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저널/프로시딩 상세정보

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H : 소장처정보

T : 목차정보

Journal of the American Geriatrics Society 43건

  1. [해외논문]   Diagnosis of Elder Abuse in U.S. Emergency Departments   SCI SCIE SSCI

    Evans, Christopher S. (School of Medicine, University of California, San Diego, California ) , Hunold, Katherine M. (School of Medicine, University of Virgina, Charlottesville, Virginia ) , Rosen, Tony (Division of Emergency Medicine, Weill Cornell Medical College, New York, New York ) , Platts‐ (Department of Emergency Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina) , Mills, Timothy F.
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 91 - 97 , 2017 , 0002-8614 ,

    초록

    Objectives To estimate the proportion of visits to U.S. emergency departments (EDs) in which a diagnosis of elder abuse is reached using two nationally representative datasets. Design Retrospective cross‐sectional analysis. Setting U.S. ED visits recorded in the 2012 Nationwide Emergency Department Sample (NEDS) or the 2011 National Hospital Ambulatory Medical Care Survey (NHAMCS). Participants All ED visits of individuals aged 60 and older. Measurements The primary outcome was elder abuse defined according to International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes. The proportion of visits with elder abuse was estimated using survey weights. Odds ratios (ORs) were calculated to identify demographic characteristics and common ED diagnoses associated with elder abuse. Results In 2012, NEDS contained information on 6,723,667 ED visits of older adults, representing an estimated 29,056,673 ED visits. Elder abuse was diagnosed in an estimated 3,846 visits, corresponding to a weighted diagnosis period prevalence of elder abuse in U.S. EDs of 0.013% (95% confidence interval (CI) = 0.012–0.015%). Neglect and physical abuse were the most common types diagnosed, accounting for 32.9% and 32.2% of cases, respectively. Multivariable analysis showed greater weighted odds of elder abuse diagnosis in women (odds ratio (OR) = 1.95, 95% CI = 1.68–2.26) and individuals with contusions (OR = 2.91, 95% CI = 2.36–3.57), urinary tract infection (OR = 2.21, 95% CI = 1.84–2.65), and septicemia (OR = 1.92, 95% CI = 1.44–2.55). In the 2011 NHAMCS dataset, no cases of elder abuse were recorded for the 5,965 older adult ED visits. Conclusion The proportion of U.S. ED visits by older adults receiving a diagnosis of elder abuse is at least two orders of magnitude lower than the estimated prevalence in the population. Efforts to improve the identification of elder abuse in EDs may be warranted.

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  2. [해외논문]   Kidney Function and Disability‐Free Survival in Older Women   SCI SCIE SSCI

    Cavanaugh, Alyson M. (Joint Doctoral Program in Public Health (Epidemiology), San Diego State University/University of California, San Diego, California ) , LaCroix, Andrea Z. (Division of Nephrology and Division of Preventive Medicine, UC San Diego, and Veterans' Affairs Healthcare System, San Diego, California ) , Kritz‐ (Division of Nephrology and Division of Preventive Medicine, UC San Diego, and Veterans' Affairs Healthcare System, San Diego, California ) , Silverstein, Donna (Fred Hutchinson Cancer Research Center, Public Health Sciences, Seattle, Washington ) , Rillamas‐ (Division of Nephrology and Division of Preventive Medicine, UC San Diego, and Veterans' Affairs Healthcare System, San Diego, California) , Sun, Eileen , Rifkin, Dena E.
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 98 - 106 , 2017 , 0002-8614 ,

