Kinship moderates the association between a demented individual's behavioral disturbance and a caregiver's burden: Findings from a national survey in Taiwan.

Aim: The present study aimed to assess the moderating role of kinship between the behavioral disturbance of care recipients (CRs) with dementia and the caregivers' (CGs') burden in Taiwan.

Methods: The data of 965 CG-CR dyads on the behavioral disturbance of CR with dementia, CG burden, CG kinship to CR and other relevant variables were obtained from the Assessment of the National Long-Term Care Need in Taiwan (ANLTCNT). To test the moderating effect of CG-CR kinship on the association between behavioral disturbance of CR and CG burden, a series of hierarchical multiple linear regression models were used after controlling for potential factors associated with CG burden.

Geriatric conditions, rather than multimorbidity, as predictors of disability and mortality among octogenarians: A population-based cohort study.

Aim: To examine the impact of geriatric conditions and multimorbidity on the risk of incident disability and mortality among young-old and old-old adults.

Methods: The present study used nationally-representative data from the "Survey of Health and Living Status of the Elderly in Taiwan" for the years 2003 and 2007. Non-disabled older adults were divided into two age groups (65-79 years and ≥80 years).

Effectiveness of the medication safety review clinics for older adults prescribed multiple medications.

Background/purpose: Polypharmacy is common among Taiwanese older adults. We aim to determine the effectiveness of the medication safety review clinics (MSRCs) for solving drug-related problems (DRPs) among older adults prescribed multiple medications.

Methods: This prospective case-series intervention study was conducted at the outpatient department of the National Taiwan University Hospital and its BeiHu Branch.

Measurement structure of the caregiver burden scale: findings from a national community survey in Taiwan.

Aim: There is no appropriate understanding of community family caregiver burden. The object of the present study was to evaluate the measurement structure of a caregiver burden scale from a nationally representative Taiwanese community sample.

Methods: Data from nationally representative subjects completing face-to-face interviews on caregiver burden were analyzed.

Multidimensional health-transition patterns among a middle-aged and older population.

Aim: Previous studies on health transition have focused on single-dimension outcomes and minimally evaluated heterogeneity. This study aimed to explore heterogeneous and multidimensional health-transition patterns on comorbidity, frailty and disability while examining the factors predicting different patterns of health transition.

Methods: This study drew on data from a nationwide and longitudinally-followed sample of 5131 Taiwanese aged 50 years and older who were interviewed in 1996, 1999, 2003 and 2007.

Sex differences in the impact of diabetes on the risk of geriatric conditions.

Aim: To examine whether sex differences exist in the relationship between diabetes and geriatric conditions.

Methods: This was a cross-sectional analysis of 2629 community-dwelling older adults, drawn from the 2003 wave of the "Survey of Health and Living Status of the Elderly in Taiwan." Selected geriatric conditions included cognitive impairment, depression, falls and urinary incontinence (UI).

Medication adherence among geriatric outpatients prescribed multiple medications.

Background: Poor medication adherence (PMA) is associated with higher risks of morbidity, hospitalization, and mortality. Polypharmacy is not only a determinant of PMA but is also associated with many adverse health outcomes.

Objective: We aimed to determine the prevalence and correlates of PMA in an older population with polypharmacy.

Potentially inappropriate medications in geriatric outpatients with polypharmacy: application of six sets of published explicit criteria.

Aim: Our aim was to compare the practicability of six different potentially inappropriate medication (PIM) criteria in geriatric outpatients with polypharmacy.

Methods: We analysed baseline data from the Medication Safety Review Clinic in Taiwanese Elders (MSRC-Taiwan) study. The prevalence and correlates of PIMs were determined on the basis of criteria developed in the USA, Canada, France, Norway, Ireland and Thailand.

Drug-related problems (DRPs) identified from geriatric medication safety review clinics.

Drug-related problems (DRPs) were identified from baseline data of 193 Medication Safety Review Clinic (MSRC) patients. MSRCs enroll older adults (≥ 65 years) with either (1) prescriptions of ≥ 8 chronic medications (drugs prescribed for ≥ 28 days) or (2) a visit to ≥ 3 different physicians at the two participating hospitals in Taipei, Taiwan from August to October 2007. The Pharmaceutical Care Network Europe (PCNE) Classification Version 5.

Multiple morbidity combinations impact on medical expenditures among older adults.

This study aims to explore the medical needs of patients who have different combinations of multiple chronic diseases in order to improve care strategy for chronic patients. This study was based on a national probability proportional to size (PPS) sampling to older adults over 50 years old. We collaborated the files of the 2000-2001 health insurance claims and selected 8 types of common chronic diseases among seniors, for the discussion of multiple combinations of chronic diseases, including hypertension, diabetes, heart disease, stroke, dementia, cancer, arthritis and chronic obstructive pulmonary disease.

The prevalence of chronic conditions and medical expenditures of the elderly by chronic condition indicator (CCI).

The aim of this study was to understand the prevalence of chronic conditions and medical expenditures of the elderly for health care planning development of chronic conditions. This research is based on the representative sample (N=114,873) of seniors over 65 years nationwide. The CCI by the U.

The prevalence of subjective frailty and factors associated with frailty in Taiwan.

This study estimated the prevalence of frailty and identified the factors associated with frailty in Taiwan using data from the Survey of Health and Living Status of the Elderly. A nationwide probability sample including 2,238 individuals aged > or =65 years was interviewed in 2003. Based on the Cardiovascular Health Study conducted by Fried, five phenotypes of frailty were selected: poor appetite, exhaustion, low physical activity, poor walking ability, and poor twisting ability of fingers.

The effectiveness of a comprehensive geriatric assessment intervention program for frailty in community-dwelling older people: a randomized, controlled trial.

