bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation and cross‐cultural adaptation of the Hendrich II Fall Risk Model to Portuguese
Authors: Caldevilla Mª Nilza , Costa Mª Arminda M. , Teles Paulo , Ferreira Pedro M. 
Published: June 2012

Scand J Caring Sci; 2013; 27; 468–474

Evaluation and cross‐cultural adaptation of the Hendrich II Fall Risk Model to Portuguese
Background:  Several tools for the assessment of the risk of falling are used commonly by clinical nurses, but none have been validated in Portuguese.Aims:  To adapt and evaluate the Hendrich II Fall Risk Model (HIIFRM) for use with elderly Portuguese inpatients.Method:  We conducted a prospective study of 586 older inpatients in acute care hospitals, from November 2007 to May 2010.Results:  The study involved 270 men and 316 women. The most frequent risk factor on admission and at discharge was a score ≥3 on the ‘Get Up and Go’ test. The adapted HIIFRM showed a sensitivity of 93.2% and 75.7%, and a specificity of 35% and 46.7%, on admission and at discharge, respectively. A positive predictive value of 17.2% on admission and 17% at discharge and a negative predictive value of 97.3% and 93%, respectively, were estimated.Conclusions:  The HIIFRM was shown to be a useful tool in predicting falls by patients. Nevertheless, the research model suggested that only four risk factors affected the occurrence of falls significantly on admission and two risk factors at discharge. Further research is required in Portuguese hospital settings.
High tryptophan diet reduces CA1 intraneuronal β‐amyloid in the triple transgenic mouse model of Alzheimer’s disease
Authors: Noristani Harun N. , Verkhratsky Alexei , Rodríguez José J. 
Published: June 2012

SummaryAlzheimer’s disease (AD) is a progressive neurodegenerative disease that impairs mnesic functions. The histopathology of the disease is manifested by the accumulation of intracellular β‐amyloid (Aβ) and subsequent formation of neuritic plaques as well as the presence neurofibrillary tangles in specific brain regions associated with learning and memory including the hippocampus. Here, we analysed the effect of chronic (1 month) food diets containing low (LTrP), normal (NTrP) and high tryptophan (HTrP), 0.04, 0.20 and 0.40 g/100 g, respectively, on CA1 serotonin transporter (SERT) fibre density, intraneuronal Aβ deposition and total number of serotonergic (5‐HT) neurons in an AD triple transgenic (3xTg‐AD) mouse model. Nontransgenic (non‐Tg) animals fed with HTrP displayed increased SERT fibre density in CA1 (35%) and in stratum lacunosum moleculare (S.Mol) (48%) compared to LTrP diet. Transgenic animals showed increased SERT fibre density in CA1 S.Mol compared to diet‐matched non‐Tg irrespective of dietary tryptophan content (104% for LTrP, 74% for NTrP and 35% for HTrP); no differences were observed in the total number of 5‐HT neurons neither in the dorsal nor in the median raphe nuclei. However, and more relevant to AD, HTrP diet reduced intraneuronal Aβ density (by a 17%) in transgenic animals compared to transgenic animals fed with NTrP diet. Our results show that increased dietary TrP intake reduces intraneuronal Aβ load in the 3xTg‐AD mouse model of AD, suggesting that enhanced TrP intake and in consequence a potential increase in 5‐HT neurotransmission may be effective in reducing plaque pathology in AD.
Deviation of innate circadian period from 24 h reduces longevity in mice
Authors: Libert Sergiy , Bonkowski Michael S. , Pointer Kelli , Pletcher Scott D. , Guarente Leonard 
Published: June 2012

SummaryThe variation of individual life spans, even in highly inbred cohorts of animals and under strictly controlled environmental conditions, is substantial and not well understood. This variation in part could be due to epigenetic variation, which later affects the animal’s physiology and ultimately longevity. Identification of the physiological properties that impact health and life span is crucial for longevity research and the development of anti‐aging therapies. Here, we measured individual circadian and metabolic characteristics in a cohort of inbred F1 hybrid mice and correlated these parameters to their life spans. We found that mice with innate circadian periods close to 24 h (revealed during 30 days of housing in total darkness) enjoyed nearly 20% longer life spans than their littermates, which had shorter or longer innate circadian periods. These findings show that maintenance of a 24‐h intrinsic circadian period is a positive predictor of longevity. Our data suggest that circadian period may be used to predict individual longevity and that processes that control innate circadian period affect aging.
Recovery of Function Following a Hip Fracture in Geriatric Ambulatory Persons Living in Nursing Homes: Prospective Cohort Study
Authors: Beaupre Lauren A. , Jones C. Allyson , Johnston D. William C. , Wilson Donna M. , Majumdar Sumit R. 
Published: June 2012

