摘要:

Ten healthy and mentally alert centenarians underwent cranial computed tomography (CT) using a fourth‐generation CT scanner. The subjects ranged in age from 100 to 102 years, and included six women and four men. Two of them used alcohol on a daily basis and five had systolic blood pressures of at least 160 mmHg. The CT scans demonstrated considerable variation in the degree of cerebral atrophy, which had no relation to either sex, alcohol use, or hypertension. Three of the centenarians had evidence of mild periventricular white matter lucency. Although progressive cerebral atrophy is an integral aspect of the normal aging process in the very elderly, its exact relationship to cognitive function remains unclea

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb06312.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

Increases in cancer incidence and mortality reflect the larger numbers of elderly in the population. Using a mortality sample of 1891 biopsy‐confirmed cancer patients, analyses reveal older breast, prostate, and cervical‐uterine cancer victims were more likely to be diagnosed with metastases. Logistic regression analyses of subsamples of breast (N= 224), lung (N= 513), and colorectal (N= 299) cancer patients indicate that age is significantly inversely related to receipt of both subsequent chemotherapy and radiation therapy, controlling for stage of disease and presence of co‐morbid disease. Exceptions to this relationship are the use of radiation therapy among nonmetastatic lung cancer patients and all breast cancer patients. The implications of these findings for current cancer control programs are disc

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb06313.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

This report describes a 12‐month fever surveillance survey in a 258‐bed veterans long‐term care institution. There were 128 episodes of fever (one episode per 24 patient‐months); 114 were studied. Lower respiratory tract infections were most frequent, 36 (32%), with 26 (23%) urinary tract infections.Streptococcus pneumoniaewas the most common pathogen in the chest infections andProteus mirabilisthe most common of the urinary tract infections. In 40 (35%) there was no evidence of a lower respiratory tract, urinary tract, or other bacterial infection. Most recovered rapidly, many with no specific treatment. There was a 16% mortality associated with the febrile e

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb06314.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

This paper investigates the six‐month hospital readmission rates among 444 patients 65 years of age or older admitted to a large metropolitan teaching hospital who had a primary discharge diagnosis of cerebrovascular disease, hip fracture, or congestive heart failure. Twenty‐four percent were readmitted to the same institution one or more times during the six‐month follow‐up. Striking variability was observed in use of hospitals across these diagnostic groups. Patients with a primary diagnosis of congestive heart failure were at highest risk of hospital readmission (36%). Multiple readmissions among the congestive heart failure group were prevalent. These preliminary data suggest that hospital readmission among the aged is a complex multifaceted ph

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb06315.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

A comprehensive review of the multidisciplinary functional assessment and treatment of 800 patients seen at a community‐based geriatric assessment center was performed to profile clinical characteristics of patients attending such a program and to evaluate possible predictors of institutionalization. The most common problems addressed were senile dementia (46%), hypertension (31%), clinically significant depression (30%), and burdened caregiver (24%). More than 90% of patients were able to remain in the community after multidisciplinary treatment of their problems and marshalling of support services. The most potent predictors of institutionalization in rank order of predictive value were: falls or unstable gait, senile dementia, caregiver strain, lack of support services, and moderate to severe impairment of ability to perform activities of dally living (multiple R = 0.45;P= .001). Advantages and impediments to community‐based assessment are discus

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb06316.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The Older Americans Resources and Services (OARS) methodology was designed to assess functional capacity in five dimensions (social resources, economic resources, mental health, physical health, and activities of daily living) and to measure use of and need for 24 types of generic services. The OARS questionnaire now has been used in more than 150 research and practice settings. Recent refinements in the OARS methodology include new information about validity and reliability, computerized summary ratings for the five dimensions of functional status, and eleven scales that measure specific aspects of functioning within the five dimensions. This paper describes the conceptual foundation, appropriate uses, psychometric properties, and recent refinements in the OARS methodology. Empirical data from a geriatric clinic population are used for purposes of illustration. The paper presents an assessment of the strengths and limitations of the OARS methodology based on more than a decade of experience. Particular attention is paid to the degree to which the measures of functional status can be related to health service use measures to inform geriatric research and practice.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb06317.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

摘要:

The 143 physicians who returned to Temple University Medical School a questionnaire on knowledge of prescribing for the elderly constituted 25% of a stratified random sample of general practitioners (GPs), family practitioners (FPs), and practitioners in internal medicine (IMs) reimbursed under Medicare in Pennsylvania in 1979. The mean score on the 23‐item drug questionnaire was significantly lower (P<.05) than the score deemed adequate by a panel of six experts in the field.Five variables, identified by survey questions, were positively associated with physicians' test scores: importance of professional meetings, perception of need for continuing medical education, board eligiblity/certification, group practice, and a practice in which the elderly constitute 25 to 49% of all patients. Two variables were negatively associated: number of years since date of licensure and the importance of drug advertisements.Respondents and nonrespondents were compared on nine variables for which American Medical Association (AMA), American Osteopathic Association (AOA), or Blue Shield data were available. Pennsylvania graduates were significantly overrepresented in the respondent group. The only other significant difference found was in field of practice, where findings differed by source of information. There was no significant difference in mean scores of early and late respondents.The research findings support those of three previous studies, not limited to the elderly, which found prescribing knowledge inadequate. They suggest the need for examining/improving the opportunities for medical students and physicians to increase their knowledge of geriatric pharmacolog

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb06318.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb06319.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb06320.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1985.tb06321.x

出版商:Blackwell Publishing Ltd    

年代:1985

数据来源: WILEY