Skip header and navigation

Refine By

23 records – page 1 of 3.

Association between frailty and dementia: a population-based study.

https://arctichealth.org/en/permalink/ahliterature107842
Source
Gerontology. 2014;60(1):16-21
Publication Type
Article
Date
2014
Author
Jenni Kulmala
Irma Nykänen
Minna Mänty
Sirpa Hartikainen
Author Affiliation
Gerontology Research Center and Department of Health Sciences, University of Jyväskylä, Finland.
Source
Gerontology. 2014;60(1):16-21
Date
2014
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging - pathology - physiology - psychology
Cross-Sectional Studies
Dementia - pathology - physiopathology - psychology
Female
Finland
Frail Elderly - psychology
Humans
Logistic Models
Male
Mental Status Schedule
Multivariate Analysis
Risk factors
Abstract
Frailty is commonly considered as a syndrome with several symptoms, including weight loss, exhaustion, weakness, slow walking speed and physical inactivity. It has been suggested that cognitive impairment should be included in the frailty index, however the association between frailty and cognition has not yet been fully established.
To investigate cross-sectionally whether frailty is associated with cognitive impairment or clinically diagnosed dementia in older people.
The study included a total of 654 persons aged 76-100 years (mean 82 ± 4.6). Frailty status of the participants was assessed using the Cardiovascular Health Study criteria. Cognitive function was assessed with the Mini-Mental State Examination (MMSE). Clinically diagnosed dementia was assessed by specialists using diagnostic criteria. The associations between frailty and cognition were investigated using logistic regression.
A total of 93 (14%) participants were classified as frail. Cognitive impairment (MMSE score
PubMed ID
23970189 View in PubMed
Less detail

Compliance of frail elderly with health services prescribed at discharge from an acute-care geriatric ward.

https://arctichealth.org/en/permalink/ahliterature205369
Source
Med Care. 1998 Jun;36(6):904-14
Publication Type
Article
Date
Jun-1998
Author
N. Leduc
T N Tannenbaum
H. Bergman
F. Champagne
A M Clarfield
S. Kogan
Author Affiliation
Groupe de recherche interdisciplinaire en santé, Université de Montréal, Québec, Canada.
Source
Med Care. 1998 Jun;36(6):904-14
Date
Jun-1998
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Community Health Services - utilization
Continuity of Patient Care - statistics & numerical data
Female
Follow-Up Studies
Frail Elderly - psychology
Health Services Accessibility
Health status
Humans
Logistic Models
Male
Models, Psychological
Motivation
Patient Compliance - psychology
Patient Discharge
Quebec
Questionnaires
Social Support
Abstract
A model of compliance by frail elderly with prescribed healthcare services was developed and tested. The discrepancy between primary care, geriatric and community health center (CLSC) services prescribed at discharge after comprehensive geriatric evaluation and treatment was measured, as were those services actually used during a 6-week interval (compliance). In this model, compliance was directly related to elders' intention to adhere to prescribed services, but this relationship was modified by organizational factors, reinforcing factors, and changes in health status during the observation period. Intention to adhere resulted from individual and reinforcing factors existing before discharge.
This model was tested on 211 patients discharged to community settings from an acute-care hospital geriatrics ward. Information was obtained through interviews with the patients or care givers and from hospital, outpatient, and local community health center charts.
On average, patients used 56.9% of services prescribed; 13% of patients did not use any of the services prescribed for them, whereas 22% used all the services prescribed. Intention to adhere was influenced by patients' perception of the benefits of prescribed services and by their perception of the ease of access to transportation. Intention itself was not found to be an important determinant of overall compliance. Among organizational factors, having the ward staff make a follow-up appointment with the patients' family doctor and with the geriatric clinic before discharge and communication with the local community health center increased overall compliance. Moreover, patients who perceived they had access to transportation and to an accompanying person were more likely to comply.
The results suggest that when discharging patients to the community, steps taken for them by the discharging healthcare providers will improve compliance.
PubMed ID
9630131 View in PubMed
Less detail

Correlates of major medication side effects interfering with daily performance: results from a cross-sectional cohort study of older psychiatric patients.

