Abstract:
:The Integrated Memory Care Clinic (IMCC) is a patient-centered medical home as defined by the National Committee for Quality Assurance directed by advanced practice registered nurses (APRNs) caring for persons living with dementia (PLWD); physicians provide specialty consultation but do not direct care or care planning. The IMCC incorporates geriatric nursing, social work, and APRNs from neurology, gerontology, palliative care, and geriatric psychiatry. APRNs provide comprehensive, coordinated primary care for dementia, other chronic conditions, and minor acute illnesses. Partnering with PLWD and families and taking a palliative-oriented, dementia-informed medical home approach, the IMCC aims to reduce dementia burden. This study describes the first 12 months of IMCC's operation with 139 enrolled PLWD-caregiver dyads. All patients have a diagnosis of dementia or mild cognitive impairment; most have Alzheimer's disease (53.2%). Patients have an average of 5.8 medical conditions and 6.9 prescriptions; 38.1% have an advanced directive, a medical power of attorney, or a living will. Mean age is 78.6, 63.3% are female, and 30.9% are African American. Mean Montreal Cognitive Assessment score is 12.6. Most require assistance in activities of daily living. Many display neuropsychiatric symptoms. The most prevalent comorbidities are hypertension, dyslipidemia, and depression. The rate of ambulatory-sensitive hospitalizations declined from 6.7% in December 2015 to less than 1% in May 2016. Caregivers were highly satisfied. We observed nonsignificant improvements in neuropsychiatric symptom severity (p=.07), caregiver distress (p=.69), and caregiver competence (p=.18). IMCC is a novel care model for PLWD and their caregivers and may be a more sustainable model than traditional primary care for this growing vulnerable population. J Am Geriatr Soc 66:2401-2407, 2018.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Clevenger CK,Cellar J,Kovaleva M,Medders L,Hepburn Kdoi
10.1111/jgs.15528subject
Has Abstractpub_date
2018-12-01 00:00:00pages
2401-2407issue
12eissn
0002-8614issn
1532-5415journal_volume
66pub_type
杂志文章abstract::Investigations of the natural history of blood pressure have generally evaluated mean systolic and diastolic pressure changes. While information, this information is not directly applicable to clinical practice settings, in which patients are usually classified as normotensive or hypertensive. We measured the actual i...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1989.tb02267.x
更新日期:1989-09-01 00:00:00
abstract:OBJECTIVES:To describe the relationship between symptom scores and mobility function measures, assess whether symptom scores and disease scores are similarly associated with mobility function, and identify clusters of symptoms that are most strongly associated with functional status in older adults. DESIGN:Secondary a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02178.x
更新日期:2009-04-01 00:00:00
abstract:OBJECTIVE:To determine whether slowing of gastric emptying and glucose absorption with guar gum would reduce the fall in blood pressure after an oral glucose load in older subjects. DESIGN:A randomized, experimental, cross-over study. SETTING:Department of Nuclear Medicine, Royal Adelaide Hospital, Adelaide, SA, Aust...
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:10.1046/j.1532-5415.2001.49037.x
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVE:To examine the association of self-reported physical activity with performance-based and self-reported physical functioning measured 3 to 5 years later. DESIGN:A population-based, longitudinal study. SETTING:The island of Oahu, Hawaii. PARTICIPANTS:Subjects were 3640 Japanese-American men older than 70 yea...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb05525.x
更新日期:1995-08-01 00:00:00
abstract:OBJECTIVE:To assess colonization and infection with methicillin-resistant Staphylococcus aureus (MRSA), high-level gentamicin-resistant enterococci (R-ENT) and gentamicin and/or ceftriaxone-resistant Gram-negative bacilli (R-GNB) and the factors that are associated with colonization and infection with these organisms. ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb06210.x
更新日期:1994-10-01 00:00:00
abstract::Because of changes that occur with aging, older people with any other risk factors for vitamin D deficiency are likely to have inadequate stores of this vitamin. The consequences of vitamin D deficiency are likely to be losses in bone, strength, and function and the development of pain. Many questions remain regarding...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1995.tb07059.x
更新日期:1995-07-01 00:00:00
abstract::Older adults with advanced chronic kidney disease (CKD) experience functional impairment that can complicate CKD management. Failure to recognize functional impairment may put these individuals at risk of further functional decline, nursing home placement, and missed opportunities for timely goals-of-care conversation...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14262
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:To examine the effect of mode of survey administration on response rates and response tendencies for the Consumer Assessment of Healthcare Providers and Systems (CAHPS) Hospice Survey and develop appropriate adjustments. DESIGN:Survey response data were obtained after sampling and fielding of the CAHPS Hosp...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15265
更新日期:2018-03-01 00:00:00
abstract::The relation of serum albumin concentration to age was assessed in a series of hospitalized medical patients. Those with disease states (e.g., dysproteinemia, renal insufficiency, hepatic dysfunction, malnutrition) potentially associated with abnormal serum albumin levels were excluded, leaving a study population of 1...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1979.tb01715.x
