Pub Date : 2014-01-01Epub Date: 2014-02-17DOI: 10.1155/2014/357857
Sujatha Kawryshanker, Warren Raymond, Katharine Ingram, Charles A Inderjeeth
Background. A geriatric evaluation and management unit (GEM) manages elderly inpatients with functional impairments. There is a paucity of literature on frailty and whether this impacts on rehabilitation outcomes. Objectives. To examine frailty score (FS) as a predictor of functional gain, resource utilisation, and destinations for GEM patients. Methods. A single centre prospective case study design. Participants (n = 136) were ≥65 years old and admitted to a tertiary hospital GEM. Five patients were excluded by the preset exclusion criteria, that is, medically unstable, severe dementia or communication difficulties after stroke. Core data included demographics, frailty score (FS), and functional independence. Results. The mean functional improvement (FIM) from admission to discharge was 11.26 (95% CI 8.87, 13.66; P < 0.001). Discharge FIM was positively correlated with admission FIM (β = 0.748; P < 0.001) and negatively correlated with frailty score (β = -1.151; P = 0.014). The majority of the patients were in the "frail" group. "Frail" and "severely frail" subgroups improved more on mean FIM scores at discharge, relative to that experienced by the "pre-frail" group. Conclusion. All patients experienced functional improvement. Frailer patients improved more on their FIM and improved relatively more than their prefrail counterparts. Higher frailty correlated with reduced independence and greater resource utilisation. This study demonstrates that FS could be a prognostic indicator of physical independence and resource utilisation.
{"title":"Effect of Frailty on Functional Gain, Resource Utilisation, and Discharge Destination: An Observational Prospective Study in a GEM Ward.","authors":"Sujatha Kawryshanker, Warren Raymond, Katharine Ingram, Charles A Inderjeeth","doi":"10.1155/2014/357857","DOIUrl":"https://doi.org/10.1155/2014/357857","url":null,"abstract":"<p><p>Background. A geriatric evaluation and management unit (GEM) manages elderly inpatients with functional impairments. There is a paucity of literature on frailty and whether this impacts on rehabilitation outcomes. Objectives. To examine frailty score (FS) as a predictor of functional gain, resource utilisation, and destinations for GEM patients. Methods. A single centre prospective case study design. Participants (n = 136) were ≥65 years old and admitted to a tertiary hospital GEM. Five patients were excluded by the preset exclusion criteria, that is, medically unstable, severe dementia or communication difficulties after stroke. Core data included demographics, frailty score (FS), and functional independence. Results. The mean functional improvement (FIM) from admission to discharge was 11.26 (95% CI 8.87, 13.66; P < 0.001). Discharge FIM was positively correlated with admission FIM (β = 0.748; P < 0.001) and negatively correlated with frailty score (β = -1.151; P = 0.014). The majority of the patients were in the \"frail\" group. \"Frail\" and \"severely frail\" subgroups improved more on mean FIM scores at discharge, relative to that experienced by the \"pre-frail\" group. Conclusion. All patients experienced functional improvement. Frailer patients improved more on their FIM and improved relatively more than their prefrail counterparts. Higher frailty correlated with reduced independence and greater resource utilisation. This study demonstrates that FS could be a prognostic indicator of physical independence and resource utilisation. </p>","PeriodicalId":39066,"journal":{"name":"Current Gerontology and Geriatrics Research","volume":"2014 ","pages":"357857"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/357857","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32230605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01Epub Date: 2014-12-22DOI: 10.1155/2014/780535
Adetola M Ogunbode, Lawrence A Adebusoye, Olufemi O Olowookere, Mayowa Owolabi, Adesola Ogunniyi
Background. Insomnia is a form of chronic sleep problem of public health importance which impacts the life of elderly people negatively. Methods. Cross-sectional study of 843 elderly patients aged 60 years and above who presented consecutively at Geriatric Centre, University College Hospital, Ibadan, Nigeria. The World Health Organization Composite International Diagnostic Interview was used to diagnose insomnia. We assessed the following candidate variables which may be associated with insomnia such as socidemographic characteristics, morbidities, and lifestyle habits. Statistical analysis was done with SPSS 17. Results. The point prevalence of insomnia was 27.5%. Insomnia was significantly associated with being female, not being currently married, having formal education, living below the poverty line, and not being physically active. Health complaints of abdominal pain, generalized body pain, and persistent headaches were significantly associated with insomnia. Conclusion. The high prevalence of insomnia among elderly patients in this setting calls for concerted effort by healthcare workers to educate the elderly on lifestyle modification.
