Abstract:
OBJECTIVES:To determine whether function-related indicators (FRIs), derived from preadmission claims data, help explain the frequent practice of forgoing secondary prevention medications observed in Medicare. DESIGN:Retrospective cohort. SETTING:National Medicare data. PARTICIPANTS:Elderly Medicare beneficiaries discharged alive from an acute myocardial infarction (AMI) hospitalization in 2007-2008 (N = 184,156). MEASUREMENTS:Study outcomes were number of guideline-recommended secondary prevention medications (statins, beta-blockers, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers) used after discharge and 12-month survival. Preadmission data (FRIs, cardiovascular conditions, comorbid conditions), type of AMI (non-ST-elevation myocardial infarction, anterior, other), and procedures and complications during the hospitalization were from claims data. RESULTS:Function-related indicators (FRIs) were common before admission; 50% of individuals had at least one (range 0-11). After discharge, 85.8% used at least one class of guideline medication, and 30.2% used all three; 19.6% died within 12 months. Each additional FRI reduced the likelihood of receiving all three medication classes by 5% (adjusted odds ratio = 0.95, 95% confidence interval (CI) = 0.94-0.96) and increased 12-month mortality by 20% (adjusted hazard ratio (aHR) = 1.20, 95% CI = 1.19-1.21). Individuals taking all three classes of medication were 30% less likely to die within 12 months than those not taking guideline medications (aHR = 0.70, 95% CI = 0.67-0.73). Similar survival benefit was observed in individuals with and without functional impairments. CONCLUSION:Greater impairment in preadmission functional status, using a measure derived from claims data, was associated with less use of secondary prevention medications after AMI. Survival benefits of taking these medications were consistent across functional impairment levels.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Chrischilles EA,Schneider KM,Schroeder MC,Letuchy E,Wallace RB,Robinson JG,Brooks JMdoi
10.1111/jgs.13953subject
Has Abstractpub_date
2016-03-01 00:00:00pages
526-35issue
3eissn
0002-8614issn
1532-5415journal_volume
64pub_type
杂志文章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:OBJECTIVES:To determine the effectiveness of vitamin D supplementation in preventing decline in physical function in older men. DESIGN:Randomized, double-blind, placebo-controlled clinical trial. SETTING:Single-center study conducted at a Veterans Affairs Healthcare System. PARTICIPANTS:Sedentary men aged 65 to 90 (...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.14510
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVES:To ascertain the association between self-report of low mood and unobtrusively measured behaviors (walking speed, time out of residence, frequency of room transitions, and computer use) in community-dwelling older adults using novel monitoring technologies. DESIGN:Longitudinal cohort study of older adults w...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12744
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVES:To test the hypothesis that sleep disturbances are independently associated with frailty status in older men. DESIGN:Cross-sectional analysis of prospective cohort study. SETTING:Six U.S. centers. PARTICIPANTS:Three thousand one hundred thirty-three men aged 67 and older. MEASUREMENTS:Self-reported sleep...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02490.x
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVES:Knowledge of male sexual function is somewhat limited because of a lack of current population-based data. This study provides information on sexual function and satisfaction in a population-based sample of men. METHODS:Men aged 40 to 79 years (n = 2115) were selected randomly from the Olmsted County populat...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb07009.x
更新日期:1995-10-01 00:00:00
abstract:OBJECTIVES:To develop and test the Function-Focused Care in Assisted Living (FFC-AL) intervention so as to alter the decline that older adults in AL experience. DESIGN:Cluster-randomized controlled trial using repeated measures to test the effect of FFC-AL. SETTING:Four AL facilities with at least 100 beds. PARTICIP...