ObjectivesTo measure 1‐year post‐hip fracture functional recovery, health‐related quality of life (HRQL), and mortality in nursing home residents.DesignProspective longitudinal cohort study.Setting and ParticipantsAmbulatory nursing home residents with or without impaired cognition consecutively admitted with hip fracture to three Canadian tertiary‐care hospitals from March 2008 through November 2009.MeasurementsParticipants or proxy respondents completed the Functional Independence Measure Motor score (FIMmotor) and EuroQol5D index score (EQ‐5Dindex) in the hospital (prefracture status) and 3, 6, and 12 months after fracture. Complications over the first postfracture year were also ascertained; the primary outcome was functional recovery (change in FIMmotor score).ResultsOf 92 eligible participants, 60 (64%) were enrolled. The mean age was 86.9 ± 8.1, 42 (70%) were female, and 45 (75%) had three or more comorbidities. Forty‐three (72%) walked independently with or without aids before fracture. By 12 months, 27 (45%) participants had died, and 10 (17%) had withdrawn. Of the remaining 23 participants, functional status according to FIMmotor score dropped substantially and significantly after the fracture (3 months, 34.0 ± 19.7; 6 months, 33.2 ± 19.7; 12 months, 32.0 ± 20.0; P < .001 from a baseline FIMmotor score of 50.1 ± 16.1). By 12 months after the fracture, only eight (35%) were walking independently, and 11 (48%) were no longer ambulatory. HRQL according to the EQ‐5Dindex also decreased significantly (P = .003), from 0.62 ± 0.20 before fracture to 0.42 ± 0.30 by 12 months after fracture.ConclusionHip fracture for nursing home residents was associated with substantial loss of functional independence, ambulation, and HRQL. Little recovery was evident after the first 3 months; there was almost 50% mortality within 12 months.
Fatigability in Basic Indoor Mobility in Nonagenarians
Authors: Mänty Minna , Ekmann Anette , Thinggaard Mikael , Christensen Kaare , Avlund Kirsten 
Published: June 2012

ObjectivesTo evaluate the prevalence and associated health factors of indoor mobility–related fatigability in nonagenarians.DesignA cross‐sectional observational study of all Danes born in 1905 and assessed in 1998.SettingCommunity, sheltered housing and nursing homes.ParticipantsIndividuals aged 92 and 93 (N = 1,181) who were independent of help in basic indoor mobility.MeasurementsFatigability in basic indoor mobility was defined as a subjective feeling of fatigue when transferring or walking indoors. Other standardized assessments include self‐report measures of medical history and performance‐based assessments of walking speed and maximum handgrip strength.ResultsTwenty‐six percent of participants reported fatigability when transferring or walking indoors; fatigability was more common in participants living in sheltered housing (32%) than in those living independently (23%, P < .001). Cardiovascular diseases, musculoskeletal pain, medications, walking speed, and depressive symptoms were independently associated with fatigability.ConclusionFatigability in basic everyday mobility is common in nondisabled nonagenarians. The results also indicate important associations between fatigability and potentially modifiable health factors.
Use of an Online Curriculum to Teach Delirium to Fourth‐Year Medical Students: A Comparison with Lecture Format
Authors: Chao Serena H. , Brett Belle , Wiecha John M. , Norton Lisa E. , Levine Sharon A. 
Published: June 2012

