Abstract:
BACKGROUND:A widely held dictum in aging research is that heterogeneity in health increases with age, but the basis for this claim has not been fully investigated. We examined heterogeneity at different ages across health characteristics to describe variation and trends; we investigated the comparative importance of between-age versus within-age heterogeneity. DESIGN:This was a cohort study. SETTING:Community-dwelling older adults. PARTICIPANTS:A total of 30,097 adults aged 45 to 86 years, from the Canadian Longitudinal Study on Aging, were included. MEASUREMENTS:Thirty-four health characteristics in eight domains (physical measures, vital signs, physiological measures, physical performance, function/disability, chronic conditions, frailty, laboratory values) were assessed cross-sectionally. We used regression models to examine heterogeneity in health characteristics (using absolute deviation) and domains (using effective variance) in relation to age. Comparison between between-age and within-age heterogeneity was quantified by estimating the age threshold at which the former exceeds the latter. RESULTS:Of the 34 health characteristics, 17 showed increased heterogeneity, 8 decreased, and 9 no association with age. The associations between heterogeneity and age increased generally but were nonlinear for most domains and nonmonotonic for some. We observed peak heterogeneity at approximately 70 years. Between-age heterogeneity, compared with within-age heterogeneity, was most important for forced expiratory volume in 1 second and grip strength but varied across characteristics. CONCLUSION:Overall health heterogeneity increases with age but does not uniformly increase across all variables and domains. Heterogeneity in aging reinforces the need for geriatric assessment and personalized care, depending on which health characteristics are assessed, their measurement properties, and their referent group. Our findings suggest further research to develop improved single-dimension and multidimensional instruments, as well as specific vital and laboratory reference ranges for older adults.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Nguyen QD,Moodie EM,Forget MF,Desmarais P,Keezer MR,Wolfson Cdoi
10.1111/jgs.16919subject
Has Abstractpub_date
2020-11-05 00:00:00eissn
0002-8614issn
1532-5415pub_type
杂志文章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 establish the prevalence and correlates of disability during the 2 years before hip fracture. DESIGN:Data from participants who experienced hip fracture in the Health and Retirement Study (HRS) with hip fracture identified using linked Medicare claims. Each participant was interviewed at varying time poi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13658
更新日期:2015-10-01 00:00:00
abstract:OBJECTIVES:To identify the practical problems that older people experience with the daily use of their medicines and their management strategies to address these problems and to determine the potential clinical relevance thereof. DESIGN:Qualitative study with semistructured face-to-face interviews. SETTING:A communit...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13126
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVES:To describe factors associated with provider-ordered influenza testing in hospitalized older adults. DESIGN:Information on participant demographics, symptoms, and provider-ordered influenza testing were collected by questionnaire and chart review. We conducted prospective laboratory-based surveillance using...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15298
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:Although frailty status is dynamic, whether improvements in frailty predict mortality is unknown. OBJECTIVE:Describe 1-year changes in a frailty index (FI) and association with 48-month mortality. DESIGN:Secondary analysis of the National Health in Aging Trends Study. SETTING:Community. PARTICIPANTS:Five...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.17002
更新日期:2020-12-29 00:00:00
abstract:OBJECTIVES:Factors specifically affecting compliance with continuous positive airway pressure (CPAP) in older patients with obstructive sleep apnea (OSA) have not been described. The purpose of this study is to determine which factors are associated with compliance and noncompliance in older patients, a growing segment...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.49238.x
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVES:To describe the prevalence of diabetes mellitus (DM) in centenarians. DESIGN:Cross-sectional, population-based. SETTING:Forty-four counties in northern Georgia. PARTICIPANTS:Two hundred forty-four centenarians (aged 98-108, 15.8% male, 20.5% African American, 38.0% community dwelling) from the Georgia Cen...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03836.x
更新日期:2012-03-01 00:00:00
abstract:OBJECTIVES:To determine the efficacy of antidepressants in people with depression and dementia. DESIGN:A systematic review and meta-analysis based on a literature search of Medline and Cochrane Trials Registry for acute-phase, double-blind, placebo-controlled, parallel-design, random-assignment trials of antidepressan...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,meta分析,评审
doi:10.1111/j.1532-5415.2011.03355.x
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVES:Impact assessment of drug benefits policies is a growing field of research that is increasingly relevant to health care planning for older people. Some cost-containment policies are thought to increase noncompliance. This paper examines mechanisms that can produce spurious reductions in drug utilization meas...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50120.x
更新日期:2002-03-01 00:00:00
abstract:BACKGROUND:The need for mentorship in aging research among postdoctoral trainees and junior faculty across medical disciplines and subspecialties is increasing, yet senior personnel with expertise in aging are lacking to fulfill the traditional dyadic mentorship role. Facilitated peer mentorship is grounded in collabor...
