bluuebunny/crossref_metadata_2025_split huggingface dataset:
Functional Impairment in Instrumental Activities of Daily Living: An Early Clinical Sign of Dementia?
Authors: Barberger‐Gateau Pascale , Fabrigoule Colette , Helmer Catherine , Rouch Isabelle , Dartigues Jean‐François 
Published: April 2015

OBJECTIVE: To estimate the predictive value of four IADLs on 3‐ and 5‐year incident dementia.DESIGN: Prospective cohort study.SETTING: A community survey in 37 randomly selected parishes.SUBJECTS: A random sample of French community dwellers aged 65 and older included in the PAQUID study followed‐up at 3 (1582 subjects) and 5 years (1283 subjects).MAIN OUTCOME MEASURES: Incidence of dementia at 3 and 5 years, diagnosed by two‐step screening: (1) MMS and DSM‐III‐R; (2) diagnosis of dementia confirmed by a neurologist.RESULTS: A score summing up the number of dependencies at baseline on four IADLs is a predictor of 3‐year but not of 5‐year incident dementia. Increase in the level of dependence between baseline and 3‐year follow‐up is associated with an increased risk of incident dementia at 5‐year follow‐up.CONCLUSION: These four IADLs can help to identify older subjects at high risk of dementia who should then undergo neuropsychological testing.
Cognitive Function and Endogenous Sex Hormones in Older Women
Authors: Barrett‐Connor Elizabeth , Goodman‐Gruen Deborah 
Published: April 2015

OBJECTIVE: To determine if endogenous hormone levels predict cognitive function in older women.DESIGN: A longitudinal, population‐based study.SETTING: Rancho Bernardo, CaliforniaPARTICIPANTS: A total of 393 community‐dwelling women aged 55 to 89 years who were not using replacement estrogen.METHODS: Between 1984 and 1987, sera were collected for measurement of total and bioavailable testosterone, total and bioavailable estradiol, and estrone Between 1988 and 1991, 12 standard neuropsychological tests were administered, including two items from the Blessed Information‐Memory‐Concentration Test, three measures of retrieval from the Buschke‐Fuld Selective Reminding Test, a category fluency test, immediate and delayed recall from the Visual Reproduction Test, the Mini‐Mental State Examination (MMSE) with individual analysis of the Serial 7's and the “World” Backwards components, and the Trail‐Making Test part B (Trails B). The association between the five hormones and the 12 cognitive function tests was tested in age‐ and education‐adjusted analyses using linear regression, partial correlation, quintile and categorical analyses.RESULTS: Women with better MMSE scores (>23) had significantly higher adjusted mean total and bioavailability testosterone levels (P = .009; P = .02, respectively). Using linear regression, the mean total testosterone was significantly associated with better performance on the World component of the MMSE (b = .12; P = .08). With regard to estrogen, the only statistically significant (P = .02) association was better performance on one test in women with very low levels of estuarial.CONCLUSIONS: In these older women, higher endogenous estrogen levels were not associated with significantly better performance on any cognitive function test. In contrast, higher levels of testosterone predicted better categorical performance on the MMSE and the World component of the MMSE. These novel findings warrant further research. J Am Geriatr Soc 47:1289–1293, 1999.
Factors Associated with Inconsistent Diagnosis of Dementia Between Physicians and Neuropsychologists
Authors: MacKnight Chris , Graham Janice , Rockwood Kenneth 
Published: April 2015

