bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Adaptations and Compliance to Exercise Training between Middle‐Aged and Older Men
Authors: Sheldahl Lois M. , Tristani Felix E. , Hastings James E. , Wenzler Richard B. , Levandoski Scot G. 
Published: April 2015

Objective: To compare the rate and magnitude of physiologic and psychologic adaptations to aerobic training between middle‐age and older men, to assess their interest in continued participation (>6 months) in a supervised high‐intensity training program, and to evaluate the safety of high‐intensity training for older people.Design: Before‐after intervention trial.Setting: Medical center in a Midwestern metropolitan city.Participants: Thirteen middle‐age (35–50 years) and 14 older (60–71 years) normal men.Intervention: Subjects trained on treadmills and leg cycle ergometers for 40 minutes 3 times per week. The intensity was increased to 85% of peak heart rate (HR) within the first 3 weeks of training.Measurement: Peak oxygen consumption, HR at submaximal work rates, three psychological tests, and election to continue in the supervised program.Results: At 6 months of training, peak oxygen consumption had increased by 12% and 11% in the middle‐aged and older groups, respectively, with 86% and 100% of this increase occurring within the first 3 months. Both groups showed comparable decreases in HR at submaximal work rates after 3 months of training with no further significant change from 3 to 6 months. None of the psychologic parameters evaluated changed significantly with 3 or 6 months of training in either group. More of the older (71%) than middle‐aged (45%) men elected to continue in the supervised program after 6 months.Conclusions: The results of this study involving small groups of carefully screened middle‐aged and older men suggest that the time course and magnitude of physiologic adaptations to aerobic training are similar between age groups when the training regimen is the same. Neither age group showed alterations in psychologic parameters nor experienced orthopedic injuries with training. The older group showed greater interest in continued participation in a supervised exercise program.
Screening Elders for Risk of Hospital Admission
Authors: Boult Chad , Dowd Bryan , McCaffrey David , Boult Lisa , Hernandez Rafael , Krulewitch Harry 
Published: April 2015

Objective: To define a set of screening criteria that identifies elders who are at high risk for repeated hospital admission in the future.Design: Longitudinal cohort study. Logistic regression analysis of data from half of the subjects was used to identify risk factors for repeated hospital admission. The ability of these risk factors to identify elders who are at high risk for repeated hospitalization in the future was then tested using data from the other half of the subjects.Setting: United States.Participants: A subsample (n = 5876) of a multistage probability sample of all non‐institutionalized U.S. civilians who were 70 years or older in 1984.Measurements: At baseline (1984), elderly subjects were asked about their demographic, socioeconomic, medical, and functional characteristics and about their recent use of health services. Their subsequent hospital admissions and mortality were then monitored through the records of the Medicare program and the National Death Index (1985–88).Results: Among the subjects in the first half of the sample, eight factors emerged as risk factors for repeated admission: older age, male sex, poor self‐rated general health, availability of an informal caregiver, having ever had coronary artery disease, and having had, during the previous year, a hospital admission, more than six doctor visits, or diabetes. Based on the presence or absence of these factors in 1984, 7.2% of the subjects in the second half of the sample were estimated to have a high probability of repeated admission (Pra ≥ 0.5) during 1985–1988. In comparison with subjects estimated to have a low risk (Pra < 0.5), this high‐risk group's actual experiences during 1985–1988 included a higher cumulative incidence of repeated admission (41.8% vs 26.2%, P < 0.0001), a higher cumulative rate of mortality (44.2% vs 19.0%, P < 0.0001), more hospital days per person‐year survived (5.2 vs 2.6), and higher hospital charges per person‐year survived ($3731 vs $1841).Conclusion: Eight easily ascertained risk factors affect elders' probability of being hospitalized repeatedly within four years. In the future, brief surveys about the presence of these factors could be used to estimate elders' risk of future hospitalization and, thereby, to identify some of those who may derive the greatest benefit from interventions designed to avert the need for hospitalization.
Nocturnal Activity and Immobility across Aging (50–98 Years) in Healthy Persons
Authors: van Hilten J. J. , Middelkoop H. A. M. , Braat E. A. M. , van der Velde E. A. , Kerkhof G. A. , Ligthart G. J. , Wauquier A. , Kamphuisen H. A. C. 
Published: April 2015

