Delirium-A Framework to Improve Acute Care for Older Persons.

Abstract:

:This article is based on the M. Powell Lawton Award Lecture that I delivered at the 2016 Gerontological Society of America Annual Meeting. I provide an overview of my journey in geriatric medicine and delirium research. I created new measures, including the Confusion Assessment Method, for identification of delirium; conceptualized a multifactorial risk model; and developed and tested intervention strategies for delirium prevention. The Hospital Elder Life Program arose from this work. In addition, like Dr. Lawton, I am working to apply my work to the policy arena. As the population ages, we face an unprecedented opportunity to realize the full benefit of aging in our society, an untapped resource. The field of aging is facing innumerable challenges in terms of continued stigma and funding shortfalls for clinical care and research. I issue a call to action to clinicians, researchers, and leaders in aging to seize this opportunity to use our know-how and expertise to transform the experience of aging for all.

journal_name

J Am Geriatr Soc

authors

Inouye SK

doi

10.1111/jgs.15296

subject

Has Abstract

pub_date

2018-03-01 00:00:00

pages

446-451

issue

3

eissn

0002-8614

issn

1532-5415

journal_volume

66

pub_type

杂志文章
  • Effect of New Oral Anticoagulants on Prescribing Practices for Atrial Fibrillation in Older Adults.

    abstract:OBJECTIVES:To determine the effect of new oral anticoagulants (NOACs) on prescribing practices in older adults with atrial fibrillation (AF). DESIGN:Retrospective observational cohort study. SETTING:Academic medical center in St. Louis, Missouri. PARTICIPANTS:Individuals aged 75 and older with AF admitted to the hos...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/jgs.15058

    authors: Fohtung RB,Novak E,Rich MW

    更新日期:2017-11-01 00:00:00

  • Geriatric research, education and clinical centers: their impact in the development of American geriatrics.

    abstract::The GRECC program was established by the VA in 1975 and has been expanded since then to 16 sites. For more than a decade, GRECC staff have made major contributions to advancing the understanding of the aging process and developing approaches that have improved the care of older veterans as well as all frail elderly pe...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1994.tb06599.x

    authors: Goodwin M,Morley JE

    更新日期:1994-09-01 00:00:00

  • American Geriatrics Society identifies another five things that healthcare providers and patients should question.

    abstract::Since 2012, the American Geriatrics Society (AGS) has also been collaborating with the American Board of Internal Medicine (ABIM) Foundation, joining its "Choosing Wisely" campaign on two separate lists of Five Things Healthcare Providers and Patients Should Question. The campaign is designed to engage healthcare orga...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章,评审

    doi:10.1111/jgs.12770

    authors: AGS Choosing Wisely Workgroup.

    更新日期:2014-05-01 00:00:00

  • Developing a geriatric business plan for an academic medical center.

    abstract::Leaders of geriatric programs at academic health centers (AHCs) face several challenges in seeking support for clinical program development. These challenges relate to how revenues from Medicare activities flow within AHCs. Typically, clinical departments such as the Department of Medicine see a very small proportion ...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1046/j.1532-5415.2002.50174.x

    authors: Goodwin JS

    更新日期:2002-04-01 00:00:00

  • Feasibility and accuracy of a postcard diary system for tracking healthcare utilization of community-dwelling older persons.

    abstract:OBJECTIVE:To test the feasibility of and to validate a self-report weekly postcard diary of health care utilization. DESIGN:Case-series and validation study. SETTING:Community-based sample of fee-for-service and health maintenance organization (HMO) patients. PARTICIPANTS:A convenience sample of 24 community-dwellin...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1995.tb06105.x

    authors: Reuben DB,Wong RC,Walsh KE,Hays RD

    更新日期:1995-05-01 00:00:00

  • The Senior Care Study. The optimal use of medications in acutely ill older patients.

    abstract:UNLABELLED:Geriatric assessment units have improved pharmacotherapy for their patients by decreasing the number of medications prescribed. The Senior Care Study, a randomized controlled trial, compared a multidisciplinary-team approach to patient care to the standard medical practice of the institution. As a part of th...

