Abstract:
OBJECTIVES:To prospectively validate and refine the 5-item "CRASH" screening tool for identifying older drivers needing a behind-the-wheel (BTW) test. DESIGN:Prospective observational study. SETTING:Geriatric and internal medicine primary care clinics affiliated with a tertiary care hospital and a local BTW program. PARTICIPANTS:Cognitively intact drivers aged 65 and older (N = 315). MEASUREMENTS:Participants completed baseline questionnaire (including CRASH tool) and assessments and BTW test (evaluator blinded to questionnaire results) and participated in 1-month telephone follow-up. Analysis included descriptive statistics and examination of predictive ability of the CRASH tool to discriminate normal (pass) from abnormal (conditional pass or fail) on the BTW test, with logistic regression and CART techniques for tool refinement. RESULTS:Two hundred sixty-six participants (84%) had a BTW test; of these, 17% had a normal rating and 83% an abnormal rating. Forty-five percent of those with an abnormal score were advised to limit driving under particular conditions. Neither the CRASH tool nor its individual component variables were significantly associated with the summary BTW score; in refined models with other variables, the best-performing tool had approximately 67% sensitivity and specificity for an abnormal BTW score. Most participants found the BTW test useful and were willing to pay a median of $50. At 1-month follow-up, no participants had stopped driving. CONCLUSION:The CRASH screening tool cannot be recommended for use in clinical practice. Findings on older adults' perceived utility of the BTW test and the stability of driving patterns at 1-month follow-up could be useful for future research studies and for design of older driver programs.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Betz ME,Haukoos JS,Schwartz R,DiGuiseppi C,Kandasamy D,Beaty B,Juarez-Colunga E,Carr DBdoi
10.1111/jgs.15222subject
Has Abstractpub_date
2018-02-01 00:00:00pages
357-363issue
2eissn
0002-8614issn
1532-5415journal_volume
66pub_type
杂志文章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::The objectives of this study were to review the diagnostic, International Classification of Disease, 9th Revision, Clinical Modification (ICD-9-CM), diagnosis related groups (DRGs), and common procedural terminology (CPT) coding and reimbursement issues (including Medicare Part B reimbursement for physicians) encounte...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1046/j.1532-5415.2002.50519.x
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVES:Evidence suggests inflammation is associated with cognitive impairment, but previous epidemiological studies have reported conflicting results. DESIGN:Prospective population-based cohort. SETTING:Epidemiology of Hearing Loss Study participants. PARTICIPANTS:Individuals without cognitive impairment in 1998...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12994
更新日期:2014-09-01 00:00:00
abstract::Although the field of frailty research has expanded rapidly, it is still a nascent concept within the clinical specialties. Frailty, conceptualized as greater vulnerability to stressors because of significant depletion of physiological reserves, predicts poorer outcomes in several medical specialties, including cardio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14902
更新日期:2017-10-01 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 describe the prevalence of coexisting conditions that affect clinical decision-making in adults with coronary heart disease (CHD). DESIGN:Cross-sectional. SETTING:National Health and Nutrition Examination Survey, 1999 to 2004. PARTICIPANTS:Eight thousand six hundred fifty-four people aged 45 and older;...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03391.x
更新日期:2011-05-01 00:00:00
abstract:OBJECTIVE:To determine the frequency of falls and identify risk factors for falls among older Mexican-American women. DESIGN:A prospective cohort study with an average follow-up of 2.7 years. SETTING:A clinical center at the Palo Alto Veterans Affairs Medical Center, California. PARTICIPANTS:152 community-dwelling M...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:
更新日期:1999-11-01 00:00:00
abstract:OBJECTIVES:To evaluate the association between neighborhood walkability and depression in older adults. DESIGN:Cross-sectional analysis using data from Adult Changes in Thought (ACT), a prospective, longitudinal cohort study. SETTING:King County, Washington. PARTICIPANTS:Seven hundred forty randomly selected men and...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01108.x
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVES:To determine the performance of the Patient Health Questionnaire 2 (PHQ-2) against the criterion standard for diagnosing major depression, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), and to examine its performance across age, sex, and racial/ethnic groups. DESIGN:Cros...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01103.x
更新日期:2007-04-01 00:00:00
abstract:OBJECTIVES:To determine whether slow gait represents a compensatory strategy to reduce the energetic cost of walking with age. DESIGN:Cross-sectional analysis. SETTING:Community-dwelling volunteers from the Baltimore Longitudinal Study of Aging (BLSA). PARTICIPANTS:Four hundred twenty community-dwelling persons aged...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.04153.x
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:To determine whether sex differences in large-artery stiffness contribute to the greater prevalence of systolic hypertension in elderly women than in elderly men. DESIGN:During a single visit arterial stiffness was assessed in the unmedicated state using four parameters. PARTICIPANTS:Three hundred seventy-...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52107.x
更新日期:2004-03-01 00:00:00
abstract::Various biological aspects of the aging process are reviewed. Aging has multiple causes. First, there is the initial genetic variability in the organism. Second, there is the destructive effect of the environment. Third, there is an accumulation in the somatic cells of changes, mutations or local chemical damage. Thes...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1966.tb03069.x
更新日期:1966-05-01 00:00:00
abstract:OBJECTIVES:To test the hypothesis that a micronutrient supplement can improve seroconversion after influenza immunization in older institutionalized people. DESIGN:: Randomized, double-blind, placebo-controlled study. SETTING:Nursing and residential homes in Liverpool, United Kingdom. PARTICIPANTS:One hundred sixty-...
