bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of Life Impact of Urge Incontinence in Older Persons: A New Measure and Conceptual Structure
Authors: DuBeau Catherine E. , Kiely Dan K. , Resnick Neil M. 
Published: April 2015

OBJECTIVETo develop a condition‐specific measure for assessing the impact of urge urinary incontinence (UI) on the quality of life (QoL) of older persons.DESIGNA 32‐item Urge Impact Scale (URIS) was drafted using content area data from focus groups composed of urge incontinent older persons. Pilot testing in 21 urge incontinent persons (mean age 67.7 years) resulted in the elimination of eight items by internal consistency, skew, and patient response criteria. The resulting scale (URIS‐24) was tested for reliability (internal consistency and test‐retest correlation) and construct validity (correlation with UI severity from voiding records) in a separate group of 27 urge incontinent persons (89% women, mean age 72 years). Factor analysis of URIS‐24 data from the combined 48 persons was used to explore the conceptual structure underlying urge UI‐related QoL.SETTINGUniversity‐affiliated community‐based practice and tertiary hospital.PARTICIPANTSCommunity‐dwelling women and men, older than age 60 and with urge incontinence at least twice weekly, recruited from newspaper, newsletter, and radio advertisements.RESULTSCronbach's alpha for URIS‐32 was 0.84, and for URIS‐24 it was 0.94. When administered (mean ± standard deviation) 9.2 ± 5.1 days apart, URIS‐24 had good test‐retest reliability for total scores (interclass coefficient = .88, concordance coefficient = .88), and individual item scores at time 2 were within 1 point (on a 5‐category Likert scale) of time 1 answers for 89% of responses. URIS‐24 scores had modest but nearly significant correlation with the number of UI episodes (r = −0.39, P = .05). Factor analysis revealed a three component structure corresponding to psychological burden, perception of personal control, and self concept.CONCLUSIONSThe URIS‐24 is an internally‐consistent, highly reproducible tool for the assessment of the QoL impact of urge UI on older persons. It can be used to evaluate QoL impact by specific items as well as by overall score. Compared with other UI‐specific QoL measures, the URIS‐24 had similar or superior internal consistency, test‐retest reliability, and validity, but it is the first measure designed and tested specifically for older persons with urge UI. These results also highlight the multifactorial structure of urge UI‐related QoL and the importance of its psychological dimensions.
The Validity of Nutritional Status as a Marker for Future Disability and Depressive Symptoms Among High‐Risk Older Adults
Authors: Boult Chad , Krinke U. Beate , Urdangarin Cristina Flood , Skarin Vicki 
Published: April 2015

OBJECTIVETo measure the validity of the DETERMINE Checklist as a marker for future functional disability, depressive symptoms, and mortality among high‐risk older adults.DESIGNA Cohort study.SETTINGAn Urban‐suburban Midwestern community.PARTICIPANTSCommunity‐dwelling Medicare beneficiaries at high risk for hospital admission who received geriatric evaluation and management (GEM) (n = 251).MEASUREMENTSDemographic, health‐related, functional, psychosocial, survival, and nutritional data were collected through telephone and in‐home interviews.RESULTSGEM recipients with baseline Checklist scores of four or higher were found to be significantly more likely than those with lower scores to have functional disability or high levels of depressive symptoms a year later. Checklist scores did not predict mortality.CONCLUSIONSThe 10‐item Checklist could be used as a secondary screen to identify older persons who, without treatment, are at especially high‐risk to have disability or depression a year later.
Weight, Weight Change, and Mortality in a Random Sample of Older Community‐Dwelling Women
Authors: Reynolds Matthew W. , Fredman Lisa , Langenberg Patricia , Magaziner Jay 
Published: April 2015

