Abstract:
OBJECTIVES:To examine the association between hospitalization, critical illness, and infection occurring during middle- and late-life and structural brain abnormalities in older adults. DESIGN:Prospective cohort study. SETTING:Atherosclerosis Risk in Communities (ARIC) Study. PARTICIPANTS:A community sample of adults who were 44 to 66 years of age at study baseline. MEASUREMENTS:Active surveillance of local hospitals and annual participant contact were used to gather hospitalization information (including International Classification of Diseases, Ninth Revision, codes) on all participants over a 24-year surveillance period. Subsequently, a subset of participants underwent 3-Tesla brain magnetic resonance imaging (MRI) to quantify total and regional brain volumes, white matter hyperintensity (WMH) volume, and white matter microstructural integrity (fractional anisotropy (FA) and mean diffusivity (MD) as measured using diffusion tensor imaging (DTI)). RESULTS:Of the 1,689 participants included (mean age at MRI 76±5), 72% were hospitalized, 14% had a major infection, and 4% had a critical illness during the surveillance period. Using covariate-adjusted regression, hospitalization was associated with 0.12-standard deviation (SD) greater WMH volume (95% confidence interval (CI)=0.00-0.24) and poorer white matter microstructural integrity (0.17-SD lower FA, 95% CI=-0.27 to -0.06; 0.16-SD greater MD, 95% CI=0.07-0.25) than no hospitalization. There was a dose-dependent relationship between number of hospitalizations, smaller brain volumes, and lower white matter integrity (p-trends ≤.048). In hospitalized participants, critical illness was associated with smaller Alzheimer's disease (AD) signature region (-1.64 cm3 , 95% CI=-3.16 to -0.12); major infection was associated with smaller AD signature region (-1.28 cm3 , 95% CI=-2.21 to -0.35) and larger ventricular volume (3.79 cm3 , 95% CI= 0.81-6.77). CONCLUSIONS:Whereas all-cause hospitalization was primarily associated with lower white matter integrity, critical illness and major infection were associated with smaller brain volume, particularly within regions implicated in AD.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Walker KA,Gottesman RF,Wu A,Knopman DS,Mosley TH Jr,Alonso A,Kucharska-Newton A,Brown CH 4thdoi
10.1111/jgs.15470subject
Has Abstractpub_date
2018-10-01 00:00:00pages
1919-1926issue
10eissn
0002-8614issn
1532-5415journal_volume
66pub_type
杂志文章abstract:OBJECTIVES:Many elderly persons have drug benefits with coverage gaps, such as in Medicare Part D. Because beneficiaries who have such gaps must pay all drug costs, an accurate knowledge of gap thresholds and communication with providers about exceeding caps is important for elderly persons to manage out-of-pocket drug...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02244.x
更新日期:2009-05-01 00:00:00
abstract:OBJECTIVES:To determine patterns of dementia diagnosis seen after chemotherapy treatment. DESIGN:Using the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database, International Classification of Diseases, Ninth Revision (ICD-9) diagnoses of dementia occurring in the years after breast cancer diagn...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.2008.01848.x
更新日期:2008-09-01 00:00:00
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
更新日期:2019-10-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb00535.x
更新日期:1980-06-01 00:00:00
abstract:OBJECTIVE:To determine the association between kyphosis (degree of forward curvature of the thoracic spine) and measures of spinal osteoporosis (height loss and vertebral fractures) and chronic back pain and disability in older women. DESIGN:A cross-sectional study. SETTING:Eleven clinical centers in the United State...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1997.tb01470.x
更新日期:1997-06-01 00:00:00
abstract:OBJECTIVES:To examine loss of community-dwelling status 9 months after hospitalization for high-acuity emergency general surgery (HA-EGS) disease among older Americans. DESIGN:Retrospective analysis of claims data. SETTING:US communities with Medicare beneficiaries. PARTICIPANTS:Medicare beneficiaries age 65 years o...
