Abstract:
OBJECTIVE:To examine the relationship between restraint use and falls while controlling for the effect of psychoactive drug use among nursing home residents, including subgroups of nursing home residents with high rates of restraint use and/or falls. DESIGN:Secondary analysis of data from a longitudinal clinical trial designed to reduce restraint use. SETTING:Three nursing homes. PARTICIPANTS:Subjects (n = 322) were either restrained (n = 119) or never restrained (n = 203) at each observation point during a 9.5-month data collection period that preceded the intervention phase of the clinical trial. MEASUREMENTS:We evaluated restraint status (independent variable) three times during the data collection period by direct observation over a 72-hour period. Incident reports documenting falls and fall-related injuries (dependent variables) were reviewed. Cognitive status was measured using the Folstein Mini-Mental State Exam and functional status (including ambulation status) by the Psychogeriatric Dependency Rating Scale. Psychoactive drug use profile was obtained through record review. MAIN RESULTS:Using multiple logistic regression, we compared the effect of restraint use on fall risk between a confused ambulatory subgroup and the remaining sample and found a significant difference in the odds ratio for falls and recurrent falls (P = .02; chi-square = 5.24, df = 1; P = .003, chi-square = 9.12, df = 1). In the confused ambulatory subgroup, restraint use was associated with increased falls (odds ratio: 1.65, 95% CI: 0.69, 3.98) as well as recurrent fall risk (odds ratio: 2.46, 95% CI: 1.03, 5.88). Increased falls and recurrent fall risk was not observed in the remaining sample (falls odds ratio: 0.49, 95% CI: 0.28, 0.87; recurrent falls odds ratio: 0.42, 95% CI: 0.20, 0.91). One subgroup, the nonconfused ambulatory residents, were never restrained; after removing this subgroup, the confused ambulatory continued to be associated, though not significantly, with a higher risk of falls and injuries. Only nonconfused nonambulatory restraints were associated with a lower risk of all three outcomes: falls (odds ratio: 0.28, 95% CI: 0.05, 1.58), recurrent falls (odds ratio: 0.48, 95% CI: 0.05, 4.72), and injurious falls (odds ratio:0.42, 95% CI: 0.04, 4.01); these results, however, were not statistically significant. There was no evidence that the effect of restraint use on fall risk depended upon the use of psychoactive drugs (chi square = 4.43; df = 2, P = .11). CONCLUSION:Restraints were not associated with a significantly lower risk of falls or injuries in subgroups of residents likely to be restrained. These findings support individualized assessment of fall risk rather than routine use of physical restraints for fall prevention. Researchers and clinicians should continue to focus efforts on developing a variety of approaches that reduce risk of falls and injuries and promote mobility rather than immobility.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Capezuti E,Evans L,Strumpf N,Maislin Gdoi
10.1111/j.1532-5415.1996.tb01822.xsubject
Has Abstractpub_date
1996-06-01 00:00:00pages
627-33issue
6eissn
0002-8614issn
1532-5415journal_volume
44pub_type
杂志文章,多中心研究abstract::The second heart sound was studied by phonocardiography and carotid tracings in 103 elderly subjects without overt evidence of heart disease. Their ages ranged from 60 to 99 years. A normal type of splitting was found in 55.3%, and a single sound in 41.7%. The difference between these percentages and those found in 60...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1977.tb00665.x
更新日期:1977-08-01 00:00:00
abstract:OBJECTIVES:To assess the physical and mental health status of older long-term cancer survivors. DESIGN:Cohort study using propensity score methods to control for baseline differences between cancer survivors and controls. SETTING:General community population in the United States. PARTICIPANTS:Nine hundred sixty-four...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.00507.x
更新日期:2005-12-01 00:00:00
abstract::A trial by any means that can possibly prevent or retard the development of arteriosclerosis is to be recommended. Arteriosclerosis is the chief cause of strokes and heart attacks. The heavy evening meal now in vogue is characteristically rich in animal fats. Normal digestion is at its peak at about the seventh hour, ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1978.tb02404.x
更新日期:1978-06-01 00:00:00
abstract::Since 2012, the American Geriatrics Society (AGS) has also been collaborating with the American Board of Internal Medicine (ABIM) Foundation, joining its "Choosing Wisely" campaign on two separate lists of Five Things Healthcare Providers and Patients Should Question. The campaign is designed to engage healthcare orga...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.12770