OBJECTIVE: To evaluate the relationship between measured weight, weight change, and 6‐year mortality risk in a random sample of 648 community‐dwelling women aged 65 and older from Baltimore, Maryland.MEASUREMENTS: Data were collected using a standardized questionnaire and administered in person by trained interviewers. Questionnaires were completed annually from 1984 to 1986, and body weight was measured at each interview. Weight was defined as body mass index (BMI) of low (<23 kg/m2), average (≥ 23 kg/m2 to ≤ 28 kg/m2), and high (> 28 kg/m2). Four mutually exclusive categories of weight change of at least 4.5% in BMI over the three annual interviews were developed to describe all possible weight change patterns: weight gain, weight loss, no change, and weight cycling.RESULTS: During the follow‐up period, 106 women (16%) died. Women with low baseline BMI, regardless of weight change, and those who lost weight, regardless of baseline BMI had increased mortality risk. Women with average baseline BMI and weight loss had a very high mortality risk (hazard ratio (HR) 3.84, 95% Confidence interval (CI) 2.14‐6.89). Women who weight cycled had increased mortality risk at low and high baseline weights, and a nonsignificant increased risk at average baseline weight (P = .069). Analyses were adjusted for age, education, smoking, alcohol usage, and pre‐existing illness and included an interaction between weight change and baseline BMI.CONCLUSIONS: These results suggest that white, older, community‐dwelling women are at an increased risk of mortality if they are underweight, lose weight, or weight cycle. J Am Geriatr Soc 47:1409–1414, 1999.
Atrial Natriuretic Peptide Levels in Geriatric Patients with Nocturia and Nursing Home Residents with Nighttime Incontinence
Authors: Ouslander Joseph , Johnson Theodore , Nasr Samer , Schnelle John , Miller Myron 
Published: April 2015

OBJECTIVES: To determine if nocturnal polyuria in geriatric patients with nocturia and nocturnal incontinence is associated with elevated plasma atrial natriuretic peptide (ANP) levels.DESIGN: Case series.SETTING: Four nursing homes and two board and care facilities.PARTICIPANTS: Fifty‐four nursing home residents and 26 board and care residents with a mean age of 86.MEASUREMENTS: Daytime (7:00 a.m. to 7:00 p.m.) and nighttime (7:00 p.m. to 7:00 a.m.) urine volumes of incontinent nursing home residents were measured over 3 days and 3 nights by reweighing preweighed adults diapers and toileting inserts emptied by research staff for the board and care group. Blood was drawn in the early morning (5:00 a.m. to 7:00 a.m.) before subjects arose and in the evening after an hour of lying in bed (8:00 p.m. to 11:00 p.m.), and plasma ANP levels were determined by radioimmunoassay.RESULTS: Forty‐nine (61%) of the subjects had nocturnal polyuria as defined by night/total urine volume ratios ≥ 50%. There was no significant difference between those with night/total ratios ≥ 50% versus <50% in plasma levels of ANP in the early morning (44.2 ± 33.3, median 35.7 pg/mL vs 40.9 ± 39.2, median 28.5; P = .36 by Mann Whitney U) or in the evening (43.4 ± 28.8, median 36.4 pg/mL vs 49.6 ± 53.1, median 34.4; P = .58). Nor was there any significant correlation between night/total urine volume ratio and morning or evening ANP levels (r = .01, P = .96 and r = .23, P = .31, respectively).CONCLUSIONS: In this sample of geriatric patients with nocturia and nursing home residents with nighttime urinary incontinence, ANP levels were elevated, but increased nighttime urine production was not associated with higher levels. Because of the variability in ANP levels, our power to detect such an association was low, and we cannot draw any definitive conclusions. Although high plasma ANP levels are unlikely to be a primary cause of nocturia and nighttime incontinence, they may, when combined with other factors such as low antidiuretic hormone levels, sleep disorders, and low functional bladder capacity, contribute to these symptoms in some geriatric patients. J Am Geriatr Soc 47:1439–1444, 1999.
Smoking and Mortality in an Older Chinese Cohort
Authors: Ho Suzanne C. , Zhan Si Yan , Tang Jin Ling , Chan Sieu Gaen , Woo Jean 
Published: April 2015