Objective: To measure the influence of age on measures of nocturnal activity and immobility in 100 healthy subjects aged 50 to 98 years.Design: Cross‐sectional study.Setting: Urban population in Leiden. Recordings were performed at home while the subjects maintained their habitual 24‐hour pattern of activities.Participants: 100 subjects without a history of major medical disorders and a normal neurological examination and performance‐oriented assessment of gait (Tinetti).Measurements: Motor activity was recorded during six successive nights with a wrist‐worn activity monitor. The occurrence of supra‐threshold motor activity was recorded over 15‐second epochs. A questionnaire was used to evaluate sleep habits and the occurrence of sleep disturbances. Four mean measures reflecting activity or immobility during the nocturnal period were calculated for each subject.Results: Only one out of four measures, (ie, the nocturnal proportion of time with movement, increased with age for females. For males, no age effects emerged. The mean duration of nocturnal immobility periods was higher in females than in males. Also, for females, the use of hypnotics increased with successive decades. Sex and the use of hypnotics were significantly related to the mean duration of immobility periods.Conclusion: If care is taken not to confound aging with illness, measures of nocturnal activity and immobility reveal only marginal effects of aging.
A Longitudinal Study of Cognitive Function in Elderly Persons with Subjective Memory Complaints
Authors: Flicker Charles , Ferris Steven H. , Reisberg Barry 
Published: April 2015

Objective: To assess change in cognitive function in elderly individuals with subjective memory loss over a follow‐up interval of more than 3 years.Design: Prospective cohort study.Setting: An outpatient research clinic in aging and dementia at a university hospital.Participants: A convenience sample of 59 healthy, elderly individuals (mean age 68.7 years) with memory complaints but no clinically apparent cognitive dysfunction.Measurements: Participants were given a full diagnostic evaluation and were administered a neuropsychological test battery at baseline and follow‐up. The cognitive assessment battery included 12 tests of recent memory, immediate memory, language function, visuospatial praxis, and psychomotor speed. Most of the tests had been established to be sensitive to cross‐sectional age differences.Results: Of 59 subjects, 54 (91.5%) were successfully followed up an average of 3.4 years later. Between baseline and follow‐up, two tests exhibited significant improvement, two tests exhibited significant decline, and the other eight were unaffected.Conclusion: Elderly individuals with subjective perceptions of cognitive decrements who fail to provide clear evidence of cognitive impairment upon clinical interview are not at high risk for progressive cognitive deterioration over the subsequent 3‐ to 4‐year interval.
Predictors of Family Caregivers' Physical and Psychological Health following Hospitalization of Their Elders
Authors: Silliman Rebecca A. 
Published: April 2015

Objective: To identify characteristics present at the time of elders' (≥75 years of age) hospitalization that predicted caregivers' self‐reported physical and psychological health 1 year later.Design: A prospective observational cohort study of 104 family caregivers followed for 1 year from the time of their elders' hospitalization.Setting: Urban community hospital with academic affiliation.Subjects: Caregivers of patients enrolled in an evaluation of inpatient interdisciplinary geriatric assessment who provided care for the entire year of follow‐up and who participated in all interviews.Main Outcomes: Self‐reported physical and psychological health.Results: Caregivers' baseline self‐reported physical health (AOR = 21.8; 95% CI = 4.65–102), the impact of caregiving on their social and leisure time activities (AOR = 9.93; 95% CI = 1.71–57.8), and their relationship to their elders (AOR = 6.50; 95% CI = 1.20–35.2) were all significantly associated with self‐reported physical health at follow‐up. Caregivers' baseline self‐reported health (AOR = 3.70; 95% CI = 1.11–12.5), whether or not they had additional current caregiving responsibilities (AOR = 6.67; 95% CI = 1.89–25.0), and the interaction of perceptions of caregiving and the adequacy of family help were significant predictors of psychological health at follow‐up, adjusted for baseline psychological health.Conclusion: Information available at the time of elderly patients' admission to the hospital can help to differentiate those caregivers at risk for future physical and psychological distress from those who are likely to continue doing well.
The Use of Intramuscular Cefoperazone versus Intramuscular Ceftriaxone in Patients with Nursing Home‐Acquired Pneumonia
Authors: Phillips Steven L. , Branaman‐Phillips Joann 
Published: April 2015