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVES:To identify fracture types in a series of older adults with pelvic fractures and to determine whether the type of pelvic fracture affected short-term outcomes and morbidity. DESIGN:Retrospective chart review. SETTING:Teaching hospital. PARTICIPANTS:One hundred eighty-one individuals aged 65 and older with...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03455.x
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVES:To describe the pattern and factors associated with daily medication use in nursing home (NH) residents with advanced dementia. DESIGN:Prospective cohort study. SETTING:Twenty-two Boston-area NHs. PARTICIPANTS:NH residents with advanced dementia (N=323). MEASUREMENTS:Data from residents' records were use...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2010.02819.x
更新日期:2010-05-01 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
abstract:OBJECTIVES:To provide descriptive epidemiological information on identified depression in nursing home residents. DESIGN:Survey of the 1996 Medical Expenditure Panel Survey-Nursing Home Component (MEPS-NHC). SETTING:Nine hundred fifty-one nursing facilities. PARTICIPANTS:Three thousand seven hundred ten noncomatose ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2003.51458.x
更新日期:2003-10-01 00:00:00
abstract::In 13 elderly patients, 12 of whom had Parkinson's disease, visual hallucinations and delirium developed as a side effect of amantadine hydrochloride (Symmetrel) therapy. The symptoms promptly disappearred when amantadine was discontinued. Thereafter, each parkinsonian patient was treated satisfactorily with levo-dopa...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1975.tb00187.x
更新日期:1975-05-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Nursing facility (NF) residents are commonly hospitalized, and many of these hospitalizations may be avoidable. A Centers for Medicare & Medicaid Services (CMS) initiative enables participating NFs to bill Medicare for providing on-site acute care to long-stay residents diagnosed with one of six a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16901
更新日期:2020-11-12 00:00:00
abstract::The primary and secondary diagnoses for 100 geriatric patients consecutively admitted to a nursing home were reviewed for accuracy and omissions. Primary diagnoses were identified as the direct basis for nursing home admission. Other physical, biochemical or behavioral disorders requiring continued therapeutic care we...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1976.tb04281.x
更新日期:1976-03-01 00:00:00
abstract::Cognitive impairment in old age is one of the most important topics in modern geriatrics. This article discusses the historical dimensions of this phenomenon. To this end, a number of primary sources ranging from antiquity to the modern era are evaluated. Although a physiology and pathology of old age were conceptuali...
journal_title:Journal of the American Geriatrics Society
pub_type: 历史文章,杂志文章
doi:10.1111/j.1532-5415.2005.53558.x
更新日期:2005-11-01 00:00:00
abstract::Oral temperature has long been used as a basis for clinical decisions. The ingestion of cold liquids such as iced water, which are frequently found at patients' bedsides or in clinic waiting areas, has been believed to potentially lower oral temperature readings. The degree and duration of this effect, however, has no...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb04245.x
更新日期:1986-07-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:Patient activation encompasses the knowledge, skills, and confidence that equip adults to participate actively in their healthcare. Patients with hearing loss may be less able to participate due to poor aural communication. We examined whether difficulty hearing is associated with lower patient ac...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15833
更新日期:2019-07-01 00:00:00
abstract::Understanding variability in conceptions of dementia in multiethnic populations is important to improve care and guide research. The objectives of this study were to describe caregiver conceptions of dementia using a previously developed typology and to examine the correlates of conceptions of dementia in a multiethni...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53409.x
更新日期:2005-08-01 00:00:00
abstract:OBJECTIVE:To examine public opinion regarding certain elements of consent: disclosure, advance directives, substitute decisions, emergency treatment, and advocacy. DESIGN:Cross-sectional random-digit-dialing telephonic survey. SETTING:General public. PARTICIPANTS:One thousand randomly-selected adults living in Ontar...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1993.tb02042.x
更新日期:1993-02-01 00:00:00
abstract:OBJECTIVES:To assess the feasibility of cognitive screening in older veterans presenting for routine primary care. DESIGN:Quality improvement initiative. SETTING:Seven Veterans Affairs Medical Centers. PARTICIPANTS:Veterans aged 70 and older without a prior diagnosis of cognitive impairment. MEASUREMENTS:Scores fro...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2010.03249.x