OBJECTIVES: Only limited data are available regarding smoking and health in later life and, in particular, in the older Chinese population. This paper reports the relationship between smoking and mortality in a Chinese cohort aged 70 years and older.SETTING: A population‐based study conducted in Hong Kong.PARTICIPANTS: A cohort comprising 2030 subjects aged 70 and older were assembled in 1991–1992 and followed for 36 months.DESIGN: A prospective cohort study.MEASUREMENTS: Baseline information regarding smoking status as well as several social and health variables were obtained through face‐to‐face interview at the respondent's place of residence. The outcome variables were mortality from all causes as well as from cancer and cardiovascular and respiratory diseases. Causes of death were ascertained from death certificates.RESULTS: The prevalence rates of smoking at baseline were 24.9% in men and 8.2% in women. A total of 534 deaths occurred during the 36‐month follow‐up period. Of these, 447 were attributable to three main causes: cancer, cardiovascular disease, and respiratory disease. Elevated mortality risks from all causes were observed among both male (RR = 1.4; 95% CI, 0.9‐1.9) and female (RR = 1.6; 95% CI, 1.0–2.5) current smokers, but the 95% confidence intervals overlapped. Significant association between current smoking and combined mortality from these three major causes was found in men; it was also found in women after excluding those with these diseases at baseline. More than a 3‐fold increased risk of cancer mortality was found in current smokers of both sexes. Although nonsignificant associations were found between former smokers and mortality risks in men, women who were former smokers had increased mortality risks from all causes as well as from cancer and respiratory diseases.CONCLUSIONS: This 3‐year prospective study of an older Chinese cohort reveals the impact of smoking on health during later life, especially in women. Smoking cessation, particularly in older men, should be beneficial in reducing mortality. Smoking cessation should begin as early as possible for women. J Am Geriatr Soc 47:1445–1450, 1999.
Higher Systemic Arterial Compliance Is Associated with Greater Exercise Time and Lower Blood Pressure in a Young Older Population
Authors: Cameron J. D. , Rajkumar C. , Kingwell B. A. , Jennings G. L. , Dart A. M. 
Published: April 2015

OBJECTIVES: Arterial compliance is an important therapeutic target in older individuals in whom stiffening of the proximal arterial circulation is thought to underlie systolic hypertension and increased cardiac work. We have shown previously that arterial compliance is related to aerobic fitness and that it is increased in young (20 to 35 years old), previously sedentary individuals by a 4‐week period of moderate aerobic training. The extent to which compliance relates to exercise performance in a random selection of young older patients has not been reported previously. Therefore, we examined the interrelationship between systemic arterial compliance (SAC) and time to cessation of exercise during a standard treadmill exercise test in an older population. DESIGN: A cross‐sectional survey.METHODS: SAC was estimated at rest using simultaneous recordings of ascending aortic flow and carotid applanation tonometry in 43 subjects aged 67 ± 7 years (mean ± SD; 24 men and 19 women). Treadmill exercise testing was performed using a modified Bruce protocol. Aerobic capacity was assessed as Heart Rate‐Blood Pressure product and exercise tolerance as total treadmill time.RESULTS: SAC and exercise tolerance were related to gender, with men exhibiting greater exercise reserve and higher SAC than women. There was a significant positive correlation between SAC and time to cessation of exercise (r = .34; P = .03), with a negative correlation between SAC and resting heart rate‐blood pressure product (r = ‐.66; P < .001). SAC was correlated with height and blood pressure. Exercise tolerance was related to height (P < .02).CONCLUSIONS: These data indicate a positive association between SAC and fitness level in healthy older people and an inverse association between SAC and systolic blood pressure. Our findings are consistent with either (1) acquisition of a more compliant circulation and lower blood pressure through more physical activity or (2) that a more compliant arterial circulation and lower blood pressure permit greater athletic performance. J Am Geriatr Soc 47:653–656, 1999.
Lower Incidence of Tardive Dyskinesia with Risperidone Compared with Haloperidol in Older Patients
Authors: Jeste Dilip V. , Lacro Jonathan P. , Bailey Anne , Rockwell Enid , Harris M. Jackuelyn , Caligiuri Michael P. 
Published: April 2015

OBJECTIVE: To compare the 9‐month cumulative incidence of tardive dyskinesia (TD) with risperidone to that with haloperidol in older patients.DESIGN: A prospective longitudinal study.SETTING: An outpatient psychiatric clinic.PARTICIPANTS: Subjects were middle‐aged and older (mean age 66 years) patients with schizophrenia, dementia, mood disorders, or other conditions with psychotic symptoms or severe behavioral disturbances. Sixty‐one patients on risperidone were matched with 61 patients from a larger sample of haloperidol‐treated patients in regard to age, diagnosis, and length of preenrollment neuroleptic intake to create clinically comparable groups. The median daily dose of each medication was 1.0 mg.MEASUREMENTS: Abnormal Involuntary Movement Scale, modified Simpson‐Angus' scale for extrapyramidal symptoms, Brief Psychiatric Rating Scale, and Mini‐Mental State Examination were administered at baseline, 1 month, and 3, 6, and 9 months. The diagnosis of TD was based on specific research criteria. The raters were blind to the patient's medication status.RESULTS: Life table analysis revealed that patients treated with haloperidol were significantly more likely to develop TD than patients treated with risperidone (P < .05, Peto‐Prentice).CONCLUSIONS: The atypical antipsychotic risperidone is significantly less likely to result in TD than the conventional neuroleptic haloperidol in a high‐risk group of older patients, at least over a 9‐month period. J Am Geriatr Soc 47:716–719, 1999.
Low Blood Pressure and Incidence of Dementia in a Very Old Sample: Dependent on Initial Cognition
Authors: Guo Zhenchao , Viitanen Matti , Winblad Bengt , Fratiglioni Laura 
Published: April 2015