https://arctichealth.org/en/permalink/ahliterature275229
Source
Int Psychogeriatr. 2016 Feb;28(2):331-40
Publication Type
Article
Date
Feb-2016
Author
Marit Tveito
Christoph U Correll
Jørgen G Bramness
Knut Engedal
Bernhard Lorentzen
Helge Refsum
Gudrun Høiseth
Source
Int Psychogeriatr. 2016 Feb;28(2):331-40
Date
Feb-2016
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Age Factors
Aged
Aged, 80 and over
Cross-Sectional Studies
Delirium - complications - psychology
Dementia - complications - psychology
Depressive Disorder, Major - diagnosis
Drug-Related Side Effects and Adverse Reactions
Female
Frail Elderly - statistics & numerical data
Hospitalization
Humans
Logistic Models
Male
Mood Disorders - drug therapy
Norway - epidemiology
Polypharmacy
Psychotropic Drugs - adverse effects - therapeutic use
Socioeconomic Factors
Abstract
Polypharmacy is common among older persons who are also vulnerable to side effects. We aimed to characterize patients who on admission to a geriatric psychiatric hospital had major medication side effects interfering with daily performance.
Cross-sectional cohort study of patients consecutively admitted to a geriatric psychiatric hospital from 2006, 06 December to 2008, 24 October. The UKU side effect rating scale was performed, and patients were divided into those with no/minor side effects versus those with major side effects. Blood levels of 56 psychotropic drugs and 27 safety laboratory tests were measured upon admission.
Of 206 patients included in the analysis, 70 (34%) had major side effects related to drug treatment. The most frequent side effects were asthenia (31%), reduced salivation (31%), concentration difficulties (28%), memory impairment (24%), and orthostatic dizziness (18%). The significant characteristics predicting major side effects were female gender (OR = 2.4, 95% confidence interval (CI) = 1.1-5.5), main diagnosis of affective disorder (OR = 4.3, 95% CI = 1.5-12.3), unreported use of psychotropic medications (OR = 2.0, 95% CI = 1.0-4.1), a higher number of reported psychotropic medications (OR = 1.7, 95% CI = 1.2-2.3), a higher number of reported medications for somatic disorders (OR = 1.2, 95% CI = 1.1-1.5), and a higher score on the Charlson comorbidity index (OR = 1.2, 95% CI = 1.0-1.4) (r 2 = 0.238, p
PubMed ID
26412479 View in PubMed
Less detail
Source
Int J Geriatr Psychiatry. 2013 Jun;28(6):607-14
Publication Type
Article
Date
Jun-2013
Author
Philip D St John
Suzanne L Tyas
Patrick R Montgomery
Author Affiliation
Section of Geriatric Medicine, Department of Medicine, and the Centre on Aging, University of Manitoba, Canada. pstjohn@hsc.mb.ca
Source
Int J Geriatr Psychiatry. 2013 Jun;28(6):607-14
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Depressive Disorder - epidemiology - psychology
Female
Frail Elderly - psychology
Humans
Logistic Models
Male
Manitoba - epidemiology
Abstract
Frailty and depressive symptoms are common issues facing older adults and may be associated.
To determine if: (i) depressive symptoms are associated with frailty; (ii) there is a gradient in this effect across the range of depressive symptoms; and (iii) the association between depressive symptoms and frailty is specific to particular types of depressive symptoms (positive affect, negative affect, somatic complaints, and interpersonal relations).
Secondary analysis of an existing population-based study was conducted.
In 1991, 1751 community-living adults aged 65+?years were interviewed.
Depressive symptoms were measured using the Center for Epidemiologic Studies-Depression (CES-D) scale. Frailty was graded from 0 (no frailty) to 3 (moderate/severe frailty). Age, gender, education, marital status, self-rated health, and the number of comorbid conditions were self-reported.
Logistic regression models were constructed with the outcome of no frailty/urinary incontinence only versus frailty.
Depressive symptoms were strongly associated with frailty, and there was a gradient effect across the entire range of the CES-D scale. The odds ratio and 95% confidence interval was 1.08 (1.06, 1.09) per point of the CES-D in unadjusted models. After potential confounding factors were adjusted, the adjusted odds ratio (95% confidence interval) was 1.03 (1.01, 1.05). Positive affect, negative affect, and somatic complaints were all associated with frailty, whereas interpersonal relations were not associated with frailty.
Depressive symptoms are associated with frailty. Clinicians should consider assessing frail older adults for the presence of depression.
PubMed ID
22961757 View in PubMed
Less detail

Disability transitions in an area-based system of long-term care for the elderly and disabled.

