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IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-26 DOI: 10.1016/S1064-7481(24)00457-3
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引用次数: 0
Treatment of Cognitive Impairment in Late Life Depression. 治疗晚年抑郁症患者的认知障碍。
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-26 DOI: 10.1016/j.jagp.2024.09.011
Paul A Newhouse, Steven P Roose
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引用次数: 0
Life Fatigue: Comment. 生命疲劳:如何。
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-25 DOI: 10.1016/j.jagp.2024.09.012
Hinpetch Daungsupawong, Viroj Wiwanitkit
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引用次数: 0
Initiation and Persistence of Antipsychotic Medications at Hospital Discharge Among Community-Dwelling Veterans With Dementia. 居住在社区的痴呆退伍军人出院时开始服用和持续服用抗精神病药物。
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-25 DOI: 10.1016/j.jagp.2024.09.010
Audrey D Zhang, Lindsay Zepel, Sandra Woolson, Katherine E M Miller, Loren J Schleiden, Megan Shepherd-Banigan, Joshua M Thorpe, Susan Nicole Hastings

Objectives: Adults with dementia are frequently prescribed antipsychotic medications despite concerns that risks outweigh benefits. Understanding conditions where antipsychotics are initially prescribed, such as hospitalization, may offer insights into reducing inappropriate use.

Design, setting, participants: Retrospective cohort study of community-dwelling veterans with dementia aged ≥68 with VA hospitalizations in 2014, using Veterans Health Administration (VA) and Medicare data.

Measurements: The primary outcome was new outpatient antipsychotic prescription at hospital discharge. We used generalized estimating equations to study associations between antipsychotic initiation and patient, hospitalization, and facility characteristics. Among veterans with antipsychotic initiation, we used a cumulative incidence function to evaluate discontinuation in the year following hospitalization, accounting for competing risks.

Results: 4,719 community-dwelling veterans with dementia had VA hospitalizations in 2014; 264 (5.6%) filled new antipsychotic prescriptions at discharge. Antipsychotic initiation was associated with discharge unit (surgical vs medical, OR 0.41, 95% CI 0.19-0.87; psychiatric vs medical, OR 6.58, 95% CI 4.48-9.67), length of stay (OR 1.03/day, 95% CI 1.02-1.05), and delirium diagnosis (OR 2.61, 95% CI 1.78-3.83), but not demographic or facility characteristics. Among veterans with antipsychotic initiation, the 1-year cumulative incidence of discontinuation was 18.2% (n = 47); 15.9% (n = 42) of those who were alive and not censored remained on antipsychotics at 1 year.

Conclusions: Antipsychotic initiation at hospital discharge was uncommon among community-dwelling veterans with dementia; however, once initiated, antipsychotic persistence at 1 year was common among those who remained community-dwelling. Hospitalization is a contributor to potentially-inappropriate medications in the community, suggesting an opportunity for medication review after hospitalization.

目的:尽管人们担心抗精神病药物的风险大于益处,但患有痴呆症的成年人仍经常被处方抗精神病药物。了解最初开具抗精神病药物处方的条件(如住院)可能有助于减少不适当用药:使用退伍军人健康管理局(VA)和医疗保险计划(Medicare)的数据,对2014年在社区居住、年龄≥68岁、在退伍军人健康管理局住院治疗的痴呆症退伍军人进行回顾性队列研究:主要结果是出院时新的门诊抗精神病药物处方。我们使用广义估计方程来研究抗精神病药物的使用与患者、住院和医疗机构特征之间的关联。在开始使用抗精神病药物的退伍军人中,我们使用累积发生率函数来评估住院后一年内的停药情况,并将竞争风险考虑在内:2014年,有4719名居住在社区的退伍军人患有痴呆症,其中264人(5.6%)在出院时开具了新的抗精神病药物处方。抗精神病药物的使用与出院单位(外科与内科,OR 0.41,95% CI 0.19-0.87;精神科与内科,OR 6.58,95% CI 4.48-9.67)、住院时间(OR 1.03/天,95% CI 1.02-1.05)和谵妄诊断(OR 2.61,95% CI 1.78-3.83)有关,但与人口统计或设施特征无关。在开始使用抗精神病药物的退伍军人中,1年内停药的累计发生率为18.2%(n = 47);15.9%(n = 42)的存活且未被删减的退伍军人在1年内仍在使用抗精神病药物:结论:出院时开始服用抗精神病药物的情况在居住在社区的痴呆症退伍军人中并不常见;但是,一旦开始服用抗精神病药物,1年后仍居住在社区的退伍军人中普遍仍在服用抗精神病药物。住院治疗可能会导致患者在社区内使用不适当的药物,这也为住院后的用药复查提供了机会。
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引用次数: 0
Acknowledgment of Triage Editors and Reviewers 2024 感谢分流编辑和审稿人 2024.
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-20 DOI: 10.1016/j.jagp.2024.09.008
Charles Reynolds
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引用次数: 0
Memoirs of a Healthcare Worker During the Pandemic. 大流行病期间的医护人员回忆录》。
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-19 DOI: 10.1016/j.jagp.2024.09.002
Deanna C Fernandes
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引用次数: 0
A Case of Gerotranscendence: Lived Experience of a Neurodegenerative Disorder and a Spiritual Awakening to Nondual Awareness. 一个老年超越的案例:神经退行性疾病的生命体验与非二元意识的精神觉醒。
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-17 DOI: 10.1016/j.jagp.2024.09.006
Helen Lavretsky, Neil Schuitevoerder
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引用次数: 0
Duties of a Friend and to the Profession are Many and Great- “Amici et Professionis Officia Multa et Magna Sunt” 朋友和职业的责任是多重而伟大的--"Amici et Professionis Officia Multa et Magna Sunt"。
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-16 DOI: 10.1016/j.jagp.2024.08.019
Christopher C. Colenda M.D., M.P.H.
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引用次数: 0
Testamentary Capacity: The Glass Testamentary Capacity Measure (G-TCM). 遗嘱能力:玻璃遗嘱能力测量法(G-TCM)。
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-16 DOI: 10.1016/j.jagp.2024.09.003
Oliver M Glass
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引用次数: 0
Social Cognition and Aging: The Importance of Performance Based Assessment Strategies to Detect Impairment Across Aging Related Conditions and Functional Domains. 社会认知与老龄化:基于表现的评估策略对检测与老龄化相关的疾病和功能领域的损伤的重要性。
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-14 DOI: 10.1016/j.jagp.2024.09.007
Philip D Harvey
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引用次数: 0
期刊
American Journal of Geriatric Psychiatry
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