Abstract:
OBJECTIVES:To identify patient factors that influence physicians' decisions to recommend screening mammograms for older women. DESIGN:A cross-sectional survey including clinical case vignettes. PARTICIPANTS:Random sample of Massachusetts internists, obstetrician/gynecologists, family/general practice physicians, and geriatricians. OUTCOME MEASURE:Proportion of screening mammograms recommended for women in different versions of each case vignette. RESULTS:A total of 482 (65%) of the eligible participants responded to a mailed survey of questions about breast cancer screening practices, attitudes toward ACS guidelines, and four clinical vignettes. Vignettes tested the impact of patient's age, cognitive function, nursing home residence, functional limitations, and comorbidity on the physician's decision to recommend a mammogram. Ninety-four percent of physicians reported often performing periodic clinical breast exams and mammograms for women aged 65 to 74. For women aged 75 to 84, 89% of physicians reported often performing periodic clinical breast exams, and 79% recommend mammograms. Only 48% strongly agreed with ACS guidelines for annual mammography for women over 65. Age, dementia, and nursing home residence were patient factors associated with decreased mammogram use, but limited mobility and chronic medical problems were not. Physicians were more likely to recommend a mammogram for a woman aged 65 to 74 than for a woman 75 to 84. (P = .002) Physicians were more likely to recommend a mammogram for a woman without dementia than for a woman with mild dementia (P < .05) and for a woman living with her daughter than a for a woman living in a nursing home (P < .001). CONCLUSIONS:Age older than 75, mild dementia, and nursing home residence are factors that negatively influence physicians' decisions to recommend mammography. Presence of chronic medical problems and functional limitations do not. Physicians appear to be using implicit judgments about quality of life and age rather than life expectancy based on comorbidity to determine breast cancer screening practices.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Marwill SL,Freund KM,Barry PPdoi
10.1111/j.1532-5415.1996.tb01371.xsubject
Has Abstractpub_date
1996-10-01 00:00:00pages
1210-4issue
10eissn
0002-8614issn
1532-5415journal_volume
44pub_type
杂志文章abstract:PURPOSE:To determine whether the management of heart failure by specialized multidisciplinary heart failure disease-management programs was associated with improved outcomes. BACKGROUND:The advent of angiotensin-converting enzyme inhibitors, beta-blockers, and spironolactone has revolutionized the management of heart ...
journal_title:Journal of the American Geriatrics Society
pub_type: 评论,杂志文章
doi:10.1046/j.1532-5415.2002.50418.x
更新日期:2002-09-01 00:00:00
abstract:OBJECTIVES:To understand characteristics of older at-risk drinkers and reasons why they decide to change or maintain their alcohol consumption. DESIGN:Secondary analysis of data from a randomized controlled trial to reduce drinking in at-risk drinkers. SETTING:Three primary care sites in southern California. PARTICI...
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.12394
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVES:To identify risk factors for new-onset geriatric epilepsy that may trigger clinicians to consider a differential diagnosis of epilepsy at symptom onset. DESIGN:Retrospective cohort study. SETTING:National Veterans Affairs (VA) databases. PARTICIPANTS:Veterans aged 66 and older in fiscal year 2000 (FY00) w...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.02124.x
更新日期:2009-02-01 00:00:00
abstract::In 50 patients with coronary heart disease (CHD) and 38 controls, comparative data on age, sex, serum cholesterol level, hypertension, obesity, diabetes, smoking habits, and ear-lobe creases were analyzed statistically. After adjustment for age differences, the factors which chiefly distinguished the two groups were t...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1977.tb00290.x
更新日期:1977-04-01 00:00:00
abstract::As nursing homes become increasingly important sites for biomedical and behavioral research, researchers must address the ethical problems of increased vulnerability and the high prevalence of mental and physical disorders in the nursing home population. Obtaining valid informed consent is but one of the many difficul...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1993.tb07470.x
更新日期:1993-07-01 00:00:00
abstract:OBJECTIVES:To test for simvastatin-induced changes in affect and affective processes in elderly volunteers. DESIGN:Randomized, clinical trial. SETTING:The Geriatric Behavioral Psychopharmacology Laboratory at the University of Pennsylvania. PARTICIPANTS:Eighty older volunteers, average age 70, with high normal/mildl...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1532-5415.2005.00542.x
更新日期:2006-01-01 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:OBJECTIVES:To model the relative contributions of driver data and clinical judgments to clinical ratings of driver capability for a state licensing authority and to compare ratings with on-road test results. DESIGN:Retrospective, logistic regression. SETTING:Missouri Driver License Bureau. PARTICIPANTS:Adults aged 6...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14022
更新日期:2016-04-01 00:00:00
abstract::A cohort of 3,595 white women aged 40-77 years was followed for an average of 10 years during which 84 new cases of hip fracture were identified. Triceps skinfold thickness and arm muscle area measured at baseline were examined as possible risk factors for hip fracture controlling for physical activity, height, menopa...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1989.tb01562.x
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:To determine whether patient age is associated with differences in flexible bronchoscopy technique and tolerance. DESIGN:Prospective cohort study. SETTING:University hospital system. PARTICIPANTS:One thousand three hundred fifty-eight adults, including 219 (16.1%) aged 70 and older, undergoing bronchoscop...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1365-2389.2003.51303.x
更新日期:2003-07-01 00:00:00
abstract::The US Department of Health and Human Services and the Foundation for the National Institutes of Health, through private sector support, sponsored the National Research Summit on Dementia Care: Building Evidence for Services and Supports (Summit) in 2017. Various workgroups were asked to address topics of interest in ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16341
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:To develop a reliable and valid dementia knowledge scale to address limitations of existing measures, support knowledge evaluation in diverse populations, and inform educational intervention development. DESIGN:A five-stage, systematic scale development process was employed to construct and assess the psych...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13707
