Abstract:
OBJECTIVES:To explore changes in care goals and treatment orders around the occurrence of pneumonia and intake problems, and whether hospitalization is in line with earlier agreed-upon do-not-hospitalize orders. DESIGN:Data were collected as part of the Dutch End of Life in Dementia study (2007-2011), a longitudinal observational study with up to 3.5 years of follow-up. SETTING:Long-term care facilities (N = 28) in the Netherlands. PARTICIPANTS:Newly admitted nursing home patients (N = 372) in various stages of dementia. MEASUREMENTS:Semiannually, physicians completed questionnaires about care goals and treatment orders, and they continuously registered episodes of pneumonia, intake problems and hospitalization. We report on changes in care goals and treatment orders during follow-up in relation to the developing of pneumonia and intake problems and on hospitalization and reasons for hospitalization. RESULTS:The proportion of patients with palliative care goals and do-not-treat orders rose during follow-up, especially before death. Treatment orders most frequently referred to resuscitation and hospitalization (do-not order increased from 73% to 92%, and from 28% to 76%, respectively). The proportions of patients with a palliative care goal and do-not-treat orders were similar after developing pneumonia, but increased after intake problems. During follow-up, 46 patients were hospitalized one or more times. Hospitalization occurred despite a do-not-hospitalize order in 21% of decisions. The most frequently reported reason for hospitalization was a fracture, especially in patients with a do-not-hospitalize order. CONCLUSION:Care plans, including global care goals (predominantly palliative care goals), are made soon after admission, and specific treatment orders are agreed upon in more detail when the condition of the patient worsens. Establishing care plans shortly after nursing home admission may help to prevent burdensome treatment.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Hendriks SA,Smalbrugge M,Hertogh CMPM,van der Steen JTdoi
10.1111/jgs.14667subject
Has Abstractpub_date
2017-04-01 00:00:00pages
769-776issue
4eissn
0002-8614issn
1532-5415journal_volume
65pub_type
杂志文章abstract:OBJECTIVES:To investigate whether higher circulating levels of C-reactive protein (CRP), interleukin-6 (IL-6), and alpha1-antichymotrypsin (ACT) are associated with worse cognitive function and decline in old age. DESIGN:Two independent population-based cohort studies. SETTING:The Rotterdam Study (mean follow-up 4.6 ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01159.x
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVES:To describe the types of continence aids that older adults hospitalized in acute medical units use and to test the association between use of continence aids and development of new urinary incontinence (UI) at discharge. DESIGN:Prospective cohort study. SETTING:A 900-bed teaching hospital in Israel. PARTI...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03413.x
更新日期:2011-06-01 00:00:00
abstract::Although there has been increasing attention to the ethical and legal issues involved in the patient's right to have treatment or hospitalization withheld, there have been few empirical evaluations of programs designed to accomplish that end. Over a 7-year period, a medical group cared for 110 patients in a skilled nu...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1988.tb03433.x
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To determine the influences of age and risk group on the survival of AIDS patients. We concentrated on transfusion because it is the commonest risk factor for AIDS in patients over 70 years of age. DESIGN:Survival curve regression analysis. PARTICIPANTS:Patients aged 13 years and over with AIDS acquired thr...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1993.tb06694.x
更新日期:1993-03-01 00:00:00
abstract:OBJECTIVE:The study describes the prevalence of medical nursing home practice. Further, it examines the extent to which physician characteristics and local county health care resources predict nursing home involvement. This information is relevant to evaluating and devising strategies that address the future provision ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1997.tb02958.x
更新日期:1997-08-01 00:00:00
abstract::Review of 8428 autopsies (1870 for known cancer) showed that 68 patients had had multiple primary malignant tumors (MPMT). Those 68 cases represented 0.8 per cent of all autopsies done, 3.6 per cent of all cancer autopsies. Diagnosis of MPMT was made only at autopsy in 24 cases (35.3 per cent). Thirty-six patients wer...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb03364.x
更新日期:1982-12-01 00:00:00
abstract:OBJECTIVES:To perform an economic evaluation of a primary care-based physical activity counseling intervention that improved physical activity levels and rapid gait speed in older veterans. DESIGN:Secondary objective of randomized trial that assessed the effect of exercise counseling (relative to usual care) on physic...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.14567
更新日期:2017-03-01 00:00:00
abstract::Drug prescribing for ambulatory patients greater than or equal to 85 years of age was studied using data from the 1980 National Ambulatory Medical Care Survey (NAMCS) on office visits to physicians. NAMCS is a survey by the US National Center for Health Statistics, which collected information on office visits and extr...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1984.tb05855.x
更新日期:1984-02-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Social media platforms are promising sources for large quantities of participant-driven research data and circumvent some common challenges when conducting dementia research. This study provides a summary of key considerations and recommendations about using these platforms as research tools for d...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16790
更新日期:2020-12-01 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 estimate prescribing tends of and correlates independently associated with high-risk anticholinergic prescriptions in adults aged 65 and older in office-based outpatient visits. DESIGN:Repeated cross-sectional analysis. SETTING:National Ambulatory Medical Care Survey (NAMCS). PARTICIPANTS:A national sa...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15357
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:To estimate the number of caregivers providing assistance to community-dwelling older persons with and without dementia and with or without substantial disability; to describe the characteristics of caregivers and care recipients in these groups; to characterize the health-related tasks that caregivers provi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14910
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVES:To relate diabetes mellitus (DM) status and duration to late-life cognitive impairment and decline in men and women. DESIGN:Prospective cohort. SETTING:Community. PARTICIPANTS:Five thousand nine hundred seven men in the Physicians' Health Study II and 6,326 women in the Women's Health Study (mean age 74.1...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2008.01686.x
更新日期:2008-06-01 00:00:00
abstract::Although computerized physician order entry (CPOE) has been successfully implemented in many acute care hospitals, few descriptions of its use in the long-term care (LTC) setting are available. This report describes the experiences of one LTC facility in developing and implementing a CPOE system with clinical decision...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53515.x
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVES:To address the competing risk of death in longitudinal studies of older persons, we demonstrate sensitivity analyses that evaluate robustness of associations between exposures and three outcome types: dichotomous, count, and time to event. DESIGN:A secondary analysis of data from a prospective cohort study....
