JAMDA
Volume 9, Issue 7 , Pages 460-475 , September 2008

Clinical Update on Nursing Home Medicine: 2008

  • Barbara J. Messinger-Rapport, MD, PhD, FACP, CMD

      Affiliations

    • Cleveland Clinic, Section of Geriatric Medicine, Cleveland, OH
  • ,
  • David R. Thomas, MD, FACP, AGSF, GSAF, CMD

      Affiliations

    • Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO
  • ,
  • Julie K. Gammack, MD

      Affiliations

    • Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO
  • ,
  • John E. Morley, MB, BCh

      Affiliations

    • Division of Geriatric Medicine, Saint Louis University School of Medicine, St. Louis, MO
    • GRECC, St. Louis VAMC, St. Louis, MO
    • Corresponding Author InformationAddress correspondence to John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S. Grand Blvd., M238, St. Louis, MO 63104

References 

  1. Messinger-Rapport BJ, Morley JE, Thomas DR, Gammack JK. Intensive Session: New approaches to medical issues in long-term care. J Am Med Dir Assoc. 2007;8:421–433
  2. Morley JE. Weight loss in the nursing home. J Am Med Dir Assoc. 2007;8:201–204
  3. Aoyama L, Weintraub N, Reuben DB. Is weight loss in the nursing home a reversible problem?. J Am Med Dir Assoc. 2006;7:S66–S72
  4. Kalantar-Zadeh K, Horich TB, Oreopoulos A, et al. Risk factor paradox in wasting diseases. Curr Opin Nutr Metab Care. 2007;10:433–442
  5. Morley JE, Thomas DR, Wilson MM. Cachexia: Pathophysiology and clinical relevance. Am J Clin Nutr. 2006;83:735–743
  6. Morley JE, Thomas DR. Cachexia: New advances in the management of wasting diseases. J Am Med Dir Assoc. 2008;9:205–210
  7. Morley JE, Perry HM, Miller DK. Editorial: Something about frailty. J Gerontol A Biol Sci Med Sci. 2002;57:M698–M704
  8. Bergman H, Ferrucci L, Guralnik J, et al. Frailty: An emerging research and clinical paradigm-issues and controversies. J Gerontol A Biol Sci Med Sci. 2007;62:731–737
  9. Abellan van Kan G, Rolland YM, Morley JE, Vellas B. Frailty: Toward a clinical definition. J Am Med Dir Assoc. 2008;9:71–72
  10. Fried LP, Ferrucci L, Darer J, et al. Untangling the concepts of disability, frailty, and comorbidity: Implications for improved targeting and care. J Gerontol A Biol Sci Med Sci. 2004;59:255–263
  11. Rockwood K, Abeysundera MJ, Mitnitski A. How should we grade frailty in nursing home patients?. J Am Med Dir Assoc. 2007;8:595–603
  12. Aggellan van Kan G, Rolland Y, Bergman H, et al. The I.A.N.A. Task Force on frailty assessment of older people in clinical practice. J Nutr Health Aging. 2008;12:29–37
  13. Morley JE, Kim MJ, Haren MT, et al. Frailty and the aging male. Aging Male. 2005;8:135–140
  14. Bartali B, Frongillo EA, Bandinelli S, et al. Low nutrient intake is an essential component of frailty in older persons. J Gerontol A Biol Sci Med Sci. 2006;61:589–593
  15. Semba RD, Bartali B, Zhou J, et al. Low serum micronutrient concentrations predict frailty among older women living in the community. J Gerontol A Biol Sci Med Sci. 2006;61:594–599
  16. Khaw KT, Wareham N, Bingham S, et al. Combined impact of health behaviours and mortality in men and women: The EPIC-Norfolk prospective population study. PLoS Med. 2008;5:e12
  17. Morley JE. Weight loss in older persons: New therapeutic approaches. Curr Pharm Des. 2007;13:3637–3647
  18. Morley JE, Silver AJ. Nutritional issues in nursing home care. Ann Intern Med. 1995;123:850–859
  19. Wilson MM, Thomas DR, Rubenstein LZ, et al. Appetite assessment: Simple appetite questionnaire predicts weight loss in community-dwelling adults and nursing home residents. Am J Clin Nutr. 2005;82:1074–1081
  20. Vellas B, Villars H, Abellan G, et al. Overview of the MNA—Its history and challenges. J Nutr Health Aging. 2006;10:456–463
  21. Thakur M, Blazer DG. Depression in long-term care. J Am Med Dir Assoc. 2008;9:82–87
  22. Cabrera MA, Mesas AE, Garcia AR, de Andrade SM. Malnutrition and depression among community-dwelling elderly people. J Am Med Dir Assoc. 2007;8:582–584
  23. Morley JE, Kraenzle D. Causes of weight loss in a community nursing home. J Am Geriatr Soc. 1994;42:583–585
  24. Finucane TE, Christmas C, Leff BA. Tube feeding in dementia: How incentives undermine health care quality and patient safety. J Am Med Dir Assoc. 2007;8:205–208
  25. Morley JE, Baumgartner RN, Roubenoff R, et al. Sarcopenia. J Lab Clin Med. 2001;137:231–243
  26. Morley JE. Anorexia, sarcopenia and aging. Nutrition. 2001;17:660–663
  27. Candow DG, Chilibeck PD. Effect of creatine supplementation during resistance training on muscle accretion in the elderly. J Nutr Health Aging. 2007;11:185–188
  28. Nieschlag E, Swerdloff R, Behre HM, et al. Investigation, treatment and monitoring of late-onset hypogonadism in males. Aging Male. 2005;8:56–58
  29. Wittert GA, Chapman IM, Haren MT, et al. Oral testosterone supplementation increases muscle and decreases fat mass in healthy elderly males with low-normal gonadal status. J Gerontol A BIol Sci Med Sci. 2003;58:618–625