OBJECTIVE: To examine whether initially low blood pressure is related to the incidence of dementia.DESIGN: A population‐based prospective study.SETTING: The Kungsholmen district of Stockholm, SwedenPARTICIPANTS: Three hundred four nondemented subjects aged 75 to 96 years at baseline.MEASUREMENTS AND MAIN RESULTS: After an average of 3 years, 81 dementia cases were identified (67 with Alzheimer's disease cases). Compared with individuals with baseline systolic pressure of 141 to 179 mm Hg, those with systolic pressure ≤ 140 mm Hg had a significantly higher risk of dementia (relative risk (RR) = 1.9, 95% confidence interval (CI), 1.2–3.2) and Alzheimer's disease (RR = 2.2, 95% CI, 1.2–3.8). However, the RR in relation to systolic pressure ≤ 140 mm Hg was 1.3 (0.8‐2.2) for all dementia and 1.5 (0.8‐2.6) for Alzheimer's disease, when the baseline Mini‐Mental State Examination (MMSE) score was included in the model as a dichotomous variable (< 24 vs ≥ 24). Baseline MMSE <24 significantly predicted the occurrence of dementia (RR = 6.9; 95% CI, 4.3–11.1). Systolic pressure ≤ 140 mm Hg was significantly related to MMSE score < 24 at baseline.CONCLUSIONS: These data suggest that low blood pressure may be an early correlate of a dementing process although a causative effect cannot be definitely ruled out. J Am Geriatr Soc 47:723–726, 1999.
Insulin Effects on the Left Ventricle in Older Hypertensive Subjects
Authors: Scuteri Angelo , Di Bernardo Maria Gabriella , De Propris Anna Maria , Marigliano Vincenzo 
Published: April 2015

BACKGROUND: To evaluate the effects of hyperinsulinemia on left ventricular (LV) structure and function in older hypertensive subjectsMETHODS: Thirty‐seven hypertensive subjects (17 men/20 women) aged 50 to 80, were studied. LV mass were evaluated echocardiographically according to the Penn convention. A 75‐g oral glucose tolerance test (OGTT) was performed after overnight fasting, and both blood glucose and insulin concentrations were assayed at 0, 30, 60, 90, 120, and 180 minutes. Comparison between groups was performed by analysis of variance. A P value of .05 was considered statistically significant.RESULTS: When the hypertensive patients were divided into two groups according to the median value of 2‐hour post‐loading plasma insulin, there was no difference in blood pressure levels between the groups. However, hyperinsulinemic hypertensive subjects had an increased LV mass (P < .05), mean wall thickness, and interventricular septum thickness (P < .05 for both parameters) and had better systolic function‐ejection and shortening fractions (P < .0001 for both indices).CONCLUSIONS: Hyperinsulinemia may be associated with increased left ventricular mass and with a better systolic performance in older hypertensive subjects. J Am Geriatr Soc 47:727–729, 1999.
Mailed Reminders for Area‐Wide Influenza Immunization: A Randomized Controlled Trial
Authors: Smith David M. , Zhou Xiao‐Hua , Weinberger Morris , Smith Faye , McDonald Robert C. 
Published: April 2015