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.1532-5415.2004.52005.x
更新日期:2004-01-01 00:00:00
abstract::Patients with dementia often manifest troublesome and disruptive behaviors in addition to intellectual impairments. This study evaluated behavioral disturbances in 126 demented patients examined sequentially, using questionnaires administered to primary caregivers to quantify the types and severity of behavioral distu...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1988.tb04260.x
更新日期:1988-09-01 00:00:00
abstract::This clinical, practice-based study explores the research question: Is there a relationship between hearing loss and functional disturbance in elderly patients? We analyzed the impact of hearing impairment on 153 patients over 65 years of age screened in primary care practice. Functional and psychosocial impairment we...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1989.tb05870.x
更新日期:1989-02-01 00:00:00
abstract::One hundred seventy-one patients, 60 years of age or older with isolated systolic hypertension, were randomly assigned to receive chlorthalidone 12.5, 25.0, or 50.0 mg or placebo once daily for 12 weeks. The majority of the patients receiving chlorthalidone 12.5 mg achieved therapeutic success with no clinically signi...
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.1532-5415.1986.tb04203.x
更新日期:1986-03-01 00:00:00
abstract:OBJECTIVES:To investigate effects of older age, comorbidities, and physiological measures on outcomes of elderly adults requiring prolonged mechanical ventilation (PMV). DESIGN:Retrospective cohort study. SETTING:Public long-term acute care hospital (LTACH) with an active program for ventilator weaning from PMV. PAR...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12597
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To identify a set of geriatric conditions as optimal targets for quality improvement to be used in a quality measurement system for vulnerable older adults. DESIGN:Discussion and two rounds of ranking of conditions by a panel of geriatric clinical experts informed by literature reviews. METHODS:A list of 78...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb04691.x
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVES:To test the efficacy of an individualized social activity intervention (ISAI) on decreasing daytime sleep, improving nighttime sleep, and lowering the day/night sleep ratio and to determine its cost. DESIGN:Pretest/posttest randomized with an experimental and control group. SETTING:Seven nursing homes. PA...
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.1532-5415.2005.53460.x
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:Acute myocardial infarction (AMI) is an important cause of mortality and morbidity in older patients. The aim of this study was to determine the proportion of unselected admissions with AMI that is older than 75 years and to examine management and outcomes in this group. DESIGN:An historical cohort study of ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb02991.x
更新日期:1999-03-01 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::Clostridium difficile causes pseudomembranous colitis and is responsible for 20% to 25% of cases of postantibiotic diarrhea. In an earlier study, nursing-home patients with C. difficile infection were noted to have a high mortality rate. Because most of these infected patients had been treated with antibiotics, it was...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1990.tb03539.x
更新日期:1990-04-01 00:00:00
abstract:OBJECTIVE:To assess the utility of geriatric targeting criteria in predicting survival and health care utilization in a cohort of hospitalized older veterans. DESIGN:A prospective cohort study assessing geriatric targeting criteria, e.g., polypharmacy, falls, or confusion, with respect to adverse outcomes at 12 months...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb01860.x
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:To assess how dietary change affects gain in strength and muscle mass during heavy resistance training of elderly men. DESIGN:Randomized controlled trial. INTERVENTION:During 12 weeks of resistance training of knee extensors and flexors, a daily supplement of 560 +/- 16 kcal/day (17% energy from protein, 43...
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.1532-5415.1992.tb01937.x
更新日期:1992-02-01 00:00:00
abstract:OBJECTIVES:To assess the relative independent contribution of changes in executive control function (ECF) and memory to changes in functional status. DESIGN:Three-year longitudinal cohort study. SETTING:A comprehensive care retirement community. PARTICIPANTS:Five hundred forty-seven noninstitutionalized people aged ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53004.x
更新日期:2005-01-01 00:00:00
abstract:OBJECTIVES:To determine the role terminally ill patients would opt to have their loved ones and physicians play in healthcare decisions should they lose decision-making capacity and how this changes over time. DESIGN:Serial interviews. SETTING:The study institutions were The Johns Hopkins Medical Institutions in Balt...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01473.x
更新日期:2007-12-01 00:00:00
abstract:OBJECTIVES:To perform a systematic review to determine the effectiveness of interventions designed to reduce potentially inappropriate prescribing (PIP) in community-dwelling older adults. DESIGN:Systematic review and narrative synthesis. SETTING:Primary and community care. PARTICIPANTS:Community-dwelling older adul...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.14133
更新日期:2016-06-01 00:00:00
abstract::(-)Deprenyl (Selegiline, Jumex, Eldepryl, Movergan), a close structural relative to phenylethylamine (PEA), is a drug with a unique pharmacological spectrum. (1) It is a highly potent and selective, irreversible inhibitor of B-type monoamine oxidase (MAO), a predominantly glial enzyme in the brain. The activity of thi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1992.tb01860.x
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVE:To identify presenting characteristics of older patients with subdural hematoma who are unlikely to survive hospitalization. DESIGN:A retrospective cohort. PATIENTS:All patients > or = 65 years of age hospitalized at a tertiary care center from 1985-1990 with the primary diagnosis of subdural hematoma. MEA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb07329.x
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVES:Older black patients are at risk for underutilization of preventive services. Our objectives were to assess the delivery of five preventive services in Title 330-funded health centers in low income neighborhoods in Cleveland, Ohio, and to determine the association of health system factors and health status w...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb03902.x
更新日期:2000-02-01 00:00:00