Objective: To compare the efficacy and safety of intramuscular cefoperazone and intramuscular ceftriaxone in the treatment of nursing home‐acquired pneumonia in the nursing home setting.Design: A randomized clinical trial.Setting: Skilled nursing wards at the Veterans Home of California.Patients: 104 residents of skilled nursing wards, aged 65 years or older.Interventions: Intramuscular administration of either cefoperazone or ceftriaxone.Measurements: The variables analyzed for baseline comparability were demographics (age, sex), clinical variables (duration in nursing home; presence of sputum, fever, cough, or leukocyte count), and clinical symptoms and signs. Efficacy was assessed by days of therapy, final maximum temperature, and clinical and bacteriological response.Results: Fifty residents received cefoperazone, 1 gm every 12 hours, intramuscularly. Fifty‐four residents received ceftriaxone, 1 gm every 24 hours, intramuscularly. The total duration of treatment was scheduled for 10 days. Clinical cure was seen in 45 (90%) of the cefoperazone treatment group and 51 (94%) of the ceftriaxone treatment group, with a mean duration of therapy of 10.30 and 9.90 days, respectively. Satisfactory sputum specimens were collected in 71% of the treated residents; the most common isolate was Streptococcus pneumoniae, followed by Haemophilus influenzae and Staphylococcus aureus, respectively. The overall mortality was 4.5% at long‐term follow‐up. Both agents were well tolerated and no therapy was discontinued due to intramuscular pain or abnormal laboratory values.Conclusions: Intramuscular cefoperazone and intramuscular ceftriaxone are safe and effective in the treatment of nursing home‐acquired pneumonia. The clinical outcomes in both treatment groups support their use within this select population without the need for transferring the patient to an acute care hospital. Clinical studies are needed to evaluate the impact of such therapy on the control of health care expenditures within the nursing home facility.
Urinary Incontinence in Nursing Homes: Incidence, Remission and Associated Factors
Authors: Ouslander Joseph G. , Palmer Mary H. , Rovner Barry W. , German Pearl S. 
Published: April 2015

Objective: To determine the incidence and remission rates of daytime urinary incontinence (UI) in a cohort of newly admitted nursing home (NH) residents.Design: Prospective cohort study.Setting: Eight proprietary NHs in Maryland.Subjects: Four hundred thirty new admissions age 65 or older who were participants in a larger prospective study of mental morbidity and adjustment to the NH.Measures: Nurses aides' reports of continence status, psychiatric examinations, and nursing staff assessments of mobility at 2 weeks, 2 months, and 1 year after NH admission.Results: The prevalence of daytime UI at admission was 39% in both females and males. Among the 293 members (68%) of the admission cohort remaining in the NHs 2 months after admission, the incidence of daytime UI was 27% (21% in females, 51% in males); daytime UI resolved in 23% (24% in females, 20% in males). Among the 178 members (41%) of the admission cohort remaining in the NHs 1 year after admission, the incidence of daytime UI between 2 months and 1 year after admission was 19% (16% in females, 46% in males); daytime UI resolved in 22% (23% in females, 14% in males). The continence status of about two‐thirds of residents remaining in the NH at 1 year after admission was stable over time: 22% had daytime UI, and 42% were continent at all three data collection points. The development of daytime UI was associated with male sex, the diagnosis of dementia, fecal incontinence, and the inability to ambulate or transfer independently. Resolution of daytime UI was associated with the absence of these characteristics.Conclusions: Despite limitations attributable to the method of defining UI and potential biases related to the attrition of the admission cohort over time, this is the first large prospective study to examine the incidence and remission patterns of daytime UI among NH residents. The strong association between UI and dementia was validated for the first time by direct psychiatric examinations. Sex and mobility are also closely associated with the development and remission of UI in this setting. This study provides some valuable data that can be used to assess the impacts of the recently developed Resident Assessment Protocol for UI and Agency for Health Care Policy and Research Clinical Practice Guidelines.
How Different are VA Nursing Home Residents?
Authors: Mehr David R. , Fries Brant E. , Williams Brent C. 
Published: April 2015

