally, developmentally, and physically capable of safel...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:To evaluate healthcare resource utilization (HCRU) by osteoarthritis (OA) pain severity. METHODS:Cross-sectional surveys of US physicians and their patients were conducted between February and May 2017. Using the Numeric Rating Scale, patients were classified by self-reported pain intensity in the last week ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2020.1841988
更新日期:2021-01-01 00:00:00
abstract::Primary care physicians often encounter epistaxis. Its treatment may involve nasal sponge tampons, double-balloon nasal catheters, and anterior gauze with posterior Foley catheters, depending on the location of the bleed. Topical anesthetic and decongestant agents are essential, and intravenous analgesia, which enhanc...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2006.06.1647
更新日期:2006-06-01 00:00:00
abstract::Lyme disease can be difficult to recognize because not all patients have erythema migrans or other classic symptoms. Therefore, laboratory testing has become an important aid to clinical diagnosis. But the story doesn't end there-serologic testing presents another set of problems and concerns. Drs. Still and Ryan expl...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.3810/pgm.1997.07.260
更新日期:1997-07-01 00:00:00
abstract::Inflammatory bowel disease (IBD) is difficult to diagnose, and differentiating between ulcerative colitis (UC) and Crohn's disease (CD) can be challenging. Overlapping symptoms of UC and CD often delay diagnosis, despite availability of endoscopic, radiologic, and histologic tools. This delay in diagnosis is quite com...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
doi:10.3810/pgm.2010.07.2184
更新日期:2010-07-01 00:00:00
abstract::Extracorporeal shock wave lithotripsy has become a valuable asset to the urologist and greatly benefits urologic stone patients. Eight years of clinical use have proven its clinical efficacy, with more than 400,000 successfully performed treatments worldwide. In a short period of time, ESWL has completely changed the ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700265
更新日期:1988-05-01 00:00:00
abstract:BACKGROUND:Adults with attention-deficit/hyperactivity disorder treated with atomoxetine were examined for time-to-onset and -resolution of common treatment-emergent adverse events (TEAEs) and male sexual dysfunction, and for changes in blood pressure (BP) and heart rate (HR) upon atomoxetine discontinuation. METHODS:...
journal_title:Postgraduate medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1080/00325481.2015.1083394
更新日期:2015-01-01 00:00:00
abstract::Trigger points (TPs) in muscles of the lower torso associated with the spine are an important cause of low back pain. The quadratus lumborum is the muscle most commonly involved, but TPs located there are often overlooked because of inadequate physical examination techniques. TPs in the lower rectus abdominis refer pa...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11697757
更新日期:1983-02-01 00:00:00