  30. Morley JE. Androgens and aging. Maturitas. 2001;38:61–71
  31. Matsumoto AM. Andropause: Clinical implications of the decline in serum testosterone levels with aging in men. J Gerontol A Biol Sci Med Sci. 2002;57:M76–M99
  32. Yeh SS, Lovitt S, Schuster MW. Pharmacological treatment of geriatric cachexia: Evidence and safety in perspective. J Am Med Dir Assoc. 2007;8:363–377
  33. Yeh SS, Blackwood K, Schuster MW. The cytokine basis of cachexia and its treatment: Are they ready for prime time?. J Am Med Dir Assoc. 2008;9:219–236
  34. Thomas DR, Cote TR, Lawhorne L, et al. Understanding clinical dehydration and its treatments. J Am Med Dir Assoc. 2008;9:292–301
  35. Crecelius C. Dehydration: Myth and reality. J Am Med Dir Assoc. 2008;9:287–288
  36. Miller M, Morley JE, Rubenstein LZ. Hyponatremia in a nursing home population. J Am Geriatr Soc. 1995;43:1410–1413
  37. Kakor P, Watson T, Lip GYH. New approaches to therapy with omega-3 fatty acids. Curr Atherosclerosis Reports. 2008;10:79–87
  38. Kromhout D, Bosschieter EB, de Lezenne Coulander C. The inverse relation between fish consumption and 20-year mortality from coronary heart disease. N Engl J Med 2985;312:1205–1209.
  39. Kromhout D, Feskens EJ, Bowles CH. The protective effect of a small amount of fish on coronary heart disease mortality in an elderly population. Int J Epidemiol. 1995;24:341–345
  40. Simon JA, Fong J, Bernert JT, Browner WS. Serum fatty acids and the risk of stroke. Stroke. 1995;26:778–782
  41. Zhang J, Sasaki S, Amano K, Kestleloot H. Fish consumption and mortality from all causes, ischemic heart disease, and stroke: An ecological study. Prev Med. 1999;28:520–529
  42. Hu FB, Bronner L, Willett WC, et al. Fish and omega-3 fatty acid intake and risk of coronary heart disease in women. JAMA. 2002;287:1815–1821
  43. Yokoyama M, Origasa H JELIS Investigators. Effects of eicosapentaenoic acid on cardiovascular events in Japanese patients with hypercholesterolemia: rationale, design, and baseline characteristics of the Japan EPA Lipid Intervention Study (JELIS). Am Heart J. 2003;146:613–620
  44. Marchioli R, Barzi F, Bomba E, et al. GISSI-Prevenzione Investigators: Early protection against sudden death by n-3 polyunsaturated fatty acids after myocardial infarction: Time-course analysis of the results of the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto Miocardico (GISSI)-Prevenzione. Circulation. 2002;105:1897–1903
  45. Barr ML, Fehily AM, Gilbert JF, et al. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: Diet and reinfarction Trial (DART). Lancet. 1989;2:757–761
  46. Singh RB, Niaz MA, Sharma JP, et al. Randomized double-blind, placebo-controlled trial of fish oil and mustard oil in patients with suspected acute myocardial infarction: The Indian experiment of infarct survival-4. Cardiovasc Drugs Ther. 1997;11:485–491
  47. Freund-Levi Y, Eriksdotter-Jonhagen M, Cederholm T, et al. Omega-3 fatty acid treatment in 174 patients with mild to moderate Alzheimer disease: OmegaAD study: A randomized double-blind trial. Arch Neurol. 2006;63:1402–1408
  48. Flaherty JH, Rudolph J, Shay K, et al. Delirium is a serious and under-recognized problem: why assessment of mental status should be the sixth vital sign. J Am Med Dir Assoc. 2007;8:273–275
  49. Eeles E, Rockwood K. Delirium in the long-term care setting: Clinical and research challenges. J Am Med Dir Assoc. 2008;9:157–161
  50. Lyons WL. Delirium in postacute and long-term care. J Am Med Dir Assoc. 2006;7:254–261
  51. Espino DV, Jules-Bradley AC, Johnston CL, Mouton CP. Diagnostic approach to the confused elderly patient. Am Fam Physician. 1998;57:1358–1366
  52. Lee J, Monette J, Sourial N, et al. The use of a cholinesterase inhibitor review committee in long-term care. J Am Med Dir Assoc. 2007;8:243–247
  53. Morley JE. Managing persons with dementia in the nursing home: High touch trumps high tech. J Am Med Dir Assoc. 2008;9:139–146
  54. Banks WA, Morley JE. Memories are made of this: Recent advances in understanding cognitive impairments and dementia. J Gerontol A Biol Sci Med Sci. 2003;58:314–321
  55. Belgeri M, Morley JE. A step back in time: Is there a place for older drugs in the treatment of dementia?. J Gerontol A Biol Sci Med Sci. 2004;59:1025–1028
  56. Hui EK, Rubenstein LZ. Promoting physical activity and exercise in older adults. J Am Med Dir Assoc. 2006;7:310–314
  57. Andel R, Crowe M, Pedersen NL, et al. Physical exercise at midlife and risk of dementia three decades later: A population-based study of Swedish twins. J Gerontol A Biol Sci Med Sci. 2008;63:62–66
  58. Raina P, Santaguida P, Ismaila A, et al. Effectiveness of cholinesterase inhibitors and memantine for treating dementia: Evidence review for a clinical practice guideline. Ann Intern Med. 2008;148:379–397