{"title":"Factors Associated with Insomnia among Elderly Patients Attending a Geriatric Centre in Nigeria.","authors":"Adetola M Ogunbode, Lawrence A Adebusoye, Olufemi O Olowookere, Mayowa Owolabi, Adesola Ogunniyi","doi":"10.1155/2014/780535","DOIUrl":"10.1155/2014/780535","url":null,"abstract":"<p><p>Background. Insomnia is a form of chronic sleep problem of public health importance which impacts the life of elderly people negatively. Methods. Cross-sectional study of 843 elderly patients aged 60 years and above who presented consecutively at Geriatric Centre, University College Hospital, Ibadan, Nigeria. The World Health Organization Composite International Diagnostic Interview was used to diagnose insomnia. We assessed the following candidate variables which may be associated with insomnia such as socidemographic characteristics, morbidities, and lifestyle habits. Statistical analysis was done with SPSS 17. Results. The point prevalence of insomnia was 27.5%. Insomnia was significantly associated with being female, not being currently married, having formal education, living below the poverty line, and not being physically active. Health complaints of abdominal pain, generalized body pain, and persistent headaches were significantly associated with insomnia. Conclusion. The high prevalence of insomnia among elderly patients in this setting calls for concerted effort by healthcare workers to educate the elderly on lifestyle modification. </p>","PeriodicalId":39066,"journal":{"name":"Current Gerontology and Geriatrics Research","volume":"2014 ","pages":"780535"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283425/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32973504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01Epub Date: 2014-03-24DOI: 10.1155/2014/358137
Robbert J J Gobbens, Marcel A L M van Assen
Frailty is a predictor of disability. A proper understanding of the contribution of individual indicators of frailty in the prediction of disability is a requisite for preventive interventions. The aim of this study was to determine the predictive power of the individual physical frailty indicators: gait speed, physical activity, hand grip strength, Body Mass Index (BMI), fatigue, and balance, for ADL and IADL disability. The sample consisted of 505 community-dwelling persons (≥75 years, response rate 35.1%). Respondents first participated between November 2007 and June 2008, and a subset of all respondents participated again one year later (N = 264, 52.3% response rate). ADL and IADL disability were assessed by the Groningen Activity Restriction Scale. BMI was assessed by self-report, and the other physical frailty indicators were assessed with the TUG test (gait speed), the LAPAQ (physical activity), a hand grip strength test, the SFQ (fatigue), and the Four-test balance scale. All six physical frailty indicators were associated with ADL and IADL disability. After controlling for previous disability, sociodemographic characteristics, self-perceived lifestyle, and chronic diseases, only gait speed was predictive of both ADL and IADL disability, whereas there was a small effect of fatigue on IADL disability. Hence, these physical frailty indicators should be included in frailty assessment when predicting future disability.
