The journals of gerontology. Series A, Biological sciences and medical sciences
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J. Gerontol. A Biol. Sci. Med. Sci. · Feb 2007
Randomized Controlled Trial Multicenter StudyAssociation between psychomotor activity delirium subtypes and mortality among newly admitted post-acute facility patients.
Delirium is common among hospitalized elders and may persist for months. Therefore, the adverse impact of delirium on independence often occurs in the post acute care (PAC) setting. The effect of psychomotor subtypes on delirium remains uncertain. The purpose of this study is to examine the association between psychomotor activity delirium subtypes and 1-year mortality among 457 newly admitted delirious PAC patients. ⋯ All three psychomotor disturbance subtypes had an elevated risk of dying during the 1-year follow-up relative to the normal psychomotor group, though the hypoactive group had the highest mortality risk and was the only group with a statistically significantly elevated risk relative to the normal group.
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This narrative review examines serum biomarkers for the diagnosis and monitoring of delirium. Serum biomarkers for delirium fall into three major groups: 1) those that are present or elevated prior to disease onset-risk markers, 2) those that rise with onset and fall with recovery-disease markers, and 3) those that rise in proportion to the consequences of disease-end products. As risk markers, we examine serum chemistries and genetic risk markers. ⋯ As end products of delirium, we examine markers of neuronal injury. Finally, we discuss methodological and biostatistical considerations for future biomarker studies. Identifying accurate biomarkers for delirium may shed further light into its pathophysiology and on the interrelationship between delirium and dementia.
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J. Gerontol. A Biol. Sci. Med. Sci. · Dec 2006
Comparative StudyDoes educational attainment contribute to risk for delirium? A potential role for cognitive reserve.
The objective of this study was to determine if level of educational attainment, a marker of cognitive reserve, was associated with the cumulative risk of delirium among hospitalized elders. ⋯ Hospitalized older persons with low educational attainment are at increased risk for delirium relative to persons with more education. This finding may have implications for the role of cognitive reserve in characterizing individual differences in risk for delirium.
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J. Gerontol. A Biol. Sci. Med. Sci. · Nov 2006
Randomized Controlled Trial Multicenter StudyEffects of a physical activity intervention on measures of physical performance: Results of the lifestyle interventions and independence for Elders Pilot (LIFE-P) study.
The Short Physical Performance Battery (SPPB), which includes walking, balance, and chair stands tests, independently predicts mobility disability and activities of daily living disability. To date, however, there is no definitive evidence from randomized controlled trials that SPPB scores can be improved. Our objective was to assess the effect of a comprehensive physical activity (PA) intervention on the SPPB and other physical performance measures. ⋯ A structured PA intervention improved the SPPB score and other measures of physical performance. An intervention that improves the SPPB performance may also offer benefit on more distal health outcomes, such as mobility disability.
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J. Gerontol. A Biol. Sci. Med. Sci. · Oct 2006
Persistent changes in interleukin-6 and lower extremity function following hip fracture.
A hip fracture often heralds a period of functional decline in elderly persons. Although an inflammatory reaction would be expected following a hip fracture, whether the degree of this response is associated with adverse functional outcomes is unknown. ⋯ Higher IL-6 levels are adversely associated with recovery of lower extremity function after hip fracture. Factors that predict cytokine response and the potential mechanisms by which this effect is mediated warrant further study.