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15697
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVES:To obtain population-based estimates of emergency department (ED) visits by long-term care (LTC) residents. DESIGN:Retrospective cohort study using administrative data. SETTING:All LTC facilities in Ontario, Canada. PARTICIPANTS:All LTC residents who visited an ED at least once during a 6-month period. M...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02736.x
更新日期:2010-03-01 00:00:00
abstract:OBJECTIVES:To determine the trajectory of handgrip strength (HGS) from age 70 to 90 and its association with mood, cognition, functional status, and mortality. DESIGN:Prospective follow-up of an age-homogenous representative community-dwelling cohort (born 1920-21) in the Jerusalem Longitudinal Cohort Study (1990-2015...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14509
更新日期:2017-03-01 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:OBJECTIVES:To determine whether the presence of high depressive symptoms (Center for Epidemiologic Studies Depression Scale (CES-D) score ≥ 14) diminished physical performance benefits after a comprehensive physical activity intervention in older adults. DESIGN:A post hoc analysis of data from the Lifestyle Interventi...
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.1532-5415.2011.03319.x
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVES:To determine whether offspring of centenarians acquired protection from age-related diseases. DESIGN:Case-control study. SETTING:The study was part of the Longevity Genes Project at Albert Einstein College of Medicine. PARTICIPANTS:Centenarians (n=145), offspring of centenarians (n=180), and spouses of th...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52068.x
更新日期:2004-02-01 00:00:00
abstract::Salivary gland function is generally well-preserved in healthy older persons. Similar results are observed in the laboratory rat. Older people are, however, more likely to experience salivary disorders due to disease or its treatment. For many patients with remaining salivary gland parenchymal tissue, improved functio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1989.tb02644.x
更新日期:1989-05-01 00:00:00
abstract:OBJECTIVES:To investigate the effects of dehydroepiandrosterone (DHEA) combined with exercise on bone mass, strength, and physical function in older, frail women. DESIGN:Double-blind, randomized, placebo-controlled trial. SETTING:A major medical institution. PARTICIPANTS:Ninety-nine women (mean age 76.6 ± 6.0) with ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2010.03019.x
更新日期:2010-09-01 00:00:00
abstract::It has been reported that postural hypotension in the elderly is common. However, these studies included institutionalized and more or less disabled persons. Furthermore, postural hypotension may be related to baseline blood pressure. In this study, the influence of age and blood pressure on the hemodynamic and plasma...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1989.tb05684.x
更新日期:1989-06-01 00:00:00
abstract::Long-term acute care (LTAC) represents a rapidly growing category of Medicare providers, but little is known about its quality, outcomes, and cost-effectiveness. Its defining characteristic, as set by Medicare, is an average length of stay of greater than 25 days. Modern LTAC emerged in the early 1980s as a setting fo...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2007.01162.x
更新日期:2007-05-01 00:00:00
abstract:OBJECTIVE:To determine if pre-complication nutrient intake can be predicted based on an admission assessment. DESIGN:Survey (cross-sectional study). SETTING:Geriatric Rehabilitation Unit (GRU) of a Veterans Administration hospital. PATIENTS:Three-hundred-twelve randomly selected admissions to the GRU. MEASUREMENTS:...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb04967.x
更新日期:1994-05-01 00:00:00
abstract:OBJECTIVES:To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. DESIGN:Randomized clinical trial. SETTING:Primary care clinics at a Veterans Affairs Medical...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.15042
更新日期:2017-10-01 00:00:00
abstract::To better understand declining autopsy rates, data have been gathered prospectively on 1080 consecutive deaths over six years among patients admitted to a medical intensive care/coronary care unit. Overall autopsy rate was 36%. Autopsy rates declined sharply with age from 60% for those aged 16 to 34 years to 23% for t...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb07260.x
更新日期:1986-12-01 00:00:00
abstract::The population of minority older adults is going to explode over the next four decades. Older adults from racial and ethnic minorities face persistent and pervasive health disparities. Health disparities exert a huge fiscal burden on the nation. The national financial cost of health disparities for the years 2002 to 2...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15939
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVES:To determine to what extent demographic, social support, socioeconomic, geographic, medical, and End-of-Life (EOL) planning factors explain racial and ethnic variation in Medicare spending during the last 6 months of life. DESIGN:Retrospective cohort study. SETTING:Health and Retirement Study (HRS). PARTI...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14263
更新日期:2016-09-01 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