    초록

    Objectives To examine the prospective association between kidney function and three outcomes: survival to age 85 with functional independence, survival to age 85 with disability, and death before age 85. Design Prospective study. Setting Women's Health Initiative, conducted at 40 U.S. clinical centers. Participants Postmenopausal women enrolled between 1993 and 1998 with baseline biomarker assessments who had the potential to reach age 85 before September 2013 (N = 7,178). Measurements Kidney function was measured according to estimated glomerular filtration rate (eGFR) calculated from serum creatinine collected at baseline. Outcomes were survival to age 85 with functional independence, survival with disability, or death before age 85. Disability was defined as mobility or activity of daily living limitations measured by questionnaire. Results eGFR was greater than 90 mL/min per 1.73 m 2 in 22.7% of women, 60 to 89 mL/min per 1.73 m 2 in 66.5%, 45 to 59 mL/min per 1.73 m 2 in 8.7%, and less than 45 mL/min per 1.73 m 2 in 2.0%. Median follow‐up was 15 years. Of 4,953 survivors, 3,155 reported no physical disability at age 85. Two thousand two hundred twenty‐five participants died before age 85. Women with an eGFR of 90 mL/min per 1.73 m 2 or greater had 2.71 times greater odds of survival to age 85 with functional independence than of dying before 85 (95% confidence interval (CI) = 1.62–4.51) than those with an eGFR less than 45 mL/min per 1.73 m 2 , women with an eGFR of 60 to 89 mL/min per 1.73 m 2 had 3.04 times (95% CI = 1.85–5.00) greater odds, and women with an eGFR of 45 to 59 mL/min per 1.73 m 2 had 2.22 times (95% CI = 1.31–3.76) greater odds. Similar, but slightly weaker odds were seen for survival to age 85 with disability. Better kidney function was not significantly associated with greater likelihood of survival to age 85 with independent function than of surviving with disability. Conclusion Better kidney function was associated with greater likelihood of survival to age 85 with and without disability.

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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]   Association Between Social Participation and 3‐Year Change in Instrumental Activities of Daily Living in Community‐Dwelling Elderly Adults   SCI SCIE SSCI

    Tomioka, Kimiko (Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Japan) , Kurumatani, Norio (Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Japan) , Hosoi, Hiroshi (Nara Prefectural Health Research Center, Nara Medical University, Kashihara, Japan)
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 107 - 113 , 2017 , 0002-8614 ,

    초록

    Objectives To investigate whether social participation (SP) in older adults is associated with ability to perform instrumental activities of daily living (IADLs). Design Prospective cohort study. Setting Two local municipalities of Nara, Japan. Participants Individuals aged 65 to 96 (n = 2,774 male, n = 3,586 female) free of IADL disability at baseline. Measurements SP and IADLs were assessed using self‐administered questionnaires. SP was categorized into five types and assessed using the number and type of social activities. IADLs were evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Logistic regression analysis stratified according to sex was used to examine change in IADLs according to SP, with nonparticipation as a reference. Results During the 3‐year follow‐up, 13.6% of men and 9.0% of women reported IADL decline. After adjusting for age, family structure, body mass index, pension, occupation, medical treatment, self‐rated health, drinking, smoking, depression, cognitive function, and activities of daily living, participation in various social activities was inversely associated with change in IADLs in women but not men. Participation in the following types of social activities had significant inverse associations with IADL disability: hobby clubs (odds ratio (OR) = 0.68, 95% confidence interval (CI) = 0.49–0.94) for men and local events (OR = 0.68, 95% CI = 0.48–0.95), hobby clubs (OR = 0.53, 95% CI = 0.36–0.79), senior citizen clubs (OR = 0.74, 95% CI = 0.56–0.97), and volunteer groups (OR = 0.56, 95% CI = 0.32–0.99) for women. Conclusion Participation in a variety of different types of social activities was associated with change in IADLs over the 3 years of this study in women, and participation in hobby clubs was associated with change in IADLs in men and women. Recommending that community‐dwelling elderly adults participate in social activities appropriate for their sex may promote successful aging.