OBJECTIVE: To determine if mailed reminders would increase area‐wide influenza immunization for persons aged 65 and older.DESIGN: A randomized, controlled trial.SETTING: Ten counties in Indiana.PARTICIPANTS: Using a Medicare database, 10,000 subjects were selected randomly from 10 counties in Indiana and randomized for the study. Using pre‐established criteria, 4503 persons in the control group and 4508 in the intervention group were eligible for study.INTERVENTION: Intervention subjects received mailed reminders during the immunization season of 1995.MEASUREMENTS: Data from mailed surveys, Medicare claims, and phone calls were used to determine immunization rates.RESULTS: Of those surveyed who received immunization, only 63.4% filed a Medicare claim. Immunization rates were high in both groups but higher in the intervention group, 69.0% versus 64.2%. Age, presence of lung disease, assignment to the intervention group, presence of heart disease, and an age‐sex interaction term were significantly and independently related to immunization.CONCLUSIONS: The Healthy People Year 2000 goal (60% immunization for persons 65 and older) was exceeded in this population. Medicare claims data do not reflect immunization rates accurately. Mailed reminders, an inexpensive intervention, increased immunization rates area‐wide and have potential for cost savings.
Mortality, Health Services Use, and Health Behavior in a Cohort of Well Older Adults
Authors: Malmgren Judith A. , Koepsell Thomas D. , Martin Diane P. , Diehr Paula , LaCroix Andrea Z. 
Published: April 2015

OBJECTIVES: To construct an evidence‐based Good Health Behavior Score and examine the relationship between aggregate health behaviors, mortality, and health services utilization in the last year of life in a cohort of well older adults.DESIGN: A prospective cohort.SETTING: A large health maintenance organization.PARTICIPANTS: 1867 older enrollees who responded to a health promotion survey.MEASUREMENTS: A baseline self‐administered questionnaire was used to ascertain health behaviors in 1987–1988, and vital status was determined 48 months later. A Good Health Behavior Score was calculated, and a Cox proportional hazards model was used to compare high, middle, and low score groups regarding risk of death. For those who died, differences in amount and type of health services utilization in relation to the summary score were compared for the year before death.RESULTS: During the 4 years of follow‐up, the mortality rate for the mid‐level score group was 50% less, and in the highest score group was 70% less, than in the lowest score group. Among decedents, no significant differences were found between high and low Good Health Behavior score groups for inpatient and outpatient utilization, pharmacy use, or total cost during the last year of life.CONCLUSION: An easily developed and simple health behavior score can predict short term mortality quite strongly. Medical care costs in the last year of life were similar in individuals with higher and lower health behavior scores.
Is Experience as a Prisoner of War a Risk Factor for Accelerated Age‐Related Illness and Disability?
Authors: Creasey Helen , Sulway Mary Rose , Psychol M. , Dent Owen , Broe G. Anthony , Jorm Anthony , Tennant Christopher 
Published: April 2015

OBJECTIVE: To determine whether the experience of internment as a Prisoner of War (POW) during World War II was associated with a higher prevalence of chronic disease and diminished functional performance in later life.DESIGN: A retrospective and prospective cohort design.SETTING: Concord Repatriation General Hospital, Sydney, Australia.PARTICIPANTS: A random sample of 101 Australian, male, ex‐prisoners of the Japanese and a comparison group of 107 non‐POW combatants from the same theatre of war.MEASUREMENTS: Outcome variables were self‐perceived health status, hospital admissions and length of stay, number of prescription medications used, number of somatic symptoms reported, number and types of medical diagnoses, a neurology of aging clinical examination, and the Instrumental Activities of Daily Living (IADL) and Physical Self Maintenance Scales (PSMS).RESULTS: Prisoners of War reported more somatic symptoms (mean 7.2 vs 5.4, P = .002) than non‐POWs, had more diagnoses (mean 9.4 vs 7.7 P < .001), and used a greater number of different medications (mean 4.5 vs 3.4, P = .001). There were no differences in hospital admissions or length of stay. Among 15 broad categories of diagnosis, differences were confined to gastrointestinal disorders (POWs 63% vs non‐POWs 49%, P = .032), musculoskeletal disorders (POWs 76% vs non‐POWs 60%, P = .011), and cognitive disorders (excluding head injury, dementia, and stroke) (POWs 31% vs non‐POWs 15%, P = .006). Of the 36 signs in the neurology of aging examination, POWs had a significantly higher proportion of seven extrapyramidal signs and six signs relating to ataxia. POWs were more likely to be impaired on the IADL scale than were non‐POWs (33% vs 17%, P = .012) but not significantly more likely to be impaired on the PSMS.CONCLUSIONS: There were few differences between POWs and controls, and those differences were relatively small. Our findings do not support a major role for a catastrophic life stress in the development of chronic illness and disability in later life. However it is possible that the POW experience played a part in premature, abnormal, or unsuccessful aging in some individuals.