D B Hogan

..20). Translation of evidence-based multi-component delirium prevention strategies into everyday clinical care, using the electronic medical record, was not found to be effective at decreasing delirium rates among hip facture patients...

..We examined the relative contribution of social and clinical factors to HRQL among older home care clients and explored whether any of the observed associations varied by sex...

..This paper describes the methodology that was developed for the systematic reviews...

..We examined the feasibility and predictive accuracy of two different interpretations of the Cardiovascular Health Study (CHS) frailty criteria in a population-based sample of AL residents...

..The aim of this study was to evaluate changes in benzodiazepine use over time, and the association between benzodiazepine use and select outcomes...

..To review three proposed approaches to office-based assessment of older drivers and to evaluate recommendations made about dementia and driving...

..In this study, we used longitudinal data to determine whether regional differences in commonly consumed medications persisted and to explore potential explanatory factors for observed differences...

..We tested this approach to see whether it would be effective if offered as a consultation service using existing health care resources...

..In this article, we provide practical guidance on management based on recommendations from the Third Canadian Consensus Conference on the Diagnosis and Treatment of Dementia...

..Between 27% and 55% of CONSORT items per study were rated as inadequately reported. The methodological limitations of these studies reduce our confidence in the validity of the conclusions drawn in the published reports...

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..While disease prevention, health promotion and environmental modifications may decrease the personal and societal impacts of these age-associated findings, health care planning for the very old should take these data into account...

..A more accurate statement about Osler's therapeutic approach was that he was a "medicinal nihilist." His demand for proof of efficacy before use of a medication remains relevant...

..This report contrasts disability in the old-old (85 years of age or older, 85+) with younger seniors (65-84 years of age) and examines whether diseases have an equivalent impact on the two groups...

..Adjusting for apolipoprotein E4 status did not change the point estimates of the ORs. The greatest impact of LLAs was seen in the CIND subtype circumscribed memory impairment...

..This study was undertaken to examine prospectively the association between the use of these and other antihypertensive drugs and cognitive function...

..Future models of frailty should incorporate more precise operationalisation of the probability of frailty and better explain the relationship between disease, disability and frailty...

..CONCLUSION: The HUI2 measure of HRQL in older persons at risk for institutionalization appears to reflect health status at a point in time and to be responsive to changes in health status over time...

..To investigate whether exercise confounds the relationship between folate and cerebrovascular events, all-cause dementia, and Alzheimer's disease...

..To evaluate the consistency of self-reported health-related quality of life (HRQL) using the Health Utilities Index Mark 2 (HUI2) with observer rated HRQL using the Minimum Data Set Health-Status Index (MDS-HSI)...

..Abraham Jacobi. Osler was not a saint, and he had his "rough side," but in his relationships with Jewish colleagues his example remains relevant...

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..We evaluated whether impairments on the Disability Assessment for Dementia (DAD) and Functional Rating Scale (FRS) can predict progression to AD...

..Prior studies on the time required for patients with dementia to progress to functional milestones used clinic-based samples. Our findings, which have potential public health implications, need to be confirmed and expanded upon...

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..2, GDS 4.8, FRS 27.5, DAD 16.9). CONCLUSION: Living situation is related to the severity of dementia at diagnosis. Primary care providers should have a low threshold for case-finding in older adults who live with family or friends...

..Higher crash rates per mile driven in older drivers have focused attention on the assessment of older drivers...

..Low serum folate levels are independently associated with a significantly higher risk of an adverse cerebrovascular event, including vascular dementia and stroke death, among older, cognitively vulnerable persons...

..The findings provide evidence of both rational prescribing practices and potential treatment bias in the pharmacotherapeutic management of daily pain in older home care clients...

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..This study assessed the congruence of course objectives and statements of commitment to change, effects on practice, unmet-needs, and the utility of supplementing CTCs with other forms of reflective work in course evaluations...

..89). A reduced risk for incident dementia or AD was not observed. Our findings suggest a possible protective effect for antioxidant vitamins in relation to cognitive decline but randomized controlled trials are required for confirmation...

..CONCLUSION: CIND consists of a heterogeneous group of disorders that can be classified syndromically. Many subclassess - not just those with pre-AD CIND - are at high risk of progression to dementia, usually to Alzheimer's disease...

..CONCLUSIONS: Further work is needed on how to optimize the impact of consensus statements and CPGs. While dissemination of the CCCD has occurred, it is currently unknown whether it has led to any change in physician practices...

..These recommendations are generally congruent with our own consensus statements. The consensus statements have been endorsed by relevant bodies in Canada...

..Frailty and fitness are important attributes of older persons, but population samples of their prevalence, attributes, and outcomes are limited...

..There is a need for empirical studies to define criteria for vascular cognitive impairment (VCI) subtypes. In this paper, we report the predictive validity of a subtype classification scheme based on clinical and radiographic features...

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..Our objective was to examine which sociodemographic, clinical, and functional characteristics are associated with pharmacotherapy for osteoporosis among community-based seniors...

..Future research in this area would be strengthened by incorporation of detailed assessments of patient-reported reasons for nonadherence, the appropriateness of drug regimens, and the effect of nonadherence on health outcomes...

..We view all three available cholinesterase inhibitors as first-line drugs...

..This association could be due to indication bias, i.e., people who elect to take lipid-lowering agents (LLAs) may be healthier than those who do not, so that it may be these other health factors that explain their lower risk of dementia...

..Even for patients who do, the proportion identified with VaD varies widely. Criteria based on empirical analyses need to be developed and validated...

..The occurrence of these problems should lead to careful evaluation followed by thoughtful, responsive treatment. Brief updates are given with recommendations for management directed at primary care physicians...

..The absence of a significant association between overall medication nonadherence and health outcomes may reflect study limitations and/or the need to differentiate among types of nonadherent behaviours...

..Recommendations are made to deal with the issues raised...

..In this review, we outline the epidemiology, risk factors associated with MC, its pathophysiology, the approach to diagnosis and the management of these individuals...

..77 for 18-month and 0.70 for 70-month mortality). INTERPRETATION: Frailty is a valid and clinically important construct that is recognizable by physicians. Clinical judgments about frailty can yield useful predictive information...

..The choices made by the leaders of Canadian geriatrics molded the evolution of the specialty and have contributed to its precarious status at the present time...

..Although consensus has yet to be attained, work accomplished to date has opened exciting new horizons. The article concludes with suggested directions for future research...

..Based on the GRIST findings, this article proposes six recommendations for improving recruitment into Canadian geriatric medicine training programs...

..The findings highlight the potential role of complex cognitive processes underlying the SRH-mortality relationship...