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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]   Using the 4 Pillars Practice Transformation Program to Increase Pneumococcal Immunizations for Older Adults: A Cluster‐Randomized Trial   SCI SCIE SSCI

    Zimmerman, Richard K. (Department of Family Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania ) , Brown, Anthony E. (Department of Family Medicine, Baylor College of Medicine, Houston, Texas ) , Pavlik, Valory N. (Department of Family Medicine, Baylor College of Medicine, Houston, Texas ) , Moehling, Krissy K. (Department of Family Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania ) , Raviotta, Jonathan M. (Department of Family Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania ) , Lin, Chyongchiou J. (Department of Family Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania ) , Zhang, Song (Department of Family Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania ) , Hawk, Mary (Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania ) , Kyle, Shakala (Department of Family Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania ) , Patel, Suchita (Centers for Disease Control and Prevention, Atlanta, Georgia ) , Ahmed, Faruque (Centers for Diseas) , Nowalk, Mary Patricia
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 114 - 122 , 2017 , 0002-8614 ,

    초록

    Objectives To test the effectiveness of a step‐by step, evidence‐based guide, the 4 Pillars Practice Transformation Program, to increase adult pneumococcal vaccination. Design Randomized controlled cluster trial (RCCT) in Year 1 (June 1, 2013 to May 31, 2014) and pre‐post study in Year 2 (June 1, 2014 to January 31, 2015) with data analyzed in 2016. Baseline year was June 1, 2012, to May 31, 2013. Demographic and vaccination data were derived from deidentified electronic medical record extractions. Setting Primary care practices (n = 25) stratified according to metropolitan area (Houston, Pittsburgh), location (rural, urban, suburban), and type (family medicine, internal medicine), randomized to receive the intervention in Year 1 (n = 13) or Year 2 (n = 12). Participants Individuals aged 65 and older at baseline (N = 18,107; mean age 74.2; 60.7% female, 16.5% non‐white, 15.7% Hispanic). Intervention The 4 Pillars Program, provider education, and one‐on‐one coaching of practice‐based immunization champions. Outcome measures were 23‐valent pneumococcal polysaccharide vaccine (PPSV) and pneumococcal conjugate vaccine (PCV) vaccination rates and percentage point (PP) changes in vaccination rates. Results In the Year 1 RCCT, PPSV vaccination rates increased significantly in all intervention and control groups, with average increases ranging from 6.5 to 8.7 PP (P Conclusion In a RCCT, PPSV vaccination rates increased in the intervention and control groups in Year 1. In a pre‐post study, private primary care practices actively participating in the 4 Pillars Practice Transformation Program improved PPSV and PCV uptake significantly more than practices that were in the maintenance phase of the study.

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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]   Two‐Year Mortality in Homebound Older Adults: An Analysis of the National Health and Aging Trends Study   SCI SCIE SSCI

    Soones, Tacara (Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York ) , Federman, Alex (Division of General Internal Medicine, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York ) , Leff, Bruce (Division of Geriatric Medicine, Department of Medicine, Johns Hopkins University, Baltimore, Maryland ) , Siu, Albert L. (Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York ) , Ornstein, Katherine (Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York)
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 123 - 129 , 2017 , 0002-8614 ,

    초록

    Objectives To determine the association between homebound status and mortality. Design Cross‐sectional. Setting Annual, in‐person interviews. Participants A nationally representative sample of community‐dwelling, Medicare beneficiaries aged 65 and older enrolled in the National Health and Aging Trends Study between 2011 and 2013 (N = 6,400). Measurements Two‐year mortality and prevalence of homebound status in the year before death are described using three categories of homebound status: homebound (never or rarely left home in the last month), semihomebound (left home with assistance, needed help or had difficulty), and nonhomebound (left home without help or difficulty). Results In unadjusted analyses, 2‐year mortality was 40.3% in homebound participants, 21.3% in those who were semihomebound and 5.8% in those who were nonhomebound. Homebound status was associated with greater 2‐year mortality, adjusted for sociodemographic characteristics, comorbidities, and functional status (hazard ratio = 2.08; 95% confidence interval = 1.63–2.65, P Conclusion Homebound status is associated with greater risk of death independent of functional impairment and comorbidities. To improve outcomes for homebound older adults and the many older adults who will become homebound in the last year of life, providers and policymakers need to extend healthcare services from hospitals and clinics to the homes of vulnerable individuals.