    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.1532-5415.1990.tb01369.x

    authors: Owens NJ,Sherburne NJ,Silliman RA,Fretwell MD

    更新日期:1990-10-01 00:00:00

  • Ertapenem therapy for community-acquired pneumonia in the elderly.

    abstract:OBJECTIVES:To compare the efficacy and safety of ertapenem, 1 g once a day, with ceftriaxone, 1 g once a day, for treatment of the subgroup of patients aged 65 and older with community-acquired pneumonia (CAP) requiring parenteral therapy. DESIGN:Combined data from patients aged 65 and older in two randomized, double-...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1046/j.1532-5415.2003.51507.x

    authors: Woods GL,Isaacs RD,McCarroll KA,Friedland IR

    更新日期:2003-11-01 00:00:00

  • Sleep disturbance, psychosocial correlates, and cardiovascular disease in 5201 older adults: the Cardiovascular Health Study.

    abstract:OBJECTIVES:To describe the prevalence of self reported sleep disturbances in older men and women and to describe their relationships with health status and cardiovascular disease (CVD). DESIGN:Cross-sectional study of sleep disturbance, CVD, general health, psychosocial factors, physical function, and use of psychotro...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1997.tb00970.x

    authors: Newman AB,Enright PL,Manolio TA,Haponik EF,Wahl PW

    更新日期:1997-01-01 00:00:00

  • Aging, regional cerebral blood flow, and neuropsychological functioning.

    abstract::Previous studies found changes in regional cerebral blood flow (rCBF) patterns related to both age and various cognitive tasks. However, no study has yet demonstrated a relationship between rCBF and performance on the Luria-Nebraska Neuropsychological Battery (LNNB) in an elderly group. Seventy-nine elderly volunteers...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1984.tb04169.x

    authors: MacInnes WD,Golden CJ,Gillen RW,Sawicki RF,Quaife M,Uhl HS,Greenhouse AJ

    更新日期:1984-10-01 00:00:00

  • Nutrition and function: is there a relationship between body mass index and the functional capabilities of community-dwelling elderly?

    abstract:OBJECTIVE:To determine if there is a relationship between body mass index and the ability to perform the usual activities of living in a sample of community-dwelling elderly. DESIGN:Secondary data analysis of The National Health and Nutrition Examination Survey-I Epidemiologic Follow-up Study (1982-1984). Follow-up ho...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1994.tb07483.x

    authors: Galanos AN,Pieper CF,Cornoni-Huntley JC,Bales CW,Fillenbaum GG

    更新日期:1994-04-01 00:00:00

  • The prevalence and design of ethics committees in nursing homes.

    abstract::A dramatic increase in the number of ethics committees in long-term care facilities (LTCFs) has occurred since 1970 in the 487 nursing homes in Minnesota. Ten percent of the LTCFs had ethics committees which were mostly formed by administrators and nurses. The committees are most often found in large urban facilities ...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1987.tb04009.x

    authors: Brown BA,Miles SH,Aroskar MA

    更新日期:1987-11-01 00:00:00

  • Functional recovery of elderly patients hospitalized in geriatric and general medicine units. The PROgetto DImissioni in GEriatria Study.

    abstract:OBJECTIVES:To investigate the characteristics of patients who regain function during hospitalization and the differences in terms of functional outcomes between patients admitted to geriatric and general medicine units. DESIGN:Multicenter, prospective cohort study. SETTING:Acute care geriatric and medical wards of fi...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章,多中心研究

    doi:10.1111/j.1532-5415.2010.03239.x

    authors: Palleschi L,De Alfieri W,Salani B,Fimognari FL,Marsilii A,Pierantozzi A,Di Cioccio L,Zuccaro SM

    更新日期:2011-02-01 00:00:00

  • Hospital use by the extremely elderly (nonagenarians): a two-year study.

    abstract::Eighty-seven community-dwelling nonagenarians provided with extensive medical and social services as needed were followed for two years. Fifty-one subjects were admitted to an acute care hospital at least once. Total durations of hospitalization for those who required it averaged 44 days per individual over the two ye...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1984.tb02038.x

    authors: Patterson C,Crescenzi C,Steel K

    更新日期:1984-05-01 00:00:00

  • Longitudinal studies on the rate of decline in renal function with age.

    abstract::Serial creatinine clearances (5 to 14 studies) were obtained for 446 normal volunteers in the Baltimore Longitudinal Study of Aging followed between 1958 and 1981. When those subjects with possible renal or urinary tract disease and subjects on diuretics and antihypertensives were removed from the study, leaving a gro...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1985.tb07117.x

    authors: Lindeman RD,Tobin J,Shock NW

    更新日期:1985-04-01 00:00:00

  • Predictors of treatment with osteoporosis medications after recent fragility fractures in a multinational cohort of postmenopausal women.

    abstract:OBJECTIVES:To determine the proportion of untreated women who reported receiving treatment after incident fracture and to identify factors that predict treatment across an international spectrum of individuals. DESIGN:Prospective observational study. Self-administered questionnaires were mailed at baseline and 1 year....

