Abstract:
OBJECTIVES:Lower than recommended doses of direct-acting oral anticoagulants are often prescribed to older adults with nonvalvular atrial fibrillation (NVAF). Our goal was to determine the consequences of lower than recommended dosing on plasma apixaban concentrations during the clinical care of older adults with NVAF. DESIGN:Convenience sample of patients receiving anticoagulation during 2017. SETTING:Academic medical center. PARTICIPANTS:Stable adults older than 65 years with NVAF receiving apixaban on a chronic basis. MEASUREMENTS:Patient age, weight, creatinine, co-medications, and apixaban concentrations. RESULTS:A total of 110 older adults with NVAF (mean age = 80.4 y; range = 66-100 y with 45% women) were studied. Overall, 48 patients received recommended dosing of 5 mg twice/day, and 42 received lower than recommended dosing. One patient in each category had concentrations below the expected 5% to 95% range at time of peak concentrations. Differences in proportion of apixaban concentrations within or outside expected ranges were not significant between patients receiving lower than recommended doses and those dosed as recommended at 5 mg twice/day (P = .35). However, in patients dosed as recommended with 5 mg twice/day, four had concentrations above the 5% to 95% range for peak levels expected at 3 to 4 hours after dosing; in two, this occurred around the midpoint of the dosing interval. Twenty patients received 2.5 mg twice/day as recommended. One-third had apixaban concentrations higher than expected peak concentrations compared with the clinical trials, and more than two-thirds had levels above the reported median for peak concentrations. CONCLUSIONS:Apixaban concentrations in older adults with NVAF seen clinically were higher than expected based on clinical trial data. The findings raise questions about the optimal dosing of apixaban in older adults with NVAF encountered outside of clinical trials and suggest a role for the monitoring of apixaban concentrations during care of patients that differ from those in randomized trials or when considering dosing outside of published guidelines. J Am Geriatr Soc 67:1902-1906, 2019.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Sukumar S,Gulilat M,Linton B,Gryn SE,Dresser GK,Alfonsi JE,Schwarz UI,Kim RB,Schwartz JBdoi
10.1111/jgs.15982subject
Has Abstractpub_date
2019-09-01 00:00:00pages
1902-1906issue
9eissn
0002-8614issn
1532-5415journal_volume
67pub_type
杂志文章abstract:OBJECTIVES:To investigate the relationship between total estradiol (E2) levels and 9-year mortality in older postmenopausal women not taking hormone replacement therapy (HRT). DESIGN:Population-based study of persons living in the Chianti geographic area (Tuscany, Italy). SETTING:Community. PARTICIPANTS:A representa...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02464.x
更新日期:2009-10-01 00:00:00
abstract::The course of untreated mild hypothyroidism was followed in 67 nursing home residents (mean age 78 years). The diagnosis was based on a normal free thyroxine index (FTI) and elevated thyrotropin concentration (TSH 4.6 to 15.0 microIU/mL, nl less than or equal to 4.5 microIU/mL. FTI and FSH were measured in follow-up 4...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1991.tb01648.x
更新日期:1991-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy of Simulated Presence, a personalized approach to enhance well-being among nursing home residents with Alzheimer's disease and related dementia's (ADRD). DESIGN:Latin-Square, double blinded, 3-factor design with restrictive randomization of three treatments (the study intervention, a...
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:10.1111/j.1532-5415.1999.tb07237.x
更新日期:1999-04-01 00:00:00
abstract:OBJECTIVES:To report use of breast cancer treatment (surgery, radiation, and chemotherapy) by patients with Alzheimer's disease (AD). DESIGN:Retrospective cohort study. SETTING:Surveillance, Epidemiology, and End Results (SEER) is a population-based cancer registry covering 14% of the U.S. population. PARTICIPANTS:F...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.00467.x
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Hospital-acquired disability (HAD) is common and often related to low physical activity while in the hospital. OBJECTIVE:To examine whether wearable hospital activity trackers can be used to predict HAD. DESIGN:A prospective observational study between January 2016 and March 2017. SETTING:An academic medi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16231
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:To determine predictors of 2-year post-hospitalization mortality in a cohort of elderly hospitalized patients originally assembled to assess the impact of a Geriatric Consultation Team (GCT). DESIGN:Two-year follow-up of an inception cohort. SETTING:University-affiliated tertiary care VA Medical Center. PA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1992.tb03648.x
更新日期:1992-12-01 00:00:00
abstract:OBJECTIVES:To clarify the effect of tooth loss on development of all-cause dementia and its subtypes in an elderly Japanese population. DESIGN:Prospective cohort study. SETTING:The Hisayama Study, Japan. PARTICIPANTS:Community-dwelling Japanese adults without dementia aged 60 and older (N = 1,566) were followed for ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14791
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVES:To examine the neuropsychological and clinical profile of help-seekers in an early-detection community dementia program and to explore any relationship between profiles and time to seek help. DESIGN:Cross-sectional. SETTING:Early-detection community dementia program. PARTICIPANTS:Help-seekers (N = 1,005) ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13938
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:To investigate the natural history, cause of death, and end-of-life experiences of individuals diagnosed with dementia with Lewy bodies (DLB). DESIGN:Twenty-question online survey administered through the Lewy Body Dementia Association. SETTING:United States. PARTICIPANTS:Caregivers, family, and friends o...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15608
更新日期:2019-01-01 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 describe the composition of the US provider workforce for adults with cancer older than 65 years and to determine whether there were differences in patients who received care from different providers (eg, nurse practitioners [NPs], physician assistants [PAs], and specialty physicians). DESIGN:Observation...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15931