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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]   Unraveling the Relationship Between Delirium, Brain Damage, and Subsequent Cognitive Decline in a Cohort of Individuals Undergoing Surgery for Hip Fracture   SCI SCIE SSCI

    Beishuizen, Sara J. E. (Geriatrics Section, Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands) , Scholtens, Rikie M. (Geriatrics Section, Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands) , van Munster, Barbara C. (Department of Geriatrics, Gelre Hospitals, Apeldoorn, the Netherlands) , de Rooij, Sophia E. (Geriatrics Section, Department of Internal Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands)
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 130 - 136 , 2017 , 0002-8614 ,

    초록

    Objectives To assess the association between serum S100B levels (a marker of brain damage), delirium, and subsequent cognitive decline. Design Substudy of a multicenter randomized controlled trial. Setting Surgical, orthopedic, and trauma surgery wards of two teaching hospitals. Participants Individuals aged 65 and older (range 65–102) admitted for hip fracture surgery (N = 385). Measurements During hospitalization, presence of delirium was assessed daily. S100B was assayed in repeated serum samples. Twelve months after discharge, cognitive decline and mortality were evaluated. Cognitive decline was defined as an increase in Informant Questionnaire on Cognitive Decline Short Form score of 1 standard deviation or more or a decrease in Mini Mental State Examination score of 3 points or more between admission and 12 months after discharge. Results Premorbid cognitive impairment was present in 226 (58.7%) participants, and 127 (33.0%) experienced perioperative delirium. Multivariable analysis showed that older age and presence of infection, but not of delirium, were associated with higher S100B levels. Levels were also higher after surgery than before. Of participants with perioperative delirium, 58.6% experienced cognitive decline or death, and only age was a risk factor; 36.5% of participants without perioperative delirium experienced cognitive decline or death in the following year, and higher S100B, premorbid cognitive impairment, and older age were risk factors. Conclusion In a cohort of older adults with hip fracture, no association was found between serum S100B levels and occurrence of delirium. S100B was associated with cognitive decline or death in the first year after hip fracture only in participants without perioperative delirium. S100B seems to be of limited value as a biomarker of brain damage associated with delirium.

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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]   Effects of Longitudinal Glucose Exposure on Cognitive and Physical Function: Results from the Action for Health in Diabetes Movement and Memory Study   SCI SCIE SSCI

    Beavers, Kristen M. (Department of Health and Exercise Science, Wake Forest University, Winston‐Salem, North Carolina ) , Leng, Iris (Department of Biostatistical Sciences, Wake Forest University, Winston‐Salem, North Carolina ) , Rapp, Stephen R. (Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston‐Salem, North Carolina ) , Miller, Michael E. (Department of Biostatistical Sciences, Wake Forest University, Winston‐Salem, North Carolina ) , Houston, Denise K. (Department of Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, School of Medicine, Wake Forest University, Winston‐Salem, North Carolina ) , Marsh, Anthony P. (Department of Health and Exercise Science, Wake Forest University, Winston‐Salem, North Carolina ) , Hire, Don G. (Department of Biostatistical Sciences, Wake Forest University, Winston‐Salem, North Carolina ) , Baker, Laura D. (Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston‐Salem, North Carolina ) , Bray, George A. (Pennington Biomedical Research Center, Louisiana State University, Baton Rouge,) , Blackburn, George L. , Hergenroeder, Andrea L. , Jakicic, John M. , Johnson, Karen C. , Korytkowski, Mary T. , Dorsten, Brent Van , Kritchevsky, Stephen B.
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 137 - 145 , 2017 , 0002-8614 ,