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章,多中心研究

    doi:10.1111/j.1532-5415.2011.03854.x

    authors: Greenspan SL,Wyman A,Hooven FH,Adami S,Gehlbach S,Anderson FA Jr,Boone S,Lacroix AZ,Lindsay R,Netelenbos JC,Pfeilschifter J,Silverman S,Siris ES,Watts NB

    更新日期:2012-03-01 00:00:00

  • The Timed Manual Performance test as a predictor of hospitalization and death in a community-based elderly population.

    abstract:OBJECTIVE:To determine the usefulness of timed manual performance measurements (TMP) as predictors of health outcomes, hospitalization, and mortality in a large, heterogeneous sample of elderly people living in the community. DESIGN:Prospective cohort study. SETTING:Central North Carolina. PARTICIPANTS:1,286 communi...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1994.tb06068.x

    authors: Williams ME,Gaylord SA,Gerritty MS

    更新日期:1994-01-01 00:00:00

  • Comparative efficacy and safety of selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors in older adults: a network meta-analysis.

    abstract:OBJECTIVES:To establish the comparative efficacy and safety of selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors in older adults using the network meta-analysis approach. DESIGN:Systematic review and network meta-analysis. PARTICIPANTS:Individuals aged 60 and older. MEASUREMENT...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章,meta分析

    doi:10.1111/jgs.13395

    authors: Thorlund K,Druyts E,Wu P,Balijepalli C,Keohane D,Mills E

    更新日期:2015-05-01 00:00:00

  • A comparison by payor/provider type of the cost of dying among frail older adults.

    abstract:OBJECTIVE:To compare expenditures and healthcare service use between decedents (in their last year of life) and survivors, all of whom were frail older people, under three payor/provider types. DESIGN:In-home interviews were conducted by home care nurses at baseline and at 6-month intervals for an 18-month period. Uti...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1996.tb02947.x

    authors: Experton B,Ozminkowski RJ,Branch LG,Li Z

    更新日期:1996-09-01 00:00:00

  • The identification of frailty: a systematic literature review.

    abstract::An operational definition of frailty is important for clinical care, research, and policy planning. The literature on the clinical definitions, screening tools, and severity measures of frailty were systematically reviewed as part of the Canadian Initiative on Frailty and Aging. Searches of MEDLINE from 1997 to 2009 w...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章,评审

    doi:10.1111/j.1532-5415.2011.03597.x

    authors: Sternberg SA,Wershof Schwartz A,Karunananthan S,Bergman H,Mark Clarfield A

    更新日期:2011-11-01 00:00:00

  • Ten-year effects of the advanced cognitive training for independent and vital elderly cognitive training trial on cognition and everyday functioning in older adults.

    abstract:OBJECTIVES:To determine the effects of cognitive training on cognitive abilities and everyday function over 10 years. DESIGN:Ten-year follow-up of a randomized, controlled single-blind trial (Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE)) with three intervention groups and a no-contact control...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章,随机对照试验

    doi:10.1111/jgs.12607

    authors: Rebok GW,Ball K,Guey LT,Jones RN,Kim HY,King JW,Marsiske M,Morris JN,Tennstedt SL,Unverzagt FW,Willis SL,ACTIVE Study Group.

    更新日期:2014-01-01 00:00:00

  • The prevalence of diabetes and associated coronary risk factors in urban and rural older Mexican populations.

    abstract:OBJECTIVE:To determine the prevalence of diabetes and examine its association with food intake, anthropometric and metabolic variables, and other coronary risk factors in urban and rural older Mexican populations. DESIGN:A cross-sectional study. SETTING:Three Mexican communities (urban areas of medium and low income ...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1998.tb06005.x

    authors: Lerman IG,Villa AR,Martinez CL,Cervantes Turrubiatez L,Aguilar Salinas CA,Wong B,Gómez Pérez FJ,Gutierrez Robledo LM

    更新日期:1998-11-01 00:00:00

  • Fatal cerebral injury in the elderly.

    abstract::A medical examiner's series of 71 elderly patients with fatal internal cerebral injuries demonstrated age differences with respect to the type of cerebral lesion and the causal incident. The elderly showed relatively fewer severe cerebral contusions than did a young group, but a higher incidence of subdural and intrap...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1978.tb03332.x

    authors: Kirkpatrick JB,Pearson J

    更新日期:1978-11-01 00:00:00

  • Is there an association between metabolic syndrome and cognitive function in very old adults? The Newcastle 85+ Study.

