bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attitudes of Older People Toward Suicide and Assisted Suicide: An Analysis of Gallup Poll Findings
Authors: Seidlitz Larry , Duberstein Paul R. , Cox Christopher , Conwell Yeates 
Published: April 2015

OBJECTIVES: To describe the older population's attitudes toward suicide and assisted suicide, and to determine whether lenient attitudes are associated with known demographic and psychosocial risk factors for completed suicide.DESIGN: Telephone survey conducted by the Gallup Organization in November 1992.PARTICIPANTS: A sample of 802 adults in the United States (541 women and 261 men) aged 60 years and older.MEASUREMENTS: The dependent variables, attitudes toward suicide, were assessed with five attitude statements. Participants rated their agreement with each statement on 4‐point Likert‐type scales, subsequently dichotomized for use in univariate analyses and logistic regressions. The independent variables included income and demographic and psychosocial risk factors for suicide: age, gender, race, marital status, religiousness, self‐rated health, and satisfaction with family relationships.RESULTS: The majority of respondents did not express lenient attitudes. In comparison with survey findings of physicians and the general population, a relatively smaller percentage (41%) of these older respondents believe that physician‐assisted suicide should be legalized. Agreement with one or more of the attitudes presented was associated with age, gender, race, marital status, and religiousness in univariate analyses (P < .05), and race, religiousness (P < .001), gender, self‐rated health, and satisfaction with family relations (P < .08) in logistic regressions.CONCLUSIONS: The hypothesized relations between risk factors for suicide and lenient attitudes toward suicide were supported. Although none of the risk factors was associated with all five attitudes, in combination the results suggested that a common set of variables predict both lenient attitudes toward suicide and suicidal behavior. Future research is necessary to determine the role of depression and other factors that may mediate the observed relationships and to determine whether the presence of specific, strongly held attitudes sanctioning suicide in an older person signals the need to assess suicide risk.
Internal Validity of the Physical Activity Index over 26 Years in Middle‐Aged and Older Men
Authors: Young Deborah Rohm , Sharp Dan S. , Petrovitch Helen , Curb J. David 
Published: April 2015

OBJECTIVE:To determine the internal validity of the physical activity index (PAI).DESIGN:Three time periods over a 26‐year period (1965/68 examination, n = 7911; 1980/82 examination, n = 2054; 1991/93 examination, n = 3425).SETTING:Honolulu, Hawaii.PARTICIPANTS:Middle‐aged to older Japanese‐American men.MEASUREMENTS:PAI, other physical activity measures, body mass index (BMI), tricep skinfold thickness, subscapular skinfold thickness, and HDL cholesterol.RESULTS:PAI level was associated significantly with levels of other physical activity measures at all time periods. Higher PAI level was associated with lower BMI at the baseline examination (1965/68), lower subscapular skinfold thickness at the 1965/68 and 1980/82 examinations, lower tricep skinfold thickness at all examinations, and higher HDL cholesterol at the 1980/82 examination. Change in PAI level from 1965/68 to 1980/82 was associated with change in BMI, subscapular, and tricep skinfold thickness levels, but there were no significant associations between change in PAI level and change in BMI, skinfold thicknesses, or HDL cholesterol levels from 1980/82 to 1991/93.CONCLUSION:PAI level is a relatively valid estimate of overall daily energy expenditure that may be an acceptable general measure across the middle‐to‐late stages of life. The PAI may also be sensitive enough to discern a shift toward less physical demanding activities as a population becomes older, although further studies should be conducted to better determine its validity in older populations.
Lack of Carbamazepine Toxicity in Frail Nursing Home Patients: A Controlled Study
Authors: Tariot Pierre N. , Frederiksen Kirsten , Erb Rosemary , Leibovici Adrian , Podgorski Carol Ann , Asnis Jamie , Cox Christopher 
Published: April 2015