https://arctichealth.org/en/permalink/ahliterature73189
Source
Health Policy. 1994 May;28(2):153-74
Publication Type
Article
Date
May-1994
Author
M. Lagergren
Author Affiliation
Department of Social Medicine, Karolinska Institute, Sundbyberg, Sweden.
Source
Health Policy. 1994 May;28(2):153-74
Date
May-1994
Language
English
Publication Type
Article
Keywords
Aged
Catchment Area (Health)
Disabled Persons
Female
Frail Elderly
Geriatric Assessment
Health Services Needs and Demand - statistics & numerical data
Health Services Research
Humans
Logistic Models
Long-Term Care - statistics & numerical data
Longitudinal Studies
Male
Mortality
Multivariate Analysis
Odds Ratio
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Abstract
OBJECTIVE: To describe patterns of individual disability development and mortality in an area-based system for long-term care of the elderly and disabled. DATA SOURCES AND STUDY SETTING: Yearly surveys according to the ASIM system from 1985 to 1991 of all citizens of Solna, Sweden, receiving long-term care services from the municipality and/or the county council. STUDY DESIGN: Linkage of individual assessments concerning disability and level of care from one survey to the next, using national registration numbers. DATA COLLECTION: Registrations according to the ASIM system concerning services actually provided, assessed need of services, social environment and disability were collected by the staff responsible for the services provided. PRINCIPAL FINDINGS: Mortality was shown to be strongly connected to disability. Disability transitions occurred in both directions for all age groups, but the average rate of disability increase rose with advancing age. Rapid disability development was shown in a multivariate analysis to be connected to institutional care and change in the level of care between surveys. CONCLUSIONS: Data describing disability development can be used for planning purposes, either directly or with the help of a simulation model. More research seems to be needed with regard to the influence of the level of care and of transfers on disability development.
PubMed ID
10171935 View in PubMed
Less detail

Elderly persons' experiences of participation in hospital discharge process.

https://arctichealth.org/en/permalink/ahliterature140366
Source
Patient Educ Couns. 2011 Oct;85(1):68-73
Publication Type
Article
Date
Oct-2011
Author
Christina Foss
Dag Hofoss
Author Affiliation
Institute of Health and Society, Department of Nursing and Health Sciences, Blindern, Oslo, Norway. i.c.foss@medisin.uio.no
Source
Patient Educ Couns. 2011 Oct;85(1):68-73
Date
Oct-2011
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Female
Frail Elderly
Health Care Surveys
Humans
Logistic Models
Male
Norway
Nurse-Patient Relations
Patient Discharge
Patient Participation
Patient Preference
Abstract
The purpose of this study was to describe older hospital patients' discharge experiences on participation in the discharge planning.
A sample of 254 patients aged 80+ was interviewed using a questionnaire developed by the research team. Data were collected by face-to-face interviewing during the first two weeks following patients discharge from hospital.
In spite of their advanced age the patients in this study did express a clear preference for participation. However, there were no significant correlation between patients' wish for participation and experienced opportunity to share decisions. Hearing ability was the only significant factor affecting the chance to participate, whereas sociodemographic factors did not significantly affect on the likelihood participation the discharge process.
The actual practice of involving old people in the discharge process is not well developed as experienced by old patients themselves. The fact that factors like gender and education have little influence on participation in the oldest patients might be related to age; when you get old enough, old is all that is 'visible'.
To determine the extent of elderly patients' desire to participate, one must actively look for it both through research and in the hands-on process of discharge.
PubMed ID
20884160 View in PubMed
Less detail

Estimating surgical volume--outcome relationships applying survival models: accounting for frailty and hospital fixed effects.

https://arctichealth.org/en/permalink/ahliterature208012
Source
Health Econ. 1997 Jul-Aug;6(4):383-95
Publication Type
Article
Author
B H Hamilton
V H Hamilton
Author Affiliation
John M. Olin School of Business, Washington University in St Louis, MO 63130, USA. hamiltonb@wuolin.wustl.edu
Source
Health Econ. 1997 Jul-Aug;6(4):383-95
Language
English
Publication Type
Article
Keywords
Aged
Female
Frail Elderly
Hip Fractures - complications - mortality - surgery
Hospital Mortality
Humans
Length of Stay
Likelihood Functions
Logistic Models
Male
Outcome Assessment (Health Care) - statistics & numerical data
Patient Discharge
Physician's Practice Patterns - standards
Proportional Hazards Models
Quebec - epidemiology
Surgery Department, Hospital - standards - utilization
Surgical Procedures, Operative - mortality - utilization
Survival Analysis
Abstract
This paper investigates the surgical volume-outcome relationship for patients undergoing hip fracture surgery in Quebec between 1991 and 1993. Using a duration model with multiple destinations which accounts for observed and unobserved (by the researcher) patient characteristics, our initial estimates show that higher surgical volume is associated with a higher conditional probability of live discharge from the hospital. However, these results reflect differences between hospitals rather than differences within hospitals over time: when we also control for differences between hospitals that are fixed over time, hospitals performing more surgeries in period t + 1 than in period t experience no significant change in outcomes, as would be predicted by the 'practice makes perfect' hypothesis. The volume-outcome relationship for hip fracture patients thus appears to reflect quality differences between high and low volume hospitals.
PubMed ID
9285231 View in PubMed
Less detail

Factors associated with institutionalization of older people in Canada: testing a multifactorial definition of frailty.

