The Emergence of Geriatric Assessment Units

Am, Epstein; Hall, Jordan; Besdine, Richard W.; Cumella, Edward J.; Feldstein, Michael; Bj, McNeil; Jw, Rowe

doi:10.7326/0003-4819-106-2-299

Cited by 109 publications

(51 citation statements)

References 7 publications

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“…The patients were referred for a variety of reasons and underwent a comprehensive geriatric assessment, including history and informant history, medication history, and physical and neurological examination [13] . They were asked to complete the Dutch version of the Mini-Mental State Examination (MMSE), with scores ranging from 0 points (poor cognitive functioning) to 30 points (good cognitive functioning) [14] .…”

Section: Patientsmentioning

confidence: 99%

Higher Serum Vitamin D<sub>3</sub> Levels Are Associated with Better Cognitive Test Performance in Patients with Alzheimer’s Disease

Oudshoorn¹,

Mattace-Raso²,

Velde³

et al. 2008

Dement Geriatr Cogn Disord

154

105

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Background/Aims: Recent studies suggest that vitamin D metabolites may be important for preserving cognitive function via specific neuroprotective effects. No large studies have examined the association between vitamin D status and cognition. Methods: In this cross-sectional study, we analyzed the serum 25-hydroxyvitamin D₃ levels and Mini-Mental State Examination (MMSE) test scores of 225 older outpatients who were diagnosed as having probable Alzheimer’s disease (AD). In addition to the 25-hydroxyvitamin D₃ levels, we analyzed the serum vitamin B₁, B₆ and B₁₂ levels. Results: An association was found between MMSE test scores and serum 25-hydroxyvitamin D₃ levels, with a β-coefficient of 0.05 (p = 0.01). Vitamin-D-sufficient patients had significantly higher MMSE scores as compared to vitamin-D-insufficient ones. No association was found with the other serum vitamin levels. Conclusions: These data support the idea that a relationship exists between vitamin D status and cognition in patients with probable AD. However, given the cross-sectional design of this study, no causality can be concluded. Further prospective studies are needed to specify the contribution of vitamin D status to the onset and course of cognitive decline and AD.

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Section: Patientsmentioning

confidence: 99%

Higher Serum Vitamin D<sub>3</sub> Levels Are Associated with Better Cognitive Test Performance in Patients with Alzheimer’s Disease

Oudshoorn¹,

Mattace-Raso²,

Velde³

et al. 2008

Dement Geriatr Cogn Disord

154

105

View full text Add to dashboard Cite

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“…qq This work was supported in part by the Geriatric Research, Education and programs to arrest or reduce the trajectory of decline 15,16 . Key elements of GEM include identifying risk for falls, pharmacologic optimization, evaluating cognitive and affective status, assessing nutrition, and identifying social support and community resources 12 .…”

Section: Introductionmentioning

confidence: 99%

Geriatric Inpatient Units in the Care of Hospitalized Frail Adults with a History of Heart Failure

Gharacholou

Sloane

Cohen

et al. 2012

International Journal of Gerontology

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s u m m a r y Background: Frail hospitalized older adults are at risk for adverse outcomes. Previous studies have suggested benefits for inpatient geriatric management (GEM). We sought to determine whether hospitalized patients with a history of heart failure (HF) benefitted from inpatient GEM or not. Methods: We studied 309 inpatients previously diagnosed with HF who were participants in a randomized trial of geriatric evaluation and management (GEM) versus usual care (UC). The intervention involved multidisciplinary teams that provided comprehensive geriatric assessment. We evaluated health-related quality of life (HRQOL), basic activities of daily living (ADLs), health service utilization, and survival at discharge, 6 months, and 1 year post randomization. Results: GEM patients had higher mean change scores for physical function (unadjusted means: 0.17 vs. e4.67, p ¼ 0.046) and basic ADLs (1.25 vs. 0.67, p ¼ 0.003) at hospital discharge, which remained significant after adjusting for baseline HRQOL scores and in-hospital days. Outcomes were not significantly different at 1 year. Length of stay for GEM was greater than UC (24 days vs. 17 days, p ¼ 0.03), but total costs at 1 year were not different (p ¼ 0.9). Mortality rates at 1 year were high and similar (GEM 29.0%, UC 27.3%, p ¼ 0.73) in both the groups. Conclusion: Inpatient GEM was associated with better maintenance of physical function and basic ADLs at hospital discharge; however, no differences in HRQOL or survival were observed between GEM and UC at 1 year post randomization. Restructuring inpatient care models to incorporate inpatient GEM principles may be one method to optimize health-care delivery.

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“…Patients were referred for a variety of reasons, by their general practitioner (78%), by the Rotterdam Institute for Community Mental Health Care (7%), by various departments within the hospital (13%) and by others (2%). All patients underwent a full comprehensive geriatric assessment [11] , including history and informant history, medication history, and physical and neurological examination. They were asked to complete the Dutch version of the MMSE (best of serial sevens) [12,13] .…”

Section: Methodsmentioning

confidence: 99%

High Systolic and Pulse Pressure Levels Are Associated with Better Cognitive Performance in Patients with Probable Alzheimer’s Disease: A Cross-Sectional Observational Study in a Geriatric Outpatient Population

Bruchem-Visser

Mattace-Raso²,

Cammen³

2009

Dement Geriatr Cogn Disord

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Background: The prevalence of cardiovascular disease and Alzheimer’s disease (AD) increases with age. A number of studies have demonstrated an association between AD and cardiovascular risk factors and disease. However, data are inconsistent. Methods: Cross-sectional observational study in a geriatric outpatient population. Analysis of data from 327 patients diagnosed with probable AD in a geriatric outpatient clinic. Comparison of blood pressure levels, cardiovascular diagnoses, and Mini-Mental State Examination (MMSE) score between the patients. Results: MMSE score decreased with age (β = –0.25; 95% CI: –0.35 to 0.15), and a positive correlation was found with systolic blood pressure (β = 0.03; 95% CI: 0.003–0.06), pulse pressure (β = 0.05; 95% CI: 0.01–0.08) and hypertension (β = 1.56; 95% CI: 0.05–3.07). An increase in cardiovascular disease load had a negative effect on cognitive performance. After adjustment for duration of dementia (data present for 216 patients), results were slightly changed. Conclusions: Higher systolic blood pressure and pulse pressure were associated with a better cognitive test performance. Patients with probable AD and 2 or more cardiovascular diagnoses had lower MMSE scores.

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The Emergence of Geriatric Assessment Units

Cited by 109 publications

References 7 publications

Higher Serum Vitamin D<sub>3</sub> Levels Are Associated with Better Cognitive Test Performance in Patients with Alzheimer’s Disease

Higher Serum Vitamin D<sub>3</sub> Levels Are Associated with Better Cognitive Test Performance in Patients with Alzheimer’s Disease

Geriatric Inpatient Units in the Care of Hospitalized Frail Adults with a History of Heart Failure

High Systolic and Pulse Pressure Levels Are Associated with Better Cognitive Performance in Patients with Probable Alzheimer’s Disease: A Cross-Sectional Observational Study in a Geriatric Outpatient Population

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