Abstract:
:Difficulties exist in making treatment decisions for the very old and dependent patient. In the years to come, these difficulties will increase. It is argued that such persons should not be abandoned to their "rights" as autonomous persons; yet quality of life judgments should also be avoided except in limited circumstances. Since aging is a process of becoming more dependent, the author proposes a dependency rule, by which greater responsibility for treatment decisions falls on care-givers as a person's dependency increases. In place of quality of life judgments he suggests a medical indications policy, if the latter includes restoration of some affective function. Five kinds of freedom are proposed, of which only some are lost in chronic illness and old age. Finally, it is suggested that life itself involves greater interdependence than the autonomy criterion itself can allow. The author focuses on the problem of dependency in the aged and the role an increase in this dependency plays, with corresponding loss of personal autonomy, in quality of life judgments. These, in turn, form the basis for treatment decisions.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Thomasma DCdoi
10.1111/j.1532-5415.1984.tb00892.xsubject
Has Abstractpub_date
1984-12-01 00:00:00pages
906-14issue
12eissn
0002-8614issn
1532-5415journal_volume
32pub_type
杂志文章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::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::Pfeiffer's Short Portable Mental Status Questionnaire (SPMSQ) is a brief screening test for organic brain syndromes. The validity of the SPMSQ was evaluated in a random sample of 119 community residents and 282 consecutively admitted medical inpatients. The SPMSQ proved to be a sensitive and specific screening test fo...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1987.tb04662.x
更新日期:1987-05-01 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::One hundred seventy-one patients, 60 years of age or older with isolated systolic hypertension, were randomly assigned to receive chlorthalidone 12.5, 25.0, or 50.0 mg or placebo once daily for 12 weeks. The majority of the patients receiving chlorthalidone 12.5 mg achieved therapeutic success with no clinically signi...
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.1532-5415.1986.tb04203.x
更新日期:1986-03-01 00:00:00
abstract:OBJECTIVES:To prospectively examine associations between accelerometer-measured physical activity (PA) and mortality in older women, with an emphasis on light-intensity PA. DESIGN:Prospective cohort study with baseline data collection between March 2012 and April 2014. SETTING:Women's Health Initiative cohort in the ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15201
更新日期:2018-05-01 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:OBJECTIVES:To explore agreement between the Family Confusion Assessment Method (FAM-CAM) for delirium identification and interviewer-rated CAM delirium ratings. DESIGN:Exploratory analysis of agreement. SETTING:Community. PARTICIPANTS:Fifty-two family caregivers and 52 elderly adults with preexisting impairment acco...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.04200.x
更新日期:2012-11-01 00:00:00
abstract:BACKGROUND:The impact of parkinsonism on survival in older persons independent of dementia is not well understood. METHODS:Participants in the clinical examination of the Canadian Study of Health and Aging who had parkinsonism and were older than age 65 were identified. The impact of parkinsonism on 5-year survival wa...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb04701.x
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVES:To describe the prevalence of and characteristics associated with major and minor depression in older medical inpatients and to compare associated characteristics by sex and history of depression. DESIGN:Cross-sectional study of two patient samples, with and without a screening diagnosis of major or minor d...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53404.x
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVES:To analyze baseline data from the Ginkgo Evaluation of Memory (GEM) study, in which information was collected on the use of all dietary supplements. DESIGN:Cross-sectional regression analysis. SETTING:GEM study sites in California, Maryland, North Carolina, and Pennsylvania. PARTICIPANTS:The GEM study enr...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2006.00942.x
更新日期:2006-11-01 00:00:00
abstract::Cerebral blood flow (CBF) was measured by the 133Xe inhalation method in patients with multi-infarct dementia (MID, N = 26), Alzheimer's dementia (AD, N = 19), and among age-matched, neurologically normal, healthy volunteers (N = 26). Cognitive performance was assessed in all subjects using the Cognitive Capacity Scre...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb04318.x
更新日期:1986-05-01 00:00:00
abstract:OBJECTIVES:To study whether exercise is associated with the risk of venous thrombosis in elderly people. DESIGN:Observational study with a median follow-up of 11.6 years. SETTING:The Cardiovascular Health Study in four U.S. communities. PARTICIPANTS:People aged 65 and older without prior venous thrombosis (deep veno...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01588.x
更新日期:2008-03-01 00:00:00
abstract::Two types of follicular change in the thyroid are described. The first represents an involutional change in which colloid cysts (macrofollicles) are often found. The second represents a hyperplastic-dysplastic (microfollicular) lesion. Two types of change in calcitonin (C) cells are also described, one of which may re...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1987.tb02337.x
更新日期:1987-09-01 00:00:00
abstract:OBJECTIVES:To examine concerns that vulnerable populations, such as depressed or cognitively impaired beneficiaries would have challenges accessing Part D coverage. DESIGN:Logistic regression analysis was used to assess whether elderly Medicare beneficiaries with depression or cognitive impairment differentially plann...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02348.x
更新日期:2009-08-01 00:00:00
abstract::Japan implemented a mandatory social long-term care insurance (LTCI) system in 2000, making long-term care services a universal entitlement for every senior. Although this system has grown rapidly, reflecting its popularity among seniors and their families, it faces several challenges, including skyrocketing costs. Th...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.2007.01281.x
更新日期:2007-09-01 00:00:00
abstract:OBJECTIVES:To describe and provide baseline data from The National Pressure Ulcer Long-Term Care Study (NPULS). DESIGN:Retrospective cohort study of detailed resident characteristics, treatments, and outcomes using convenience sampling. SETTING:One hundred nine long-term care facilities throughout the United States. ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2002.50510.x
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVE:To determine demographic, functional, and health-related factors that may have influenced the selection of older adults for a randomized trial of balance enhancement. DESIGN:Comparison of participants with nonparticipants at various stages of the recruiting process. SETTING:Northeastern suburban community. ...
