Abstract:
OBJECTIVE:To identify age-related differences in the treatment of patients with acute myocardial infarction. DESIGN:Retrospective cohort study. SETTING:Two university-affiliated medical centers with integrated clinical programs. PATIENTS:329 patients admitted with acute myocardial infarction in 1988-1990 for whom complete medical records were available. Study exclusions included patients transferred from other hospitals specifically to undergo angiography or other cardiac procedures, nursing home residents, patients with metastatic cancer or dementia, and patients in whom "do not resuscitate" orders were written during the first 2 hospital days. MEASUREMENTS:Medical records were reviewed to determine socio-demographic data, comorbidity, admission severity of illness, medications, the use of specific diagnostic and therapeutic modalities during and after hospitalization, treatment limitations, and patient outcomes. MAIN RESULTS:Chronological age of patients was related to the use of several diagnostic and therapeutic modalities. Using logistic regression to adjust for comorbidity, severity, infarct size and location, and other covariates, patients 75 years and older were 12 times less likely to receive thrombolytic therapy, 8 times less likely to undergo coronary angiography, and 7 times less likely to undergo coronary angioplasty than patients less than 65 years of age. However, age was not related to the use of other modalities, including echocardiography or gated blood pool scanning, pulmonary artery catheterization, and transvenous pacing. Finally, in a logistic regression model, the risk of in-hospital death was 4 times greater for patients 75 years and older than patients less than 65 years. CONCLUSIONS:Physicians' management of patients with acute myocardial infarction differed greatly according to patient age for some diagnostic and therapeutic modalities, but not for others. These findings indicate that generalizations about age-related practice variations should not be based on analysis of a single procedure. Moreover, judgments about the appropriateness of age-related differences in management require knowledge of the relative effectiveness of management strategies in older and younger patients.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Rosenthal GE,Fortinsky RHdoi
10.1111/j.1532-5415.1994.tb06553.xsubject
Has Abstractpub_date
1994-08-01 00:00:00pages
826-32issue
8eissn
0002-8614issn
1532-5415journal_volume
42pub_type
杂志文章,多中心研究abstract:OBJECTIVES:To develop and evaluate the psychometric properties of two new urge incontinence-specific instruments that measure quality of life and symptom annoyance. DESIGN:New instruments were developed and validated in racially, ethnically, and age-diverse community-dwelling women with urge or mixed incontinence with...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb01294.x
更新日期:1999-08-01 00:00:00
abstract::The author's concept of loneliness is described, especially as it concerns the elderly. An attempt is made to develop an understanding of the word, with its implications for guidance in the nursing profession. The nurse's defenses against her own feelings of loneliness and depression can inhibit therapeutic interactio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1978.tb05048.x
更新日期:1978-04-01 00:00:00
abstract:OBJECTIVES:To evaluate the effectiveness of wheelchair assessment and configuration on pressure injury incidence, mobility, and functioning in a wheelchair. DESIGN:Randomized controlled trial with participants individually randomized into intervention and control groups. SETTING:Nursing home. PARTICIPANTS:Nursing ho...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.15495
更新日期:2018-09-01 00:00:00
abstract::Logical bases (five of which are outlined) underlie action in nutrition and aging. First, nutrition, health, and aging form an integral triad affecting all. This basis has been applied to the conceptualization of the Nutrition Program for Older Americans (NPOA). Second, in North America, malnutrition is a sequitur of ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1978.tb01958.x
更新日期:1978-05-01 00:00:00
abstract:OBJECTIVES:To describe the essential components of an Agile Implementation (AI) process, which rapidly and effectively implements evidence-based healthcare solutions, and present a case study demonstrating its utility. DESIGN:Case demonstration study. SETTING:Integrated, safety net healthcare delivery system in India...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15283
更新日期:2018-07-01 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:OBJECTIVES:To determine whether performance speeds mediate the association between visual impairment and self-reported mobility disability over an 8-year period. DESIGN:Longitudinal analysis. SETTING:Salisbury, Maryland. PARTICIPANTS:Salisbury Eye Evaluation Study participants aged 65 and older (N=2,520). MEASUREME...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12937
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:To evaluate the usefulness of standardized neuropsychological tests in the psychometric differentiation of patients with very mild or mild Alzheimer's Disease (AD) and/or major depression presenting in a tertiary clinic with memory/attention complaints. DESIGN:Controlled prospective clinicoexperimental desig...
journal_title:Journal of the American Geriatrics Society
pub_type: 临床试验,杂志文章
doi:10.1111/j.1532-5415.1995.tb07402.x
更新日期:1995-11-01 00:00:00
abstract:OBJECTIVE:To survey physicians to determine whether sociodemographic and practice-related variables are predictive of their attitudes toward suicide. DESIGN:Mailed questionnnaire survey. SETTING:Monroe County, New York. PARTICIPANTS:A 50 percent random sample of practicing primary care physicians. Of 186 potential r...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1995.tb05814.x
更新日期:1995-04-01 00:00:00
abstract:BACKGROUND/OBJECTIVE:Delirium in the intensive care units (ICUs) is prevalent, with both delirium duration and delirium severity associated with adverse outcomes. We designed a pragmatic trial to test the efficacy of a pharmacological management of delirium (PMD) bundle in improving delirium/coma-free days and reducing...
