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 physical performance, physical activity, function, disability, and medical resource use and cost. SETTING:Veterans Affairs Medical Center, Durham, North Carolina. PARTICIPANTS:Male veterans aged ≥70 years (n = 398). INTERVENTION:An experienced health counselor provided baseline in-person exercise counseling, followed by telephone counseling at 2, 4, and 6 weeks, and monthly thereafter through one year. Each participant's primary care physician provided initial endorsement of the intervention, followed by monthly automated telephone messages tailored to the patient. Individualized progress reports were mailed quarterly. MEASUREMENTS:Intervention costs were assessed. Health care resource use and costs were estimated from enrollment through one year follow-up. The incremental cost of achieving clinically significant changes in major trial endpoints was calculated. RESULTS:The total direct cost of the intervention per participant was $459, 85% of which was counselor effort. With overhead, program cost totaled $696 per participant. Medical costs during follow-up reached $10,418 with the intervention, versus $12,052 with usual care (difference = -$1,634 (95% confidence interval = -$4,683 to $1,416; P = .29)). Expressed in terms of short-term clinical outcomes, the intervention cost $4,971 per additional patient reaching target exercise levels, or $4,640 per patient achieving a clinically significant change in rapid gait speed. CONCLUSION:Improvements in physical activity and rapid gait speed in the physical activity counseling group were obtained at a cost that represents a small fraction of patients' annual health care costs.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Cowper PA,Peterson MJ,Pieper CF,Sloane RJ,Hall KS,McConnell ES,Bosworth HB,Ekelund CC,Pearson MP,Morey MCdoi
10.1111/jgs.14567subject
Has Abstractpub_date
2017-03-01 00:00:00pages
533-539issue
3eissn
0002-8614issn
1532-5415journal_volume
65pub_type
杂志文章,随机对照试验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:OBJECTIVES:To determine whether serum calcium is associated with cognitive function in elderly individuals in the general population. DESIGN:Prospective follow-up study of two independent, population-based cohorts. SETTING:The Rotterdam Study (median follow-up 11 years) and the Leiden 85-plus Study (median follow-up ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01418.x
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the skeletal health, calcium, and vitamin D homeostasis of patients upon their entry to a long-term-care facility. Factors that could contribute to the risk of future osteoporotic fractures were also evaluated. DESIGN:Cross-sectional study. PATIENTS:Two hundred eighty-seven consecutive admission...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1993.tb06452.x
更新日期:1993-10-01 00:00:00
abstract:OBJECTIVES:To determine whether there may be a common mechanism resulting in global sensory impairment of the five classical senses (vision, smell, hearing, touch, and taste) in older adults. DESIGN:Representative, population-based study. SETTING:National Social Life, Health, and Aging Project. PARTICIPANTS:Communit...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13955
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVES:To confirm associations of apolipoprotein E (ApoE) ε4 carrier status, sex, and time-dependent cognitive status with mortality risk and to investigate these joint effects of these associations in a cohort of community-dwelling U.S. adults. DESIGN:Prospective cohort study. SETTING:The Baltimore Longitudinal ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12156
更新日期:2013-04-01 00:00:00
abstract::Despite the increasing importance of gerontology to medical practice, it has been difficult to incorporate it into the curriculum of most medical schools. The aim of this project was to explore the feasibility of introducing gerontology into medical education by utilizing the framework of an existing clinical program....
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1979.tb06060.x
更新日期:1979-08-01 00:00:00
abstract::As nursing homes become increasingly important sites for biomedical and behavioral research, researchers must address the ethical problems of increased vulnerability and the high prevalence of mental and physical disorders in the nursing home population. Obtaining valid informed consent is but one of the many difficul...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1993.tb07470.x
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVES:To verify the change in health variables and parameters of health service utilization in a group of active caregivers for older persons with dementia in comparison with former caregivers who had ceased to provide home care for at least 6 months (death of the patient or institutionalized care). DESIGN:A pros...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50209.x
更新日期:2002-05-01 00:00:00
abstract::Thirty-two demented, elderly residents of a nursing home were admitted to a specially designed dementia unit. Each patient was assessed three times: prior to admission, and at four and 12 months after admission to the unit. Patients were evaluated using a modified version of a previously published assessment scale as ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1987.tb04638.x
更新日期:1987-04-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:To explore the opinion of the Dutch general public and of physicians regarding euthanasia in patients with advanced dementia. DESIGN:A cross-sectional survey. SETTING:The Netherlands. PARTICIPANTS:Random samples of 1,965 citizens (response = 1,965/2,641 [75%]) and 1,147 physicians (response = 1...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16692
更新日期:2020-10-01 00:00:00
abstract::Optimizing the management of antibiotic resistance is an important strategy in improving outcomes for infectious diseases in older persons. Strategies that manage antibiotic resistance must take into account all clinical settings, because resistant pathogens previously seen only in acute care facilities are becoming i...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1046/j.1532-5415.50.7s.5.x
更新日期:2002-07-01 00:00:00
abstract::The incidence, ecology, and mortality of gram-negative bacillary bacteremia in elderly patients were studied in an analysis of 334 episodes over a four-year-period in a 489-bed North Carolina community teaching hospital, 135 (40.4%) of which occurred in patients 70 years of age or older. The bacteremia rate per 1000 h...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1987.tb02311.x
更新日期:1987-03-01 00:00:00