OBJECTIVE: To explore reasons for discrepancy in the diagnosis of cognitive impairment between physicians and neurophysiologists.DESIGN: Retrospective analysis of national survey data.SETTING: Canadian Study of Health and Aging Phase 1, a national survey of community‐dwelling and institutionalized older Canadians.PARTICIPANTS: 1879 subjects who completed all components of a clinical examination.MEASUREMENTS: Data available to both disciplines (demographic data, functional status, Modified Mini‐Mental State (3MS), schedule H of the Cambridge Mental Disorders of the Elderly Examination (CAMDEX)), results of the physician's history and physical examination, and results of a psychometric test battery. Subjects were classified as No Cognitive Impairment, Cognitive Impairment Not Dementia (CIND), and Dementia, the latter according to the criteria of the Diagnostic and Statistical Manual, 3rd Ed., Revised. Preliminary diagnoses by physicians and neurophysiologists were compared.RESULTS: In university modeling, higher education increased consistency. Lower scores on the 3MS, depression reported in the CAMDEX, focal neurological signs, and all neuropsychological variables decreased agreement. In multivariate modeling, higher education and identification of long‐term memory impairment by the neurophysiologist increased agreement; lower scores on the 3MS, depression reported on the CAMDEX, and identification of short‐term memory impairment or constructional impairment led to disagreement. When the category of CIND was removed, kappa for agreement increased from 0.51 to 0.92.CONCLUSIONS: Physicians and neurophysiologists have different, complementary approaches to the diagnosis of dementia, and a consensus approach should be used. The category of CIND requires elucidation. Identification of dementia in subjects with depression or low education is difficult, and new strategies are required. J Am Geriatr Soc 47:1294–1299, 1999.
Health‐Life Expectancy According to Various Functional Levels
Authors: Sauvaget Catherine , Tsuji Ichiro , Aonuma Takanori , Hisamichi Shigeru 
Published: April 2015

OBJECTIVES: To estimate disability‐free life expectancy according to three functional levels.DESIGN: A 2‐year prospective study of older residents in a rural Japanese community. The functional ability of each individual was determined with self‐completed questionnaires at baseline (1994) and at follow‐up (1996).SETTING AND PARTICIPANTS: All residents of Wakuya Town, Japan, who were aged 65 years or older at the start of the study in 1994 (n = 3590).MEASUREMENTS: Single‐year increment‐decrement life tables were constructed from mortality rates and incidence of disability rates. Independent life expectancies in three functional areas: basic activities of daily living (ADL), instrumental activities of daily living (IADL), and mobility, were estimated for each sex and each year of age.RESULTS: The incidence and prevalence of disability were similar in men and women. For both sexes, independent life in IADL was shorter than independent life in ADL and mobility. The development and progression of disability were different between sexes: men experienced disability at a younger age and at a faster rate than women.CONCLUSIONS: The slow progress of disability, with a longer duration in a disabled state among women, induces a heavy burden on health and welfare resources. Interventions to delay the onset of disability in women should reduce the economic burden to society as well as improve the quality of life. Prospective studies to look at the process of disablement, based on direct observation, are needed to confirm the gender differences. J Am Geriatr Soc 47:1326–1331,1999.
APOE 4 and Hip Fracture Risk in a Community‐Based Study of Older Adults
Authors: Johnston Janet M. , Cauley Jane A. , Ganguli Mary 
Published: April 2015

OBJECTIVES: To investigate whether the APOE 4 allele was associated with increased risk of hip fracture in an older community‐based sample and whether such an increased risk was independent of dementia and history of falling.DESIGN: Case‐control study nested within a prospective community study.SETTING: The Monongahela Valley Independent Elders Survey (MoVIES), an ongoing prospective community study of older adults in southwestern Pennsylvania.PARTICIPANTS: A total of 899 MoVIES participants (63.9% women; mean age, 76.2 years, SD = 4.9 years), who provided both information on hip fractures and blood samples for genotyping.MEASUREMENTS: Interview questions regarding hip fractures and falls, polymerase chain reaction to determine APOE genotype, and clinical assessment using a standardized protocol to determine the presence or absence of dementia.RESULTS: Twenty‐five subjects reported having hip fractures in the year preceding screening interviews. Subjects with one or two APOE 4 alleles were twice as likely as subjects without an APOE 4 allele to report hip fractures (age‐adjusted OR = 2.1,95% CI: 0.9–4.7). Based on multivariate analysis, subjects with a history of falling were more likely to report hip fractures (OR = 4.7, 95% CI: 2.1–10.8). After adjusting for history of falls and diagnosis of dementia, subjects with an APOE 4 allele were still twice as likely to report hip fractures (adjusted OR = 2.1, 95% CI: 0.9 – 4.7).CONCLUSIONS: The APOE 4 allele appears to be a risk factor for hip fracture, independent of the effect of dementia and falling. Theoretically, this may be mediated by alterations in vitamin K metabolism. Caution should be used in interpreting these results, because the 95% confidence intervals for the odds ratios include 1. J Am Geriatr Soc 47:1342–1345,1999.
Prevalence of Antidepressant Use Among Older People: Population‐Based Observations
Authors: Mamdani Muhammad , Herrmann Nathan , Austin Peter 
Published: April 2015