    abstract:OBJECTIVES:To determine, using data from the Newcastle 85+ Study, whether there is an association between modern diagnostic criteria for metabolic syndrome (MetS) and cognitive function in very old adults (≥85) and whether inflammation, physical activity, or diabetes mellitus status affects this association. DESIGN:Lo...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/jgs.13358

    authors: Harrison SL,Stephan BC,Siervo M,Granic A,Davies K,Wesnes KA,Kirkwood TB,Robinson L,Jagger C

    更新日期:2015-04-01 00:00:00

  • Prevalence and Preventability of Drug-Related Hospital Readmissions: A Systematic Review.

    abstract:OBJECTIVES:To summarize the evidence on the prevalence and preventability of drug-related hospital readmissions. DESIGN:A systematic review was performed of studies that examined drug-related hospital readmissions. PubMed, EMBASE, and the Cochrane Library were searched from inception through August 2016. Reference lis...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/jgs.15244

    authors: El Morabet N,Uitvlugt EB,van den Bemt BJF,van den Bemt PMLA,Janssen MJA,Karapinar-Çarkit F

    更新日期:2018-03-01 00:00:00

  • Insulin resistance and executive dysfunction in older persons.

    abstract:OBJECTIVES:To evaluate the association between insulin resistance (IR) and executive dysfunction in a large, population-based study of older persons without diabetes mellitus (DM) or dementia. DESIGN:Cross-sectional study. SETTING:Outpatient clinic in Greve in Chianti and Bagno a Ripoli, Italy. PARTICIPANTS:A total ...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.2004.52466.x

    authors: Abbatecola AM,Paolisso G,Lamponi M,Bandinelli S,Lauretani F,Launer L,Ferrucci L

    更新日期:2004-10-01 00:00:00

  • Predictors of change in walking velocity in older adults.

    abstract:OBJECTIVE:To determine factors that predict change in walking velocity in older people using a multivariate model. DESIGN:Longitudinal observational study. SUBJECTS:A total of 588 persons older than age 60, including subjects residing in a continuing care retirement community (CCRC) (n = 248), and homebound (n = 79) ...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1996.tb02427.x

    authors: Gibbs J,Hughes S,Dunlop D,Singer R,Chang RW

    更新日期:1996-02-01 00:00:00

  • Assessing environmentally determined mobility disability: self-report versus observed community mobility.

    abstract:OBJECTIVES:To examine the test-retest reliability and concurrent validity of a new self-report measure of mobility function by comparing it with observed mobility, self-reported activity of daily living (ADL) function, and performance-based measures of gait and balance. DESIGN:Cross-sectional study involving two group...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章,多中心研究

    doi:10.1111/j.1532-5415.2005.53222.x

    authors: Shumway-Cook A,Patla A,Stewart AL,Ferrucci L,Ciol MA,Guralnik JM

    更新日期:2005-04-01 00:00:00

  • A plan for regional medical health centers for the geriatric patient.

    abstract::A rough plan is proposed which may facilitate the care of geriatric patients. The plan is to introduce pilot programs of geriatric regional centers attached to Veteran's Administration hospitals. Thus, at minimal cost, the problems of geriatric medicine would be under the supervision of our excellent university medica...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1966.tb03082.x

    authors: Dawson D

    更新日期:1966-05-01 00:00:00

  • Driving Fitness in Different Forms of Dementia: An Update.

    abstract:BACKGROUND/OBJECTIVES:Most forms of dementia are associated with progressive cognitive and noncognitive impairments that can severely affect fitness to drive. Whether safe driving is still possible in the single case, however, is often difficult to decide and may be dependent on both severity and type of the respective...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/jgs.16077

    authors: Toepper M,Falkenstein M

    更新日期:2019-10-01 00:00:00

  • Brophy v New England Sinai Hospital, Inc. Brief amicus curiae, Society for the Right to Die, Inc. on behalf of appellant.

    abstract::On September 11, 1986, the Supreme Judicial Court of Massachusetts, in a 4-3 decision, authorized removal of the artificial feeding tube. It held that the "substituted judgment" of an incompetent person in a persistent vegetative state to refuse artificially administered sustenance must be honored. The Court also refu...

    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:

    authors:

    更新日期:1987-07-01 00:00:00