abstract:BACKGROUND:Frailty in older vascular surgery patients is associated with increased mortality, hospital stay, and morbidity. The association of frailty with hospital-acquired geriatric syndromes such as delirium and functional decline has not been well studied. OBJECTIVES:To investigate the association between frailty ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16907
更新日期:2020-11-05 00:00:00
abstract::Older women are often sexually active, but physicians caring for older women rarely address sexual concerns. Although women's desire for sex declines with age, a majority of older women rate sex as having importance in their lives. Women identify emotional intimacy as an important reason for engaging in sexual relatio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15198
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:To analyze the relationship between serum total cholesterol (TC) and all-cause mortality, taking into account various potential confounders. DESIGN:Population-based prospective cohort study. SETTING:Older Italians residing in the general community. PARTICIPANTS:Four thousand five hundred twenty-one men an...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1365-2389.2003.51313.x
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVES:To examine the relationship between total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) and the incidence of coronary heart disease (CHD) in elderly men. DESIGN:Prospective. SETTING:Population based. PARTICIPANTS:A sample of 2,424, Japanese-American men aged 71 to 93 was used. MEASUREM...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52551.x
更新日期:2004-12-01 00:00:00
abstract:OBJECTIVES:To examine the effect of interventions to optimize medication use on adverse drug reactions (ADRs) in older adults. DESIGN:Systematic review and meta-analysis. EMBASE, PubMed, OVID, Cochrane Library, Clinicaltrials.gov, and Google Scholar were searched through April 30, 2017. SETTING:Randomized controlled ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,meta分析
doi:10.1111/jgs.15195
更新日期:2018-02-01 00:00:00
abstract::The Wisconsin Drug Utilization Review Project used Medicaid claims data to examine the use of long-term, full doses histamine-2 receptor antagonists (H2RAs) among long-term care facility (LTCF) residents, ie, doses exceeding 800 mg per day of cimetidine or 150 mg per day of ranitidine for 12 weeks or more. Additional ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1988.tb04024.x
更新日期:1988-06-01 00:00:00
abstract::In this paper, we present the consensus statement from a national conference on research priorities and methodologies for studying geriatric evaluation and management (GEM) programs. These conclusions, discussion points, and recommendations resulted from discussions of plenary papers, working group deliberations, and ...
journal_title:Journal of the American Geriatrics Society
pub_type: 共识发展会议,杂志文章,评审
doi:10.1111/j.1532-5415.1991.tb05936.x
更新日期:1991-09-01 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::A cohort of 3,595 white women aged 40-77 years was followed for an average of 10 years during which 84 new cases of hip fracture were identified. Triceps skinfold thickness and arm muscle area measured at baseline were examined as possible risk factors for hip fracture controlling for physical activity, height, menopa...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1989.tb01562.x
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:To investigate mortality risk and survival time in new-incident cases of cognitive impairment (CI) in old age. DESIGN:Prospective cohort study in six German cities. SETTING:German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe). PARTICIPANTS:Two thousand eighty-nine nondemented...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/jgs.14666
更新日期:2017-04-01 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::The elderly take more drugs than the young, and are therefore more susceptible to adverse drug interactions. Prescribing the minimum number of agents is recommended. Drug absorption, metabolism, and excretion may be altered by various interactions. Dose-response relationships of oral anticoagulants, oral hypoglycemics...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb01358.x
更新日期:1982-11-01 00:00:00
abstract::This study was undertaken to identify the demographic characteristics of patients aged 55 or older in a drug-overdose group admitted to the Emergency Department of Arizona Health Sciences Center during the 3-year period, August 1975-July 1978. Of the 646 overdose patients observed, 60 (9.5 percent) were aged 55 or old...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb00004.x
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVES:To determine whether histamine2-receptor antagonist (H2RA) dose modified for renal impairment affects gastrointestinal (GI) disease control. DESIGN:Concurrent medical record review. SETTING:One hundred forty-six nursing facilities throughout the United States. PARTICIPANTS:Three hundred thirty-six patient...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1034/j.1600-0579.2003.00209.x
更新日期:2003-05-01 00:00:00
abstract:OBJECTIVES:To examine whether the total burden of comorbidity and pattern of co-occurring conditions varies in individuals with heart failure (HF) with preserved left ventricular ejection fraction (LVEF) (HF-P) or HF with reduced LVEF (HF-R). DESIGN:Cross-sectional cohort study. SETTING:Four participating health plan...
journal_title:Journal of the American Geriatrics Society
pub_type: 历史文章,杂志文章,多中心研究
doi:10.1111/jgs.12062
更新日期:2013-01-01 00:00:00
abstract:OBJECTIVES:A common assumption is that life-sustaining treatments are much less cost-effective for older patients than for younger patients. We estimated the incremental cost-effectiveness of providing mechanical ventilation and intensive care for patients of various ages who had acute respiratory failure. DESIGN:Retr...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.49080.x
更新日期:2001-04-01 00:00:00
abstract::The objective of this study was to use performance-based measurements to identify, in a population of community-dwelling American Indians aged 55 and older, the prevalence and correlates of lower body functioning. Data were collected as part of a cross-sectional study of disability from members of a tribe in the south...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03869.x
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVES:To demonstrate reliability and feasibility of a standardized protocol to assess and score quality indicators relevant to pressure ulcer (PU) care processes in nursing homes (NHs). DESIGN:Descriptive. SETTING:Eight NHs. PARTICIPANTS:One hundred ninety-one NH residents for whom the PU Resident Assessment Pr...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2003.51402.x
更新日期:2003-09-01 00:00:00