OBJECTIVE: To assess the prevalence of antidepressant use with respect to age, gender, and time during a 5‐year period from 1993 to 1997.DESIGN: A retrospective, population‐based study in which data regarding a cross‐sectional series of annual antidepressant use were obtained from administrative claims and census databases for more than 1.4 million older persons during calendar years 1993 through 1997.PARTICIPANTS: All residents of Ontario aged 65 or older.MAIN OUTCOME MEASURES: Changes in the prevalence of antidepressant users as a function of age group, gender, and time.RESULTS: A general, positive, linear trend in the prevalence of antidepressant users with increasing age group was consistently detected regardless of gender and year assessed (P < .001 for both genders and all years). The age‐adjusted relative risk of women being dispensed an antidepressant relative to men was significantly higher during each year but seemed to decrease slightly over time: 1.74 (95% CI, 1.72‐1.76) in 1993 and 1.65 (95% CI, 1.63‐1.67) in 1997. The multiple linear regression model revealed significant relationships between the prevalence of antidepressant users and increasing age group, female gender, and increasing year of assessment (P < .001 for each variable). The prevalence was observed to range from a low of 5.6% in 65 to 69‐year‐old men in 1993 to a high of 17.2% among 85 to 89‐year‐old women in 1997.CONCLUSIONS: Our findings reveal that the prevalence of antidepressant users is dynamic and is significantly and independently associated with age, gender, and time of assessment. J Am Geriatr Soc 47:1350–1353,1999.
Assessment of Agitation in Alzheimer's Disease: The Agitated Behavior in Dementia Scale
Authors: Logsdon Rebecca G. , Teri Linda , Weiner Myron F. , Gibbons Laura E. , Raskind Murray , Peskind Elaine , Grundman >Michael , Koss Elisabeth , Thomas Ronald G. , Thai Leon J. ,   Alzheimer's Disease Cooperative Study
Published: April 2015

OBJECTIVES: To develop and evaluate the psychometric properties of a new measure of agitation, the Agitated Behavior in Dementia scale (ABID). The ABID consists of 16 items designed specifically to evaluate frequency of and caregiver reaction to common agitated behaviors in community‐residing dementia patients.DESIGN: The ABID was administered at the baseline assessment of a multi‐site controlled treatment study to reduce agitation in Alzheimer's Disease (AD). Reliability was assessed by evaluating internal consistency and test‐retest correlations. Validity was assessed by examining correlations with other constructs, including demographics, cognitive status, and overall behavioral disturbance.SETTING: Twenty‐one sites across the US, comprising the Alzheimer's Disease Cooperative Study, contributed subjects to the investigation.PARTICIPANTS: A total of 148 community‐residing AD patients, living with a spouse or adult relative who acted as an informant. Mean age was 75 years, and mean Mini‐Mental State Exam (MMSE) score was 13.MEASUREMENTS: Cognitive status was assessed using the MMSE. Behavioral disturbance was assessed using the Behavior Rating Scale for Dementia of the Consortium to Establish a Registry for Alzheimer's Disease, the Revised Memory and Behavior Problems Checklist, and the Cohen‐Mansfield Agitation Inventory.RESULTS: Reliability of the ABID was excellent, with internal consistency of 0.70 and test‐retest reliability of 0.60 to 0.73. Validity was confirmed by correlations with related measures and lack of correlation with unrelated constructs.CONCLUSIONS: The ABID is brief, easy to administer, and provides objectively anchored observations of problems. It is a promising measure for studies of community‐residing AD patients. J Am Geriatr Soc 47:1354–1358,1999.
A Simple Test of Central Processing Speed: An Extension of the Short Blessed Test
Authors: Ball Linda J. , Bisher Gordon B. , Birge Stanley J. 
Published: April 2015

