Journal of the American Geriatrics Society
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Multicenter Study
Patterns of surgical care and complications in elderly adults.
To determine whether procedures, hospitals visited, and complications would differ according to decade in elderly adults and from those of younger adults. ⋯ This article reports the pattern of surgical procedures, complications, and mortality found in NACOR, which is one of the few data sets that contains data from community hospitals and individuals with all types of insurance. Because the outcomes portion of the data set is under development, it is not possible to investigate the relationship between hospital type and complications or mortality, but this study underscores the magnitude of geriatric surgery that occurs in community hospitals as an area for future outcomes studies.
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Randomized Controlled Trial Multicenter Study
A standardized, bundled approach to providing geriatric-focused acute care.
To determine whether a bundled intervention can increase detection of delirium and facilitate safer use of high-risk medications. ⋯ An intervention focused on delirium prevention and recognition by bedside staff combined with computerized decision support facilitates safer prescribing of high-risk medications and possibly results in less need for extended care.
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Randomized Controlled Trial Multicenter Study
Successfully reducing antibiotic prescribing in nursing homes.
To determine whether antibiotic prescribing can be reduced in nursing homes using a quality improvement (QI) program that involves providers, staff, residents, and families. ⋯ This magnitude of effect is unusual in efforts to reduce antibiotic use in nursing homes. Outcomes could be attributed to the commitment of the providers; outreach to providers and staff; and a focus on common clinical situations in which antibiotics are generally not indicated; and suggest that similar results can be achieved on a wider scale if similar commitment is obtained and education provided.
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Multicenter Study
Association between hearing impairment and self-reported difficulty in physical functioning.
To determine whether hearing impairment, defined by using objective audiometry, is associated with multiple categories of self-reported physical functioning in a cross-sectional, nationally representative sample of older adults. ⋯ Hearing impairment in older adults is independently associated with greater disability and limitations in multiple self-reported categories of physical functioning.
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Multicenter Study
Identifying common characteristics of frailty across seven scales.
To determine whether commonly used frailty scales exhibit shared characteristics when applied to a representative sample of middle-aged and older Europeans. ⋯ On each frailty scale, frailty score increased nonlinearly with age, mortality risk increased with frailty score, and women had higher scores than men but demonstrated better survival. Each scale except the frailty phenotype demonstrated an upper limit to frailty below the scale's theoretical maximum. Across commonly used frailty scales, these characteristics are common in nature but differ in magnitude.