  59. Rolland Y, Pillard F, Klapouszczak A, et al. Exercise program for nursing home residents with Alzheimer's disease: A 1-year randomized, controlled trial. J Am Geriatr Soc. 2007;55:158–165
  60. Heyn PC, Johnson KE, Kramer AF. Endurance and strength training outcomes on cognitively impaired and cognitively intact older adults: a meta-analysis. J Nutr Health Aging. 2008;12:401–409
  61. Williams CL, Tappen RM. Exercise training for depressed older adults with Alzheimer's disease. Aging Ment Health. 2008;12:72–80
  62. Volicer L, Simard J, Pupa JH, et al. Effects of continuous activity programming on behavioral symptoms of dementia. J Am Med Dir Assoc. 2006;7:426–431
  63. Resnick HE, Heineman J, Stone R, Shorr RI. Diabetes in U.S. Nursing homes, 2004. Diabetes Care. 2008;31:287–288
  64. Morley JE. Diabetes mellitus: a major disease of older persons. J Gerontol A Biol Sci Med Sci. 2000;55:M255–M256
  65. Rodriguez-Saldana J, Morley JE, Reynoso MT, et al. Diabetes mellitus in a subgroup of older Mexicans: Prevalence, association with cardiovascular risk factors, functional and cognitive impairment, and mortality. J Am Geriatr Soc. 2002;50:111–116
  66. Miller DK, Lui LY, Perry HM, et al. Reported and measured physical functioning in older inner-city diabetic African Americans. J Gerontol A Biol Sci Med Sci. 1999;54:M230–M236
  67. Morley GK, Mooradian AD, Levine AS, Morley JE. Mechanism of pain in diabetic peripheral neuropathy (Effect of glucose on pain perception in humans). Am J Med. 1984;77:79–82
  68. Kim MJ, Rolland Y, Cepeda O, et al. Diabetes mellitus in older men. Aging Male. 2006;9:139–147
  69. Mooradian AD, Morley JE. Micronutrient status in diabetes mellitus. Am J Clin Nutr. 1987;45:877–895
  70. Morley JE. An overview of diabetes mellitus in older persons. Clin Geriatr Med. 1999;15:211–224
  71. Morley JE. The elderly Type 2 diabetic patient: Special considerations. Diabet Med. 1998;15:S41–S46
  72. Morley JE. Falls—where do we stand?. Mo Med. 2007;104:63–67
  73. Grodstein F, Chen J, Wilson RS, Manson JE. Nurses' Health Study (Type 2 diabetes and cognitive function in community-dwelling elderly women). Diabetes Care. 2001;24:1060–1065
  74. Ziegler D. Treatment of diabetic neuropathy and neuropathic pain: How far have we come?. Diabetes Care. 2008;31:S255–S261
  75. Ziegler D, Hanefeld M, Ruhnau KJ, et al. Treatment of symptomatic diabetic peripheral neuropathy with the antioxidant alpha-lipoic acid (A 3-week multicentre randomized controlled trial (ALADIN Study)). Diabetologia. 1994;38:1425–1433
  76. Jin HY, Joung SJ, Park JH, et al. The effect of alpha-lipoic acid on symptoms and skin blood flow in diabetic neuropathy. Diabet Med. 2007;24:1034–1038
  77. Donofrio PD, Raskin P, Rosenthal NR, et al. Safety and effectiveness of topiramate for the management of painful diabetic peripheral neuropathy in an open-label extension study. Clin Ther. 2005;27:1420–1431
  78. Mascitelli L, Pezzetta F. Diabetes and osteoporotic fractures. CMAJ. 2007;177:1391–1392
  79. Strotmeyer ES, Cauley JA. Diabetes mellitus, bone mineral density, and fracture risk. Curr Opin Endocrinol Diabetes Obes. 2007;14:429–435
  80. Patel S, Hyer S, Tweed K, et al. Risk factors and falls in older women with type 2 diabetes mellitus. Calcif Tissue Int. 2008;82:87–91
  81. Epstein S, Leroith D. Diabetes and fragility fractures—a burgeoning epidemic?. Bone. 2008;43:3–6
  82. Nelson JM, Dufraux K, Cook PF. The relationship between glycemic control and falls in older adults. J Am Geriatr Soc. 2007;55:2041–2044
  83. Berlowitz DR, Brandeis GH, Morris JN, et al. Deriving a risk-adjustment model for pressure ulcer development using the Minimum Data Set. J Am Geriatr Soc. 2001;49:866–871
  84. Brandeis GH, Ooi WL, Hossain M, et al. A longitudinal study of risk factors associated with the formation of pressure ulcers in nursing homes. J Am Geriatr Soc. 1994;42:388–393
  85. Spector WD. Correlates of pressure sores in nursing homes: Evidence from the National Medical Expenditure Survey. J Invest Dermatol. 1994;102:42S–45S
  86. Rosenthal MJ, Fajardo M, Gilmore S, et al. Hospitalization and mortality of diabetes in older adults (A 3-year prospective study). Diabetes Care. 1998;21:231–235
  87. Meyers RM, Broton JC, Woo-Rippe KW, et al. Variability in glycosylated hemoglobin values in diabetic patients living in long-term care facilities. J Am Med Dir Assoc. 2007;8:511–514
  88. Joseph J, Koka M, Aronow WS. Prevalence of hemoglobin A1C less than 7.0%, of a blood pressure less than 130/80 mm Hg, and of a serum low-density lipoprotein cholesterol less than 100 mg/dL in older patients with diabetes mellitus in an academic nursing home. J Am Med Dir Assoc. 2008;9:51–54
  89. Rizvi AA. Management of diabetes in older adults. Am J Med Sci. 2007;333:35–47
  90. Holt RM, Schwartz FL, Fhubrook JH. Diabetes care in extended-care facilities: Appropriate intensity of care? Diabetes Care 1007;30:1454–1458.