Objective: To identify similarities and differences between VA nursing home residents and other nursing home residents.Design: Comparison of cross‐sectional data from three sources.Participants: Residents of VA nursing homes nationwide in early October 1986 (n = 10,117); participants in the 1985 National Nursing Home Survey (NNHS) (n = 5,243); residents assessed in New York State nursing homes in 1988 (n = 94,840).Measures: Age‐stratified comparisons were made between the VA and the NNHS for gender, marital status, race, ethnicity, length of stay, activities of daily living (ADL) status, and selected diagnoses and conditions. Additionally, case‐mix data were compared between the VA and the New York State populations.Main Results: The population of VA nursing homes is over‐whelmingly men (96.1% versus 28.4% in the NNHS), and 31.2% of the VA population is under 65 years of age compared with 11.6% in the NNHS. Young (<65) VA residents are considerably more impaired in ADL than young residents in the NNHS; differences are less pronounced in those over 65 years old. VA case mix is slightly higher than the overall New York State population though the distribution of residents into categories in the Resource Utilization Groups, Version II system is somewhat different.Conclusions: VA nursing homes contain a substantial distinctive population of seriously impaired residents under 65 years of age. Though differences exist, older VA residents have many similarities to residents of non‐VA nursing homes and constitute a functionally impaired population that can provide insights into the status of nursing home residents generally.
Physical Performance Test and Activities of Daily Living Scales in the Assessment of Health Status in Elderly People
Authors: Rozzini Renzo , Frisoni Giovanni B. , Bianchetti Angelo , Zanetti Orazio , Trabucchi Marco 
Published: April 2015

Objective: To compare the ability of Basic Activities of Daily Living (BADL), Instrumental Activities of Daily Living (IADL), and the Physical Performance Test (PPT) to detect health status impairments.Patients: Five hundred forty nine community‐dwelling elders (89.8% of the eligible elderly population) aged 70 and over; mean age [was] 76.8 ± 6.1; 179 were males and 370 females.Setting: City of Ospitaletto, Brescia, Northern Italy.Measurements: A multidimensional questionnaire assessing demographic variables, indicators of social activities, psychological function, and somatic health and functional status (BADL and IADL). Also, the PPT was administered.Results: Cognitive and affective status were independently associated with BADL, IADL function, and age; number of drugs were also associated with IADL function. Other health variables (number of diseases, number of symptoms, and global health score) did not independently contribute to explaining the BADL and IADL variance. Cognitive status, number of symptoms, number of diseases, number of drugs, and global health were independently associated with PPT.Conclusions: Chronic diseases may affect functional status in a manner that is insensitive to traditional self‐report ADL and IADL measures. Performance‐based measures may capture this impairment before more severe functional loss emerges.
Memory Complaints of Elderly People in a Population Survey: Variation According to Dementia Stage and Depression
Authors: Grut Michaela , Jorm Anthony F. , Fratiglioni Laura , Forsell Yvonne , Viitanen Matti , Winblad Bengt 
Published: April 2015