更新日期:1979-01-01 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: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::What ethical concerns regarding the application of new antidementia compounds are pertinent to the best interests of patients with Alzheimer's disease and their caregivers? Based on collected preliminary anecdotal accounts, these concerns are important and should be considered carefully by clinicians, researchers, and...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb03819.x
更新日期:1998-06-01 00:00:00
abstract::All autopsies (n = 34) performed over a period from July 1, 1981 to June 30, 1988 in a teaching nursing home were reviewed to determine the autopsy rate, to evaluate premortem versus postmortem diagnostic discrepancies, and to see if educational efforts could improve each. The autopsy rate was 3.5%. Major discrepancie...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1990.tb03477.x
更新日期:1990-02-01 00:00:00
abstract:OBJECTIVES:To examine current utilization patterns of cholinesterase inhibitor (ChEI) therapy for dementia to determine treatment duration, use in long-term care, how often patients receive these drugs until death, and frequency of switching between the available ChEIs. DESIGN:A population-based healthcare administrat...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2007.01377.x
更新日期:2007-10-01 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: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
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: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
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVES:To determine the relationship between frailty and overall and cardiovascular mortality. DESIGN:Longitudinal mortality analysis. SETTING:National Health and Nutrition Examination Survey (NHANES) 1999-2004. PARTICIPANTS:Community-dwelling older adults aged 60 and older (N = 4,984; mean age 71.1 ± 0.19, 56% ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15220
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:To examine the association between handgrip strength and mortality in older Mexican American men and women. DESIGN:A 5-year prospective cohort study. SETTING:Five southwestern states: Texas, New Mexico, Colorado, Arizona, and California. PARTICIPANTS:A population-based sample of 2,488 noninstitutionalized...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50312.x
更新日期:2002-07-01 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 describe the pattern and factors associated with daily medication use in nursing home (NH) residents with advanced dementia. DESIGN:Prospective cohort study. SETTING:Twenty-two Boston-area NHs. PARTICIPANTS:NH residents with advanced dementia (N=323). MEASUREMENTS:Data from residents' records were use...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02819.x
更新日期:2010-05-01 00:00:00
abstract::During 26 years of surveillance of the Framingham Study Cohort of 5,209 subjects, 176 men and 119 women developed occlusive peripheral arterial disease manifested as intermittent claudication (IC). The incidence increased sharply with age until the age of 75, with about a twofold male predominance at all ages. An inci...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1985.tb02853.x
更新日期:1985-01-01 00:00:00
abstract:OBJECTIVES:To assess whether older age is independently associated with hemorrhage risk in patients with atrial fibrillation, whether or not they are taking warfarin therapy. DESIGN:Cohort study. SETTING:Integrated healthcare delivery system. Thirteen thousand five hundred fifty-nine adults with nonvalvular atrial fi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2006.00828.x
更新日期:2006-08-01 00:00:00
abstract:OBJECTIVES:To assess the effect of methicillin-resistant Staphylococcus aureus (MRSA) colonization on morbidity and mortality of nursing home residents. DESIGN:Three-year cohort study from 2000 to 2003. SETTING:Twenty-three nursing homes of all types and regions in the northern part of Belgium (Flanders). PARTICIPAN...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2006.00972.x
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:To determine the internal validity of the physical activity index (PAI). DESIGN:Three time periods over a 26-year period (1965/68 examination, n = 7911; 1980/82 examination, n = 2054; 1991/93 examination, n = 3425). SETTING:Honolulu, Hawaii. PARTICIPANTS:Middle-aged to older Japanese-American men. MEASURE...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb05564.x
更新日期:1995-09-01 00:00:00
abstract:UNLABELLED:This longitudinal study of glucose tolerance in the residents of a Jewish home for the aged (JHA) is now in its 25th year. Of 1,177 supposedly nondiabetic persons screened on admission from 1965 to 1986, 22.5% had impaired glucose tolerance (IGT), reflecting its undiagnosed prevalence among the Jewish elderl...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1989.tb06676.x
更新日期:1989-12-01 00:00:00
abstract::The Geriatric Pharmacy elective course at the University of Kentucky College of Pharmacy uses a simulated medication adherence project to increase awareness of adherence concerns facing older adults who take multiple medications. This study evaluated the effect of this project. Students enrolled in this 3-credit hour ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02364.x
更新日期:2009-08-01 00:00:00
abstract::Urinary incontinence and other lower urinary tract symptoms exert a major influence on the health and independence of frail older people. Detrusor underactivity (DU) is defined as a contraction of reduced strength and/or duration, resulting in prolonged bladder emptying and/or a failure to achieve complete bladder emp...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2006.00917.x
更新日期:2006-12-01 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