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Journal of the American Geriatrics Society 43건

  1. [해외논문]   Hip Fracture: Can We Do Better?   SCI SCIE SSCI

    Ouellet, Jennifer A. (School of Medicine, Yale University, New Haven, Connecticut ) , Cooney Jr, Leo M. (School of Medicine, Yale University, New Haven, Connecticut)
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 22 - 24 , 2017 , 0002-8614 ,

    초록

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  2. [해외논문]   Benefit of Warfarin in Older Persons with Atrial Fibrillation   SCI SCIE SSCI

    Murphy, Terrence E. (Geriatrics Section, Department of Internal Medicine, Program on Aging, School of Medicine, Yale University, New Haven, Connecticut ) , Chaudhry, Sarwat I. (Section of General Internal Medicine, Department of Internal Medicine, Program on Aging, School of Medicine, Yale University, New Haven, Connecticut)
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 25 - 26 , 2017 , 0002-8614 ,

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  3. [해외논문]   Trends in Operative and Nonoperative Hip Fracture Management 1990–2014: A Longitudinal Analysis of Manitoba Administrative Data   SCI SCIE SSCI

    Cram, Peter (Department of Medicine, University of Toronto, Toronto, Ontario ) , Yan, Lin (Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba ) , Bohm, Eric (Division of Orthopaedic Surgery, University of Manitoba, Winnipeg, Manitoba ) , Kuzyk, Paul (Division of Orthopaedic Surgery, Sinai Health System, Toronto, Ontario ) , Lix, Lisa M. (Division of Orthopaedic Surgery, University of Manitoba, Winnipeg, Manitoba ) , Morin, Suzanne N. (Department of Medicine, McGill University, Montreal, Quebec ) , Majumdar, Sumit R. (University of Alberta, Edmonton, Alberta ) , Leslie, William D. (Department of Medicine, University of Manitoba, Winnipeg, Manitoba)
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 27 - 34 , 2017 , 0002-8614 ,

    초록

    Objectives To evaluate longitudinal trends in the use of total hip arthroplasty (THA), hemiarthroplasty (HA), internal fixation (IF), and nonoperative management and to identify individual‐level factors associated with nonoperative treatment of hip fracture (HF). Design Longitudinal analysis of administrative data. Setting Manitoba, Canada. Participants All adults who experienced nontraumatic hip fractures between 1990 and 2014 (N = 19,626; mean age 80.6, 72.3% female). Measurements Billing codes were used to identify surgical treatment, and trends in treatment over time were examined. Regression models were developed to identify individual factors associated with receiving nonoperative management. Results Use of THA increased from 0.6% for all HFs in 1990–94 to 5.3% in 2010–14, use of HA increased from 19.3% to 29.7%, and use of IF declined from 71.8% to 59.9% (P P Conclusion HF is increasingly treated with THA and HA, whereas rates of nonoperative management and IF are declining. Future efforts should focus on ensuring that all individuals are optimally triaged to the best procedure for them, with nonoperative management considered for individuals with extremely poor prefracture health.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  4. [해외논문]   Influence of Competing Risks on Estimating the Expected Benefit of Warfarin in Individuals with Atrial Fibrillation Not Currently Taking Anticoagulants: The Anticoagulation and Risk Factors in Atrial Fibrillation Study   SCI SCIE SSCI

    Ashburner, Jeffrey M. (Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts ) , Go, Alan S. (Division of Research, Kaiser Permanente Northern California, Oakland, California ) , Chang, Yuchiao (Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts ) , Fang, Margaret C. (Department of Medicine, University of California, San Francisco, San Francisco, California ) , Fredman, Lisa (Epidemiology Department, School of Public Health, Boston University, Boston, Massachusetts ) , Applebaum, Katie M. (Department of Environmental and Occupational Health, Milken Institute, School of Public Health, George Washington University, Washington, District of Columbia ) , Singer, Daniel E. (Division of General Internal Medicine, Massachusetts General Hospital, Boston, Massachusetts)
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 35 - 41 , 2017 , 0002-8614 ,