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doi:10.1111/jgs.16046
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVES:To apply diagnostic criteria for mild cognitive impairment (MCI) to a geographically representative sample, to estimate the prevalence of MCI, and to estimate 10-year trajectories of incident disability for cognitively intact participants and subgroups with MCI. DESIGN:Prospective cohort; 10 years of follow...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.2005.53566.x
更新日期:2005-11-01 00:00:00
abstract::The Schulich School of Medicine, University of Western Ontario, Canada, has created a mandatory clerkship in Elder Care that consists of small group seminars, clinical experiences, and an Elder Care manual. This article describes the use of a paper-based log to track students' clinical encounters to determine whether ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01206.x
更新日期:2007-07-01 00:00:00
abstract::Prescription drugs are not always taken as directed. When there is a discrepancy between the use of a drug and the prescription directions, the drug-taking behavior is considered "nonadherent." To determine the extent of prescription non adherence by old persons and the reasons for nonadherence, an in-home survey was ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb05623.x
更新日期:1982-05-01 00:00:00
abstract::Twenty-five geriatric patients with severe motor urge incontinence were treated with terodiline and meladrazine separately and in combination. Because of poor general state of health and serious concomitant diseases the frequency of dropouts was high. Separate administration of the drugs improved the majority of the p...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章
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更新日期:1985-01-01 00:00:00
abstract:OBJECTIVE:To review (1) Changes in cardiac impulse generation, conduction, and ventricular filling in normal aging and disease; (2) Pacemaker technology and nomenclature; (3) Expert guidelines about pacemaker use; (4) Studies of pacemaker effectiveness and utilization. DESIGN:Articles were identified through a Medline...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1994.tb01760.x
更新日期:1994-03-01 00:00:00
abstract::The long-held belief that outcome data from intervention trials in men are generalizable to women has created the framework in which the primary prevention of coronary heart disease (CHD) in women is viewed, but over the past decade, data have accumulated to refute such a supposition of generalizability. These lines o...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.12140
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVES:To determine whether there is racial variation in hospice enrollees in rates of hospitalization and hospice disenrollment and, if so, whether systematic differences in hospice provider patterns explain the variation. DESIGN:Longitudinal cohort study. SETTING:Hospice. PARTICIPANTS:Medicare beneficiaries (N...
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doi:10.1111/jgs.15228
更新日期:2018-02-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02553.x
更新日期:2009-12-01 00:00:00
abstract:OBJECTIVES:To study sensor monitoring (use of a sensor network placed in the home environment to observe individuals' daily functioning (activities of daily living and instrumental activities of daily living)) as a method to measure and support daily functioning for older people living independently at home. DESIGN:Sy...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.12563
更新日期:2013-12-01 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 feasibility of using the American Board of Internal Medicine Care of the Vulnerable Elderly Practice Improvement Module (CoVE PIM) in an internal medicine residency program and to assess aggregate resident documentation of geriatric screening in continuity clinics. DESIGN:Needs assessment c...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.03134.x
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVES:To determine the prevalence and outcomes of breathlessness in older Americans. SETTING:Community-dwelling older adults. PARTICIPANTS:Individuals aged 70 and older in the nationally representative Health and Retirement Study (2008, follow-up through 2012) (N = 3,671; mean age 78). MEASUREMENTS:Breathlessne...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14313
更新日期:2016-10-01 00:00:00
abstract::Caregiving can have a profound effect on the health of the caregiver, yet research on caregiving among American Indians is limited. The purpose of this study was to examine the influence of caregiving on the health-related quality of life (HRQoL) of American Indians enrolled in the Education And Research Towards Healt...
journal_title:Journal of the American Geriatrics Society
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16781
更新日期:2020-12-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1993.tb06758.x
更新日期:1993-09-01 00:00:00
abstract:BACKGROUND:Elderly adults (65 years of age and older) are of particular concern for traumatic amputations due to age-related changes in vision and coordination, making them more susceptible to injury. OBJECTIVES:The objective of this study is to describe the epidemiology of traumatic amputations in the elderly adults ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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更新日期:2016-01-01 00:00:00
abstract:OBJECTIVES:To determine whether urinary incontinence (UI) is an independent predictor of death, nursing home admission, decline in activities of daily living (ADLs), or decline in instrumental activities of daily living (IADLs). DESIGN:A population-based prospective cohort study from 1993 to 1995. SETTING:Community-d...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52207.x
更新日期:2004-05-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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更新日期:2020-11-05 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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更新日期:2016-04-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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更新日期:2005-01-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb02653.x
更新日期:2000-03-01 00:00:00
abstract:OBJECTIVES:To quantitatively summarize changes in cognitive performance in individuals with severe aortic stenosis undergoing transcatheter aortic valve implantation (TAVI). DESIGN:Metaanalysis. PARTICIPANTS:Individuals undergoing TAVI (N = 1,065 (48.5% male) from 18 studies, average age ≥80). MEASUREMENTS:The MEDLI...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,meta分析,评审
doi:10.1111/jgs.15123
更新日期:2018-02-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2016-06-01 00:00:00
abstract::Brain atrophy in 154 men and 147 women without neurologic deficits was quantitatively studied by means of computed tomography. The ages ranged from 20 to 79 years. The volume percentage of brain to cranial cavity (Craniocerebral Index, or CCI) was calculated by means of computer programs available in CT systems. The m...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb07092.x
更新日期:1982-04-01 00:00:00