OBJECTIVE: To evaluate the efficacy and reliability of a simple measure of central processing speed: the time to recite the months of the year in reverse order, from the Short Blessed Test of Orientation, Concentration, and Memory (SBT).DESIGN: Cross‐sectional and longitudinal designs were used to establish validity and test‐retest reliability.SETTING: Participants' homes and by telephone interview.PARTICIPANTS: An age‐stratified sample of 120 community‐dwelling women, aged 67–94, randomly selected from Medicare recipients of the St. Louis Metropolitan Statistical Area.MEASUREMENTS: Dependent variables were the SBT, the Trail Making Test, computer‐generated simple and choice reaction time, and time to say the months of the year backward (TMYB). The independent variable was age.RESULTS: Significant Pearson product‐moment correlations were obtained for Trail Making and TMYB with a simple and choice reaction time after controlling for age and cognitive status. An exponential relationship was observed between age and TMYB, expressed both cross‐sectionally and as rate of change. Test‐retest reliability for TMYB was 0.90.CONCLUSIONS: TMYB is a valid and reliable measure of central processing speed that compares favorably to the more elaborate and time‐consuming Trail Making B test. Because of its simplicity and ease of administration, this test provides the clinician with a practical measure of central processing speed. TMYB extends the utility of the widely used Short Blessed Test by measuring this additional and important domain of brain function. J Am Geriatr Soc 47:1359–1363,1999.
Sleep Problems as a Risk Factor for Falls in a Sample of Community‐Dwelling Adults Aged 64–99 years
Authors: Brassington Glenn S. , King Abby C. , Bliwise Donald L. 
Published: April 2015

OBJECTIVES: The purpose of this study was to determine if reported nighttime sleep problems and daytime sleepiness were associated with reported falling during the previous 12 months in a representatively sampled older adult population.DESIGN: Random‐digit dial telephone survey.SETTING: Representatively sampled older adult population living in northern California.PARTICIPANTS: Participants were 971 women and 555 men, aged 64 to 99 years.MEASUREMENTS: Twenty‐minute telephone interview adapted from the National Health Interview Survey.RESULTS: Two hundred and eighty‐four participants reported falling during the previous 12 months (19% of the sample). Significantly more women fell than men (20% and 14%, respectively, P < .001). The following variables were significant risk factors for falling in univariate analyses: female gender, being unmarried, living alone, income less than $15,000 per year, difficulty walking, having more than one chronic medical condition, history of cardiovascular disease, hypertension, arthritis, sensory impairment, psychological difficulties, and nighttime sleep problems. All of the nighttime sleep problem variables remained significant risk factors for falling after controlling for other risk factors for falling.CONCLUSIONS: The results provide support for an independent association between reported sleep problems and falls in an older population. One of the implications of these data is that behavioral research focusing on the effectiveness of insomnia treatment in old age should not only examine typical sleep‐related outcomes (e.g., total time asleep, number of awakenings) but also the occurrence of falls as well.
Moderate Alcohol Consumption and Hearing Loss: A Protective Effect
Authors: Popelka Michael M. , Cruickshanks Karen J. , Wiley Terry L. , Tweed Theodore S. , Klein Barbara E.K. , Klein Ronald , Nondahl David M. 
Published: April 2015

OBJECTIVE: To determine if moderate alcohol consumption is associated inversely with hearing loss in a large population based study of older adults.DESIGN: Cross‐sectional population based cohort study. Data are from the 1993–1995 examinations for the population based Epidemiology of Hearing Loss Study (EHLS) (n = 3571) and the Beaver Dam Eye Study (BDES) (n = 3722).SETTING: Midwestern community of Beaver Dam, Wisconsin.PARTICIPANTS: Residents of Beaver Dam aged 43 to 84 in 1987–1988 were eligible for the BDES (examinations in 1988–1990 and 1993–1995). During 1993–1995, this same cohort was eligible to participate in the baseline examination for the EHLS.MEASUREMENTS: Hearing thresholds were measured by pure tone air and bone conduction audiometry (250–8000 Hz.). History of alcohol consumption in the past year, heavy drinking (ever), medical history, occupation, noise exposure, and other lifestyle factors were ascertained by a questionnaire that was administered as an interview.RESULTS: In multiple logistic regression analyses controlling for potential confounders, moderate alcohol consumption (>140 grams/week) was inversely associated with hearing loss (PTA.5,1,2,4 >25 dB HL; odds ratio [OR] = .71, 95% confidence interval [CI] = .52, .97; where PTA is pure tone average). A similar association was found for moderate hearing loss (PTA.5,1,2,4 >40 dB HL; OR = 0.49, 95% CI = 0.32, 0.74). Alcohol consumption was associated inversely with the odds of having a low frequency hearing loss (OR = 0.61) or a high frequency hearing loss (OR = 0.60). These findings did not vary significantly by age or gender. There was an increase in the odds of having a high frequency hearing loss (OR = 1.35, 95% CI = 1.04, 1.75), in those with a history of heavy drinking (≥4 drinks/day). Including cardiovascular disease or its related factors did not significantly attenuate the protective effect.CONCLUSIONS: There is evidence of a modest protective association of alcohol consumption and hearing loss in these cross‐sectional data. This finding is in agreement with a small body of evidence suggesting that hearing loss is not an inevitable component of the aging process.
Cognitive Decline Is Associated with Systemic Oxidative Stress: The EVA Study
Authors: Berr Claudine , Balansard Bertrand , Arnaud Josianne , Roussel Anne‐Marie , Alpérovitch Annick ,   EVA Study Group
Published: April 2015