    초록

    Objectives To provide greater understanding of the “real world” effect of anticoagulation on stroke risk over several years. Design Cohort study. Setting Anticoagulation and Risk Factors in Atrial Fibrillation Study community‐based cohort. Participants Adults with nonvalvular atrial fibrillation (AF) between 1996 and 2003 (13,559). Measurements All events were clinician adjudicated. Extended Cox regression with longitudinal warfarin exposure was used to estimate cause‐specific hazard ratios (HRs) for thromboembolism and the competing risk event (all cause death). The Fine and Gray subdistribution regression approach was used to estimate this association while accounting for competing death events. As a secondary analysis, follow‐up was limited to 1, 3, and 5 years. Results The rate of death was much higher in the group not taking warfarin (8.1 deaths/100 person‐years (PY)) than in the group taking warfarin (5.5 deaths/100 PY). The cause‐specific HR indicated a large reduction in thromboembolism with warfarin use (adjusted HR = 0.57, 95% confidence interval (CI) = 0.50–0.65), although this association was substantially attenuated after accounting for competing death events (adjusted HR = 0.87, 95% CI = 0.77–0.99). In analyses limited to 1 year of follow‐up, with fewer competing death events, the results for models that did and did not account for competing risks were similar. Conclusion Analyses accounting for competing death events may provide a more‐realistic estimate of the longer‐term stroke prevention benefits of anticoagulants than traditional noncompeting risk analyses for individuals with AF, particularly those who are not currently treated with anticoagulants.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  5. [해외논문]   Urinary Incontinence in Older Women: The Role of Body Composition and Muscle Strength: From the Health, Aging, and Body Composition Study   SCI SCIE SSCI

    Suskind, Anne M. (Department of Urology, University of California, San Francisco, California ) , Cawthon, Peggy M. (California Pacific Medical Center Research Institute, San Francisco, California ) , Nakagawa, Sanae (Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California ) , Subak, Leslee L. (Department of Urology, University of California, San Francisco, California ) , Reinders, Ilse (Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, Maryland ) , Satterfield, Suzanne (Department of Preventive Medicine, Health Science Center, University of Tennessee, Memphis, Tennessee ) , Cummings, Steve (Department of Medicine, University of California, San Francisco, California ) , Cauley, Jane A. (Department of Epidemiology, Graduate School for Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania ) , Harris, Tamara (Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, Maryland ) , Huang, Alison J. (Department of Medicine, University of California, San Francisco, California)
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 42 - 50 , 2017 , 0002-8614 ,

    초록

    Objectives To evaluate prospective relationships between body composition and muscle strength with predominantly stress urinary incontinence (SUI) and urgency urinary incontinence (UUI) in older women. Design Prospective community‐dwelling observational cohort study (Health, Aging, and Body Composition study). Participants Women initially aged 70 to 79 recruited from Pittsburgh, Pennsylvania, and Memphis, Tennessee (N = 1,475). Measurements Urinary incontinence was assessed using structured questionnaires. Body mass index (BMI), grip strength, quadriceps torque, and walking speed were assessed using physical examination and performance testing. Appendicular lean body mass (ALM) and whole‐body fat mass were measured using dual‐energy X‐ray absorptiometry. Results At baseline, 212 (14%) women reported at least monthly predominantly SUI and 233 (16%) at least monthly predominantly UUI. At 3 years, of 1,137 women, 164 (14%) had new or persistent SUI, and 320 (28%) had new or persistent UUI. Women had greater odds of new or persistent SUI if they demonstrated a 5% or greater decrease in grip strength, (adjusted odds ratio (AOR) = 1.60, P = .047) and lower odds of new or persistent SUI if they demonstrated a 5% or greater decrease in BMI (AOR = 0.46, P = .01), a 5% or greater increase in ALM corrected for BMI (AOR = 0.17, P = .004), or a 5% or greater decrease in fat mass (AOR = 0.53, P = .01). Only a 5% or greater increase in walking speed was associated with new or persistent UUI over 3 years (AOR = 1.54, P = .04). Conclusion In women aged 70 and older, changes in body composition and grip strength were associated with changes in SUI frequency over time. In contrast, changes in these factors did not influence UUI. Findings suggest that optimization of body composition and muscle strength is more likely to modify risk of SUI than of UUI in older women.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  6. [해외논문]   Association Between Hospital Readmission and Acute and Sustained Delays in Functional Recovery During 18 Months After Elective Surgery: The Successful Aging after Elective Surgery Study   SCI SCIE SSCI

