ISSN:0889-4655    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Older adults over the age of 65 are the fastest growing segment of the US population. However, the prevalence of cardiovascular disease (CVD) is highest in this population and CVD is the primary cause of death for elders. Cardiovascular disease risk factors are similar for both younger and older age groups and include hypertension, cigarette smoking, hyperlipidemia, and diabetes. Evidence for managing and treating these CVD risk factors in elders is presented.

ISSN:0889-4655    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

It is well known that older individuals are at higher risk of developing cardiovascular disease (CVD). In addition, evidence exists for the relationship between psychosocial factors and the pathogenesis and cognitive consequences of CVD. However, less is known about the effect of psychosocial factors on the development and consequences of CVD in older individuals. Using a biopsychosocial framework, this article examines the influence of psychosocial factors, specifically depression, anxiety, and social isolation on older persons with CVD as well as the influence of CVD on psychosocial factors. The effectiveness of interventions for modifying adverse psychosocial factors is also discussed.

ISSN:0889-4655    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Research on acute myocardial infarction (AMI) suggests that older persons may delay significantly longer than younger persons between the first appearance of symptoms of AMI and seeking treatment and that this delay is associated with increased morbidity and mortality. The factors that potentially influence delay in older persons can be grouped into 4 categories: (a) symptom attribution to aging, (b) symptom severity and duration, (c) symptom attribution to comorbid and chronic conditions, and (d) previous experience with cardiac problems. This article explores the link between symptom interpretation and health care seeking behaviors in elderly patients with AMI as it relates to delay in seeking treatment for AMI. Potential nursing interventions are presented.

ISSN:0889-4655    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Although compliance behaviors of heart failure (HF) patients have become the focus of increasing scrutiny in the last decade, the prevalence of noncompliance among elderly patients with HF is poorly understood. We conducted this study to describe and compare the compliance behaviors of elderly patients (≥65 years) and younger patients (<65 years) with HF on 6 prescribed activities: medical appointments, medications, diet, exercise, smoking cessation, and alcohol abstinence. Data from a sample of 140 older (50%) and younger (50%) HF patients matched for gender and disease severity were collected with the HF Compliance Questionnaire and analyzed via descriptive statistics, chi-square, pairedt-tests, and Pearson correlations. We found that elderly patients were more compliant with diet (77% vs 65%,p= .001) and exercise (67% vs 55%,p= .021) than were their younger counterparts. There was no difference in the other health care behaviors. Of the 70 elderly patients, 51% reported some degree of difficulty complying with exercise while 37%, 24%, and 23% had difficulty following diet, keeping follow-up appointments, and taking medications, respectively. A smaller percentage of elders continued to smoke (9%) and drink alcohol (18%). Patients were asked why they had difficulty following their health care regimens; responses varied by prescribed activity. Lastly, we found inverse relationships between perceived difficulty following and compliance with all of the 6 behaviors measured (p< .001); as difficulty increased, compliance decreased. Strategies to help older patients minimize perceived difficulties associated with health care regimens may improve compliance and long-term morbidity and mortality from HF. Assumptions about older age being related to noncompliance appear invalid in patients with HF.

ISSN:0889-4655    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

The purpose of this investigation was to determine medication adherence rates among 3 groups of elderly individuals 62 years of age or older, experiencing comorbid conditions including at least 1 cardiovascular disorder. Data, taken from a 3-week period, were combined across the groups to calculate the percentage of prescribed doses taken, percentage of days with correct number of doses, and percentage of expected doses with the correct timing of administration. Multiple linear regression also was performed on several sociodemographic variables to determine their ability to predict adherence. Risks for poor adherence and suggestions to increase adherence are presented.

ISSN:0889-4655    

出版商:OVID    

年代:2003

数据来源: OVID

摘要:

Purpose.Chronic heart failure (HF) and cognitive impairments (CI) are common problems in the elderly. Both are associated with increased mortality and disability, decreased quality of life, and increased health care costs. While these conditions may occur by chance in the same individual, there is increasing evidence that HF is independently associated with CI. The purpose of this article is to review and critique the literature addressing the prevalence, type, and severity of CI in HF patients, the clinical factors associated with CI, and the potential pathophysiology underlying the development of CI, and to recommend priority areas for future research.Results.Memory and attention deficits are the most frequently occurring CI in this patient populaton, followed by slowed motor response times and difficulties in problem solving. Prevalence rates range from 30% to 80% depending upon the age of the patients and the characteristics of the sample being studied. Most patients have mild impairments, although as many as one fourth may have moderate to severe CI. The relationship between left ventricular ejection fraction and cognition is inconsistent and may be nonlinear. The pathophysiology underlying the development of CI in HF patients may be related to both cerebral infarction and cerebral hypoperfusion either alone or in combination.Conclusions.The current literature is limited by studies with sometimes small or nonrepresentative samples, few matched control studies, and lack of longitudinal data that could indicate the conditions that favor the development of CI over time. Future research needs to focus on (1) determining the types, frequency, and severity of impairments in cognitive functioning among a representative sample of HF patients, (2) explicating the pathological mechanisms and the clinical factors that underlie the development of cognitive deficits, and (3) identifying the ways CI influences quality of life. Interventions can then be developed to prevent or delay the occurrence of CI or to minimize their effect on patient self-management and quality of life.

ISSN:0889-4655    

出版商:OVID    

年代:2003

数据来源: OVID