OBJECTIVE: To assess the effects of carbamazepine and placebo on measures of toxicity in frail nursing home patients.DESIGN: A nonrandomized, double‐blind, placebo‐controlled crossover study.SETTING: Two nursing homes in Rochester, New York.PARTICIPANTS: Twenty‐five subjects (mean age 84.5 years) with dementia.INTERVENTION: Carbamazepine and placebo during two 5‐week periods separated by a 2‐week washout. The modal dose for each patient was 300 mg/day.MEASUREMENTS: Adverse experiences, comorbid events, and physical signs and symptoms were assessed continuously, and laboratory data were examined at the beginning and end of each treatment period.RESULTS: One subject died with a pneumonia (and elevated white blood cell count), and one subject developed probable carbamazepine‐induced tics. There was a minimal drop in hematocrit and a slight elevation of liver enzymes, none of which was clinically significant. There was otherwise no excess of adversity or comorbid events on carbamazepine versus placebo, and there was no change in electrolytes or other laboratory measures.CONCLUSION: The findings indicate that carbamazepine in this dose range was well tolerated for the 5‐week treatment period in this frail sample. These data supplement the literature regarding carbamazepine toxicity, which is devoid of controlled studies in older subjects.
Nutrient Intake of Nursing‐Home Residents Receiving Pureed Foods or a Regular Diet
Authors: Johnson Rita M. , Smiciklas‐Wright Helen , Soucy Irene M. , Rizzo Joyce A. 
Published: April 2015

OBJECTIVE: To evaluate (1) the nutrient content of menus planned for regular consistency meals and pureed meals in a long‐term care facility and (2) to assess nutrient intakes of women consuming these meals.DESIGN: A descriptive survey.SETTING: A nursing home facility in central Pennsylvania.PARTICIPANTS: Fifty‐one female nursing home residents were chosen randomly. Thirty‐one received a regular diet and 20 received a pureed diet.MEASUREMENTS: Demographic and health variables were collected from medical records. Nutrient variables were calculated for regular and pureed consistency meals, as served. Nutrient intake data for each woman were based on seven consecutive days of food intake and nutrient supplement use.MAIN RESULTS: Energy and nutrient values for regular diet menus (i.e., food served) were higher than for pureed menus, but both had values exceeding recommended allowances for most nutrients. Average energy and nutrient intakes were similar for both groups of women (t test, P < 0.05). Data showed that many women in both groups had lower than the recommended intakes of iron, zinc, calcium, and Vitamin D.CONCLUSIONS: Both regular and pureed consistency diets provided to residents met current recommended allowances. Diet consistency did not affect nutrient intakes. Intakes were adequate overall; however, a low intake of the same nutrients generally occurred in both groups.
Difficulty with Holding Urine Among Older Persons in a Geographically Defined Community: Prevalence and Correlates
Authors: Wetle Terrie , Scherr Paul , Branch Laurence G. , Resnick Neil M. , Harris Tamara , Evans Denis , Taylor James O. 
Published: April 2015

OBJECTIVE: The goal of this study was to estimate the prevalence and correlates of difficulty holding urine among a population of community‐dwelling older people.DESIGN: Population‐based cross‐sectional study.SUBJECTS: A population census identified all residents aged 65 years and older residing in East Boston, Massachusetts, in 1982.MEASURES: Data collected via in‐home interviews were used to estimate the prevalence of difficulty holding urine and to provide information regarding potential correlates of urinary difficulty.RESULTS: Of the 3809 study participants (85% response rate), 28% reported having “difficulty holding urine until they can get to a toilet” at least some of the time, and 8% reported difficulty “most” or “all of the time.” Difficulty was associated with age and sex; 44% of women and 34% of men reported some difficulty (P < .001), and 9% of women and 6% of men (P < .001) reported difficulty most or all of the time. For respondents aged 65 to 74 years, 40% reported some difficulty, compared with 47% of those aged 85 and older (Ptrend < .001); difficulty most or all of the time was reported by 6% of those aged 65 to 74 and 12% of those aged 85 and older (Ptrend < .001). Difficulty holding urine was associated with important health and functional measures including depression, stroke, chronic cough, night awakening, fecal incontinence, problems with activities of daily living, decreased frequency and ease in getting out of the house, and poor self‐perception of health.CONCLUSIONS: Difficulty holding urine is a prevalent condition among older people living in the community and is associated highly with a number of health conditions and functional problems.
Xerostomia, Xerogenic Medications and Food Avoidances in Selected Geriatric Groups
Authors: Loesche W. J. , Bromberg J. , Terpenning M. S. , Bretz W. A. , Dominguez B. L. , Grossman N. S. , Langmore S. E. 
Published: April 2015