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.1532-5415.1996.tb06405.x
更新日期:1996-04-01 00:00:00
abstract::Salivary gland function is generally well-preserved in healthy older persons. Similar results are observed in the laboratory rat. Older people are, however, more likely to experience salivary disorders due to disease or its treatment. For many patients with remaining salivary gland parenchymal tissue, improved functio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1989.tb02644.x
更新日期:1989-05-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine if reported nighttime sleep problems and daytime sleepiness were associated with reported falling during the previous 12 months in a representatively sampled older adult population. DESIGN:Random-digit dial telephone survey. SETTING:Representatively sampled older ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb02596.x
更新日期:2000-10-01 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:OBJECTIVES:To determine the distribution of influenza vaccine coverage in the United States in 2008. DESIGN:Cross-sectional analysis. SETTING:The 2008 Behavioral Risk Factor Surveillance Survey, which employs random-digit dialing to interview noninstitutionalized adults in the United States and territories. PARTICIP...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02904.x
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVES:To determine whether older adults with mild cognitive impairment (MCI), a condition not previously explored as a risk factor, have more hospitalizations and 30-day readmissions than those with normal cognition. DESIGN:Post hoc analysis of prospectively gathered data on incident hospitalization and readmissi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/jgs.13593
更新日期:2015-09-01 00:00:00
abstract::The influence of aging on serum levels of gonadotropins (FSH and LH), testosterone and estradiol was studied in the following groups: 4 normal men (ages 30 to 50), 38 men with symptoms of the male climacteric (ages 51 to 84), 25 men with relative impotence (ages 31 to 50), 10 normal women (ages 24 to 31), and 6 menopa...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1976.tb04294.x
更新日期:1976-04-01 00:00:00
abstract:OBJECTIVES:To determine the long-term survival and independence of individuals with stroke and percutaneous endoscopic gastrostomy (PEG) tube placement. DESIGN:Retrospective cohort study. SETTING:A longitudinal nationally representative community-based sample of older adults. PARTICIPANTS:Individuals with stroke who...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14908
更新日期:2017-08-01 00:00:00
abstract::The ratio of pepsinogen I to pepsinogen II in the circulation decreases progressively with increasing severity of atrophic gastritis of the fundic gland mucosa. Fasting blood was obtained from 359 free-living and institutionalized elderly people (age range, 60 to 99 years). A pepsinogen I/pepsinogen II ratio less than...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb03985.x
更新日期:1986-11-01 00:00:00
abstract::The implications for society of increasing life span to 120 years can only be guessed, but comparing the diversity of responses to aging in different countries may give insights into the possible effect. A European Union-funded study of the recipients of community care services in 11 European countries illustrates how...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53497.x
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVES:To evaluate medication use, out-of-pocket spending, and medication switching during the transition period for patients dually eligible for Medicaid and Medicare (dual eligibles). DESIGN:Time-trend analysis, using segmented linear regression. SETTING:Patient-level pharmacy dispensing data from January 2005 ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.02025.x
更新日期:2008-12-01 00:00:00
abstract:OBJECTIVES:To report on the efficacy, safety, and tolerability of sertraline in the treatment of elderly depres-sed patients with and without comorbid medical illness. SETTING:Multicenter. DESIGN:Randomized, double-blind, placebo-controlled study. PARTICIPANTS:A total of 752 patients aged 60 and older with diagnosis...
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.1532-5415.2004.52015.x
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVES:To compare the effectiveness of acute geriatric unit care, based on all or part of the Acute Care for Elders (ACE) model and introduced in the acute phase of illness or injury, with that of usual care. DESIGN:Systematic review and meta-analysis of 13 randomized controlled and quasi-experimental trials with ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,meta分析,评审
doi:10.1111/jgs.12028
更新日期:2012-12-01 00:00:00