{"title":"The Prediction of ADL and IADL Disability Using Six Physical Indicators of Frailty: A Longitudinal Study in the Netherlands.","authors":"Robbert J J Gobbens, Marcel A L M van Assen","doi":"10.1155/2014/358137","DOIUrl":"https://doi.org/10.1155/2014/358137","url":null,"abstract":"<p><p>Frailty is a predictor of disability. A proper understanding of the contribution of individual indicators of frailty in the prediction of disability is a requisite for preventive interventions. The aim of this study was to determine the predictive power of the individual physical frailty indicators: gait speed, physical activity, hand grip strength, Body Mass Index (BMI), fatigue, and balance, for ADL and IADL disability. The sample consisted of 505 community-dwelling persons (≥75 years, response rate 35.1%). Respondents first participated between November 2007 and June 2008, and a subset of all respondents participated again one year later (N = 264, 52.3% response rate). ADL and IADL disability were assessed by the Groningen Activity Restriction Scale. BMI was assessed by self-report, and the other physical frailty indicators were assessed with the TUG test (gait speed), the LAPAQ (physical activity), a hand grip strength test, the SFQ (fatigue), and the Four-test balance scale. All six physical frailty indicators were associated with ADL and IADL disability. After controlling for previous disability, sociodemographic characteristics, self-perceived lifestyle, and chronic diseases, only gait speed was predictive of both ADL and IADL disability, whereas there was a small effect of fatigue on IADL disability. Hence, these physical frailty indicators should be included in frailty assessment when predicting future disability. </p>","PeriodicalId":39066,"journal":{"name":"Current Gerontology and Geriatrics Research","volume":"2014 ","pages":"358137"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/358137","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32302274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01Epub Date: 2014-01-12DOI: 10.1155/2014/949180
Johanne Desrosiers, Anabelle Viau-Guay, Marie Bellemare, Louis Trudel, Isabelle Feillou, Anne-Céline Guyon
Introduction. In long-term care (LTC), person-centred approaches are encouraged. One such approach, relationship-based care (RBC), aims among other things to reduce residents' agitated behaviours. RBC has been used in numerous Quebec LTC facilities over the past decade but it has never been studied. Objective. Explore correlations between use of RBC by trained caregivers and the frequency of agitated and positive behaviours of residents with cognitive impairments. Methods. Two independent raters observed fourteen caregiver/resident dyads in two LTC facilities during assistance with hygiene and dressing. Checklists were used to quantify caregivers' RBC use and residents' agitated and positive behaviours. Results. Scores for RBC use were high, suggesting good application of the approach by caregivers. Correlation analyses showed that offering residents realistic choices and talking to them during care were associated with both positive and agitated behaviours (P from 0.03 to 0.003). However, many other components of RBC were not associated with residents' behaviours during care. Conclusions. There were only a few quantitative links between the RBC checklist items and the frequency of agitated or positive behaviours. Other studies with a more rigorous research design are needed to better understand the impact of relationship-based care on residents' behaviours.
{"title":"Relationship-based care and behaviours of residents in long-term care facilities.","authors":"Johanne Desrosiers, Anabelle Viau-Guay, Marie Bellemare, Louis Trudel, Isabelle Feillou, Anne-Céline Guyon","doi":"10.1155/2014/949180","DOIUrl":"10.1155/2014/949180","url":null,"abstract":"<p><p>Introduction. In long-term care (LTC), person-centred approaches are encouraged. One such approach, relationship-based care (RBC), aims among other things to reduce residents' agitated behaviours. RBC has been used in numerous Quebec LTC facilities over the past decade but it has never been studied. Objective. Explore correlations between use of RBC by trained caregivers and the frequency of agitated and positive behaviours of residents with cognitive impairments. Methods. Two independent raters observed fourteen caregiver/resident dyads in two LTC facilities during assistance with hygiene and dressing. Checklists were used to quantify caregivers' RBC use and residents' agitated and positive behaviours. Results. Scores for RBC use were high, suggesting good application of the approach by caregivers. Correlation analyses showed that offering residents realistic choices and talking to them during care were associated with both positive and agitated behaviours (P from 0.03 to 0.003). However, many other components of RBC were not associated with residents' behaviours during care. Conclusions. There were only a few quantitative links between the RBC checklist items and the frequency of agitated or positive behaviours. Other studies with a more rigorous research design are needed to better understand the impact of relationship-based care on residents' behaviours. </p>","PeriodicalId":39066,"journal":{"name":"Current Gerontology and Geriatrics Research","volume":"2014 ","pages":"949180"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3913456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32112616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01Epub Date: 2014-11-16DOI: 10.1155/2014/623203