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/jgs.15781
更新日期:2019-05-01 00:00:00
abstract:OBJECTIVES:To assess the feasibility of a vitamin D intervention delivered through a Meals-on-Wheels (MOW) program to improve 25-hydroxyvitamin D (25(OH)D) concentrations and reduce falls in homebound older adults. DESIGN:Single-blind, cluster randomized trial. SETTING:MOW, Forsyth County, North Carolina. PARTICIPAN...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/jgs.13610
更新日期:2015-09-01 00:00:00
abstract:OBJECTIVES:Medicare value-based payment programs evaluate physicians' performance on their patients' annual Medicare costs and clinical outcomes. However, little is known about how geriatricians, who disproportionately provide care for medically complex older adults, perform on these measures. DESIGN:A retrospective s...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16297
更新日期:2020-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was fourfold; to determine the rate of delirium among hospitalized older persons, to contrast the clinical outcomes of patients with and without delirium, to identify clinical predictors of delirium, and to validate the predictive model in an independent sample of patients. DESIGN:T...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb06551.x
更新日期:1994-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Mammographic screening for breast cancer is of uncertain clinical benefit for women 75 years of age and older. Some have argued against instituting routine screening in this age group, noting that disability and shorter life expectancy may diminish the desirability and cost-effectiveness of sc...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1998.tb02746.x
更新日期:1998-08-01 00:00:00
abstract:BACKGROUND:Coffee and tea are two of the most widely consumed beverages worldwide and have been associated with reduced risk of mortality in some studies. However, it is unknown whether consumption of these beverages is associated with survival to an advanced age. OBJECTIVE:To examine associations of coffee and tea co...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16467
更新日期:2020-09-01 00:00:00
abstract::Ethical issues surrounding decisions to limit treatment often focus on dramatic and highly technical interventions, such as mechanical ventilation. Many less dramatic forms of therapy are considered routine, and ethical aspects of their use may be less closely examined. Nutritional support can be crucially important i...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1984.tb02009.x
更新日期:1984-03-01 00:00:00
abstract:OBJECTIVES:To examine the association between alcohol intake and problem drinking history and bone mineral density (BMD), falls and fracture risk. DESIGN:Cross-sectional and prospective cohort study. SETTING:Six U.S. clinical centers. PARTICIPANTS:Five thousand nine hundred seventy-four men aged 65 and older. MEASU...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2006.00912.x
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVES:To determine the perspectives of seriously ill individuals on reasons for 30-day hospital readmission. DESIGN:A prospective qualitative study was conducted employing individual interviews conducted at bedside. SETTING:Department of Veterans Affairs Greater Los Angeles Healthcare System. PARTICIPANTS:Serio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13238
更新日期:2015-03-01 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:OBJECTIVES:To assess the effect of exposure to evidence-based medication after hospital discharge for Medicare beneficiaries with acute myocardial infarction (AMI). DESIGN:A discrete-time hazard model was used to estimate time to outcome associated with exposure to four drug classes (angiotensin-converting enzyme inhi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2012.04165.x
更新日期:2012-10-01 00:00:00
abstract::All living beings are at risk for experiencing infections; humans are no exception. The prestige and credibility of modern medicine is built in large part on achievements in preventing and treating infectious diseases. For most of human history, there was little that could be done to prevent and treat infections. Mill...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.16205
更新日期:2020-01-01 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::At an active outpatient geriatric program the gerontological team observed that Alzheimer patients appear to have fewer physical ailments than other elderly patients. To test this hypothesis, we reviewed a sample of 348 clinic patients. One hundred forty-three had a normal mental status; 75 had Alzheimer's disease as ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1988.tb01804.x
更新日期:1988-03-01 00:00:00
abstract:OBJECTIVES:To identify risk factors for five different subtypes of disability. DESIGN:Prospective cohort study. SETTING:Greater New Haven, Connecticut. PARTICIPANTS:Seven hundred fifty-four community-living residents aged 70 and older and initially nondisabled in four essential activities of daily living (bathing, d...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2009.02443.x
更新日期:2009-10-01 00:00:00
abstract:OBJECTIVE:To determine whether mortality is independently associated with urinary incontinence. DESIGN:6-year prospective study that started in 1983/84. SETTING:A Midwestern County. PARTICIPANTS:Probability sample of 1956 community-residing persons 60 years of age and older in 1983/84. MEASUREMENTS:The independent ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb01749.x
更新日期:1994-03-01 00:00:00
abstract::In reviewing the literature on treatment approaches with the psychiatric elderly, a large number of studies were found which espouse comprehensive rehabilitation programs that usually require supplementation of existing personnel and expansion of facilities. Although some agencies and institutions are fortunate in sec...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1977.tb00648.x
更新日期:1977-07-01 00:00:00
abstract::The aim of this study was to evaluate the usefulness of Silver's Cerebral Function Test in predicting the management and placement of patients admitted to a psychogeriatric hospital. Overall, 205 consecutively admitted patients and 54 age-matched controls living in the community were examined, thereby greatly extendin...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1977.tb00409.x
更新日期:1977-06-01 00:00:00
abstract:OBJECTIVES:To examine differences in a proxy measure of muscle quality across the adult life span and explore potential mechanisms of muscle quality change through identification of cross-sectional correlates of muscle quality. DESIGN:Cross-sectional study. SETTING:Baltimore Longitudinal Study of Aging. PARTICIPANTS...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12653
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVES:To evaluate changes in acute health services use of Senior PharmAssist participants. DESIGN:Retrospective analysis. SETTING:Community-based, nonprofit program in Durham County, North Carolina. PARTICIPANTS:Adults aged 60 and older with income of 200% of the federal poverty level or less who enrolled in th...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15617
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To determine whether older people who use nonsteroidal anti-inflammatory agents (NSAIDs) have increased levels of blood urea nitrogen (BUN), serum creatinine, and BUN:serum creatinine ratio. DESIGN:Cross-sectional, secondary data analysis. SETTING:Older people living in the communities of East Boston, MA, N...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb02561.x
更新日期:1999-05-01 00:00:00