https://arctichealth.org/en/permalink/ahliterature212102
Source
J Am Geriatr Soc. 1996 May;44(5):578-82
Publication Type
Article
Date
May-1996
Author
K. Rockwood
P. Stolee
I. McDowell
Author Affiliation
Division of Geriatric Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Source
J Am Geriatr Soc. 1996 May;44(5):578-82
Date
May-1996
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Canada
Cognition
Cross-Sectional Studies
Female
Frail Elderly
Geriatric Assessment
Health status
Homes for the Aged
Humans
Institutionalization
Logistic Models
Male
Mental health
Nursing Homes
Abstract
To test a model of frailty by examining factors associated with institutionalization of older people in Canada; to assess whether diagnostic data provided information about risk beyond that provided by data on functional capacity and demographic variables.
Cross-sectional study of 1258 institutional subjects and 9113 community-dwelling older adults from the Canadian Study of Health and Aging.
Multiple logistic regression analysis showed that female gender, being unmarried, absence of a caregiver, presence of cognitive impairment (including all types of dementia), functional impairment, diabetes mellitus, stroke, and Parkinson's disease were independently associated with being in a long-term care facility.
Frailty appears to be a multidimensional construct, and not simply a synonym for dependence in Activities of Daily Living. Studies of health outcomes in older people should include diagnostic data as well as demographic information and data on functional capacity.
PubMed ID
8617909 View in PubMed
Less detail

Factors associated with the prevalence of various self-reported impairments among older people residing in the community.

https://arctichealth.org/en/permalink/ahliterature226064
Source
Can J Public Health. 1991 Jul-Aug;82(4):240-4
Publication Type
Article
Author
W F Forbes
L M Hayward
N. Agwani
Author Affiliation
Program in Gerontology, University of Waterloo, Ontario, Canada.
Source
Can J Public Health. 1991 Jul-Aug;82(4):240-4
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Canada
Female
Frail Elderly
Health Surveys
Humans
Logistic Models
Male
Middle Aged
Prevalence
Risk
Sex Factors
Socioeconomic Factors
Abstract
Self-reported data from the Health and Activity Limitation Survey (HALS) and the General Social Survey (GSS) are used to estimate the prevalence of psychological or mental, mobility, agility, seeing and hearing impairments in the elderly population. Multiple impairments are common in the elderly population and the prevalence of the various impairments increases with age in a log-linear manner. Relative risks are estimated for the various impairments on the basis of income, marital status, housing tenure and living arrangements. Among these four variables, low income appears to have the greatest effect.
PubMed ID
1954590 View in PubMed
Less detail

Healthcare utilisation and knowledge concerning prescribed drugs among older people.

https://arctichealth.org/en/permalink/ahliterature141985
Source
Eur J Clin Pharmacol. 2010 Oct;66(10):1047-54
Publication Type
Article
Date
Oct-2010
Author
Jimmie Kristensson
Sara Modig
Patrik Midlöv
Ingalill Rahm Hallberg
Ulf Jakobsson
Author Affiliation
Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, 221 00 Lund, Sweden. Jimmie.Kristensson@med.lu.se
Source
Eur J Clin Pharmacol. 2010 Oct;66(10):1047-54
Date
Oct-2010
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Ambulatory Care - statistics & numerical data
Confounding Factors (Epidemiology)
Delivery of Health Care - utilization
Female
Frail Elderly
Health Knowledge, Attitudes, Practice
Hospitalization - statistics & numerical data
Humans
Inpatients - statistics & numerical data
Length of Stay - statistics & numerical data
Linear Models
Logistic Models
Male
Odds Ratio
Office visits - statistics & numerical data
Outpatients - statistics & numerical data
Prescription Drugs
Randomized Controlled Trials as Topic
Registries
Research Design
Sweden
Abstract
The aim of this study was to explore healthcare consumption in relation to more versus less knowledge concerning prescribed drugs among older people with functional dependency and repeated healthcare contacts, and to explore the determinants of more versus less knowledge
The sample comprised 63 persons (mean age 82.8 years). Data concerning use and knowledge about drugs, demographics, health complaints and self-reported diseases were collected from the baseline measure in an ongoing randomised controlled trial (RCT) and merged with data from two public registers about healthcare consumption 2 years prior to baseline measurement. Data were analysed descriptively and using regression analysis.
Fifty-two percent of the sample (n?=?33) had less knowledge (defined as not knowing the indications for 50% or less of their prescribed drugs) and these had more acute hospitals stays (median 2 vs 0), more total hospital stays (median 2 vs 1) and more bed days in hospital (median 18 vs 3) than those with more knowledge. Bed days and visits to other outpatient staff groups were associated with less knowledge; visits to physicians were associated with more knowledge.
The healthcare consumption pattern of those with less knowledge differed from that of those with more knowledge in terms of more acute inpatient care. The results indicate that there is a need for the health system to create mechanisms to ensure that patients do not lose their knowledge about their drugs when admitted in an acute situation; there is also an apparent need for educational intervention with patients, starting at the time of admission.
PubMed ID
20652233 View in PubMed
Less detail

23 records – page 1 of 3.