Abstract:
BACKGROUND/OBJECTIVE:The benefits and harms of screening of Alzheimer disease and related dementias (ADRDs) are unknown. This study addressed the question of whether the benefits outweigh the harms of screening for ADRDs among older adults in primary care. DESIGN, SETTING, AND PARTICIPANTS:Single-blinded, two-arm, randomized controlled trial (October 2012-September 2016) in urban, suburban, and rural primary care settings in Indiana. A total of 4005 primary care patients (aged ≥65 years) were randomized to ADRD screening (n = 2008) or control (n = 1997). INTERVENTION:Patients were screened using the Memory Impairment Screen or the Mini-Cog and referred for a voluntary follow-up diagnostic assessment if they screened positive on either or both screening tests. MEASUREMENTS:Primary measures were health-related quality of life (HRQOL; Health Utilities Index) at 12 months, depressive symptoms (Patient Health Questionnaire-9), and anxiety symptoms (Generalized Anxiety Disorder seven-item scale) at 1 month. RESULTS:The mean age was 74.2 years (SD = 6.9 years); 2257 (66%) were female and 2301 (67%) were white. At 12 months, we were unable to detect differences in HRQOL between the groups (effect size = 0.009 [95% confidence interval {CI} = -0.063 to 0.080]; P = .81). At 1 month, differences in mean depressive symptoms (mean difference = -0.23 [90% CI = -0.42 to -0.039]) and anxiety symptoms (mean difference = -0.087 [90% CI = -0.246 to 0.072]) were within prespecified equivalency range. Scores for depressive and anxiety symptoms were similar between the groups at all time points. No differences in healthcare utilization, advance care planning, and ADRD recognition by physicians were detected at 12 months. CONCLUSION:We were unable to detect a difference in HRQOL for screening for ADRD among older adults. We found no harm from screening measured by symptoms of depression or anxiety. Missing data, low rates of dementia detection, and high rate of refusal for follow-up diagnostic assessments after a positive screen may explain these findings. J Am Geriatr Soc 68:535-543, 2020.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Fowler NR,Perkins AJ,Gao S,Sachs GA,Boustani MAdoi
10.1111/jgs.16247subject
Has Abstractpub_date
2020-03-01 00:00:00pages
535-543issue
3eissn
0002-8614issn
1532-5415journal_volume
68pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:To investigate the accuracy of cranial computerized tomography (CT) scans in distinguishing patients with Alzheimer's disease from those with other dementing conditions. DESIGN:Retrospective clinicopathological correlation with pre-mortem CT scans. SETTING:Urban and rural hospitals and nursing homes in the ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1992.tb02014.x
更新日期:1992-05-01 00:00:00
abstract:OBJECTIVE:To determine the prevalence of dental problems in Paget's patients and in a control population without Paget's disease. The relationship of localization of bony involvement of Paget's disease with the prevalence of dental, auditory, visual, and smell changes is examined. DESIGN:Cross-sectional national surve...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb06618.x
更新日期:1995-12-01 00:00:00
abstract:OBJECTIVES:To determine whether providing physical therapy (PT) services in the emergency department (ED) improves outcomes for older adults who fall. DESIGN:We used Medicare claims data to examine differences in recurrent fall-related ED revisit rates of older adults who presented to the ED for a ground-level fall an...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15469
更新日期:2018-11-01 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::Neurotoxic effects of habitual alcohol consumption were investigated by correlating the subjects' estimates of abstinence or frequency and amount of alcohol consumed with measurements of gray matter blood flow utilizing the 133Xe inhalation method. Two hundred and twenty-two subjects were studied, including 136 health...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1983.tb02198.x
更新日期:1983-09-01 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:To examine the associations between typology of family relationship and risk of elder mistreatment (EM). DESIGN:Population-based epidemiological cross-sectional study. SETTING:Community-dwelling older adults in the greater Chicago area. PARTICIPANTS:A total of 3157 US older Chinese immigrants. MEASUREMEN...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15892
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVES:To identify factors associated with incomplete bladder emptying in older women with overactive bladder (OAB) symptoms. DESIGN:Retrospective medical records review. SETTING:Urodynamic laboratory at a large academic health care system in the southeast United States. PARTICIPANTS:Medical records from women a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13474
更新日期:2015-07-01 00:00:00
abstract::The objective of this study was to assess potential age-related differences in oncologist communication during conversations about adjuvant therapy decisions and subsequent patient decision outcomes. Communication was observed between a cross-section of female patients aged 40 to 80 with early-stage breast cancer (n=1...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2009.02512.x
更新日期:2009-11-01 00:00:00
abstract::Diastolic left ventricular function was comparatively assessed in 19 healthy elderly individuals (mean age 71 years) and in 20 young normal subjects (mean age 26 years), using digitized echocardiograms. Peak and average filling rates were slower in the group of elderly subjects than in the younger population (128 +/- ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1985.tb04186.x
更新日期:1985-11-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that mild cognitive impairment (MCI) is associated with poorer financial and healthcare decision-making. DESIGN:Community-based epidemiological cohort study. SETTING:Communities throughout northeastern Illinois. PARTICIPANTS:Older persons without dementia from the Rush Memory and Agi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13346
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:To evaluate the relationship between serum insulin-like growth factor 1 (IGF-1), IGF-1 binding protein 1 (IGFBP-1), and IGF-1 binding protein 2 (IGFBP-2) and fasting insulin, fasting glucose, adiposity, and mortality in older adults. DESIGN:A prospective cohort study with mean follow-up of 6.2 years. SETTIN...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02318.x
