Journal of the American Geriatrics Society
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To describe the occurrence of delirium in a cohort of older medical intensive care unit (ICU) patients and its short-term duration in the hospital and to determine the association between preexisting dementia and the occurrence of delirium. ⋯ Delirium is a frequent complication in older ICU patients and often persists beyond their ICU stay. Delirium in older ICU persons is a dynamic and complex process. Dementia is an important predisposing risk factor for the development of delirium in this population during and after the ICU stay.
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To determine whether a simple question about steadiness at admission predicts in-hospital functional decline and whether unsteadiness at admission predicts failure of in-hospital functional recovery of patients who have declined immediately before hospitalization. ⋯ A simple question about steadiness identified patients at increased risk for in-hospital ADL decline and, in patients who lost ADL function immediately before admission, failure to recover.
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To examine the association between muscle strength and total and cause-specific mortality and the plausible contributing factors to this association, such as presence of diseases commonly underlying mortality, inflammation, nutritional deficiency, physical inactivity, smoking, and depression. ⋯ In older disabled women, handgrip strength was a powerful predictor of cause-specific and total mortality. Presence of chronic diseases commonly underlying death or the mechanisms behind decline in muscle strength in chronic disease, such as inflammation, poor nutritional status, disuse, and depression, all of which are independent predictors of mortality, did not explain the association. Handgrip strength, an indicator of overall muscle strength, may predict mortality through mechanisms other than those leading from disease to muscle impairment. Grip strength tests may help identify patients at increased risk of deterioration of health.
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To examine psychotropic prescription use in community-dwelling elderly in the United States and its association with predisposing, enabling, and need factors. ⋯ Nearly one in five community-dwelling elderly persons used psychotropic medications, primarily antidepressants followed by antianxiety agents. Enabling and need factors were consistently associated with psychotropic classes examined, whereas most predisposing factors varied with the type of psychotropic drug class.