OBJECTIVE: To study the relationship between complaints of xerostomia and salivary performance and food avoidances in four geriatric groups chosen to reflect a broad spectrum of individuals along the health‐disease continuum. To determine whether xerogenic medications taken by these individuals could be associated with either complaints of xerostomia or with food avoidances.DESIGN: Cross‐sectional survey. Clinical examinations and interview.SETTING: A VA dental clinic and a retirement home.PATIENTS AND OTHER PARTICIPANTS: Subjects were 529 individuals older than 56 years of age, living both in institutions and in the community (average age 70 years). Two hundred eight persons were recruited from a VA Dental Clinic, 114 from a residential retirement home, and 132 from a nursing/long‐term‐care facility; 75 were from an acute care ward and had a diagnosis of a cerebral vascular accident or other neurological condition.OUTCOME MEASURES: Prevalence of xerostomia, dental morbidity, salivary flow, and food avoidances.RESULTS: About 72% of the subjects experienced xerostomia sometime during the day. Stimulated salivary flow was found to be significantly lower in individuals who complained of xerostomia than in those who did not. Fifty‐five percent of participants reported using one or more xerogenic medications, with an 86% prevalence in the nursing/long‐term‐care facility. Individuals with xerostomia had difficulty in chewing and in starting a swallow and were significantly more likely to avoid crunchy foods such as vegetables, dry foods such as bread, and sticky foods such as peanut butter in their diets. Specific medications such as the inhalants ipratropium and triamcinolone and the systemic agents oxybutynin and triazolam could be statistically associated with xerostomia and/or low salivary flow, and/or specific food avoidances.CONCLUSION: Xerostomia apparently affects the ability to chew and start a swallow. This leads to avoidance of certain foods, which raises the possibility that xerostomia could contribute to undernutrition in older persons. The topically applied ipratropium and triamcinolone and the systemic agents amitriptyline, oxybutynin and triazolam could be statistically associated with one or more complaints of xerostomia.
Social and Leisure Activities and Risk of Dementia: A Prospective Longitudinal Study
Authors: Fabrigoule Colette , Letenneur Luc , Dartigues Jean François , Zarrouk Mounir , Commenges Daniel , Barberger‐Gateau Pascale 
Published: April 2015

OBJECTIVE: To study the relationship between social and leisure activities and risk of subsequent dementia in older community residents.SETTING: A cohort study of people aged 65 and older were followed‐up 1 and 3 years after a baseline screening (the Paquid study).PARTICIPANTS: 2040 older subjects living at home in Gironde (France) were randomly selected and followed for at least 3 years.DATA COLLECTION: Information about social and leisure activities was collected during the baseline screening with an interview by a psychologist. Incident cases of dementia were detected during the first and third year follow‐up screenings according to the DSM‐III‐R criteria.MAIN RESULTS: All but one of the social and leisure activities noted were significantly associated with a lower risk of dementia. Only golden club participation was not significantly associated with this risk. After adjustment for age and cognitive performance measured by the Mini‐Mental State Exam, visual memory test, and verbal fluency test, only traveling (Relative risk (RR) = .48, 95% Confidence Interval (95%CI) = .24‐.94), odd jobs or knitting (RR = .46, 95%CI = .26‐.85), and gardening (RR = .53, 95%CI = .28‐.99) remained significant.CONCLUSIONS: Regular participation in social or leisure activities such as traveling, odds jobs, knitting, or gardening were associated with a lower risk of subsequent dementia.
Dysphagia and Dietary Levels in Skilled Nursing Facilities
Authors: Groher Michael E. , McKaig T. Neil 
Published: April 2015

OBJECTIVE: To determine the appropriateness of dietary levels of residents with suspected feeding and/or swallowing disorders.DESIGN: Chart review, evaluation, intervention, observation.SETTING: Two skilled nursing facilities, one in Washington, one in Florida.SUBJECTS: Two hundred twelve residents, mean age 72.9, suspected of having feeding and/or swallowing disorders.MEASUREMENTS: After documentation of dietary level, each resident on a mechanically modified diet was given an evaluation by a speech/language pathologist specific to their feeding and swallowing skills. Changes in the dietary level were made, and the residents were followed for 30 days to evaluate their response.RESULTS: Thirty‐one percent of the residents in the two facilities were prescribed a mechanically altered diet. Ninety‐one percent were at dietary levels below that which they could tolerate safely; four percent were at dietary levels higher than they could tolerate; five percent were considered to be at the appropriate diet level.CONCLUSIONS: Many nursing home residents may be inappropriately placed or maintained on mechanically altered diets. Regular reevalution of their dietary level is necessary because most may be able to eat safely at higher levels. Active participation by speech/language pathologists knowledgeable in the assessment of oropharyngeal dysphagia is helpful in this process.
The Use of Expandable Metal Stents for Large Airway Obstruction in Older Patients
Authors: Jack Catherine I.A. , Lye Michael , Wilson Graeme , Hind Charles R.K. 
Published: April 2015