    초록

    Objectives To test whether average long‐term glucose exposure is associated with cognitive and physical function in middle‐aged and younger‐old adults with type 2 diabetes mellitus. Design Prospective cohort study. Setting Data obtained as part of the Action for Health in Diabetes (Look AHEAD) trial (NCT00017953) and Look AHEAD Movement and Memory ancillary study (NCT01410097). Participants Overweight and obese individuals with type 2 diabetes mellitus aged 45 to 76 at baseline (N = 879). Measurements Glycosylated hemoglobin (HbA1c) was measured at regular intervals over 7 years, and objective measures of cognitive function (Trail‐Making Test, Modified Stroop Color‐Word Test, Digit Symbol‐Coding, Rey Auditory Verbal Learning Test, Modified Mini‐Mental State Examination) and physical function (Short Physical Performance Battery, expanded Physical Performance Battery, 400‐m and 20‐m gait speed) and strength (grip and knee extensor strength) were assessed at the Year 8 or 9 follow‐up examination. Results Average HbA1c exposure was 7.0 ± 1.1% (53 ± 11.6 mmol/mol), with 57% of participants classified as having HbA1c levels of less than 7% ( 64 mmol/mol). After adjustment for age, sex, race, education, smoking status, alcohol intake, knee pain, physical fitness, body mass index, diabetes mellitus medication and statin use, ancillary year visit, and study arm and site, higher HbA1c was associated with worse physical but not cognitive function. Further adjustment for prevalent diabetes mellitus–related comorbidities made all associations nonsignificant. Results did not differ when stratified according to participant baseline age ( Conclusion Results presented here suggest that, in the absence of diabetes mellitus–related complications, longitudinal glucose exposure is not associated with future cognitive and physical function. Optimal management of diabetes mellitus–related comorbidities may prevent or reduce the burden of disability associated with type 2 diabetes mellitus.

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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]   Problem Drinking and Depression in Older Adults with Multiple Chronic Health Conditions   SCI SCIE SSCI

    Mowbray, Orion (School of Social Work, University of Georgia, Athens, Georgia ) , Washington, Tiffany (School of Social Work, University of Georgia, Athens, Georgia ) , Purser, Greg (School of Social Work, University of Georgia, Athens, Georgia ) , O'Shields, Jay (School of Social Work, University of Georgia, Athens, Georgia)
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 146 - 152 , 2017 , 0002-8614 ,

    초록

    Objectives To examine the intersection of depression and alcohol use among older adults with multiple chronic health conditions (MCCs). Design Wave 1 data from the National Social Life, Health and Aging Project (2005–06). Setting Community‐based sampling throughout the United States. Participants Individuals aged 57 to 85 who identified as active alcohol consumers (N = 1,643). Measurements Participants reported whether they currently had MCCs, problem drinking (defined as affirming two or more of the four CAGE screening questions), symptoms associated with depression, and other social and health measures. Results Although older adults with MCCs were no more likely to be problem drinkers than those with no MCCs, those with MCCs and depression were nearly five times as likely to experience problem drinking as older adults with MCCs and no depression. Conclusion Older adults with MCCs have differences that have implications for health, including mental health problems. Implementing screening and assessment in medical care settings for problem drinking and improving self‐management interventions to include consequences of alcohol use components are critical avenues for reducing healthcare expenditures and improving quality of life of individuals with MCC.

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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]   T‐Cell Phenotypes Predictive of Frailty and Mortality in Elderly Nursing Home Residents   SCI SCIE SSCI

    Johnstone, Jennie (Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada) , Parsons, Robin (McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada) , Botelho, Fernando (McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada) , Millar, Jamie (McMaster Immunology Research Centre, McMaster University, Hamilton, Ontario, Canada) , McNeil, Shelly (Canadian Center for Vaccinology, IWK Health Center and Capital Health, Dalhousie University, Halifax, Nova Scotia, Canada) , Fulop, Tamas (Department of Medicine, Geriatrics Division, Research Center on Aging, University of Sherbrooke, Sherbrooke, Quebec, Canada) , McElhaney, Janet E. (Health Sciences North Research Institute, Sudbury, Ontario, Canada) , Andrew, Melissa K. (Department of Medicine, Dalhousie University,) , Walter, Stephen D. , Devereaux, P.J. , Malek, Mehrnoush , Brinkman, Ryan R. , Bramson, Jonathan , Loeb, Mark
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 153 - 159 , 2017 , 0002-8614 ,