  91. Haas LB. Optimizing insulin use in type 2 diabetes: Role of basal and prandial insulin in long-term care facilities. J Am Med Dir Assoc. 2007;8:502–510
  92. Mazza AD, Morley JE. Update on diabetes in the elderly and the application of current therapeutics. J Am Med Dir Assoc. 2007;8:489–492
  93. Zarowitz BJ, Tangalos EG, Hollenack K, O'Shea T. The application of evidence-based principles of care in older persons (issue 3): Management of diabetes mellitus. J Am Med Dir Assoc. 2006;7:234–240
  94. Colberg SR, Somma CT, Sechrist SR. Physical activity participation may offset some of the negative impact of diabetes on cognitive function. J Am Med Dir Assoc. 2008;9:434–438
  95. Wedick NM, Barrett-Connor E, Knoke JD, Wingard DL. The relationship between weight loss and all-cause mortality in older men and women with and without diabetes mellitus: The Rancho Bernardo study. J Am Geriatr Soc. 2002;50:1810–1815
  96. Tariq SH, Karcic E, Thomas DR, et al. The use of a no-concentrated-sweets diet in the management of type 2 diabetes in nursing homes. J Am Diet Assoc. 2001;101:1463–1466
  97. Coulston AM, Mandelbaum D, Reaven GM. Dietary management of nursing home residents with non-insulin-dependent diabetes mellitus. Am J Clin Nutr. 1990;51:67–71
  98. Parkner T, Laursen T, Vestergaard ET, et al. Insulin and glucose profiles during continuous subcutaneous insulin infusion compared with injection of a long-acting insulin in Type 2 diabetes. Diabet Med. 2008;25:585–591
  99. Schiel R, Muller UA. Efficacy and treatment satisfaction of once-daily insulin glargine plus one or two oral antidiabetic agents versus continuing premixed human insulin in patients with type 2 diabetes previously on long-term conventional insulin therapy: The Switch pilot study. Exp Clin Endocrinol Diabetes. 2007;115:627–633
  100. Fulcher GR, Gilbert RE, Yue DK. Glargine is superior to neutral protamine Hagedorn for improving glycated haemoglobin and fasting blood glucose levels during intensive insulin therapy. Intern Med J. 2005;35:536–542
  101. Diabetes Prevention Program Research GroupCrandall J, Schade D, et al. The influence of age on the effects of lifestyle modification and metformin in prevention of diabetes. J Gerontol A Biol Sci Med Sci. 2006;61:1075–1081
  102. Lee A, Morley JE. Metformin decreases food consumption and induces weight loss in subjects with obesity with type II non-insulin-dependent diabetes. Obes Res. 1998;6:47–53
  103. Kumar VB, Bernardo AE, Vyas K, et al. Effect of metformin on nitric oxide synthase in genetically obese (ob/ob) mice. Life Sci. 2001;69:2789–2799
  104. Lipscombe LL, Gomes T, Levesque LE, et al. Thiazolidinediones and cardiovascular outcomes in older patients with diabetes. JAMA. 2007;298:2634–2643
  105. Singh S, Loke YK, Furberg CD. Long-term risk of cardiovascular events with rosiglitazone: A meta-analysis. JAMA. 2007;298:1189–1195
  106. Meier C, Kraenzlin ME, Bodmer M, et al. Use of thiazolidinediones and fracture risk. Arch Intern Med. 2008;168:820–825
  107. Benvenuti S, Cellai I, Luciani P, et al. Rosiglitazone stimulates adipogenesis and decreases osteoblastogenesis in human mesenchymal stem cells. J Endocrinol Invest. 2007;30:RC26–RC30
  108. Lee A, Patrick P, Wishart J, et al. The effects of miglitol on glucagon-like peptide-1 secretion and appetite sensations in obese type 2 diabetics. Diabetes Obes Metab. 2002;4:329–335
  109. van de Laar FA, Lucassen PL, Akkermans RP, et al. Alpha-glucosidase inhibitors for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005;18:CD003639
  110. Morley JE. Postprandial hypotension—the ultimate Big Mac attack. J Gerontol A Biol Sci Med Sci. 2001;56:M744–M748
  111. Morley JE. The aging gut: Physiology. Clin Geriatr Med. 2007;23:757–767
  112. Fisher AA, Davis MW, Srikusalanukul W, Budge MM. Postprandial hypotension predicts all-cause mortality in older, low-level care residents. J Am Geriatr Soc. 2005;53:1313–1320
  113. Edwards BJ, Perry HM, Kaiser FE, et al. Relationship of age and calcitonin gene-related peptide to postprandial hypotension. Mech Ageing Dev. 1996;87:61–73
  114. Shibao C, Gamboa A, Diedrich A, et al. Acarbose, an alpha-glucosidase inhibitor, attenuates postprandial hypotension in autonomic failure. Hypertension. 2007;50:54–61
  115. Gentilcore D, Bryant B, Wishart JM, et al. Acarbose attenuates the hypotensive response to sucrose and slows gastric emptying in the elderly. Am J Med. 2005;118:1289
  116. Sasaki E, Goda K, Nagata K, et al. Acarbose improved severe postprandial hypotension in a patient with diabetes mellitus. J Diabetes Complications. 2001;15:158–161
  117. Pham DQ, Nogid A, Plakogiannis R. Sitagliptin: A novel agent for the management of type 2 diabetes mellitus. Am J Health Syst Pharm. 2008;65:521–531
  118. Gaede P, Lund-Andersen H, Parving HH, Pedersen O. Effect of a multifactorial intervention on mortality in type 2 diabetes. N Engl J Med. 2008;358:580–591
