Differential Prescribing of Antimuscarinic Agents in Older Adults with Cognitive Impairment.

Background: Oral oxybutynin has been associated with the development of cognitive impairment.

Objective: The objective of this study was to describe the use of oral oxybutynin versus other antimuscarinics (e.g.

A Community-Based Collaborative Care Model to Improve Functional Health in Underserved Community-Dwelling Older Adults.

Objective: Examine the effects of a 6-month health multidimensional intervention on physical function, bone density, and mood in a diverse sample of community-dwelling older adults at risk for frailty and excess disability.

Method: A quasi-experimental, pre- post-program design was implemented. Adults aged 55 years and older ( n = 337, 60% African American) participated in the intervention and received assessments at baseline, 6 months, and 12 months.

Cognitive Dysfunction, Medication Management, and the Risk of Readmission in Hospital Inpatients.

Objectives: To determine whether cognitive dysfunction, in particular impaired executive function, may be a risk factor for early readmission in older adults independently managing their medications.

Design: Prospective observational study.

Setting: Tertiary hospital.

The Nursing Home Falls Self-Efficacy Scale: development and testing.

We examined a brief measure of falls self-efficacy in nursing home residents participating in a pilot randomized controlled trial to study the effects of hip protectors on the prevention of fractures (N = 116, mean age 82 ± 8, 72% female). Internal consistency reliability was acceptable with Cronbach's alpha of .79.

Adherence to hip protectors and implications for U.S. long-term care settings.

Objectives: Determine nursing home characteristics related to adherence to use of a hip protector (HP) to prevent fracture; also describe adherence and related resident characteristics.

Design: A multicenter, randomized controlled trial of a HP in which adherence to wearing the HP was monitored by research staff 3 times a week for up to 21 months; data were collected by interviews and chart review.

Setting: Thirty-five nursing homes in Boston, St.

Vitamin D deficiency is associated with worse cognitive performance and lower bone density in older African Americans.

Background: Vitamin D deficiency is common in older adults and is more prevalent among persons with darker pigmented skin. The detrimental effects of vitamin D deficiency on the bone are widely known; however, recent data suggest that vitamin D deficiency may contribute to other disorders, including low mood, cognitive impairment, and impaired mobility.

Objective: The purpose of this study was to determine whether nonskeletal diseases such as depression, cognitive impairment, and physical disability, which have been associated with vitamin D deficiency, are more commonly seen in older African Americans.

Osteoporotic fractures: a brain or bone disease?

Osteoporosis is a skeletal disorder that predisposes individuals to increased risk of fracture. However, most osteoporotic fractures occur in women who do not meet criteria for osteoporosis. Hence, bone density, by itself, is a relatively poor predictor of fracture.

The Hip Impact Protection Project: design and methods.

Background: Nearly 340,000 hip fractures occur each year in the U.S. With current demographic trends, the number of hip fractures is expected to double at least in the next 40 years.

Hormone therapy and stroke.

Available biochemical and clinical data are sufficiently compelling to recommend low dose or transdermal hormone therapy for the management of menopausal symptoms when possible. Women initiating low dose or transdermal hormone therapy are not at increased risk of cardiovascular disease, stroke, venous thrombotic disease, and breast cancer. Evidence suggests that these outcomes are favorably affected by low-dose hormone therapy and persist with continuation of therapy.

Efficacy of a hip protector to prevent hip fracture in nursing home residents: the HIP PRO randomized controlled trial.

Context: Past studies of the efficacy of hip protectors to prevent hip fracture in nursing home residents have had conflicting results, possibly due to potential biases from clustered randomization designs and modest adherence to intervention.

Objective: To determine whether an energy-absorbing and energy-dispersing hip protector would reduce the risk of hip fracture when worn by nursing home residents.

Design, Setting, And Participants: Multicenter, randomized controlled clinical trial in which 37 nursing homes were randomly assigned to having residents wear a 1-sided hip protector on the left or right hip.

Vitamin D deficiency is associated with low mood and worse cognitive performance in older adults.

Background: Vitamin D deficiency is common in older adults and has been implicated in psychiatric and neurologic disorders. This study examined the relationship among vitamin D status, cognitive performance, mood, and physical performance in older adults.

Methods: A cross-sectional group of 80 participants, 40 with mild Alzheimer disease (AD) and 40 nondemented persons, were selected from a longitudinal study of memory and aging.

Prevention of osteoporotic fractures in the elderly.

Osteoporosis is a common and preventable disorder of the older adult skeleton that predisposes an individual to an increased risk of fracture, a major cause of disability in older adults. Most patients with osteoporosis have an identifiable cause of bone loss. Factors contributing to osteoporotic fractures are more often associated with disordered neuromuscular function affecting postural stability than disordered skeletal integrity.

The use of estrogen in older women.

The menopause is associated with a relatively abrupt decline in the ovarian production of estrogen that results in a state of estrogen deficiency. This estrogen deficiency state is associated with an accelerated expression of cardiovascular disease, osteoporosis, urogenital atrophy, dermal aging, an increased expression of colorectal cancer, an alteration in the expression of breast cancer that results in more malignant forms of the disease, and the loss of neurons from the brain that is associated with a more rapid decline in cognitive function, balance, and an earlier expression of Alzheimer's disease. Macular degeneration and cataract formation may be additional consequences of the estrogen deficiency state.

Prevention of brain aging and dementia.

The brain is subjected to multiple factors that result in damage to its cellular constituents, the neuron and supporting cells, and the neural networks that form the bases of cognitive ability. Like other systems, the brain has remarkable capacity to repair that damage and to adapt or compensate for the loss of neurons and the disruption of the neural architecture. Brain aging and dementia can be conceptualized as a balance between neuronal injury and repair.