    Pisani, Margaret A. (School of Medicine, Yale University, New Haven, Connecticut ) , Albuquerque, Asha (School of Medicine, Yale University, New Haven, Connecticut ) , Marcantonio, Edward R. (Harvard Medical School, Boston, Massachusetts ) , Jones, Richard N. (Departments of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, Rhode Island ) , Gou, Ray Yun (Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts ) , Fong, Tamara G. (Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts ) , Schmitt, Eva M. (Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts ) , Tommet, Douglas (Departments of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, Rhode Island ) , Isaza Aizpurua, Ilean I. (Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts ) , Alsop, David C. (Harvard Medical School, Boston, Massachusetts ) , Inouye, Sharon K. (Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts ) , Travison, Thomas G. (Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts)
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 51 - 58 , 2017 , 0002-8614 ,

    초록

    Objectives To examine the effect of hospital readmission on functional recovery after elective surgery in older adults. Design Prospective cohort of individuals aged 70 and older undergoing elective surgery, enrolled from June 2010 to August 2013. Setting Two academic medical centers. Participants Community‐dwelling older adults (N = 566; mean age ± standard deviation 77 ± 5) undergoing major elective surgery and expected to be admitted for at least 3 days. Measurements Readmission was assessed in multiple interviews with participants and family members over 18 months and validated against medical record review. Physical function was assessed according to ability to perform instrumental activities of daily living (IADLs) and activities of daily living (ADL), Medical Outcomes Study 12‐item Short‐Form Survey Physical Component Summary score, and a standardized functional composite. Results Two hundred fifty‐five (45%) participants experienced 503 readmissions. Readmissions were associated with delays in functional recovery in all measures of physical function. Having two or more readmissions over 18 months was associated with persistent and significantly greater risk of IADL dependence (relative risk (RR) = 1.8, 95% confidence interval (CI) = 1.5–2.3) and ADL dependence (RR = 3.3, 95% CI = 1.7–6.4). Degree of functional impairment increased progressively with number of readmissions. Readmissions within 2 months resulted in delayed functional recovery to baseline by 18 months, and readmissions between 12 and 18 months after surgery resulted in loss of functional recovery previously achieved. Conclusion Readmission after elective surgery may contribute to delays in functional recovery and persistent functional deficits in older adults.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  7. [해외논문]   Informed Family Member Involvement to Improve the Quality of Dementia Care in Nursing Homes   SCI SCIE SSCI

    Tjia, Jennifer (Division of Epidemiology, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts ) , Lemay, Celeste A. (Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts ) , Bonner, Alice (School of Nursing, Northeastern University, Boston, Massachusetts ) , Compher, Christina (Healthcare Management Solutions, LLC, La Vergne, Tennessee ) , Paice, Kelli (Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts ) , Field, Terry (Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts ) , Mazor, Kathleen (Department of Medicine, University of Massachusetts Medical School, Worcester, Massachusetts ) , Hunnicutt, Jacob N. (Division of Epidemiology, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts ) , Lapane, Kate L. (Division of Epidemiology, Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts ) , Gurwitz, Jerry (Department of Medicine, University of Massachusetts Medical School,)
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 59 - 65 , 2017 , 0002-8614 ,

    초록

    Objectives To describe the extent to which nursing homes engaged families in antipsychotic initiation decisions in the year before surveyor guidance revisions were implemented. Design Mixed‐methods study based on semistructured interviews. Setting U.S. nursing homes (N = 20) from five CMS regions (III, IV, VI, VIII, IX). Participants Family members of nursing home residents (N = 41). Measurements Family member responses to closed‐ and open‐ended questions regarding involvement in resident care and antipsychotic initiation. Two researchers used a content analytical approach to code open responses to themes of family involvement in behavior management, decision‐making, knowledge of risks and benefits, and informed consent. Results Fifty‐four percent of family members felt highly involved in decisions about behavior management. Forty‐two percent recalled being asked how to manage resident behavior without medication, and 17% recalled receipt of information about antipsychotic risks and benefits. Sixty‐six percent felt highly involved in the process of initiating antipsychotic medication; 24% reported being asked for input into the antipsychotic initiation decision and knowing before the antipsychotic was started. Conclusion Under existing federal regulations but before guidance revisions were implemented in 2013, more than 40% of families reported being involved in nonpharmacological behavior management of family members, but fewer than one in four reported being involved throughout the entire antipsychotic prescribing process. Interventions that standardize family engagement and promote adherence to existing federal regulations are needed. This discussion builds on these findings to weigh the policy options of greater enforcement of existing regulations versus enactment of new legislation to address this challenging issue.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  8. [해외논문]   Relationship Between Frailty and Oral Function in Community‐Dwelling Elderly Adults   SCI SCIE SSCI