  119. American Diabetes Association. Statement from the American Diabetes Association related to the ADVANCE Study Announcement. http://www.diabetes.org/for-media/pr-statement-advance-study-021308.jspAccessed May 21, 2008
  120. American Diabetes Association. Statement from the American Diabetes Association related to the ACCORD Trial Announcement. http://www.diabetes.org/for-media/pr-ada-statement-related-to-accord-trail-announcement-020608.jspAccessed May 21, 2008
  121. Negoro H, Morley JE, Rosenthal MJ. Utility of serum fructosamine as a measure of glycemia in young and old diabetic and non-diabetic subjects. Am J Med. 1988;85:360–364
  122. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001;285(19):2486–2497
  123. Grundy SM, Cleeman JI, Merz CNB, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. Circulation. 2004;110(2):227–239
  124. American Diabetes Association. Standards of medical care in diabetes—2008. Diabetes Care. 2008;31:S12–S54
  125. Afilalo J, Duque G, Steele R, et al. Statins for secondary prevention in elderly patients. J Am Coll Cardiol. 2008;51:37–45
  126. Young-Xu Y, Jabbour S, Goldberg R, et al. Usefulness of statin drugs in protecting against atrial fibrillation in patients with coronary artery disease. Am J Cardiol. 2003;92:1379–1383
  127. Kjekshus J, Pedersen T, Olsson A, et al. The effects of simvastatin on the incidence of heart failure in patients with coronary heart disease. J Card Fail. 1997;3:249–254
  128. Shepherd J, Blauw GJ, Murphy MB, et al. Pravastatin in elderly individuals at risk of vascular disease (PROSPER): A randomised controlled trial. Lancet. 2002;360:1623–1630
  129. Allen Maycock CA, Muhlestein JB, Horne BD, et al. Statin therapy is associated with reduced mortality across all age groups of individuals with significant coronary disease, including very elderly patients. J Am Coll Cardiol. 2002;40(10):1777–1785
  130. Kashani A, Phillips CO, Foody JM, et al. Risks associated with statin therapy: A systematic overview of randomized clinical trials. Circulation. 2006;114(25):2788–2797
  131. Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: Prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005;366:1267–1278
  132. LaRosa JC, Grundy SM, Waters DD, et al. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med. 2005;352:1425–1435
  133. Waters DD, LaRosa JC, Barter P, et al. Effects of high-dose atorvastatin on cerebrovascular events in patients with stable coronary disease in the TNT (treating to new targets) study. J Am Coll Cardiol. 2006;48:1793–1799
  134. Serruys PWJC, de Feyter P, Macaya C, et al. Fluvastatin for prevention of cardiac events following successful first percutaneous coronary intervention: A randomized controlled trial. JAMA. 2002;287:3215–3222
  135. Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: The Scandinavian Simvastatin Survival Study (4S). Lancet. 1994;344:1383–1389
  136. Ridker PM, Cannon CP, Morrow D, et al. C-reactive protein levels and outcomes after statin therapy. N Engl J Med. 2005;352:20–28
  137. Kastelein JJP, Akdim F, Stroes ESG, et al. Simvastatin with or without ezetimibe in familial hypercholesterolemia. N Engl J Med. 2008;358:1431–1443
  138. Canner PL, Berge KG, Wenger NK, et al. Fifteen year mortality in Coronary Drug Project patients: Long-term benefit with niacin. J Am Coll Cardiol. 1986;8:1245–1255
  139. Keech A, Simes RJ, Barter P, et al. Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): Randomised controlled trial. Lancet. 2005;366:1849–1861
  140. Ginsberg H, Bonds D, Lovato L, et al. Evolution of the Lipid Trial Protocol of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial. Am J Cardiol. 2007;99:S56–S67
  141. Bays H. Effects of colesevelam hydrochloride on low-density lipoprotein cholesterol and high-sensitivity C-reactive protein when added to statins in patients with hypercholesterolemia. Am J Cardiol. 2006;97:1198–1205
  142. Mozaffarian D, Rimm EB. Fish intake, contaminants, and human health: Evaluating the risks and the benefits. JAMA. 2006;296:1885–1899
  143. Wang C, Harris WS, Chung M, et al. n-3 Fatty acids from fish or fish-oil supplements, but not alpha-linolenic acid, benefit cardiovascular disease outcomes in primary- and secondary-prevention studies: A systematic review. Am J Clin Nutr. 2006;84:5–17
  144. Hooper L, Thompson RL, Harrison RA, et al. Omega 3 fatty acids for prevention and treatment of cardiovascular disease. Cochrane Database Syst Rev. 2004;(4):CD003177
  145. Yokoyama M, Origasa H, Matsuzaki M, et al. Effects of eicosapentaenoic acid on major coronary events in hypercholesterolaemic patients (JELIS): A randomised open-label, blinded endpoint analysis. Lancet. 2007;369:1090–1098
  146. Krishna R, Anderson MS, Bergman AJ, et al. Effect of the cholesteryl ester transfer protein inhibitor, anacetrapib, on lipoproteins in patients with dyslipidaemia and on 24-h ambulatory blood pressure in healthy individuals: Two double-blind, randomised placebo-controlled phase I studies. Lancet. 2007;370:1907–1914
