Journal of the American Geriatrics Society
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Review
The energetic pathway to mobility loss: an emerging new framework for longitudinal studies on aging.
The capacity to walk independently is a central component of independent living. Numerous large and well-designed longitudinal studies have shown that gait speed, a reliable marker of mobility, tends to decline with age and as a consequence of chronic disease. This decline in performance is of utmost importance because slow walking speed is a strong, independent predictor of disability, healthcare utilization, nursing home admission, and mortality. ⋯ Based on work in the Baltimore Longitudinal Study of Aging, examples of measures, operationalized dimensions, and analytical models that may be implemented to address this are provided. The main premise is simple: the biochemical processes that maintain life, secure homeostatic equilibrium, and prevent the collapse of health require energy. If energy becomes deficient, adaptive behaviors develop to conserve energy.
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Multicenter Study Comparative Study
The optimum follow-up period for assessing mortality outcomes in injured older adults.
To compare mortality rates of hospitalized injured aged 67 and older across commonly used follow-up periods (e.g., in-hospital, 30-day, 1-year) and to determine the postinjury time after which mortality rates stabilize. ⋯ In-hospital mortality is much lower than postdischarge mortality in injured older adults, with a substantial portion of persons dying shortly after discharge from the hospital. Mortality appears to stabilize by 6 months after injury, although 60-day postadmission follow-up captures most of the excess daily mortality rate.
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To examine a new method of classifying disability subtypes by combining self-reported and performance-based tools to predict mortality in older Chinese adults. ⋯ Combined use of self-reported and PP tools is necessary when screening for mutually exclusive disability subtypes that confer significantly higher or lower mortality risks on a population of older adults.
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Comparative Study
Driving patterns of older adults: results from the Second Injury Control and Risk Survey.
To describe older adults' driving patterns, including self-imposed driving restrictions and motor vehicle crashes (MVCs). ⋯ Large majorities of older adults, including those aged 85 and older, are current drivers. Although many limit driving in hazardous conditions, fewer do for medical reasons. Men and older adults who live alone are more likely to report a recent MVC; those who self-limit their driving are less likely to report crash involvement.