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:To assess colonization and infection with methicillin-resistant Staphylococcus aureus (MRSA), high-level gentamicin-resistant enterococci (R-ENT) and gentamicin and/or ceftriaxone-resistant Gram-negative bacilli (R-GNB) and the factors that are associated with colonization and infection with these organisms. ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb06210.x
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVES:To compare self-reporting of pain by cognitively impaired (CI) older adults living in the community with reports of their caregivers; to identify the factors associated with differences in agreement; and to identify those pain assessment tools that are most useful to nonprofessional caregivers. DESIGN:Prosp...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2000.tb03871.x
更新日期:2000-12-01 00:00:00
abstract:OBJECTIVES:To investigate the effects of the changes in serum bioavailable and total testosterone (TT) levels with aging on visceral body fat distribution and muscle strength in Chinese men. DESIGN:Cross-sectional study. SETTING:Ambulatory care. PARTICIPANTS:Four hundred seventy-five healthy ambulatory Chinese men (...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.01746.x
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVES:To evaluate the effect on outcomes of the Ohio Department of Public Safety statewide geriatric triage criteria, established in 2009 for emergency medical services (EMS) to use for injured individuals aged 70 and older. DESIGN:Retrospective cohort study of the Ohio Trauma Registry. SETTING:All hospitals in ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14376
更新日期:2016-10-01 00:00:00
abstract:OBJECTIVES:To assess the prevalence of protocols or guidelines for selected domains of inpatient care for older adults; to explore associations between hospital characteristics and adoption of these guidelines or protocols. DESIGN:Telephone- and Web-based questionnaire. SETTING:General acute care hospitals in Pennsyl...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2010.03056.x
更新日期:2010-10-01 00:00:00
abstract::Two cases are reported of left atrial myxoma in elderly patients, diagnosed by combined M-mode and bidimensional echocardiography. One patient was an 80-year-old man presenting with typical signs of mitral obstruction by an atrial tumor. His symptoms were erroneously attributed to chronic bronchitis until an echocardi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1981.tb01748.x
更新日期:1981-10-01 00:00:00
abstract:BACKGROUND:Weight loss among older patients is a severe problem, associated with an increased incidence of infections, decubiti, and death. Megestrol acetate (MA) causes weight gain in cachectic cancer and AIDS patients, but its effects in older cachectic patients are unknown. OBJECTIVE:To compare the effects of MA or...
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.1532-5415.2000.tb04993.x
更新日期:2000-05-01 00:00:00
abstract::Thirty-two patients entered a simple-blind, cross-over study on the action of tocopherol in osteoarthritis; only 3 did not complete the course. Each patient was randomly assigned either to the tocopherol group (600 mg/day for 10 days) or to the placebo group. After 10 days the groups were transposed. The analgesic and...
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.1532-5415.1978.tb01345.x
更新日期:1978-07-01 00:00:00
abstract::Despite concerted effort to rehabilitate and return patients to their homes, the majority of nursing home patients are destined to spend the remainder of their days in institutional settings. These custodial care patients are elderly, have many functional disabilities, and are often demented. The traditional medical a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1985.tb05442.x
更新日期:1985-12-01 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:OBJECTIVES:To assess how various stakeholders involved with nursing home care rate the importance of various quality-of-life (QoL) items for hypothetical residents with varying types of impairment. DESIGN:A community-based exploratory description of a convenience sample. SETTING:Eleven nursing homes in Florida, New J...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2005.00493.x
更新日期:2005-12-01 00:00:00
abstract:OBJECTIVES:To determine the utility of hypodermoclysis in the management of dehydration in nursing home residents and to review the recent literature on the use of clysis in older adults. DESIGN:A retrospective chart review. SETTING:Two continuing care retirement community nursing home units in Cincinnati. PARTICIPA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1996.tb01870.x
更新日期:1996-08-01 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