Objective: To study the relationship between subjective memory complaints, cognitive functioning, and clinical diagnosis of dementia.Design: Cross‐sectional, total‐population survey.Measurements: A two‐phase study was done. All 2368 were screened by Mini‐Mental State Examination (MMSE). Then the 314 who screened positive and a sample of 354 who screened negative were examined clinically (by examining the subject and interviewing an informant) for DMS‐III‐R criteria for dementia, Clinical Dementia Rating (CDR) scale for severity of dementia and the presence of memory complaints or depressed mood.Setting: An area in Stockholm, Sweden.Participants: All inhabitants of the area (2368) born in 1912 or before, living at home or in institutions.Results: A greater percentage of informants reported marked memory impairment than did the subjects themselves. Neither the informants' nor the subject' reports differed according to the type of dementia, but they differed clearly according to the stage of dementia. Informants reported memory impairment more frequently as dementia severity increased, while the subjects' complaints of marked memory impairment were most common in mild‐moderate dementia. Furthermore, non‐demented subjects with marked complaints performed more poorly on the MMSE. Subjects with depressed mood were also more likely to complain about their memory, both in the demented and non‐demented groups.Conclusion: Our data show the validity of the informants' reports about the subjects' memory deficits. Moreover, the study confirmed the clinical impression that the patient's own complaints should not be ignored, as subjects in the mild stage of dementia often have some insight into their own memory deficit. However, depressed individuals may underestimate their own memory, and individuals with moderate‐severe dementia may overestimate theirs.
Verbal Learning and/or Memory Improves with Glycemic Control in Older Subjects with Non‐Insulin‐Dependent Diabetes Mellitus
Authors: Gradman Theodore J. , Laws Ami , Thompson Larry W. , Reaven Gerald M. 
Published: April 2015

Objective: To determine whether cognitive function improves with improved glycemic control in older subjects with non‐insulin‐dependent diabetes (NIDDM). We hypothesized that with improved glycemic control: 1) learning and memory, 2) attention, and 3) complex perceptual‐motor function would improve, but that 4) simple perceptual‐motor function would not.Design: Non‐randomized control trial.Setting: Aging Study Unit, Department of Veterans Affairs Medical Center.Subjects: Thirty subjects with NIDDM; 17 on oral hypoglycemic agents; 13 untreated at study entry. Thirteen normal controls.Intervention: Subjects on oral hypoglycemic agents were taken off medications. After 1 month, they and previously untreated subjects began treatment with glipizide. Dose was titrated up weekly until fasting plasma glucose was less than 7.8 mmol/L or maximal dose (40 mg/day). Controls received no medication.Measurements: Fasting plasma glucose (FPG), glycated hemoglobin, and measures of cognitive function in four general categories: 1) learning and memory, 2) ability to sustain attention, 3) complex perceptual‐motor function, and 4) simple perceptual‐motor function. All were evaluated in subjects with NIDDM at baseline (T1), after 1‐month washout (T2), and after 2 (T3) and 4 months (T4) of optimal glycemic control or maximal dose. Controls were evaluated at the same intervals.Results: FPG and glycated hemoglobin rose in previously treated subjects from T1 to T2 (9.4 ± SEM 0.4 to 14.7 ± 0.7 mmol/L and 10.9 ± 0.7% to 12.2 ± 0.6%, respectively) but were unchanged in previously untreated subjects (11.3 ± 0.6 to 11.8 ± 0.9 mmol/L and 10.9 ± 0.7% to 11.7 ± 0.7%). With glipizide treatment, there was a decrease in FPG level at T3 (9.4 ± 0.5 mmol/L in previously treated, 6.9 ± 0.4 mmol/L in previously untreated), which persisted at T4. Glycated hemoglobin fell similarly. FPG and glycated hemoglobin were unchanged in controls. As hypothesized, learning and memory improved over time with treatment in both groups of subjects but was unchanged in controls (P < 0.05). Detailed analysis indicated that the improvement occurred primarily in the learning of verbal material. Contrary to hypothesis, attention and complex perceptual‐motor function did not show improvement. As expected, simple perceptual‐motor function did not show any improvement with treatment.Conclusions: The results are consistent with previous findings that poor glycemic control in older subjects with NIDDM is associated with decreased cognitive functioning, and suggest that verbal learning and memory may improve with improved glycemic control.