The Emergence of Geriatric Assessment Units

Am, Epstein; Hall, Jordan; Besdine, Richard W.; Cumella, Edward J.; Feldstein, Michael; Bj, McNeil; Jw, Rowe

doi:10.7326/0003-4819-106-2-299

Cited by 109 publications

(51 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The patients were referred for a variety of reasons and underwent a comprehensive geriatric assessment, including history and informant history, medication history, and physical and neurological examination [13] . They were asked to complete the Dutch version of the Mini-Mental State Examination (MMSE), with scores ranging from 0 points (poor cognitive functioning) to 30 points (good cognitive functioning) [14] .…”

Section: Patientsmentioning

confidence: 99%

Higher Serum Vitamin D<sub>3</sub> Levels Are Associated with Better Cognitive Test Performance in Patients with Alzheimer’s Disease

Oudshoorn¹,

Mattace-Raso²,

Velde³

et al. 2008

Dement Geriatr Cogn Disord

151

105

View full text Add to dashboard Cite

Background/Aims: Recent studies suggest that vitamin D metabolites may be important for preserving cognitive function via specific neuroprotective effects. No large studies have examined the association between vitamin D status and cognition. Methods: In this cross-sectional study, we analyzed the serum 25-hydroxyvitamin D₃ levels and Mini-Mental State Examination (MMSE) test scores of 225 older outpatients who were diagnosed as having probable Alzheimer’s disease (AD). In addition to the 25-hydroxyvitamin D₃ levels, we analyzed the serum vitamin B₁, B₆ and B₁₂ levels. Results: An association was found between MMSE test scores and serum 25-hydroxyvitamin D₃ levels, with a β-coefficient of 0.05 (p = 0.01). Vitamin-D-sufficient patients had significantly higher MMSE scores as compared to vitamin-D-insufficient ones. No association was found with the other serum vitamin levels. Conclusions: These data support the idea that a relationship exists between vitamin D status and cognition in patients with probable AD. However, given the cross-sectional design of this study, no causality can be concluded. Further prospective studies are needed to specify the contribution of vitamin D status to the onset and course of cognitive decline and AD.

show abstract

Section: Patientsmentioning

confidence: 99%

Higher Serum Vitamin D<sub>3</sub> Levels Are Associated with Better Cognitive Test Performance in Patients with Alzheimer’s Disease

Oudshoorn¹,

Mattace-Raso²,

Velde³

et al. 2008

Dement Geriatr Cogn Disord

151

105

View full text Add to dashboard Cite

show abstract

“…qq This work was supported in part by the Geriatric Research, Education and programs to arrest or reduce the trajectory of decline 15,16 . Key elements of GEM include identifying risk for falls, pharmacologic optimization, evaluating cognitive and affective status, assessing nutrition, and identifying social support and community resources 12 .…”

Section: Introductionmentioning

confidence: 99%

Geriatric Inpatient Units in the Care of Hospitalized Frail Adults with a History of Heart Failure

Gharacholou

Sloane

Cohen

et al. 2012

International Journal of Gerontology

View full text Add to dashboard Cite

s u m m a r y Background: Frail hospitalized older adults are at risk for adverse outcomes. Previous studies have suggested benefits for inpatient geriatric management (GEM). We sought to determine whether hospitalized patients with a history of heart failure (HF) benefitted from inpatient GEM or not. Methods: We studied 309 inpatients previously diagnosed with HF who were participants in a randomized trial of geriatric evaluation and management (GEM) versus usual care (UC). The intervention involved multidisciplinary teams that provided comprehensive geriatric assessment. We evaluated health-related quality of life (HRQOL), basic activities of daily living (ADLs), health service utilization, and survival at discharge, 6 months, and 1 year post randomization. Results: GEM patients had higher mean change scores for physical function (unadjusted means: 0.17 vs. e4.67, p ¼ 0.046) and basic ADLs (1.25 vs. 0.67, p ¼ 0.003) at hospital discharge, which remained significant after adjusting for baseline HRQOL scores and in-hospital days. Outcomes were not significantly different at 1 year. Length of stay for GEM was greater than UC (24 days vs. 17 days, p ¼ 0.03), but total costs at 1 year were not different (p ¼ 0.9). Mortality rates at 1 year were high and similar (GEM 29.0%, UC 27.3%, p ¼ 0.73) in both the groups. Conclusion: Inpatient GEM was associated with better maintenance of physical function and basic ADLs at hospital discharge; however, no differences in HRQOL or survival were observed between GEM and UC at 1 year post randomization. Restructuring inpatient care models to incorporate inpatient GEM principles may be one method to optimize health-care delivery.

show abstract

“…Patients were referred for a variety of reasons, by their general practitioner (78%), by the Rotterdam Institute for Community Mental Health Care (7%), by various departments within the hospital (13%) and by others (2%). All patients underwent a full comprehensive geriatric assessment [11] , including history and informant history, medication history, and physical and neurological examination. They were asked to complete the Dutch version of the MMSE (best of serial sevens) [12,13] .…”

Section: Methodsmentioning

confidence: 99%

High Systolic and Pulse Pressure Levels Are Associated with Better Cognitive Performance in Patients with Probable Alzheimer’s Disease: A Cross-Sectional Observational Study in a Geriatric Outpatient Population

Bruchem-Visser

Mattace-Raso²,

Cammen³

2009

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

Background: The prevalence of cardiovascular disease and Alzheimer’s disease (AD) increases with age. A number of studies have demonstrated an association between AD and cardiovascular risk factors and disease. However, data are inconsistent. Methods: Cross-sectional observational study in a geriatric outpatient population. Analysis of data from 327 patients diagnosed with probable AD in a geriatric outpatient clinic. Comparison of blood pressure levels, cardiovascular diagnoses, and Mini-Mental State Examination (MMSE) score between the patients. Results: MMSE score decreased with age (β = –0.25; 95% CI: –0.35 to 0.15), and a positive correlation was found with systolic blood pressure (β = 0.03; 95% CI: 0.003–0.06), pulse pressure (β = 0.05; 95% CI: 0.01–0.08) and hypertension (β = 1.56; 95% CI: 0.05–3.07). An increase in cardiovascular disease load had a negative effect on cognitive performance. After adjustment for duration of dementia (data present for 216 patients), results were slightly changed. Conclusions: Higher systolic blood pressure and pulse pressure were associated with a better cognitive test performance. Patients with probable AD and 2 or more cardiovascular diagnoses had lower MMSE scores.

show abstract

The Emergence of Geriatric Assessment Units

Cited by 109 publications

References 7 publications

Higher Serum Vitamin D<sub>3</sub> Levels Are Associated with Better Cognitive Test Performance in Patients with Alzheimer’s Disease

Higher Serum Vitamin D<sub>3</sub> Levels Are Associated with Better Cognitive Test Performance in Patients with Alzheimer’s Disease

Geriatric Inpatient Units in the Care of Hospitalized Frail Adults with a History of Heart Failure

High Systolic and Pulse Pressure Levels Are Associated with Better Cognitive Performance in Patients with Probable Alzheimer’s Disease: A Cross-Sectional Observational Study in a Geriatric Outpatient Population

Contact Info

Product

Resources

About