This randomized, controlled trial assessed the effectiveness of comprehensive geriatric assessment (CGA) and subsequent intervention in pre-frail and frail community-dwelling elderly based on the Fried Frailty Criteria (FFC) and the Barthel Index (BI) A total of 310 pre-frail or frail elderly from a single community were identified using the FFC. Of these, 152 were randomly assigned to the intervention group for CGA and appropriate intervention by medication adjustment, exercise instruction, nutrition support, physical rehabilitation, social worker consultation, and specialty referral. Clinical outcome was re-evaluated by the FFC and BI 6 months later.

Health, financial stresses, and life satisfaction affecting late-life depression among older adults: a nationwide, longitudinal survey in Taiwan.

The purpose of this study was to determine the incidence of depression in late life and to explore associated risk factors among Taiwanese elderly. The analyses were based on nationally representative data from the Survey of Health and Living Status of the Elderly in 1999 and 2003. A total of 1,487 respondents aged 65 years and older who completed the 10-item Center for Epidemiological Survey Depression (CES-D) scale in these two surveys and without depression in 1999 were included in the final analyses.

Social determinants of emergency utilization associated with patterns of care.

Purpose: To investigate the emergency room (ER) utilization among disabled Taiwanese older adults with different patterns of care arrangement.

Method: A national probability sample of 13,957 disabled older adults (aged 50 and above) was recruited. Individual interview data and National Health Insurance administrative data were used to examine the effects of care arrangements on ER utilization 1 year after the baseline interview.

Polypharmacy among disabled Taiwanese elderly: a longitudinal observational study.

Background And Objective: It is not known whether the correlates of polypharmacy among disabled elderly are similar to those for older adults in general. Furthermore, data on polypharmacy in the Taiwanese population are limited. Therefore, this study was conducted to determine the prevalence and correlates of polypharmacy among disabled Taiwanese elderly (aged >or=65 years).

Characteristics of outpatient prescriptions for frail Taiwanese elders with long-term care needs.

Objective: To describe medication prescription patterns and associated factors among frail Taiwanese elders with long-term care needs defined as having physical or cognitive functioning impairments.

Design: Longitudinal observational study from July 2001 to June 2002.

Setting: Community and Institutions.

Home environmental problems and physical function in Taiwanese older adults.

Environmental hazards play an important role in the disablement process. The purpose of this study was to investigate the relationship between home environmental problems and personal physical function. Data were based on a two-stage nationwide survey and evaluation on the needs of long-term care in Taiwan.

Geographical variations in elderly disability in Taiwan.

Inequality in health has long been a topic of discussion. The purpose of this research was to provide estimates of the proportions of elderly who had difficulties in activities of daily living in each of the 23 administrative areas of Taiwan, and to assess if there was geographical disparity in disability across areas. A nationally representative sample of 303,545 subjects was selected for interview.

Prognostic value of mortality in emergency department sepsis score, procalcitonin, and C-reactive protein in patients with sepsis at the emergency department.

The prognostic value of procalcitonin (PCT) in patients with sepsis at the emergency department (ED) has not been evaluated. We conducted a prospective observational study to compare the prognostic value of PCT on sepsis and compared with a validated score, Mortality in Emergency Department Sepsis (MEDS) score, and C-reactive protein (CRP) in the setting of ED of an urban, university-based medical center. Five hundred twenty-five consecutive adult patients admitted to the ED fulfilling the American College of Clinical Pharmacists/Society of Critical Care Medicine Consensus Conference definition of sepsis were prospectively enrolled.

A prospective cohort study on the effect of sexual activity, libido and widowhood on mortality among the elderly people: 14-year follow-up of 2,453 elderly Taiwanese.

Background: Sexual activity in elderly people is a topic of growing interest but the relationships of sexual activity, libido and widowhood to mortality have been barely investigated.

Methods: A total of 2,453 subjects enrolled from a nationwide survey on health status of residents aged 65 years or older in Taiwan between 1989 and 1991 were followed up until 31 December 2003 for ascertaining cause of death. Information on the frequency of sexual activity, libido (sexual desire), widowhood, disease status and relevant risk factors for risk of death at baseline were collected.

Comparison of clinical manifestations and outcome of community-acquired bloodstream infections among the oldest old, elderly, and adult patients.

Valid studies comparing the clinical characteristics among adult, elderly, and the oldest old bacteremic patients are lacking. We conducted a prospective, observational study in the emergency department (ED) of a university medical center between June 2001 and June 2002. All patients >18 years of age who registered in the ED with a clinically significant, culture-positive, bloodstream infection (BSI) were enrolled.

Reduction of disability after stroke is a more informative predictor of long-time survival than initial disability status.

Purpose: Few studies have evaluated the roles of reducing disability after stroke in predicting survival. This study aimed to investigate the effects of improvement in the Barthel Index (BI) and other prognostic factors on survival in patients with first-time noncardioembolic ischemic stroke.

Method: BI effectiveness was defined as the improvement of BI between initial stroke (within 3 days) and 2 months after stroke.

Establishing the minimal clinically important difference of the Barthel Index in stroke patients.

Background: The interpretation of the change scores of the Barthel Index (BI) in follow-up or outcome studies has been hampered by the fact that its minimal clinically important difference (MCID) has not been determined.

Objective: This article was written to establish the MCID of the BI in stroke patients.

Methods: Both anchor-based and distribution-based methods were used to establish the MCID.

Post-hospital care of stroke patients in Taipei: use of services and policy implications.

Background And Purpose: Population ageing in Taiwan is proceeding at an accelerating rate. The percentage of elderly is expected to increase from 9.7% in 2005 to 20% in 2025.