  147. Roberts CG, Guallar E, Rodriguez A. Efficacy and safety of statin monotherapy in older adults: A meta-analysis. J Gerontol A Biol Sci Med Sci. 2007;62:879–887
  148. Nybo H, Petersen HC, Gaist D, et al. Predictors of mortality in 2,249 nonagenarians—the Danish 1905-Cohort Survey. J Am Geriatr Soc. 2003;51:1365–1373
  149. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 Report. JAMA. 2003;289:2560–2571
  150. Lip GY, Lip PL, Zarifis J, et al. Fibrin D-dimer and beta-thromboglobulin as markers of thrombogenesis and platelet activation in atrial fibrillation (Effects of introducing ultra-low-dose warfarin and aspirin). [see comments] Circulation. 1996;94:425–431
  151. Anonymous Prevention of stroke by antihypertensive drug treatment in older persons with isolated systolic hypertension (Final results of the Systolic Hypertension in the Elderly Program (SHEP). SHEP Cooperative Research Group). JAMA. 1991;265:3255–3264
  152. Staessen JA, Fagard R, Thijs L, et al. Randomised double-blind comparison of placebo and active treatment for older patients with isolated systolic hypertension (The Systolic Hypertension in Europe (Syst-Eur) Trial Investigators). Lancet. 1997;350:757–764
  153. Bulpitt C, Fletcher A, Beckett N, et al. Hypertension in the Very Elderly Trial (HYVET): Protocol for the main trial. Drugs Aging. 2001;18:151–164
  154. Bulpitt CJ, Beckett NS, Cooke J, et al. Results of the pilot study for the Hypertension in the Very Elderly Trial. J Hypertens. 2003;21:2409–2417
  155. Beckett NS, Peters R, Fletcher AE, et al. Treatment of hypertension in patients 80 years of age or older. N Engl J Med. 2008;358:1887–1898
  156. Forette F, Seux ML, Staessen JA, et al. Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial. Lancet. 1998;352:1347–1351
  157. van Dijk EJ, Breteler MM, Schmidt R, et al. The association between blood pressure, hypertension, and cerebral white matter lesions: Cardiovascular determinants of dementia study. Hypertension. 2004;44:625–630
  158. Dufouil C, Chalmers J, Coskun O, et al. Effects of blood pressure lowering on cerebral white matter hyperintensities in patients with stroke: The PROGRESS (Perindopril Protection Against Recurrent Stroke Study) Magnetic Resonance Imaging Substudy. Circulation. 2005;112:1644–1650
  159. Soderlund H, Nilsson LG, Berger K, et al. Cerebral changes on MRI and cognitive function: The CASCADE study. Neurobiol Aging. 2006;27:16–23
  160. Steffens DC, Potter GG, McQuoid DR, et al. Longitudinal magnetic resonance imaging vascular changes, apolipoprotein E genotype, and development of dementia in the neurocognitive outcomes of depression in the elderly study. Am J Geriatr Psychiatry. 2007;15:839–849
  161. Tzourio C. Vascular factors and cognition: Toward a prevention of dementia?. J Hypertens Supplement. 2003;21:S15–S19
  162. Sumukadas D, Witham MD, Struthers AD, McMurdo ME. Effect of perindopril on physical function in elderly people with functional impairment: A randomized controlled trial. CMAJ. 2007;177:867–874
  163. Fagard RH, Staessen JA, Thijs L, et al. Response to antihypertensive therapy in older patients with sustained and nonsustained systolic hypertension (Systolic Hypertension in Europe (Syst-Eur) Trial Investigators). Circulation. 2000;102:1139–1144
  164. Somes G, Pahor M, Shorr R, et al. The role of diastolic blood pressure when treating isolated systolic hypertension. Arch of Intern Med. 1999;159:2004–2009
  165. Fagard RH, Staessen JA, Thijs L, et al. On-treatment diastolic blood pressure and prognosis in systolic hypertension. Arch Intern Med. 2007;167:1884–1891
  166. Fletcher AE, Bulpitt CJ, Thijs L, et al. Quality of life on randomized treatment for isolated systolic hypertension: Results from the Syst-Eur Trial. J Hypertens. 2002;20:2069–2079
  167. ALLHAT Collaborative Research Group. Major cardiovascular events in hypertensive patients randomized to doxazosin vs chlorthalidone: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2000;283:1967–1975
  168. The ALLHAT Officers and Coordinators for the ALLHAT Collaborative Research Group. Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT). JAMA. 2002;288:2981–2997
  169. Messerli FH, Grossman E, Goldbourt U. Are beta-blockers efficacious as first-line therapy for hypertension in the elderly? (A systematic review). JAMA. 1998;279:1903–1907
  170. Golomb BA, Dimsdale JE, White HL, et al. Reduction in blood pressure with statins: Results from the UCSD Statin Study, a randomized trial. Arch Intern Med. 2008;168:721–727
  171. Strandberg TE, Pitkala KH, Berglind S, et al. Multifactorial intervention to prevent recurrent cardiovascular events in patients 75 years or older: The Drugs and Evidence-Based Medicine in the Elderly (DEBATE) study: A randomized, controlled trial. Am Heart J. 2006;152:585–592