    Watanabe, Yutaka (Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan) , Hirano, Hirohiko (Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan) , Arai, Hidenori (National Center for Geriatrics and Gerontology, Aichi, Japan) , Morishita, Shiho (National Center for Geriatrics and Gerontology, Aichi, Japan) , Ohara, Yuki (Department of Oral Health Education, Graduate School of Medical and Dental Science, Tokyo Medical and Dental University, Tokyo, Japan) , Edahiro, Ayako (Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan) , Murakami, Masaharu (Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan) , Shimada, Hiroyuki (National Center for Geriatrics and Gerontology, Aichi, Japan) , Kikutani, Takeshi (Division of Clinical Oral Rehabilitation, Graduate School of Life Dentistry, Nippon Dental University, Tokyo, Japan) , Suzuki, Takao
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 66 - 76 , 2017 , 0002-8614 ,

    초록

    Objectives To determine the standard values of and age‐related changes in objective oral function of healthy older people; compare oral function of robust, prefrail, and frail older people; and determine the association between oral function and frailty. Design Cross‐sectional analysis. Setting General community. Participants Elderly adults (≥65) from the Obu Study of Health Promotion for the Elderly were included and assigned to the robust, prefrail, and frail groups (N = 4,720). Measurements Each participant underwent detailed physical testing to assess frailty. The frailty phenotype was defined according to the presence of limitations in three or more of the following five domains: mobility, strength, endurance, physical activity, and nutrition. The numbers of present teeth and functional teeth were counted, and occlusal force, masseter muscle thickness, and oral diadochokinesis (ODK) rate were measured, along with sociodemographic and functional status, comorbidities, and blood chemistry. Results The number of present teeth, occlusal force, masseter muscle thickness, and ODK rate decreased with age. The frail group had significantly fewer present teeth (women aged ≥70), lower occlusal force (women aged ≥70; men aged ≥80), lower masseter muscle thickness, and lower ODK rate than the robust group. Multivariate analysis indicated that age, Geriatric Depression Scale score, skeletal muscle mass index, Mini‐Mental State Examination score, hypertension, diabetes mellitus, albumin and triglyceride levels, and oral function were significantly associated with frailty. Conclusion Age‐related differences in oral function were found in older adults. Moreover, frail older individuals had significantly poorer oral function than prefrail and robust individuals. The risk of frailty was associated with lower occlusal force, masseter muscle thickness, and ODK rate.

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    회원님의 원문열람 권한에 따라 열람이 불가능 할 수 있으며 권한이 없는 경우 해당 사이트의 정책에 따라 회원가입 및 유료구매가 필요할 수 있습니다.이동하는 사이트에서의 모든 정보이용은 NDSL과 무관합니다.

    NDSL에서는 해당 원문을 복사서비스하고 있습니다. 아래의 원문복사신청 또는 장바구니담기를 통하여 원문복사서비스 이용이 가능합니다.

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  9. [해외논문]   Changes in Medication Use After Dementia Diagnosis in an Observational Cohort of Individuals with Diabetes Mellitus   SCI SCIE SSCI

    Sarkar, Urmimala (Center for Vulnerable Populations, Division of General Internal Medicine, University of California San Francisco, San Francisco, California ) , Lyles, Courtney (Center for Vulnerable Populations, Division of General Internal Medicine, University of California San Francisco, San Francisco, California ) , Steinman, Michael (Division of Geriatrics, University of California San Francisco and San Francisco Veterans Affairs Medical Center, San Francisco, California ) , Huang, Elbert S. (School of Medicine, University of Chicago, Chicago, Illinois ) , Moffet, Howard H. (Division of Research, Kaiser Permanente, Oakland, California ) , Whitmer, Rachel A. (Division of Research, Kaiser Permanente, Oakland, California ) , Warton, E. Margaret (Division of Research, Kaiser Permanente, Oakland, California ) , Karter, Andrew J. (Division of Research, Kaiser Permanente, Oakland, California)
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 77 - 82 , 2017 , 0002-8614 ,