E Paul Cherniack, Ariella R Cherniack
Many studies utilizing dogs, cats, birds, fish, and robotic simulations of animals have tried to ascertain the health benefits of pet ownership or animal-assisted therapy in the elderly. Several small unblinded investigations outlined improvements in behavior in demented persons given treatment in the presence of animals. Studies piloting the use of animals in the treatment of depression and schizophrenia have yielded mixed results. Animals may provide intangible benefits to the mental health of older persons, such as relief social isolation and boredom, but these have not been formally studied. Several investigations of the effect of pets on physical health suggest animals can lower blood pressure, and dog walkers partake in more physical activity. Dog walking, in epidemiological studies and few preliminary trials, is associated with lower complication risk among patients with cardiovascular disease. Pets may also have harms: they may be expensive to care for, and their owners are more likely to fall. Theoretically, zoonotic infections and bites can occur, but how often this occurs in the context of pet ownership or animal-assisted therapy is unknown. Despite the poor methodological quality of pet research after decades of study, pet ownership and animal-assisted therapy are likely to continue due to positive subjective feelings many people have toward animals.
{"title":"The benefit of pets and animal-assisted therapy to the health of older individuals.","authors":"E Paul Cherniack, Ariella R Cherniack","doi":"10.1155/2014/623203","DOIUrl":"https://doi.org/10.1155/2014/623203","url":null,"abstract":"<p><p>Many studies utilizing dogs, cats, birds, fish, and robotic simulations of animals have tried to ascertain the health benefits of pet ownership or animal-assisted therapy in the elderly. Several small unblinded investigations outlined improvements in behavior in demented persons given treatment in the presence of animals. Studies piloting the use of animals in the treatment of depression and schizophrenia have yielded mixed results. Animals may provide intangible benefits to the mental health of older persons, such as relief social isolation and boredom, but these have not been formally studied. Several investigations of the effect of pets on physical health suggest animals can lower blood pressure, and dog walkers partake in more physical activity. Dog walking, in epidemiological studies and few preliminary trials, is associated with lower complication risk among patients with cardiovascular disease. Pets may also have harms: they may be expensive to care for, and their owners are more likely to fall. Theoretically, zoonotic infections and bites can occur, but how often this occurs in the context of pet ownership or animal-assisted therapy is unknown. Despite the poor methodological quality of pet research after decades of study, pet ownership and animal-assisted therapy are likely to continue due to positive subjective feelings many people have toward animals. </p>","PeriodicalId":39066,"journal":{"name":"Current Gerontology and Geriatrics Research","volume":"2014 ","pages":"623203"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/623203","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32882184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Despite years of intensive investigation that has been made in understanding prostate cancer, it remains a major cause of death in men worldwide. Prostate cancer emerges from multiple alterations that induce changes in expression patterns of genes and proteins that function in networks controlling critical cellular events. Based on the exponential aging of the population and the increasing life expectancy in industrialized Western countries, prostate cancer in the elderly men is becoming a disease of increasing significance. Aging is a progressive degenerative process strictly integrated with inflammation. Several theories have been proposed that attempt to define the role of chronic inflammation in aging including redox stress, mitochondrial damage, immunosenescence, and epigenetic modifications. Here, we review the innate and adaptive immune systems and their senescent remodeling in elderly men with prostate cancer.