更新日期:2009-07-01 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
abstract::A survey of 977 community subjects aged 65 or older identified 719 of them as not impaired in physical health. Of these, 104 (14 percent) perceived their physical status to be poor, whereas 615 (86 percent) accurately perceived it to be unimpaired. There were no significant differences between the two groups with rega...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1979.tb06051.x
更新日期:1979-07-01 00:00:00
abstract:OBJECTIVES:To determine the frequency of vitamin D deficiency and secondary hyperparathyroidism in Australian hip fracture patients living in the community. PATIENTS:A total of 283 consecutive patients with hip fracture admitted over a 15-month period to a university teaching hospital in Western Australia. Included we...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb03001.x
更新日期:1999-03-01 00:00:00
abstract::In the last decade, a new degenerative dementia, probably the second most common after Alzheimer's disease (AD), has been increasingly recognized under the consensus name of dementia with Lewy bodies (DLB). This article reviews current clinical, genetic, and pathological DLB data and indicates directions for future re...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1998.tb06016.x
更新日期:1998-11-01 00:00:00
abstract:OBJECTIVES:To assess the utility of verbal fluency discrepancy scores in predicting progression to Alzheimer's disease (AD) in a cohort of individuals with mild cognitive impairment (MCI). DESIGN:Case control. SETTING:Cases identified from new referrals to a memory clinic and controls identified from The Irish Longit...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15294
更新日期:2018-04-01 00:00:00
abstract::The aim of this study was to evaluate the effect of a geriatric-anesthesiologic intervention program for the prevention and treatment of acute confusional states (ACS) in elderly patients treated for femoral neck fractures. The intervention program was based on the results of previous prospective studies in similar pa...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1991.tb03618.x
更新日期:1991-07-01 00:00:00
abstract::The reports on 72 of 190 accidents occurring among 189 nursing home residents during a 3-month period were drawn at random and reviewed. The majority of the accidents were falls, either major or minor. Personal data on the residents included age, sex, mental status, number of diseases, and number of drugs administered...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1978.tb05391.x
更新日期:1978-09-01 00:00:00
abstract:OBJECTIVE:To further validate an objective measure of physical illness burden, the Cumulative Illness Rating Scale (CIRS). DESIGN:Survey with correlation of CIRS ratings made from physician interviews and review of medical records with post-mortem ratings made independently at tissue autopsy. SUBJECTS:Victims of comp...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1993.tb05945.x
更新日期:1993-01-01 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 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::The authors compared the demographic and clinical characteristics and treatment recommendations for elderly (greater than or equal to 60 years) and younger patients (17 to 59 years) seen for an emergency psychiatric consultation in a teaching general hospital. Findings revealed 11 distinctive characteristics that diff...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb05474.x
更新日期:1986-02-01 00:00:00
abstract:OBJECTIVES:To estimate the prevalence of self-harm, suicidal ideation (SI), and suicide attempts (SA) in older adults in the emergency department (ED), including differences according to age, sex, and race and ethnicity. DESIGN:Quasi-experimental, multiphase, eight-center study with prospective review of consecutive c...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/jgs.14529
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:To examine rates and predictors of lifetime and recent depression treatment in a sample of 1,801 depressed older primary care patients DESIGN:Cross sectional survey data collected from 1999 to 2001 as part of a treatment effectiveness trial. SETTING:Eighteen primary care clinics belonging to eight organiza...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2003.51159.x
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVES:To examine the relative effect of comorbidities, noncancer symptoms, and cancer-related factors on the functioning of older adult long-term survivors of breast, colorectal, and prostate cancers. DESIGN:Data from in-person interviews with survivors of a tumor registry-based stratified random sample were used...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02515.x
更新日期:2009-11-01 00:00:00
abstract::Long-term acute care (LTAC) represents a rapidly growing category of Medicare providers, but little is known about its quality, outcomes, and cost-effectiveness. Its defining characteristic, as set by Medicare, is an average length of stay of greater than 25 days. Modern LTAC emerged in the early 1980s as a setting fo...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2007.01162.x
更新日期:2007-05-01 00:00:00
abstract::Delirium is an organic mental disorder defined as transient, fluctuating global dysfunction of cognition. It is common in elderly medical inpatients, yet its varied presentation is often missed or misdiagnosed. ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1990.tb01505.x
更新日期:1990-11-01 00:00:00
abstract::Capitated or salaried managed care systems offer an important opportunity to provide high quality, cost-effective end-of-life care. However, capitated healthcare delivery systems have strong incentives to avoid patient populations in need of such care. Care currently provided at the end of life in fee-for-service prac...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb01047.x
更新日期:1998-03-01 00:00:00
abstract:OBJECTIVES:To evaluate the association between regular antiepileptic drug (AED) use and incident dementia. DESIGN:Case-control analysis. SETTING:Finnish public health register and German health insurance data. PARTICIPANTS:Individuals with dementia of any type (German data, N=20,325) and Alzheimer's disease (AD; Fin...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15358
更新日期:2018-07-01 00:00:00