Journal of the American Geriatrics Society
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Understanding the contributors to physical disability in older adults is an important component of the national health objective of expanding disability-free life by the year 2000. The purpose of this study was to determine the frequency with which older adults attribute their difficulty performing a number of common daily tasks to "old age" and to identify specific conditions and diseases associated with this attribution. Finally we sought to determine the characteristics that might differentiate persons able to attribute their disability to specific conditions from those who cite old age as the etiology of their disability. ⋯ These data suggest that a significant proportion of functional decline attributed to "aging" in older adults may be associated with specific conditions. Identifying and reducing the impact of these conditions may prove to be a useful approach to preventing or minimizing functional loss.
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To investigate the relationship between sleep-disordered breathing (SDB) and essential hypertension in a population of older male hypertensives. ⋯ This investigation supports data showing that undiagnosed SDB is a common phenomenon in older male individuals, leading to impaired daytime functioning and impairment of overall quality of life. More importantly, our data suggests that untreated SDB may have an adverse effect on the efficacy of antihypertensive treatment in hypertensive individuals with sleep-disordered breathing.
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To better understand primary treatment recommendations and the variables that might influence treatment decisions of physicians who treat agitated dementia patients. ⋯ The findings indicate that physicians, regardless of specialty, are likely to use medication and to weight clinically relevant information in a similar fashion when managing agitated dementia patients.
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To determine whether physicians followed a hospital policy permitting them to not offer cardiopulmonary resuscitation (CPR) to patients considered unlikely to benefit from this therapy. ⋯ Despite a policy that allows them to do otherwise, physicians usually offered CPR to patients, regardless of benefit. Most physicians believed that CPR should be offered to all patients. These findings suggest that policies such as that of San Francisco General Hospital may not be compelling because physicians hold attitudes that are inconsistent with the policies.
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Despite the many complications and minimal benefits associated with long-term enteral nutrition in patients with advanced dementia, it is, nevertheless, a widespread practice in nursing homes throughout the United States. This paper presents a review of the literature on dementia, geriatric nutrition, and enteral feeding. There appears to be limited research to support the long-term benefits and safety of enteral nutrition in advanced dementia. Additionally, it is not yet clear that long-term enteral nutrition in advanced dementia results in an improved quality of life.