{"title":"Senescent remodeling of the innate and adaptive immune system in the elderly men with prostate cancer.","authors":"Gianluigi Taverna, Mauro Seveso, Guido Giusti, Rodolfo Hurle, Pierpaolo Graziotti, Sanja Stifter, Maurizio Chiriva-Internati, Fabio Grizzi","doi":"10.1155/2014/478126","DOIUrl":"https://doi.org/10.1155/2014/478126","url":null,"abstract":"<p><p>Despite years of intensive investigation that has been made in understanding prostate cancer, it remains a major cause of death in men worldwide. Prostate cancer emerges from multiple alterations that induce changes in expression patterns of genes and proteins that function in networks controlling critical cellular events. Based on the exponential aging of the population and the increasing life expectancy in industrialized Western countries, prostate cancer in the elderly men is becoming a disease of increasing significance. Aging is a progressive degenerative process strictly integrated with inflammation. Several theories have been proposed that attempt to define the role of chronic inflammation in aging including redox stress, mitochondrial damage, immunosenescence, and epigenetic modifications. Here, we review the innate and adaptive immune systems and their senescent remodeling in elderly men with prostate cancer. </p>","PeriodicalId":39066,"journal":{"name":"Current Gerontology and Geriatrics Research","volume":"2014 ","pages":"478126"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/478126","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32295865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01Epub Date: 2014-04-30DOI: 10.1155/2014/923717
Rachel V Thakore, Young M Lee, Vasanth Sathiyakumar, William T Obremskey, Manish K Sethi
Purpose. To determine if the American Society of Anesthesiologist (ASA) score can be used to predict hospital charges for inpatient services. Materials and Methods. A retrospective chart review was conducted at a level I trauma center on 547 patients over the age of 60 who presented with a hip fracture and required operative fixation. Hospital charges associated with inpatient and postoperative services were organized within six categories of care. Analysis of variance and a linear regression model were performed to compare preoperative ASA scores with charges and inpatient services. Results. Inpatient and postoperative charges and services were significantly associated with patients' ASA scores. Patients with an ASA score of 4 had the highest average inpatient charges of services of $15,555, compared to $10,923 for patients with an ASA score of 2. Patients with an ASA score of 4 had an average of 45.3 hospital services compared to 24.1 for patients with a score of 2. Conclusions. A patient's ASA score is associated with total and specific hospital charges related to inpatient services. The findings of this study will allow payers to identify the major cost drivers for inpatient services based on a hip fracture patient's preoperative physical status.
{"title":"Geriatric Hip Fractures and Inpatient Services: Predicting Hospital Charges Using the ASA Score.","authors":"Rachel V Thakore, Young M Lee, Vasanth Sathiyakumar, William T Obremskey, Manish K Sethi","doi":"10.1155/2014/923717","DOIUrl":"https://doi.org/10.1155/2014/923717","url":null,"abstract":"<p><p>Purpose. To determine if the American Society of Anesthesiologist (ASA) score can be used to predict hospital charges for inpatient services. Materials and Methods. A retrospective chart review was conducted at a level I trauma center on 547 patients over the age of 60 who presented with a hip fracture and required operative fixation. Hospital charges associated with inpatient and postoperative services were organized within six categories of care. Analysis of variance and a linear regression model were performed to compare preoperative ASA scores with charges and inpatient services. Results. Inpatient and postoperative charges and services were significantly associated with patients' ASA scores. Patients with an ASA score of 4 had the highest average inpatient charges of services of $15,555, compared to $10,923 for patients with an ASA score of 2. Patients with an ASA score of 4 had an average of 45.3 hospital services compared to 24.1 for patients with a score of 2. Conclusions. A patient's ASA score is associated with total and specific hospital charges related to inpatient services. The findings of this study will allow payers to identify the major cost drivers for inpatient services based on a hip fracture patient's preoperative physical status. </p>","PeriodicalId":39066,"journal":{"name":"Current Gerontology and Geriatrics Research","volume":"2014 ","pages":"923717"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/923717","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32380992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01Epub Date: 2014-05-29DOI: 10.1155/2014/861613
Kyler M Godwin, Robert O Morgan, Annette Walder, David M Bass, Katherine S Judge, Nancy Wilson, A Lynn Snow, Mark E Kunik
Dementia is prevalent and costly, yet the predictors of inpatient hospitalization are not well understood. Logistic and negative binomial regressions were used to identify predictors of inpatient hospital utilization and the frequency of inpatient hospital utilization, respectively, among veterans. Variables significant at the P < 0.15 level were subsequently analyzed in a multivariate regression. This study of veterans with a diagnosis of dementia (n = 296) and their caregivers found marital status to predict hospitalization in the multivariate logistic model (B = 0.493, P = 0.029) and personal-care dependency to predict hospitalization and readmission in the multivariate logistic model and the multivariate negative binomial model (B = 1.048, P = 0.007, B = 0.040, and P = 0.035, resp.). Persons with dementia with personal-care dependency and spousal caregivers have more inpatient admissions; appropriate care environments should receive special care to reduce hospitalization. This study was part of a larger clinical trial; this trial is registered with ClinicalTrials.gov NCT00291161.