    초록

    Objectives To assess changes in medication use after a diagnosis of dementia in individuals with type 2 diabetes mellitus. Design Difference‐in‐differences analysis of changes in the number of dispensed chronic medications between individuals with and without newly diagnosed dementia. Setting Integrated healthcare delivery system, Kaiser Permanente Northern California. Participants Individuals aged 50 and older without prevalent dementia with type 2 diabetes mellitus enrolled in a baseline survey. During 5 years of follow‐up, 193 individuals with a new diagnosis of dementia were identified, and risk‐set sampling was used to randomly select five reference subjects per case matched on 5‐year age categories and sex (965 matched participants), resulting in an analytical sample of 1,158. Measurements The exposure was new diagnosis of dementia. The primary outcome was change in number of current chronic medications (total, cardiovascular (blood pressure and lipid control), diabetes mellitus) at three times: 1 year before index date (preindex date), date of diagnosis of dementia or matched reference date (index date), and up to 1 year after index date or end of follow‐up if censored before 1 year (postindex date). Results After adjustment, the number of chronic medications and the subset of cardiovascular medications declined after a dementia diagnosis in the overall cohort and in age‐, sex‐, and time‐matched reference individuals, but the decline was significantly greater in the group with dementia (0.71 medications fewer than the reference group, P = .02). The number of diabetes mellitus medications declined in both groups, but the declines were not statistically different (0.18 medications fewer than the reference group, P = .008). Conclusions Use of cardiometabolic medications fell after a diagnosis of dementia, as recommended in national guidelines.

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  10. [해외논문]   Racial Differences in the Incidence of Cardiovascular Risk Factors in Older Black and White Adults   SCI SCIE SSCI

    Howard, George (Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama ) , Safford, Monika M. (Division of General Internal Medicine, Weill Cornell Medical College, New York, New York ) , Moy, Claudia S. (National Institute of Neurological Disorders and Stroke, Bethesda, Maryland ) , Howard, Virginia J. (Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama ) , Kleindorfer, Dawn O. (Department of Neurology, University of Cincinnati, Cincinnati, Ohio ) , Unverzagt, Fredrick W. (Department of Psychology, Indiana University, Indianapolis, Indiana ) , Soliman, Elsayed Z. (Department of Epidemiology, School of Medicine, Wake Forest University, Winston‐Salem, North Carolina ) , Flaherty, Matthew L. (Department of Neurology, University of Cincinnati, Cincinnati, Ohio ) , McClure, Leslie A. (Department of Epidemiology and Biostatistics, School of Public Health, Drexel University, Philadelphia, Pennsylvania ) , Lackland, Daniel T. (Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina ) , Wadley, Virginia G. (Department of Gerontology, Geriatrics and Palliative Care, School of M) , Pulley, LeaVonne , Cushman, Mary
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 83 - 90 , 2017 , 0002-8614 ,

    초록

    Objectives To describe the incidence of cardiovascular risk factors, or race‐related disparities in incidence, across the age spectrum in adults. Design Longitudinal cohort. Setting National sample. Participants Community‐dwelling black and white adults recruited between 2003 and 2007. Measurements Incident hypertension, diabetes mellitus, dyslipidemia and atrial fibrillation over 10 years of follow‐up in 10,801 adults, stratified according to age (45–54, 55–64, 65–74, ≥75). Results There was no evidence ( P ≥ .68) of an age‐related difference in the incidence of hypertension for white men (average incidence 38%), black men (48%), or black women (54%), although for white women incidence increased with age (45–54, 27%; ≥75, 40%). Incidence of diabetes mellitus was lower at older ages for white men (45–54, 15%; ≥75, 8%), black men (45–54, 29%; ≥75, 13%), and white women (45–54, 11%; ≥75, 4%), although there was no evidence ( P = .11) of age‐related changes for black women (average incidence 21%). For dyslipidemia, incidence for all race–sex groups was approximately 20% for aged 45 to 54 but approximately 30% for aged 54 to 64 and 65 to 74 and approximately 22% for aged 75 and older. Incidence of atrial fibrillation was low at age 45 to 54 ( Conclusion Incidence of risk factors remains high in older adults. Blacks have a higher incidence of hypertension, diabetes mellitus, and dyslipidemia after age 45, underscoring the ongoing importance of prevention of all three conditions in mid‐ to later life.

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