Web‐based learning methods are being used increasingly to teach core curriculum in medical school clerkships, but few studies have compared the effectiveness of online methods with that of live lectures in teaching the same topics to students. Boston University School of Medicine has implemented an online, case‐based, interactive curriculum using videos and text to teach delirium to fourth‐year medical students during their required 1‐month Geriatrics and Home Medical Care clerkship. A control group of 56 students who received a 1‐hour live delirium lecture only was compared with 111 intervention group students who completed the online delirium curriculum only. Evaluation consisted of a short‐answer test with two cases given as a pre‐ and posttest to both groups. The total possible maximum test score was 34 points, and the lowest possible score was −8 points. Mean pre‐ and posttest scores were 10.5 ± 4.0 and 12.7 ± 4.4, respectively, in the intervention group and 9.9 ± 3.5 and 11.2 ± 4.5, respectively, in the control group. The intervention group had statistically significant improvement between the pre‐ and posttest scores (2.21‐point difference; P < .001), as did the control group (1.36‐point difference; P = .03); the difference in test score improvement between the two groups was not statistically significant. An interactive case‐based online curriculum in delirium is as effective as a live lecture in teaching delirium, although neither of these educational methods alone produces robust increases in knowledge.
Discrepancy Between Self‐ and Proxy‐Rated Pain in Alzheimer's Disease: Results from the Danish Alzheimer Intervention Study
Authors: Jensen‐Dahm Christina , Vogel Asmus , Waldorff Frans B. , Waldemar Gunhild 
Published: June 2012

ObjectivesTo investigate the prevalence of self‐ and proxy‐reported pain in a cohort with Alzheimer's disease (AD) and to identify characteristics of individuals with AD reporting pain.DesignData were collected at the baseline visit of the Danish Alzheimer Intervention Study.SettingCommunity.ParticipantsThree hundred twenty‐one community‐living individuals with AD (MMSE ≥ 20) and their primary caregivers.MeasurementsPain was assessed as part of the EuroQol EQ‐5D (caregiver‐ and self‐rated). The Cornell Scale for Depression in Dementia, Quality of Life in Alzheimer's Disease Scale, EQ‐5D visual analog scale, Mini‐Mental State Examination, and Neuropsychiatric Inventory Questionnaire were also used.ResultsFair agreement was found between self‐ and proxy ratings on pain (kappa = 0.34). Thirty‐three percent of individuals with AD reported pain, whereas caregivers reported that 52% had pain (
P
< .001). Individuals who had self‐ or proxy‐rated pain were significantly more likely to be female, had more depressive and other neuropsychiatric symptoms, and rated their quality of life lower.ConclusionSelf‐ and proxy‐reported pain differ in individuals with mild AD, with proxies rating more pain than the individuals with AD. Self‐ and proxy‐rated pain was significantly associated with more neuropsychiatric and depressive symptoms and lower quality of life. In general, this study indicates that pain occurs frequently even in individuals with mild AD and that pain assessment may require self‐ and proxy report to identify individuals with need for possible treatment.
Ethnic Disparities in Adherence to Antihypertensive Medications of Medicare Part D Beneficiaries
Authors: Holmes Holly M. , Luo Ruili , Hanlon Joseph T. , Elting Linda S. , Suarez‐Almazor Maria , Goodwin James S. 
Published: June 2012

ObjectivesTo determine the level of adherence to medications and characteristics of Part D beneficiaries associated with higher levels of antihypertensive medication adherence.DesignRetrospective cohort study.SettingMedicare claims and Part D event files.ParticipantsMedicare Part D enrollees with prevalent uncomplicated hypertension who filled at least one antihypertensive prescription in 2006 and two prescriptions in 2007.MeasurementsMedication adherence was defined as an average medication possession ratio of 80% or greater. Potential factors associated with adherence evaluated were age, sex, race or ethnicity, socioeconomic factors, comorbidity, medication use, copayments, being in the coverage gap, and number of unique prescribers.ResultsOverall adherence was 79.5% of 168,522 Medicare Part D enrollees with prevalent uncomplicated hypertension receiving antihypertensive medicines in 2007. In univariate analysis, adherence varied significantly according to most patient factors. In multivariable analysis, lower odds of adherence persisted for blacks (odds ratio (OR) = 0.53, 95% confidence interval (CI) = 0.51–0.55), Hispanics (OR = 0.58, 95% CI = 0.55–0.61), and other non‐white races (OR = 0.80 95% CI = 0.75–0.85) than for whites. Greater comorbidity and concurrent medication use were also associated with poorer adherence. Adherence was significantly different across several geographic regions.ConclusionA number of associations were identified between patient factors and adherence to antihypertensive drugs, with significant differences in adherence according to ethnicity. Improving adherence could have significant public health implications and could improve outcomes specific to hypertension, as well as improving cost and healthcare utilization.
Association Between Mobility, Participation, and Wheelchair‐Related Factors in Long‐Term Care Residents Who Use Wheelchairs as Their Primary Means of Mobility
Authors: Mortenson W. Ben , Miller William C. , Backman Catherine L. , Oliffe John L. 
Published: June 2012