{"title":"Predictors of Inpatient Utilization among Veterans with Dementia.","authors":"Kyler M Godwin, Robert O Morgan, Annette Walder, David M Bass, Katherine S Judge, Nancy Wilson, A Lynn Snow, Mark E Kunik","doi":"10.1155/2014/861613","DOIUrl":"10.1155/2014/861613","url":null,"abstract":"<p><p>Dementia is prevalent and costly, yet the predictors of inpatient hospitalization are not well understood. Logistic and negative binomial regressions were used to identify predictors of inpatient hospital utilization and the frequency of inpatient hospital utilization, respectively, among veterans. Variables significant at the P < 0.15 level were subsequently analyzed in a multivariate regression. This study of veterans with a diagnosis of dementia (n = 296) and their caregivers found marital status to predict hospitalization in the multivariate logistic model (B = 0.493, P = 0.029) and personal-care dependency to predict hospitalization and readmission in the multivariate logistic model and the multivariate negative binomial model (B = 1.048, P = 0.007, B = 0.040, and P = 0.035, resp.). Persons with dementia with personal-care dependency and spousal caregivers have more inpatient admissions; appropriate care environments should receive special care to reduce hospitalization. This study was part of a larger clinical trial; this trial is registered with ClinicalTrials.gov NCT00291161. </p>","PeriodicalId":39066,"journal":{"name":"Current Gerontology and Geriatrics Research","volume":"2014 ","pages":"861613"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4058849/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32468557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01Epub Date: 2014-11-06DOI: 10.1155/2014/735235
Abdullah Alkhawaldeh, Margo B Holm, Jamal Qaddumi, Wasileh Petro, Madi Jaghbir, Omar Al Omari
Background. Recently, the percentage of older adults in developing countries has increased significantly. Objective. This study examined patterns and factors associated with primary health care services utilization in the past 1, 6, and 12 months. Method. A cross-sectional study design was used to collect data from 190 older adults in the Irbid governorate of Jordan. Results. Primary health care services were used by less than half of the participants in the past 1 month, by 68.4% in the past 6 months, and by 73.8% in the past 12 months. Primary health care (PHC) services use was associated with age, education level, tobacco use, chronic illnesses, perceived general health status today, a physical component summary score, employment, and perceived general health status in the past 6 and 12 months. The primary predictor of PHC services use at 1, 6, and 12 months was chronic illnesses (OR = 13.32), (OR = 19.63), and (OR = 17.91), respectively. Conclusion. Although many factors were associated with PHC service utilization, the strongest predictor of PHC service utilization was chronic illnesses.