  172. Flaherty JH, Morley JE, Murphy DJ, Wasserman MR. The development of outpatient Clinical Glidepaths. J Am Geriatr Soc. 2002;50:1886–1901
  173. Morley JE. Caring for the vulnerable elderly: Are available quality indicators appropriate. J Am Med Dir Assoc. 2008;9:1–3
  174. Levenson SA, Morley JE. Evidence rocks in long-term care, but does it roll?. J Am Med Dir Assoc. 2007;8:493–501
  175. Koka M, Joseph J, Aronow WS. Adequacy of control of hypertension in an academic nursing home. J Am Med Dir Assoc. 2007;8:538–540
  176. Aronow WS. Drug therapy of older persons with hypertension. J Am Med Dir Assoc. 2006;7:193–196
  177. Joseph J, Koka M, Aronow WS. Prevalence of use of antiplatelet drugs, beta blockers, statins, and angiotensin-converting enzyme inhibitors or angiotensin receptor blockers in older patients with coronary artery disease in an academic nursing home. J Am Med Dir Assoc. 2008;9:124–127
  178. Joseph J, Koka M, Aronow WS. Prevalence of a hemoglobin A1C less than 7.0%, of a blood pressure less than 130/80 mm Hg, and of a serum low-density lipoprotein cholesterol less than 10 mg/dL in older patients with diabetes mellitus in an academic nursing home. J Am Med Dir Assoc. 2008;9:51–54
  179. Koka M, Joseph J, Aronow WS. Prevalence of adequate and of optimal control of serum low-density lipoprotein cholesterol in an academic nursing home. J Am Med Dir Assoc. 2007;8:604–606
  180. Roberts CG, Guallar E, Rodriquez A. Efficacy and safety of statin monotherapy in older adults: a meta-analysis. J Gerontol A Biol Sci Med Sci. 2007;62:879–887
  181. Thomas DR. Management of pressure ulcers. J Am Med Dir Assoc. 2006;7:46–59
  182. Lynn J, West J, Hausmann S, et al. Collaborative clinical quality improvement for pressure ulcers in nursing homes. J Am Geriatr Soc. 2007;55:1663–1669
  183. Berlowitz DR, Brienza DM. Are all pressure ulcers the result of deep tissue injury? (A review of the literature). Ostomy Wound Manage. 2007;53:34–38
  184. Black J, Baharestani M, Cuddigan J, et al. National Pressure Ulcer Advisory Panel's updated pressure ulcer staging system. Dermatol Nurs. 2007;19:343–349
  185. Quintavalle PR, Lyder CH, Mertz PJ, et al. Use of high-resolution, high-frequency diagnostic ultrasound to investigate the pathogenesis of pressure ulcer development. Adv Skin Wound Care. 2006;19:498–505
  186. Thomas DR. The new F-tag 314: Prevention and management of pressure ulcers. J Am Med Dir Assoc. 2006;7:523–531
  187. Thomas DR, Osterweil D. Is a pressure ulcer a marker for quality of care?. J Am Med Dir Assoc. 2005;6:228–229
  188. Abel RL, Warren K, Bean G, et al. Quality improvement in nursing homes in Texas: Results from a pressure ulcer prevention project. J Am Med Dir Assoc. 2005;6:181–188
  189. Reddy M, Gill SS, Rochon PA. Preventing pressure ulcers: A systematic review. JAMA. 2006;296:974–984
  190. Bourdel-Marchasson I, Barateau M, Rondeau V, et al. A multi-center trial of the effects of oral nutritional supplementation in critically ill older inpatients (GAGE Group. Groupe Aquitain Geriatrique d'Evaluation). Nutrition. 2000;16(1):1–5
  191. Defloor T, Grypdonck MF. Validation of pressure ulcer risk assessment scales: A critique. J Adv Nurs. 2004;48:613–621
  192. Vanderwee K, Grypdonck M, Defloor T, et al. Non-blanchable erythema as an indicator for the need for pressure ulcer prevention: a randomized-controlled trial. J Clin Nurs. 2007;16:325–335
  193. DeFloor T, De Bacquer D, Grypdonck MH, et al. The effect of various combinations of turning and pressure reducing devices on the incidence of pressure ulcers. Int J Nurs Stud. 2005;42:37–46
  194. Vanderwee K, Grypdonck MH, De Bacquer D, Defloor T, et al. Effectiveness of turning with unequal time intervals on the incidence of pressure ulcer lesions. J Adv Nurs. 2006;57:59–68
  195. Thomas DR. Physicians Information Education Resource, American College of Physicians. www.acponline.org/clinical_information/journals_publications/acp_internist/jul-aug07/special.htmAccessed August 4, 2008
  196. Bouza C, Saz Z, Munoz A, Amate J. Efficacy of advanced dressings in the treatment of pressure ulcers: A systematic review. J Wound Care. 2005;14:193
  197. Jones KR, Fennie K. Factors influencing pressure ulcer healing in adults over 50: An exploratory study. J Am Med Dir Assoc. 2007;8:378–387
  198. Thomas DR. Managing pressure ulcers: Learning to give up cherished dogma. J Am Med Dir Assoc. 2007;8:347–348
  199. Petty TL. COPD in perspective. Chest. 2002;121:116S–120S
  200. Barnes PJ. New therapies for chronic obstructive pulmonary disease. Thorax. 1998;53:137–147
  201. Vestbo J, Hogg JC. Convergence of the epidemiology and pathology of COPD. Thorax. 2006;61:86–88
  202. Anthonisen NR, Connett JE, Murray RP. Smoking and lung function of Lung Health Study participants after 11 years. Am J Respir Crit Care Med. 2002;166:675–679