ObjectivesTo explore how wheelchair‐related factors, mobility, and participation are associated in a sample of long‐term care residents who use wheelchairs as their primary means of mobility.DesignCross‐sectional survey.SettingEleven residential care facilities in the lower mainland of British Columbia, Canada.ParticipantsOne hundred forty‐six self‐responding residents and 118 proxy respondents: mean age 84 (range 60–103). Most were female (69%), and a small proportion (9%) drove a power wheelchair.MeasurementsThe Nursing Home Life Space Diameter Assessment was used to measure resident mobility, and the Late Life Function and Disability Instrument: Disability Component was used to measure participation frequency in daily activities.ResultsPath analysis indicated that wheelchair‐related factors were associated with participation frequency directly and indirectly through their relationship with mobility. The final model explained 46% of the variance in resident mobility and 53% of the variance in resident participation frequency. Wheelchair skills, which include the ability to transfer in and out of and propel a wheelchair, were important predictors of life‐space mobility and frequency of participation, and life space mobility was a significant predictor of frequency of participation. Depression was associated with poorer wheelchair skills and mobility and less‐frequent participation. Counterintuitively, perceived environmental barriers were positively associated with frequency of participation.ConclusionThe findings suggest that, by addressing wheelchair‐related factors, resident's mobility and participation may be improved, but the efficacy of this approach needs to be confirmed experimentally.
Environmental Determinants of Quality of Life in Nursing Home Residents with Severe Dementia
Authors: Garre‐Olmo Josep , López‐Pousa Secundino , Turon‐Estrada Antoni , Juvinyà Dolors , Ballester David , Vilalta‐Franch Joan 
Published: June 2012

ObjectivesTo determine the relationship between quality of life (QOL) and environmental factors of temperature, noise, and lighting in nursing home residents with severe dementia.DesignCross‐sectional, observational, analytical.SettingEight public, long‐term care nursing homes in the province of Girona, Spain.ParticipantsRandom sample of 160 nursing home residents with severe dementia.MeasurementsFunctional and cognitive impairment, pain, neuropsychiatric disturbances, and QOL were determined using standardized instruments. Temperature, noise, and lighting in bedrooms, dining rooms, and living rooms were measured in the morning and afternoon using a multifunction environment meter in a standardized manner.ResultsAdjusted multivariate linear regression models demonstrated that environmental measures were independently associated with QOL and related factors. High temperature in the bedroom was associated with lower QOL (standardized β = 0.184), high noise levels in the living room were associated with low behavioral signs of social interactions (β = 0.196), and low lighting levels in the bedroom were associated with number of signs of negative affective mood (β = −0.135).ConclusionThe QOL of nursing home residents with severe dementia was related to environmental factors such as temperature, noise, and lighting. The monitoring of these environmental factors may improve these individuals' QOL.
Glycosylated Hemoglobin and Functional Decline in Community‐Dwelling Nursing Home–Eligible Elderly Adults with Diabetes Mellitus
Authors: Yau Celia K. , Eng Catherine , Cenzer Irena Stijacic , John Boscardin W. , Rice‐Trumble Kathy , Lee Sei J. 
Published: June 2012

