摘要:

Recent reports have suggested that the antibody response of elderly persons to standard doses of influenza vaccine is depressed. We examined the effect of an additional threefold dose of influenza B vaccine on the antibody response in elderly, ambulatory veterans.One hundred thirty‐one male subjects aged 70 years and older were randomized to receive one of three influenza vaccine regimens: Group I received standard trivalent influenza vaccine containing 15 micrograms of B/USSR/100/83 in one arm and placebo in the other; Group II received standard trivalent vaccine in one arm and a supplemental dose of 45 micrograms of B/USSR in the other; Group III received the same dose as group II combined in one arm with a placebo in the other.Antibody levels were measured at baseline, 1 month, and 5 months.Nearly 80% of the participants achieved levels of antibody to B/USSR considered protective; seroconversion rates varied from 40% to 61%. No significant differences in antibody response to B/USSR occurred among the vaccine groups, and there were more side effects at higher doses. The higher dose groups did, however, achieve greater antibody levels to the drifted influenza B virus which circulated during the year of the study. Response to the influenza A components of the vaccine, however, may have been blunted in Group III which received a large dose of A and B antigens all at one sit

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb06152.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

A self‐administered postal questionnaire was presented to all attending members (843) of local summer meetings of a national association for retired persons. A 71% response rate (599) revealed that 33% of the total sample population experienced some form of urinary incontinence. Twenty‐three and seven‐tenths percent (142) experienced occasional urine dribbling, 2.3% (14) were unable to prevent involuntary emptying of their bladder, and 7.3% (44) suffered both problems. Eighty‐three percent of the respondents were between the ages of 65 and 85 years. Females accounted for 75% of all respondents. Respondents 75 years of age or older had a higher occurrence of all forms of urinary incontinence(P =.057), and a strong association existed with the same age‐group and uncontrolled emptying of the bladder(P =.02). Thirty‐seven percent of the females and 22% of the males reported having had an incontinent episode(P =.002). High parity (four or more births) was significantly associated with incontinence in females(P =.04). These survey findings provide prevalence estimates of urinary incontinence that are greater than those previously reported and show statistical differences by age and gender. The study population is not representative of all the noninstitutionalized elderly, but consists primarily of individuals who are active, ambulatory, generally healthy and may underestimate the magnitude of the problem. Urinary incontinence is substantiated as a major health problem in even the most functional community‐residing eld

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb06153.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

To assess the utility of bedside diagnostic measures to detect prognostically significant peripheral vascular disease, we examined 60 nursing home residents by physical examination, Doppler sphygmomamometry and pneumatic oscillometry, and recorded the clinical history. Eighty‐eight percent of the cases had tibial/brachial arterial systolic pressure indices below 0.95, the lower limit traditionally considered normal. Yet, no more than 5% of the patients carried a previous diagnosis of peripheral vascular disease or had intermittent claudication, leg ulcers or gangrene. Approximately half of the patients had tibial/brachial pressure indices less than 0.7, and one year later in these cases, there was significantly greater morbidity and nearly twice the mortality of patients with less severe disease. We conclude that simple bedside diagnostic tests of arterial disease used in this study discloses a high prevalence of disease in institutionalized elderly patients and identifies a group at particular risk for morbid complication

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb06154.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

To determine how accurately elderly subjects recall recent falls, we studied 304 ambulatory men and women over the age of 60 years who completed a 12‐month prospective study of risk factors for falling. We developed a system of weekly follow‐up and home visits to record and confirm all falls. During the study, 179 participants suffered at least one fall that was confirmed by home visit. At the end of the study, all subjects were interviewed by telephone about whether they had suffered a fall during the preceding 3, 6, or 12 months. Depending on the time period of recall, 13% to 32% of those with confirmed falls did not recall falling during the specific period of time. Recall was better for the preceding 12 months than for 3 or 6 months. There were only weak correlations (r = 0.28 to 0.59) between the number of falls that were documented and the number that the subjects recalled during each of these periods. Those with lower scores on the Mini‐Mental State Examination were more likely to forget falls. We conclude that elderly subjects often do not recall falls that occurred during specific periods of time over the preceding 3 to 12 months. Researchers and clinicians should consider using methods besides long‐term recall for ascertaining and counting falls over specific periods

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb06155.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb06156.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb06157.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

A better understanding of the processes through which elderly individuals perceive, evaluate, and act on symptoms will enable physicians to respond more appropriately to the needs of older patients. This paper reviews existing evidence on how the experience of chronic disease and the atypical presentation of symptoms influence symptom recognition and reporting among elderly individuals. A discussion of research on health perceptions suggests that some elderly may inappropriately deny illness and delay seeking medical care, while others with overly negative health perceptions may make excessive physician visits. An overview is presented of the process by which elderly individuals come to seek care from their physicians, combining evidence from the diverse literatures on chronic illness, atypical presentation of disease, and health perceptions. We conclude by discussing the practical implications of this information for clinicians working with the elderly.

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb06158.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb06159.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

摘要:

Age‐rationing of health care is beginning to be widely debated. Two recent proposals are examined. It is argued that age‐rationing proposals must be viewed in the light of current rationing practices, and that all such proposals must be placed in the context of a more just overall health care sys

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb06160.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1988.tb06163.x

出版商:Blackwell Publishing Ltd    

年代:1988

数据来源: WILEY