journal_title:Journal of the American Geriatrics Society
pub_type: 评论,杂志文章
doi:10.1111/jgs.15792
更新日期:2019-04-01 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::Many physicians report that Internet health information can affect their clinical decisions. Much of Internet geriatric health information (IGHI) is not controlled for quality, and there is no available process to assess the quality of IGHI used in clinical practice or in medical education. The objective of this proje...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53272.x
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVES:To determine the clinical presentation, findings, and outcomes of older adults (> 60) with severe acute respiratory syndrome (SARS) and compare these with a control group of younger patients (< or or =60). DESIGN:Retrospective cohort study. SETTING:A community-based, acute hospital in Hong Kong. PARTICIPA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52362.x
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVES:To compare the effectiveness of tai chi and low-level exercise in reducing falls in older adults; to determine whether mobility, balance, and lower limb strength improved and whether higher doses of tai chi resulted in greater effect. DESIGN:Randomized controlled trial. SETTING:Eleven sites throughout New ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1532-5415.2012.03928.x
更新日期:2012-05-01 00:00:00
abstract:BACKGROUND:Previous research has identified several barriers faced by clinicians in detecting and reporting elder abuse, such as lack of knowledge about the process to report suspected cases of abuse and lack of access to experts to consult with. A novel intervention was designed and tested that embedded two Adult Prot...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16433
更新日期:2020-08-01 00:00:00
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
更新日期:1996-02-01 00:00:00
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 whether serum levels of 25-hydroxyvitamin D (25(OH)D) and parathyroid hormone (PTH) predict accelerated decline in muscular strength or onset of new disability in mobility and upper extremity functioning over a 3-year follow-up. DESIGN:A community-based prospective cohort study. PARTICIPANTS:S...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50219.x
更新日期:2002-05-01 00:00:00
abstract:OBJECTIVES:Evidence suggests inflammation is associated with cognitive impairment, but previous epidemiological studies have reported conflicting results. DESIGN:Prospective population-based cohort. SETTING:Epidemiology of Hearing Loss Study participants. PARTICIPANTS:Individuals without cognitive impairment in 1998...
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更新日期:2014-09-01 00:00:00
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pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53165.x
更新日期:2005-03-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1046/j.1532-5415.50.7s.5.x
更新日期:2002-07-01 00:00:00
abstract::Mortality in 159 patients who sustained 163 hip fractures in a single geriatric hospital and residential health facility in a ten-year period was studied. This study confirms the major problem of mortality associated with hip fractures in the very elderly. Factors that seemed associated with mortality were preoperativ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1983.tb05119.x
更新日期:1983-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the use of pentoxifylline to treat impotence in men with mild to moderate penile vascular insufficiency. DESIGN:Double-blind randomized clinical trial. SETTING:Sexual Dysfunction Clinic at VA Medical Center, Sepulveda, CA. PARTICIPANTS:Convenience sample of couples. INTERVENTION:Twelve weeks o...
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.1532-5415.1993.tb06941.x
更新日期:1993-04-01 00:00:00
abstract:OBJECTIVES:To determine the effectiveness of vitamin D supplementation in preventing decline in physical function in older men. DESIGN:Randomized, double-blind, placebo-controlled clinical trial. SETTING:Single-center study conducted at a Veterans Affairs Healthcare System. PARTICIPANTS:Sedentary men aged 65 to 90 (...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.14510
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVES:To develop and validate a picture-based memory impairment screen (PMIS) for the detection of dementia. DESIGN:Cross-sectional. SETTING:Outpatient clinics, Baby Memorial Hospital, Kozhikode city in the southern Indian state of Kerala. PARTICIPANTS:Three hundred four community-residing adults aged 55 to 94 ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.04191.x
更新日期:2012-11-01 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
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12594
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To study the effectiveness of rehabilitative and medically oriented day hospital care on community-based long-term care patients. DESIGN:A randomized, controlled trial. SETTING AND PARTICIPANTS:177 patients on home-care in a rural area were randomized into two groups. Patients in one group were offered a 2-...
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.1532-5415.1998.tb06645.x
更新日期:1998-09-01 00:00:00
abstract::The treatment of cerebrovascular insufficiency and its many symptoms in the ever-increasing numbers of the aged, is of major concern to physicians engaged in such care. Despite past skepticism as to the degree of efficacy of cerebral vasodilators, there is renewed interest in this form of therapy. Our investigation wa...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章
doi:10.1111/j.1532-5415.1977.tb00840.x
更新日期:1977-12-01 00:00:00
abstract:OBJECTIVES:To determine factors that predict site of death (hospital vs nursing home (NH)), related costs, and geographic variation in site of death of NH residents admitted under the Medicare Part A Benefit. DESIGN:Retrospective cohort study. SETTING:NHs located in the United States (N=13,146). PARTICIPANTS:All per...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52352.x
更新日期:2004-08-01 00:00:00