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.1532-5415.2011.03699.x
更新日期:2011-12-01 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
abstract:BACKGROUND/OBJECTIVES:Recently revised vaccination recommendations for US adults, aged 65 years and older, include both 23-valent pneumococcal polysaccharide vaccine (PPSV23) and 13-valent pneumococcal conjugate vaccine (PCV13), with PCV13 now recommended for immunocompetent older people based on shared decision making...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16373
更新日期:2020-06-01 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:OBJECTIVES:To determine, in a sample of Ashkenazi Jewish aged 95 and older, whether there is a compression of morbidity similar to what has been reported in other cohorts with exceptional longevity. DESIGN:Case-control study. SETTING:Longevity Genes Project (LGP) and New England Centenarian Study (NECS). PARTICIPANT...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14222
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVES:To evaluate the effectiveness of wheelchair assessment and configuration on pressure injury incidence, mobility, and functioning in a wheelchair. DESIGN:Randomized controlled trial with participants individually randomized into intervention and control groups. SETTING:Nursing home. PARTICIPANTS:Nursing ho...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.15495
更新日期:2018-09-01 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::Forty-three elderly patients with massive bleeding of hemorrhoidal varices were treated by cryosurgery at a single outpatient session, using nitrous oxide gas, without premedication or anesthesia. The results were excellent in all but one patient, who had ulcerative colitis and required another session of cryotherapy ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1984.tb05152.x
更新日期:1984-01-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Delirium is common in older adults, especially following hospitalization. Because low vitamin D levels may be associated with increased delirium risk, we aimed to determine the prognostic value of blood vitamin D levels, extending our previous genetic analyses of this relationship. DESIGN:Prospec...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16853
更新日期:2020-10-05 00:00:00
abstract::Tetanus is more common in the elderly, who have a higher case-fatality rate than younger age groups. Immunization against tetanus is recommended for all elderly, including nursing home residents, but the tetanus immunization policies of nursing homes are unknown. Nursing home medical directors in Maryland were surveye...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1990.tb03454.x
更新日期:1990-12-01 00:00:00
abstract:OBJECTIVES:Older patients with asthma or chronic obstructive pulmonary disease are particularly susceptible to exacerbations that may be associated with incorrect use of inhalers. Educational programs with inhaler technique review seem to be effective, but no studies have addressed their cost-effectiveness in older adu...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15834
更新日期:2019-07-01 00:00:00
abstract::The immune status of 17 healthy individuals 100-103 years of age (centenarians) was investigated. Qualitative values for immunoglobulins IgG, IgM, IgA, and IgE were within normal ranges for subjects more than 60 years of age with the exception of elevated IgM in one individual. Cell marker studies employing a panel of...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1984.tb02021.x
更新日期:1984-04-01 00:00:00
abstract:OBJECTIVE:To compare characteristics, healthcare use, and costs of care of veterans in the rapidly expanding Veterans Health Administration (VHA) medical foster home (MFH) with those of three other VHA long-term care (LTC) programs. DESIGN:Descriptive, unmatched study. SETTING:VHA MFHs, home-based primary care (HBPC)...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14517
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVES:To determine how often neuroimaging confirms, clarifies, or contradicts initial diagnoses of late-life cognitive disorders. DESIGN:Retrospective case review. SETTING:Outpatient clinic specializing in memory disorders. PARTICIPANTS:One hundred ninety-three consecutively referred cognitively impaired patien...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02975.x
更新日期:2010-08-01 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:OBJECTIVE:To describe the effect of age on the care of patients hospitalized with acute myocardial infarction (MI). DESIGN:Retrospective chart review of all cases with a primary or secondary discharge diagnosis of acute MI. SETTING:Two large community hospitals in Milwaukee, Wisconsin, from July 1, 1990 to June 30, 1...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb07196.x
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVES:To estimate potential cost savings generated by a program of hip protectors in the nursing home from a Medicare perspective. DESIGN:A state-transition Markov model considering short-term and long-term outcomes of hip protectors for a hypothetical nursing home population, stratified by age, sex, and function...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53102.x
更新日期:2005-02-01 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:OBJECTIVES:To study the distribution of adiponectin isoforms in a group of very old patients. DESIGN:Cross-sectional. SETTING:Geriatric ambulatory clinic of the Department of Medicine at Policlinico "Tor Vergata." PARTICIPANTS:One hundred eight elderly adults (mean age 85.0+/-3.2) with or without a history of a prev...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02773.x
更新日期:2010-04-01 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::Aortic systolic murmurs and aortic dilatation were studied in a randomized sample of 100 hospital patients over the age of 60. Clinical, phonocardiographic, radiologic and carotid-pulse data provided the basis for graphic characterization of the murmurs. Senile aortic dilatation was common (66 patients). In a high per...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1976.tb03314.x
更新日期:1976-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Observation stays are increasingly common for older adults, yet little is known about the extent to which they are being used as the Centers for Medicare and Medicaid Services (CMS) originally intended for unscheduled or acute problems and whether different types of services are reflected in curre...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16441
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVES:To investigate the correlation between zopiclone use and risk of hip fracture in elderly adults. DESIGN:Case-control study. SETTING:Claim data from the Taiwan National Health Insurance Program. PARTICIPANTS:Individuals aged 65 and older who experienced their first episode of hip fracture between 1998 and ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13823
更新日期:2015-12-01 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
更新日期:2006-08-01 00:00:00
abstract::Difficulties exist in making treatment decisions for the very old and dependent patient. In the years to come, these difficulties will increase. It is argued that such persons should not be abandoned to their "rights" as autonomous persons; yet quality of life judgments should also be avoided except in limited circums...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1984.tb00892.x
更新日期:1984-12-01 00:00:00