    초록

    Objectives To determine whether immune phenotypes associated with immunosenescence are predictive of frailty and mortality within 1‐year in elderly nursing home residents. Design Cross sectional study of frailty; prospective cohort study of mortality. Setting Thirty‐two nursing homes in four Canadian cities between September 2009 and October 2011. Participants Nursing home residents aged 65 and older (N = 1,072, median age 86, 72% female). Measurements After enrollment, peripheral blood mononuclear cells were obtained and analyzed using flow cytometry for CD4 + and CD8 + T‐cell subsets (naIve, memory (central, effector, terminally differentiated, senescent), and regulatory T‐cells) and cytomegalovirus (CMV)‐reactive CD4 + and CD8 + T‐cells. Multilevel linear regression analysis was performed to determine the relationship between immune phenotypes and frailty; frailty was measured at the time of enrollment using the Frailty Index. A Cox proportional hazards model was used to determine the relationship between immune phenotypes and time to death (within 1 year). Results Mean Frailty Index was 0.44 ± 0.13. Multilevel regression analysis showed that higher percentages of naIve CD4 + T‐cells ( P = .001) and effector memory CD8 + T‐cells ( P = .02) were associated with a lower mean Frailty Index, whereas a higher percentage of CD8 + central memory T‐cells was associated with a higher mean Frailty Index score ( P = .02). One hundred fifty one (14%) members of the cohort died within 1 year. Multivariable analysis showed a significant negative multiplicative interaction between age and percentage of CMV‐reactive CD4 + T‐cells (hazard ratio = 0.87, 95% confidence interval = 0.79–0.96). No other significant factors were identified. Conclusion Immune phenotypes found to be predictive of frailty and mortality in this study can help further understanding of immunosenescence and may provide a rationale for future intervention studies designed to modulate immunity.

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  10. [해외논문]   Changes in Drug Use and Polypharmacy After the Age of 90: A Longitudinal Study of the Danish 1905 Cohort   SCI SCIE SSCI

    Wastesson, Jonas W. (Max‐Planck Odense Center on the Biodemography of Aging, University of Southern Denmark, Odense, Denmark) , Oksuzyan, Anna (Max Planck Institute for Demographic Research, Rostock, Germany) , von Bornemann Hjelmborg, Jacob (Unit of Epidemiology, Biostatistics and Biodemography, University of Southern Denmark, Odense, Denmark) , Christensen, Kaare (Max‐Planck Odense Center on the Biodemography of Aging, University of Southern Denmark, Odense, Denmark)
    Journal of the American Geriatrics Society v.65 no.1 ,pp. 160 - 164 , 2017 , 0002-8614 ,

    초록

    Objectives To determine the longitudinal development of drug use in very old adults. Design Longitudinal cohort study with waves in 1998, 2000, 2002, and 2005. Setting Nationwide study in Denmark. Participants All living Danes born in 1905 were approached in 1998; 2,262 responded at baseline. Measurements Self‐reported use of regularly taken drugs. Mean and median number of drugs and growth curve models were used to identify the change in number of drugs as the cohort aged from 92 to 100. Results The within‐person use of drugs increased with age for women (0.19 per year; 95% confidence interval (CI) = 0.15–0.24) and men (0.15 per year; 95% CI = 0.06–0.24). Persons leaving the study prematurely had higher baseline values and a steeper increase in their annual use of drugs. The population‐level mean number of drugs increased from baseline (3.6 drugs) to the first follow‐up (4.1 drugs) but thereafter remained stable at approximately 4 drugs. Women used more drugs than men at all waves. Conclusion In this first longitudinal study of drug use in nonagenarians, individuals used an increasing number of drugs as they aged. This increase is difficult to detect in cross‐sectional analyses of the population‐level mean. More efforts to understand what is reasonable prescribing at these older ages are needed.

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