  203. Barr RG, Bourbeau J, Camargo CA, Ram FS. Inhaled tiotropium for stable chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2005;(2):CD002876
  204. Brusasco V, Hodder R, Miravitlles M, et al. Health outcomes following treatment for six months with once daily tiotropium compared with twice daily salmeterol in patients with COPD. Thorax. 2003;58:399–404
  205. Sin DD, McAlister FA, Man SF, Anthonisen NR. Contemporary management of chronic obstructive pulmonary disease: Scientific review. JAMA. 2003;290:2301–2312
  206. Groenewegen KH, Schols AM, Wouters EF. Mortality and mortality-related factors after hospitalization for acute exacerbation of COPD. Chest. 2003;124:459–467
  207. Sapey E, Stockley RA. COPD exacerbations (2: Aetiology). Thorax. 2006;61:250–258
  208. Murphy TF, Brauer AL, Schiffmacher AT, Sethi S. Persistent colonization by Haemophilus influenzae in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2004;170:266–272
  209. O'Driscoll BR, Kay EA, Taylor RJ, et al. A long-term prospective assessment of home nebulizer treatment. Respir Med. 1992;86:317–325
  210. Calverley P, Pauwels R, Vestbo J, et al. Trial of inhaled steroids and long-acting beta2 agonists study group Combined salmeterol and fluticasone in the treatment of chronic obstructive pulmonary disease: A randomised controlled trial. Lancet. 2003;361:449–456
  211. Burge PS, Calverley PM, Jones PW, et al. Prednisolone response in patients with chronic obstructive pulmonary disease: Results from the ISOLDE study. Thorax. 2003;58:654–658
  212. Decramer M, Gosselink R, Bartsch P, et al. Effect of treatments on the progression of COPD: Report of a workshop held in Leuven, 11–12 March 2004. Thorax. 2005;60:343–649
  213. Kamel HK, Hussain MS, Tariq S, et al. Failure to diagnose and treat osteoporosis in elderly patients hospitalized with hip fracture. Am J Med. 2000;109:326–328
  214. Gloth FM, Simonson W. Osteoporosis is underdiagnosed in skilled nursing facilities: A large-scale heel BMD screening study. J Am Med Dir Assoc. 2008;9:190–193
  215. Zylstra RG, Porter LL, Shapiro JL, Prater CD. Prevalence of osteoporosis in community-dwelling individuals with intellectual and/or developmental disabilities. J Am Med Dir Assoc. 2008;9:109–113
  216. Wright RM. Use of osteoporosis medications in older nursing facility residents. J Am Med Dir Assoc. 2007;8:453–457
  217. Kamel HK. Update on osteoporosis management in long-term care: Focus on bisphosphonates. J Am Med Dir Assoc. 2007;8:434–440
  218. Duque G. To treat or not to treat, that is the question: Proceedings of the Quebec Symposium for the Treatment of Osteoporosis in Long-Term Care Institutions, Saint-Hyacinthe, Quebec, November 5, 2004. J Am Med Dir Assoc. 2007;8:e67–e73
  219. Zarowitz BJ, Stefanacci R, Hollenack K, O'Shea T. The application of evidence-based principles of care in older persons (issue 1): Management of osteoporosis. J Am Med Dir Assoc. 2007;8:e51–e57
  220. MacLean C, Newberry S, Maglione M, et al. Systematic review: Comparative effectiveness of treatments to prevent fractures in men and women with low bone density or osteoporosis. Ann Intern Med. 2008;148:197–213
  221. Sawka AM, Papaioannou A, Adachi JD, et al. Does alendronate reduce the risk of fracture in men? (A meta-analysis incorporating prior knowledge of anti-fracture efficacy in women). BMC Musculoskelet Disord. 2005;6:39
  222. Greenspan SL, Nelson JB, Trump DL, Resnick NM. Effect of once-weekly oral alendronate on bone loss in men receiving androgen deprivation therapy for prostate cancer: A randomized trial. Ann Intern Med. 2007;146:416–424
  223. Black DM, Delmas PD, Eastell R, et al. HORIZON Pivotal Fracture Trial (Once-yearly zoledronic acid for treatment of postmenopausal osteoporosis). N Engl J Med. 2007;356:1809–1822
  224. Lyles KW, Colon-Emeric CS, Magaziner JS, et al. Zoledronic acid and clinical fractures and mortality after hip fracture. N Engl J Med. 2007;357:1799–1809
  225. Saag KG, Shane E, Boonen S, et al. Teriparatide or alendronate in glucocorticoid-induced osteoporosis. N Engl J Med. 2007;357:2028–2039
  226. Vestergaard P, Jorgensen NR, Mosekilde L, Schwarz P. Effects of parathyroid hormone alone or in combination with antiresorptive therapy on bone mineral density and fracture risk—a meta-analysis. Osteoporos Int. 2007;18:45–57
  227. Tang BM, Eslick GD, Nowson C, et al. Use of calcium or calcium in combination with vitamin D supplementation to prevent fractures and bone loss in people aged 50 years and older: A meta-analysis. Lancet. 2007;370:657–666
  228. Boonen S, Lips P, Bouillon R, et al. Need for additional calcium to reduce the risk of hip fracture with vitamin D supplementation: Evidence from a comparative metaanalysis of randomized controlled trials. J Clin Endocrinol Metab. 2007;92:1415–1423

PII: S1525-8610(08)00264-8

doi: 10.1016/j.jamda.2008.07.006

JAMDA
Volume 9, Issue 7 , Pages 460-475 , September 2008