OBJECTIVE: To review the indications, management, and outcome of 30 older patients who had expandable metal stents inserted for large airway obstruction.DESIGN: Information was collected retrospectively from case notes about presentation, radiographic appearances, pulmonary function, including arterial oxygen tension, and histology. Survival data were collected by reviewing hospital or General Practice records.MEASUREMENTS: Spirometry, peak expiratory flow rate, and blood gases were recorded before and after stent insertion.MAIN RESULTS: There was a significant improvement in the patient's mean forced expiratory volume in 1‐second (FEV1) and mean peak expiratory flow rate (PEFR). The arterial oxygen tension (pO2) increased from 8.6 Kpa to 10.6 Kpa. The mean length of survival for the whole group was just under 5 months.CONCLUSIONS: Airway stenting for obstruction provides palliative and functional benefits in these severely disabled patients and a consequent improvement in quality of remaining life.
The Effect of Medical Status on the Activity Level of Older Pain Clinic Patients
Authors: Farrell Michael J. , Gerontol M , Gibson Stephen J. , Helme Robert D. 
Published: April 2015

OBJECTIVE: This project sought to assess the effect of disease status on the activity level of older people suffering from chronic pain.DESIGN: A retrospective comparison of groups defined by disease attributes.SETTING: Outpatient pain management clinic for older people.SAMPLE: The sample consisted of 115 patients, of a possible 144, aged between 52 and 91 years, who were assessed upon admission to a multidisciplinary pain management clinic. Subjects were allocated to groups for comparison on the basis of the diagnosis of their pain problem and the extent of coexistent medical problems.MEASUREMENTS: Groups were compared on scores of activity level using the Human Activity Profile, with and without pain (McGill Pain Questionnaire) and depressive symptom (Geriatric Depression Scale) scores as covariates.MAIN RESULTS: Both pain diagnosis and number of additional medical problems characterized groups that were distinguishable by level of activity. A musculoskeletal disorder was associated with greater impact on activity than either postherpetic neuralgia or pain associated with a psychiatric diagnosis. Less activity was also evident among the subjects with several additional medical problems. However, this effect did not operate independently of depressive symptoms.CONCLUSIONS: Disease status is a factor that rarely explains variations in the pain experience of young adult patients with chronic pain. The results from this study suggest that disease state does influence self‐reported activity level in older people with chronic pain. The influence of medical status should be acknowledged as an important factor when assessing and managing the older patient with chronic pain.
Predictors of Hand Function in Older Persons: A Two‐Year Longitudinal Analysis
Authors: Hughes Susan L. , Gibbs James , Dunlop Dorothy , Singer Ruth 
Published: April 2015

OBJECTIVE: To validate a hierarchical model of hand function in older persons, using longitudinal data.DESIGN: Longitudinal observational study (2‐year data from an ongoing longitudinal study).SUBJECTS: 689 persons older than age 60, including Continuing Care Retirement Community (n = 230), homebound (n = 204), and ambulatory (n = 255) respondents. Mean age at baseline 76.6 (SD = 8.8).MEASUREMENT: Independent variables included sociodemographics, physician measures of upper joint impairment, self‐reported comorbidity, arthritis pain, depression, and anxiety. The dependent variables included grip strength and a timed manual performance test.MAIN RESULTS: Using generalized estimated equations (GEE) to test our hierarchial model, we found that gender and upper extremity joint impairment were the strongest predictors of a longitudinal measure of grip strength. Grip strength, in turn, along with demographics, comorbidity, and a measure of psychological status, was significantly related to timed manual performance.CONCLUSIONS: The longitudinal analyses confirmed a previous cross‐sectional finding that upper extremity joint impairment contributes significantly to reduced grip strength, which, in turn, contributes to reduced hand performance on a timed test.
Depression in Alzheimer's Disease Patients: Caregivers as Surrogate Reporters
Authors: Logsdon Rebecca G. , Teri Linda 
Published: April 2015

