For this secondary data analysis of a large clinical drug study, researchers investigated the independent prognostic utility of self-report quality-of-life measures versus clinical measures for assessing patient risk for heart-failure-related hospitalization. The experience of heart failure varies over the life course; hence, four age groups were investigated. Quality-of-life measures, specifically health-related quality-of-life and psychosocial quality-of-life measures, were found to be independent and significant predictors of heart-failure-related hospitalizations, as compared to traditional clinical indicators. In addition, the psychosocial quality-of-life measure varied by age group in its importance as a predictor of hospitalization, suggesting differential relevance over the life course. Specifically, psychosocial quality of life was most strongly predictive of hospitalization for those ages 21-44, was less predictive for those ages 45-54, and was nonsignificant for those 55-64 years of age and those 65 and over. Including self-report quality-of-life measures provides a more complete picture of the factors associated with risk of hospitalization at different points in the life course for individuals with heart failure. These findings suggest that researchers and practitioners could use self-report quality-of-life measures as additional prognostic indicators of a patient's condition and risk for heart-failure-related hospitalization, especially for younger patients.
Research investigating the knowledge and attitudes of diverse older adults about hospice care and end-of-life issues is needed to expand service utilization. This pilot study explored an urban area’s perceptions and awareness of hospice through local churches. The sample consisted of 148 adults age 43 and older. Although recruitment efforts resulted in a relatively homogenous sample, findings suggest a lack of knowledge about whether hospice is covered by Medicare, Medicaid, or private insurance. Perceptions of the expense of hospice, however, were not associated with knowledge of coverage. Respondents generally agreed that hospice is important and would recommend its services for their family members.
Background:
‘Unsafe’ movement strategies used to perform everyday activities were
quantified using scores for tasks included in the Short Form Safe Functional
Motion test series (SSFM). Baseline scores were independently associated
with incident fractures after adjusting for factors known to effect fracture
risk. The purpose of the present study is to determine whether the SSFM, a
series of tests of habitual motion, is associated with incident fragility
fracture at any skeletal sites.
Methods:
An osteoporosis clinic database was queried for adults with baseline SSFM
scores and corresponding data for prevalent fractures, femoral neck bone
mineral density (fnBMD), osteoporosis medication use, and incident fractures
at 1-year and 3-year follow ups [
n
= 1700 (118 incident
fractures) and
n
= 1058 (202 incident fractures),
respectively]. Multiple logistic regressions, adjusted for sex, age, fnBMD,
osteoporosis medication use, and any prevalent fractures at baseline, were
used to determine whether baseline SSFM scores were associated with incident
fragility fractures.
Results:
An Sfm-3 score was a significant independent predictor of any fracture at 1
year [adjusted odds ratio (95% CI) = 1.118 (1.025, 1.219) for each 10-point
decrease in Sfm-3;
p
= 0.012], and 3-year follow up
[adjusted odds ratio (95% CI) = 1.183 (1.098, 1.274) for each 10-point
decrease in Sfm-3;
p
< 0.0001].
Conclusions:
Scores on the SSFM predict fracture risk such that for each 10-point drop in
score the odds of fracture are increased by up to 18% independent of risk
associated with age, bone mineral density, use of bone-sparing medications,
and history of a fracture.
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