摘要:

The elderly residents of an urban subsidized apartment building were interviewed in their apartments to determine a comprehensive medication profile. The interviews were conducted by doctor of pharmacy candidates, and 155 residents (81.2%) participated. Compliance was similar to rates previously reported (49.3%), and adverse drug reactions were common (29.1%). Other findings included: 1) compliance did not decrease with advancing age; 2) most elderly individuals could open child‐resistant containers (83.4%), read standard container labels (79.7%), and identify teaspoon (97.3%) and tablespoon (88.5%) quantities; 3) inability to open easy‐open (flip‐off) containers decreased compliance (P = .03); 4) men were more compliant than women (68.4 v 42.4%, P = .006) but were taking fewer medications (3.3 per male v 5.0 per female); 5) only 12.6% of respondents thought they were taking too much medication but when they did compliance diminished (P = .003); 6) medications were infrequently shared (5.6% of respondents reported sharing); and 7) only 6.4% of respondents reported medication expense as a co

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb06332.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Eight percent of the elderly patients discharged from a geriatric unit in one year were readmitted within three months. Forty‐six percent had been living alone and nearly all of these had received full community support at the time of discharge. Recurrent problems were the reason for readmission in 59% of cases, mainly due to falls, incontinence, and confusion. Only 54% of the readmitted patients were discharged home again—those with new additional problems tended to die in hospital, whereas those with recurrent problems often required institutional long‐term care. It is concluded that even with careful discharge planning, a proportion of patients will require readmission, some of which will also require long‐term institutional care. This number is quite small in terms of the total number of patients discharged from a geriatric unit and should not be a reason for seeking nursing home care at an earl

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb06333.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

An Inventory presenting characteristics useful in the clinical identification of dementia of the Alzheimer type (DAT) is presented. The Inventory includes aphasia, amnesia, abnormal cognition and visuospatial skills, inappropriate lack of concern, and normal motor functions. In a retrospective study of 50 consecutive dementia patients, the DAT Inventory correctly identified 100% of DAT subjects and 94% of non‐DAT cases. Utilization of positive criteria can aid in the identification of DAT and can facilitate recognition of treatable illnesses masquerading as DA

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb06334.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The stage of a cancer at diagnosis is multiply determined, theoretically depending on such disparate factors as tumor biology, patient education, and physician behaviors. Data from all Hispanic and non‐Hispanic white residents of New Mexico diagnosed with a malignancy from 1969 through 1982 were analyzed to determine the relationship between the age of the patient and the stage of cancer at the time of diagnosis. Three general patterns were apparent. For cancers of the bladder, breast, cervix, ovary, thyroid, and uterus, and for melanoma, there were significant linear trends for the cancers to be diagnosed at more advanced stages in older patients. For cancers of the lung, pancreas, rectum, and stomach, there were significant linear trends for cancers to be diagnosed at an earlier stage in older patients. For cancers of the colon, kidney, liver, and prostate, there were no significant linear trends in stage at diagnosis versus age of the patien

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb06335.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

Cardiovascular disease, so common in the elderly, has become an urgent public health concern. Major contributing factors include hypertension, dyslipidemia, impaired glucose tolerance, physical indolence, and cigarette smoking. Diet plays a major role in atherogenesis by its influence in blood lipids, blood pressure, and glucose tolerance, although its impact in the elderly is speculative owing to a paucity of direct evidence. But a rationale exists. Most cardiovascular risk factors are more prevalent in the elderly than in the young adult. The rise in blood pressure and blood lipids with advancing age is not inevitable. Diet may contribute to hypertension through an excess of calories, saturated fat, cholesterol, or salt and a deficiency of potassium, calcium, and magnesium. Antiatherogenic diets low in saturated fat and cholesterol, rich in fiber, and with substitution of polyunsaturated fat and restricted calories tend to normalize serum lipids and to cause lesions to involute. Emphasis on vegetable protein and fiber‐rich food has merit because they provide more fiber, polyunsaturated fatty acids, magnesium, selenium, complex carbohydrate, potassium, and copper, and less cholesterol, saturated fat, and sodium. The recommended fat‐modified diets are adequate in protein, vitamins, and minerals and need not be deficient in any nutrient or economically nonfeasible. The accelerating decline in cardiovascular mortality, which has included the elderly, indicates that such disease is controllable and not inevitable, even in the elderly. The decrease has occurred concurrently with reduced consumption of saturated fat and cholesterol, increased use of vegetable oils, and improved levels of cardiovascular risk fact

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb06336.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

This report provides a comprehensive description of an established outpatient geriatric consultation service. The basic objectives of the service are to promote health and to prevent or minimize disability. The consultation service uses a multidisciplinary team with core participants from medicine, nursing, and social work and is based in a setting where a wide range of specialty consultants and ancillary services are available. A detailed description of 131 individuals who received geriatric consultations during a one‐year period is provided. Despite a substantial burden of disability, most older persons after the consultation process were able to continue living in their own preferred setting. The degree to which the geriatric consultation service contributed to these favorable outcomes is currently being evaluated through a randomized clinical tria

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb06337.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

摘要:

The recent legal decision in the Bartling case affirmed that competent patients may refuse life‐sustaining treatment, even if they are not terminal or comatose and even if physicians object because of ethics or conscience. However, clinicians may be concerned that patient refusal of treatment is not truly informed. Physicians have an obligation to benefit patients as well as to respect patients' wishes. They may fulfill both obligations by determining whether further medical treatment is indicated, identifying reversible conditions that may impair patient decision making, and checking that the patient's decision is informe

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb06338.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb06339.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb06340.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY

ISSN:0002-8614    

DOI:10.1111/j.1532-5415.1986.tb06341.x

出版商:Blackwell Publishing Ltd    

年代:1986

数据来源: WILEY