OBJECTIVE: To evaluate the use of caregivers as surrogate reporters of depressive symptoms in Alzheimer's disease (AD) patients on five depression measures.DESIGN: Scale characteristics, including means, ranges, internal consistency, sensitivity, and item content of modified self‐report questionnaire and interview depression measures were compared.PARTICIPANTS: Seventy‐six patients, diagnosed with both depression and AD, and their family caregivers participated in this investigation. All subjects were community‐residing participants in a treatment outcome investigation of behavioral treatment for depression.MEASUREMENTS: A Schedule for Affective Disorders and Schizophrenia (SADS) interview was completed on all subjects to establish a diagnosis of depression. Caregivers then completed three additional questionnaire measures about their patient: the Beck Depression Inventory (BDI), the Geriatric Depression Scale (GDS), and the Center for Epidemiological Studies‐Depression Scale (CESD), all modified to provide a surrogate report of their patient's depressive symptoms. In addition, two interview measures were completed based on interviews with the caregiver and patient: the Hamilton Depression Rating Scale (HDRS) and the cornell Scale for Depression in Dementia (CSDD).RESULTS: Mean scores for this sample were above the recommended cutoff score for mild levels of depression on all measures. coefficient alpha levels were comparable to levels reported for the traditional self‐report formats. Sensitivity varied among the measures, with the CSDD most sensitive and the HDRS least sensitive. Item content varied across measures, particularly between questionnaire and interview measures.CONCLUSIONS: Based on these results, it appears that caregivers are able to act as surrogate reporters of depression in AD patients. The modification of self‐report questionnaires did not decrease their internal consistency, and they remained highly correlated with each other, supporting their validity when used in this manner. A two‐step process of evaluating AD patients for depression is recommended: first, a surrogate report questionnaire completed by caregivers to screen patients, eliminating those who are unlikely to be depressed, and then a more extensive interview with those patients‐and their caregivers‐ who appear likely to be depressed.
Health Services Use and Mortality Among Older Primary Care Patients with Alcoholism
Authors: Callahan Christopher M. , Tierney William M. 
Published: April 2015

OBJECTIVE: To describe the prevalence of alcoholism in an older primary care population and to compare rates of health services use and mortality among those with and those without evidence of alcoholism.DESIGN: Baseline screening for alcoholism using the CAGE questionnaire and longitudinal assessment of health services use and mortality using an electronic medical record system.SETTING: An academic primary care group practice at an urban ambulatory care clinic.PATIENTS: A total of 3954 patients aged 60 and older who completed the CAGE alcoholism screening questionnaire during routine office visits.MAIN OUTCOME MEASURES: Comorbidity, preventive health services use, hospital episodes and length of stay, emergency room visits, ambulatory care visits, total outpatient charges, and mortality.RESULTS: The prevalence of current evidence of alcoholism, as defined by a CAGE score ≤ 2 and alcohol use in the previous 12 months, was 10.6%. Patients with evidence of alcoholism were younger (66.2 vs 68.3 years), had fewer years of education (8.4 vs 9.1), were more likely to be male (65.8 vs 27.2%), black (71.2 vs 62.6%), smokers (40.4 vs 26.3%), and malnourished (32.5 vs 26.3%). Patients with alcoholism were more likely to have a diagnosis of obstructive lung disease (22.9 vs 18.3%), injuries (14.2 vs 8.3%), and gout (6.7 vs 2.9%) and less likely to have a diagnosis of hypertension (56.9 vs 61.8%), arthritis (23.3 vs 29.3%), and diabetes (15.9 vs 23.3%). Among those with evidence of alcoholism, 41.6% had a diagnosis of alcoholism in their outpatient medical record. Rates of completion of preventive health services did not differ between the two groups, and there was no difference in the number of ambulatory care visits, emergency room visits, or total outpatient charges.Patients with evidence of alcoholism were more likely to be hospitalized (21.5 vs 16.9%) and more likely to die within 2 years (10.6% vs 6.3%).CONCLUSIONS: One of 10 older patients in this primary care practice had current evidence of alcoholism, fewer than half of whom had documentation of alcohol abuse in their medical records. These patients were more likely to be hospitalized and more likely to die but did not consume a greater amount of outpatient resources. Further research is needed to determine if interventions to reduce alcohol use would also reduce excess hospitalizations and mortality among these older patients.