更新日期:2015-11-01 00:00:00
abstract::Evidence of poor performance in the evaluation and management of common geriatric conditions suggests the need for changing physician behavior in these areas. Traditional lecture-style continuing medical education (CME) has not been shown to be effective. Expert faculty initially trained 60 nonexpert peer educators to...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2007.01205.x
更新日期:2007-08-01 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:OBJECTIVES:To estimate the incidence of chronic activities of daily living (ADL) disability and to analyze the sociodemographic, health status, adverse lifestyle, and leisure-time physical activity predictors for chronic ADL disability. DESIGN:We recruited a cohort of community-dwelling older people in Taipei, Taiwan,...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb05231.x
更新日期:1999-09-01 00:00:00
abstract::To better understand declining autopsy rates, data have been gathered prospectively on 1080 consecutive deaths over six years among patients admitted to a medical intensive care/coronary care unit. Overall autopsy rate was 36%. Autopsy rates declined sharply with age from 60% for those aged 16 to 34 years to 23% for t...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1986.tb07260.x
更新日期:1986-12-01 00:00:00
abstract:OBJECTIVES:To characterize emergency department (ED) use by nursing home residents in the United States. DESIGN:Analysis of the National Hospital Ambulatory Medical Care Survey. SETTING:U.S. EDs from 2005 to 2008. PARTICIPANTS:Individuals visiting U.S. EDs stratified according to nursing home residency. MEASUREMENT...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2011.03587.x
更新日期:2011-10-01 00:00:00
abstract::The introduction of Japan's long-term care insurance (LTCI) system in April 2000 has made long-term care an explicit and universal entitlement for every Japanese person aged 65 and older based strictly on physical and mental status. At the start of the program, more than two million seniors were expected to apply for ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53175.x
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVES:As a person's age increases and his/her health status declines, new challenges arise that may lead physicians to consider deprescribing statins. We aimed to provide insight into recommendations available in international cardiovascular disease prevention guidelines regarding discontinuation of statin treatme...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16219
更新日期:2020-02-01 00:00:00
abstract::Aortic systolic murmurs and aortic dilatation were studied in a randomized sample of 100 hospital patients over the age of 60. Clinical, phonocardiographic, radiologic and carotid-pulse data provided the basis for graphic characterization of the murmurs. Senile aortic dilatation was common (66 patients). In a high per...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1976.tb03314.x
更新日期:1976-08-01 00:00:00
abstract:BACKGROUND/OBJECTIVES:The American College of Cardiology (ACC) Geriatric Cardiology Section Leadership Council recently outlined 4 key domains (which are composed of 14 subdomains) that are important to assess in older adults with heart failure (HF). We sought to determine which geriatric domains/subdomains are routine...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.16183
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVES:To quantify incidence of tooth loss, prosthodontic dental restoration, and chewing difficulty onset and the effect of tooth loss and prosthodontic restoration on chewing difficulty onset. DESIGN:A prospective cohort study of oral health and related behaviors with in-person interviews and clinical examinatio...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2004.52253.x
更新日期:2004-06-01 00:00:00
abstract::Two concurrent studies of geriatric outpatients who received diagnoses of depression were conducted. In the first, patients were treated with one of two tricyclic antidepressants or with a placebo. In the second, patients were assigned to groups receiving either psychodynamic group therapy or cognitive-behavioral grou...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb01987.x
更新日期:1982-11-01 00:00:00
abstract:OBJECTIVE:To describe the prevalence and content of long-term care facility policies regarding the use of life-sustaining treatments (cardiopulmonary resuscitation (CPR), artificial hydration and nutrition, dialysis, antibiotics for life-threatening infections, transfer to acute care hospital) and advance directives in...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb06980.x
更新日期:1994-11-01 00:00:00
abstract:OBJECTIVES:To explore the effect of inflammation and undernutrition on the association between hypocholesterolemia and higher overall mortality in high-functioning older persons. DESIGN:Prospective cohort study. SETTING:Three U.S. communities. PARTICIPANTS:A cohort of 870 participants from the MacArthur Studies of S...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1034/j.1601-5215.2002.51014.x
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVES:To prospectively validate and refine the 5-item "CRASH" screening tool for identifying older drivers needing a behind-the-wheel (BTW) test. DESIGN:Prospective observational study. SETTING:Geriatric and internal medicine primary care clinics affiliated with a tertiary care hospital and a local BTW program. ...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.15222
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVES:To compare the effects of 12 months of vitamin D3 supplementation with that placebo on lean mass, bone mineral density (BMD), and muscle strength in overweight or obese postmenopausal women completing a structured weight-loss program. DESIGN:Double-blind, placebo-controlled randomized clinical trial. SETTI...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14049
更新日期:2016-04-01 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::The effect of age on glucose tolerance, insulin secretion, and in vivo insulin action (insulin clamp) was studied in 48 nonobese subjects, all of whom were fully ambulatory and in good general health. The observed age-related increase in fasting plasma glucose (r = 0.35, P less than 0.01) was not due to an increase in...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb05662.x
更新日期:1982-09-01 00:00:00
abstract:OBJECTIVES:To assess the feasibility and validity of the International Dementia Alliance (IDEAL) instrument for Informal Caregivers (IDEAL-IC), which is based on the IDEAL instrument for professionals (IDEAL-P), for staging individuals with dementia. DESIGN:Cross-sectional. SETTING:Memory clinic of a university hospi...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.14205
更新日期:2016-08-01 00:00:00