OBJECTIVE: To determine whether systemic oxidative stress status is associated with cognitive decline.DESIGN: A longitudinal population‐based study.SETTING: A cohort study of older subjects in Nantes, France.PARTICIPANTS: A total of 1166 high cognitive functioning subjects aged 60 to 70 in the Etude du Vieillissement Artériel (EVA) cohort with a 4 year follow‐up.MEASUREMENTS: Subjects completed a baseline interview and a global cognitive test (Mini‐Mental Status Examination (MMSE)). Blood samples were obtained at baseline to determine plasma levels of selenium, carotenoids, thiobarbituric acid reactant substances (TBARS), an indicator of lipoperoxidation, and red blood cell vitamin E. Risk of cognitive decline, defined as a loss of 3 points in MMSE score between baseline and the 4 year follow‐up, was assessed by oxidative stress level.RESULTS: Subjects with the highest levels of TBARS show an increased risk of cognitive decline (adjusted odds ratio (OR) = 2.25; confidence interval (CI) 95% = 1.26–4.02). This result is reinforced in the lower antioxidant status subgroup. Subjects with low levels of selenium have an increased risk of cognitive decline (OR = 1.58; CI 95% = 1.08–2.31) after adjustment for various confounding factors.CONCLUSIONS: These results suggest that increased levels of oxidative stress and/or antioxidant deficiencies may pose risk factors for cognitive decline. The direct implication of oxidative stress in vascular and neurodegenerative mechanisms that lead to cognitive impairment should be further explored.
Influenza Outbreak Detection and Control Measures in Nursing Homes in the United States
Authors: Zadeh Mina M. , Bridges Carolyn Buxton , Thompson William W. , Arden Nancy H. , Fukuda Keiji 
Published: April 2015

OBJECTIVE: To evaluate the use of influenza vaccine, rapid influenza testing, and influenza antiviral medication in nursing homes in the US to prevent and control outbreaks.METHODS: Survey questionnaires were sent to 1017 randomly selected nursing homes in nine states. Information was collected on influenza prevention, detection and control practices, and on outbreaks during three influenza seasons (1995–1998).RESULTS: The survey response rate was 78%. Influenza vaccine was offered to residents and staff by 99% and 86%, respectively, of nursing homes. Among nursing homes offering the influenza vaccine, the average vaccination rate was 83% for residents and 46% for staff. Sixty‐seven percent of the nursing homes reported having access to laboratories with rapid antigen testing capabilities, and 19% reported having a written policy for the use of influenza antiviral medications for outbreak control. Nursing homes from New York, where organized education programs on influenza detection and control have been conducted for many years, were more likely to have reported a suspected or laboratory‐confirmed influenza outbreak (51% vs 10%, P = .01), to have access to rapid antigen testing for influenza (92% vs 63%, P = .01), and to use antivirals for prophylaxis and treatment of influenza A for their nursing home residents (94% vs 55%, P = .01) compared with nursing homes from the other eight states.CONCLUSIONS: Influenza outbreaks among nursing home residents can lead to substantial morbidity and mortality when prevention measures are not rapidly instituted. However, many nursing homes in this survey were neither prepared to detect nor to control influenza A outbreaks. Targeted, sustained educational efforts can improve the detection and control of outbreaks in nursing homes.