ObjectivesTo determine whether glycosylated hemoglobin (HbA1c) levels predict functional decline in older adults.DesignLongitudinal cohort study.ParticipantsCommunity‐dwelling, nursing home (NH)‐eligible individuals with diabetes mellitus enrolled at On Lok between October 2002 and December 2008 (367 participants, 1,579 HbA1c measurements).SettingOn Lok Lifeways, the original model for Programs of All‐Inclusive Care for the Elderly.MeasurementsThe outcomes were functional decline or death at 2 years. The primary predictor was HbA1c. Age, sex, race and ethnicity, baseline function, comorbid conditions, length of time enrolled at On Lok, insulin use, and clustering of HbA1c within participants were adjusted for with mixed‐effects Poisson regression.ResultsMean age was 80, and 185 participants (50%) were taking insulin. Sixty‐three percent of participants experienced functional decline, and 75% experienced death or functional decline during the study period. At 2 years, higher HbA1c was associated with less functional decline or death (P for trend = .006). Accounting for clustering and confounding factors, HbA1c of 8.0% to 8.9% was associated with a lower likelihood (relative risk = 0.88, 95% confidence interval = 0.79–0.99) of functional decline or death than HbA1c of 7.0% to 7.9%.ConclusionIn community‐dwelling, NH‐eligible individuals with diabetes mellitus, HbA1c of 8.0% to 8.9% is associated with better functional outcomes at 2 years than HbA1c of 7.0% to 7.9%, suggesting that the current American Geriatrics Society guideline recommending a HbA1c target of 8.0% or less for older adults with limited life expectancy may be lower than necessary to maintain function.
Kidney Function and Cognitive and Functional Decline in Elderly Adults: Findings from the Singapore Longitudinal Aging Study
Authors: Feng Liang , Yap Keng Bee , Yeoh Lee Ying , Ng Tze Pin 
Published: June 2012

ObjectivesTo investigate whether lower estimated glomerular filtration rate (eGFR) or chronic kidney disease (CKD) was associated with subsequent cognitive and instrumental activity of daily living (IADL) decline in a prospective cohort study.DesignProspective cohort study, followed for up to 4 years.SettingGeneral community.ParticipantsOne thousand three hundred fifteen adults aged 55 and older from the Singapore Longitudinal Aging Study.MeasurementsBaseline data included eGFR levels, presence of CKD (eGFR < 60 mL/min per 1.73 m2), and known confounders. Cognitive decline was defined as a drop of 2 or more points on the Mini‐Mental State Examination (MMSE) and functional decline as a drop of 2 or more points in IADL score.ResultsDecreasing levels of eGFR and the presence of CKD were associated with greater odds of cognitive decline at follow‐up independent of confounding risk factors in multivariate analyses: estimated 14% increment in odds of cognitive decline per 10 mL/min/1.73 m2 decrease in eGFR (odds ratio = 1.94, 95% confidence interval = 1.23–3.05; P = .004 for CKD vs non‐CKD). Similar associations were found in a cognitively normal subgroup (MMSE > 23) at baseline. In the whole sample, CKD, but not eGFR, was found to be significantly associated with higher risk of IADL decline.ConclusionCKD in older persons was significantly associated with cognitive and functional decline. Future research should target the development and evaluation of strategies to delay or prevent cognitive decline and physical disability in elderly adults with impaired kidney function.
Objectively Measured Sleep Quality and Nursing Home Placement in Older Women
Authors: Spira Adam P. , Covinsky Kenneth , Rebok George W. , Stone Katie L. , Redline Susan , Yaffe Kristine 
Published: June 2012

ObjectivesTo determine the association between objectively measured sleep and subsequent placement in a nursing home or a personal care home.DesignProspective cohort.SettingParticipants' homes and sites of the Study of Osteoporotic Fractures.ParticipantsOne thousand six hundred sixty‐four community‐dwelling women with a mean age of 83 ± 4.MeasurementsAt baseline, participants completed an average of 4 nights of wrist actigraphy; they provided data on place of residence at baseline and at follow‐up, 5 years later.ResultsAt baseline, participants had a mean total sleep time of 408 ± 72 minutes, mean wake after sleep onset of 71 ± 43 minutes, and mean sleep efficiency of 79 ± 11%. At follow‐up, 71 (4%) were residing in a nursing home, and 127 (8%) were in a personal care home. Women with the most wake after sleep onset (by quartile) had more than twice the odds as those with the least of placement in a nursing home (adjusted odds ratio (AOR) = 2.94, 95% confidence interval (CI) = 1.34–6.44) or a personal care home (AOR = 2.33, 95% CI = 1.26–4.30). Similarly, women with the lowest sleep efficiency had more than three times the odds as those with the highest of nursing home placement (AOR = 3.25, 95% CI = 1.35, 7.82) and more than twice the odds of placement in a personal care home (AOR = 2.38, 95% CI = 1.33, 4.24). There was no association between sleep duration and placement.ConclusionIn very old community‐dwelling women, greater wake after sleep onset and lower sleep efficiency are risk factors for placement in a nursing home or personal care home. Sleep duration alone does not appear to increase the risk of placement in these long‐term care settings.