{"title":"A Cross-Sectional Study to Examine Factors Associated with Primary Health Care Service Utilization among Older Adults in the Irbid Governorate of Jordan.","authors":"Abdullah Alkhawaldeh, Margo B Holm, Jamal Qaddumi, Wasileh Petro, Madi Jaghbir, Omar Al Omari","doi":"10.1155/2014/735235","DOIUrl":"https://doi.org/10.1155/2014/735235","url":null,"abstract":"<p><p>Background. Recently, the percentage of older adults in developing countries has increased significantly. Objective. This study examined patterns and factors associated with primary health care services utilization in the past 1, 6, and 12 months. Method. A cross-sectional study design was used to collect data from 190 older adults in the Irbid governorate of Jordan. Results. Primary health care services were used by less than half of the participants in the past 1 month, by 68.4% in the past 6 months, and by 73.8% in the past 12 months. Primary health care (PHC) services use was associated with age, education level, tobacco use, chronic illnesses, perceived general health status today, a physical component summary score, employment, and perceived general health status in the past 6 and 12 months. The primary predictor of PHC services use at 1, 6, and 12 months was chronic illnesses (OR = 13.32), (OR = 19.63), and (OR = 17.91), respectively. Conclusion. Although many factors were associated with PHC service utilization, the strongest predictor of PHC service utilization was chronic illnesses. </p>","PeriodicalId":39066,"journal":{"name":"Current Gerontology and Geriatrics Research","volume":"2014 ","pages":"735235"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/735235","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32843426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2014-01-01Epub Date: 2014-02-17DOI: 10.1155/2014/934852
Aftab Haq, Sachin Patil, Alexis Lanteri Parcells, Ronald S Chamberlain
Elderly patients in the USA account for 26-50% of all intensive care unit (ICU) admissions. The applicability of validated ICU scoring systems to predict outcomes in the "Oldest Old" is poorly documented. We evaluated the utility of three commonly used ICU scoring systems (SAPS II, SAPS III, and APACHE II) to predict clinical outcomes in patients > 90 years. 1,189 surgical procedures performed upon 951 patients > 90 years (between 2000 and 2010) were analyzed. SAPS II, SAPS III, and Acute APACHE II were calculated for all patients admitted to the SICU. Differences between survivors and nonsurvivors were analyzed using the Student's t-test and binary logistic regression analysis. A receiver operating characteristic (ROC) curve was constructed for each scoring system studied. The area under the ROC curve (aROC) for the SAPS III was 0.81 at a cut-off value of 57, whereas the aROC for SAPS II was 0.75 at a cut-off score of 44 and the aROC for APACHE II was 0.74 at a cut-off score of 13. The SAPS III ROC curve for prediction of hospital mortality exhibited the greatest sensitivity (84%) and specificity (66%) with a score of 57 for the "Oldest Old" population.
{"title":"The Simplified Acute Physiology Score III Is Superior to the Simplified Acute Physiology Score II and Acute Physiology and Chronic Health Evaluation II in Predicting Surgical and ICU Mortality in the \"Oldest Old\".","authors":"Aftab Haq, Sachin Patil, Alexis Lanteri Parcells, Ronald S Chamberlain","doi":"10.1155/2014/934852","DOIUrl":"https://doi.org/10.1155/2014/934852","url":null,"abstract":"<p><p>Elderly patients in the USA account for 26-50% of all intensive care unit (ICU) admissions. The applicability of validated ICU scoring systems to predict outcomes in the \"Oldest Old\" is poorly documented. We evaluated the utility of three commonly used ICU scoring systems (SAPS II, SAPS III, and APACHE II) to predict clinical outcomes in patients > 90 years. 1,189 surgical procedures performed upon 951 patients > 90 years (between 2000 and 2010) were analyzed. SAPS II, SAPS III, and Acute APACHE II were calculated for all patients admitted to the SICU. Differences between survivors and nonsurvivors were analyzed using the Student's t-test and binary logistic regression analysis. A receiver operating characteristic (ROC) curve was constructed for each scoring system studied. The area under the ROC curve (aROC) for the SAPS III was 0.81 at a cut-off value of 57, whereas the aROC for SAPS II was 0.75 at a cut-off score of 44 and the aROC for APACHE II was 0.74 at a cut-off score of 13. The SAPS III ROC curve for prediction of hospital mortality exhibited the greatest sensitivity (84%) and specificity (66%) with a score of 57 for the \"Oldest Old\" population. </p>","PeriodicalId":39066,"journal":{"name":"Current Gerontology and Geriatrics Research","volume":"2014 ","pages":"934852"},"PeriodicalIF":0.0,"publicationDate":"2014-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2014/934852","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32231922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}