更新日期:2019-07-01 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::A retrospective analysis was made of the records of 100 consecutive geriatric patients with community-acquired bacteremia, admitted to a suburban hospital. The most frequently identified tissue sources for these bacteremias were the urinary tract (34 percent), biliary tract (20 percent), and lungs (13 percent). In 11 ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb00622.x
更新日期:1980-07-01 00:00:00
abstract:OBJECTIVES:To evaluate whether levels of cognitive reserve (CR), as measured using the Wechsler Adult Intelligence Scale (WAIS)-III vocabulary test, moderated longitudinal associations between cognitive functions and decline in gait speed in a community-based cohort of older adults without dementia, specifically, wheth...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.04193.x
更新日期:2012-11-01 00:00:00
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
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVES:Older people approaching end of life are commonly prescribed multiple medications, many of which may be inappropriate or futile. Our objective was to examine the effect of applying the STOPPFrail, a recently developed deprescribing tool, to the medication regimens of older patients with advanced frailty. DE...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16278
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVES:To develop and validate a comprehensive quality assessment tool for emergency department (ED) geriatric care. DESIGN:Four-step study: (1) Content development of tool by a multidisciplinary panel, (2) survey of ED lead physicians and nurses, (3) development of subscales using principal component analysis and...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15137
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVES:To determine the association between multiple chronic conditions and risk of incident mild cognitive impairment (MCI) and dementia. DESIGN:Prospective cohort study. SETTING:Olmsted County, Minnesota. PARTICIPANTS:Cognitively normal individuals (N = 2,176) enrolled in the Mayo Clinic Study of Aging (MCSA)....
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13612
更新日期:2015-09-01 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:OBJECTIVES:To model the relative contributions of driver data and clinical judgments to clinical ratings of driver capability for a state licensing authority and to compare ratings with on-road test results. DESIGN:Retrospective, logistic regression. SETTING:Missouri Driver License Bureau. PARTICIPANTS:Adults aged 6...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14022
更新日期:2016-04-01 00:00:00
abstract:OBJECTIVES:To search for a potential role of endothelin-1 (ET-1), a potent vasoconstrictor and presumably neurotoxic 21-amino acid peptide, for dysfunction of brain signal processing and cerebrovascular morbidity in nondemented patients with cerebral arteriosclerosis. DESIGN:Cross-sectional study with longitudinal fol...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1997.tb05166.x
更新日期:1997-04-01 00:00:00
abstract:OBJECTIVES:To determine the association between psychoactive medications and crash risk in drivers aged 60 and older. DESIGN:Retrospective population-based case-crossover study. SETTING:A database study that linked the Western Australian Hospital Morbidity Data System and the Pharmaceutical Benefits Scheme. PARTICIP...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03561.x
更新日期:2011-09-01 00:00:00
abstract::Measurements were made of the overnight mobility of a group of elderly hospital patients whose clinical status had been assessed using the Norton clinical assessment score. The number of movements on the first two nights after admission differed from subsequent nights. There was a significant correlation between mobil...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb04903.x
更新日期:1986-09-01 00:00:00
abstract:OBJECTIVE:To compare the diagnoses, psychiatric and medical comorbidities, and prior and current treatment received by late-middle-aged and older affective disorder patients in mental health and medical service settings and to identify predictors of these patients' length of inpatient care. DESIGN:Department of Vetera...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb01832.x
更新日期:1996-06-01 00:00:00
abstract:OBJECTIVES:To compare two sarcopenia definitions and examine the relationship between them and lower extremity function and other health related factors using data from the baseline examination of the Health Aging and Body Composition (Health ABC) Study. DESIGN:Observational cohort study. SETTING:Two U.S. communities...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2003.51534.x
更新日期:2003-11-01 00:00:00
abstract:OBJECTIVES:To explore how different frameworks and categories of chronic conditions impact multimorbidity (defined as two or more chronic conditions) prevalence estimates and associations with patient-important functional outcomes. DESIGN:Baseline data from a population-based cohort study. SETTING:National sample of ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15921
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVES:To determine whether resting heart rate is associated with several types of osteoporotic fractures, mortality, and cause-specific mortality in older women. DESIGN:A prospective cohort study. SETTING:Four communities across the United States. PARTICIPANTS:We prospectively assessed resting pulse rate in 9,7...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50110.x
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVE:To describe the total cost of pressure ulcer prevention, component costs of each intervention, and the relationship of costs to subjects' risk level. DESIGN:3-month cohort trial. SETTING:A 600-bed, state-supported, long-term care facility. PATIENTS:A total of 539 war veterans, 83% of whom were male; mean a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb06095.x
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVES:For older adults screened by an Area Agency on Aging (AAA) in the National Aging Network, we aimed to examine the 12-month mortality rate for wait-listed callers compared with those who received services within 12 months, and to assess whether the mortality rate differed according to how quickly they receive...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16232
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:To estimate potential cost savings generated by a program of hip protectors in the nursing home from a Medicare perspective. DESIGN:A state-transition Markov model considering short-term and long-term outcomes of hip protectors for a hypothetical nursing home population, stratified by age, sex, and function...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53102.x
更新日期:2005-02-01 00:00:00