PubMed Health⌕ Search

Biomedical subjects

F Kohout

Publications and source records attributed to F Kohout.

14 recordsLinked to original sources
PubMed1999

A nursing intervention to decrease depression in family caregivers of persons with dementia.

The goal of this study was to evaluate a community-based psychoeducational-nursing intervention designed to teach home caregivers to manage behavioral problems of persons with Alzheimer's disease and related dementias (ADRD) using the Progressively Lowered Stress Threshold (PLST) model, and to compare this intervention with routine information and referrals for case management, community-based services, and support groups. Previous caregiver studies have overwhelmingly pointed to the adverse effects of caregiving on the caregivers' physical and mental health, and high prevalence rates of depression among caregivers of persons with ADRD have consistently been reported. Therefore, a primary aim was to evaluate the impact of the intervention on caregivers' affective responses, especially depression. Data from both the Profile of Moods States and the Geriatric Depression Rating Scale support the effectiveness of this intervention in decreasing depression among caregivers who received the experimental training. Additional analysis of factors associated with caregiver depression are also reported. The pivotal role of psychiatric nurses in the assessment and treatment of depression among caregivers of persons with ADRD is discussed.

Adaptation, Psychological↗
PubMed1996

Apolipoprotein E and cognitive change in an elderly population.

The apolipoprotein E (apoE) epsilon 4 allele is overrepresented, and the apoE epsilon 2 allele underrepresented, in Alzheimer's disease. To assess the risk of cognitive impairment in individuals with these genotypes in the general population, we studied a population-based sample of 1,899 individuals 65 years and older as a follow-up to the Iowa 65+ Rural Health Study. Multiple regression and logistic regression analyses demonstrated significant effects of apoE epsilon 4 and apoE epsilon 2 in predicting performance on a delayed recall task over a 4- to 7-year period. The magnitude of this effect was, however, fairly modest, with odds ratios for developing impairment of approximately 1.37 (95% confidence interval: 1.007, 1.850; p = 0.045) for apoE epsilon 4 and 0.53 (95% confidence interval: 0.368, 0.777; p = 0.001) for apoE epsilon 2. These effects were more pronounced in women than men. Importantly, 85% of elderly apoE E4/4 individuals (average age, 81) scored in the unimpaired range on a screening mental status test. Thus, many individuals reach old age without cognitive impair- ment despite inheritance of one or two apoE epsilon 4 alleles. This suggests that apoE genotyping will have limited utility as a diagnostic or prognostic indicator of cognitive decline in individuals.

Aged↗
PubMed1993

Intercommunity variations in the association between social ties and mortality in the elderly. A comparative analysis of three communities.

Identical measures of social ties obtained from three community-based cohorts aged 65 and over from East Boston, MA; New Haven, CT; and two rural counties in Iowa permit the first direct cross-community comparison of the hypothesis that social isolation increases 5-year mortality risks (1982 to 1987) for older men and women. In sex-specific proportional hazards analyses, social ties were significantly and inversely related to mortality independently of age in all three cohorts (e.g., relative hazard (RH) = 1.97 to 3.06 for men and women, comparing those with no ties to those with four types of ties). After controlling for age, pack-years of smoking, body mass, chronic conditions, angina, and physical and cognitive disability, social ties remain significant predictors of mortality risk for the men and women in New Haven (RH = 2.4 and 1.8) and for women in Iowa (RH = 1.9). For the men in Iowa (RH = 1.4) and the men and women in East Boston (RH = 1.0 and 1.3), the associations are weaker and nonsignificant.

Aged↗
PubMed1988

The effect of a fluoridated dentifrice on root and coronal caries in an older adult population.

Little information is available on the effect of fluorides on root surface caries in adults. This double-blind clinical study of 810 healthy adults, aged 54 and older, demonstrated decided cariostatic effects of a fluoridated dentifrice containing 1,100 ppm F as sodium fluoride. Statistically significant differences on both coronal (41%) and root surface caries (67%) incidence were produced in the test group and compared with a control dentifrice group during 1 year of study.

Aged↗
PubMed1988

Identification of high caries risk adults: attitudes, social factors and diseases.

Since agent, host and environmental factors have been associated with caries, the development of multivariate risk assessment models is warranted. This process comprises the identification of risk factors, the development and testing of risk models, assessment and targeting. Work-in-progress by the authors in delineating oral, social/behavioural and medical risk factors for root caries in older adults shows that regression models explain 48 per cent of the variance in root caries scores for males and 47 per cent for females. Discriminant analyses using the risk factors identified in the regressions differentiated between people who did and did not get root caries during an 18-month period. The sensitivity of the predictions for men was 0.75 and the specificity was 0.79. For women, the sensitivity was 0.79 and the specificity was 0.83. These results suggest that it will be possible to develop a clinically useful risk assessment model. Future studies should include data on oral risk factors, such as micro-organisms present, salivary flow and buffering capacity, that can be added to the multivariate model.

Adult↗
PubMed1985

Relationship of free-recall memory to hypertension in the elderly. The Iowa 65+ Rural Health Study.

The relationship between hypertension and performance on a test of free recall memory was explored in a geographically-defined population of free-living subjects 65 years and older. Those with diastolic but not isolated systolic hypertension had a significantly lower performance on the memory test, after controlling for general health status, antihypertensive medication use and other factors which might confound or modify this association. These findings from a population study confirm the results of prior investigations in smaller numbers of highly selected subjects and suggest that further study may lead to improved prevention of cognitive decline in the elderly.

Aged↗
PubMedDate not supplied

Sensory focus as therapeutic treatments for acute pain.

This study examined the hypothesis that instructing patients to focus on their sensations (sensory focus) during root canal therapy reduces painful response. Before dental treatment, patients were randomly assigned to one of four audiotaped conditions: sensory focus with and without procedural information, procedural information, or no-intervention. Patients were categorized as to how much control they desired and felt. The "high desire for control/low felt control" subgroup's sensory pain intensity scores in the sensory focus condition were significantly lower than the "high desire for control/low felt control" subgroup's sensory intensity scores in the no-intervention comparison condition. This was true immediately after treatment (F(1,303) = 13.37; p < or = .001) and 1 week after treatment (F(1,303) = 14.30; p < or = .001). Immediately after treatment, the high desire for control/low felt control subgroup in the sensory/procedural condition was significantly lower on sensory pain intensity scores than the high desire/low felt subgroup in the no-intervention condition (F(1,303) = 3.75; p < or = .001). This difference was not observed on the 1-week recall of pain. Adding procedural information to the instructions to focus on sensation did not increase the pain-reducing effects. Results extend prior findings that sensory focus significantly reduces sensory pain intensity only among patients who are classified as having a high desire for control and low perceived control. These results are congruent with theoretical arguments that coping preferences moderate the reaction of patients to various therapeutic strategies.

Adaptation, Psychological↗
PubMedDate not supplied

Quantitative digital fluorography. Computer vs. human estimation of vascular stenoses.

Digital subtracted images of iodinated rods, incorporating accurately measured areas of eccentric stenosis were obtained. The average subjective estimations of fractional area reduction (211 readings each) by three experienced angiographers were compared with values obtained using an interactive computer algorithm using the densitometric data. Results were analyzed to identify major influences on accuracy, including iodine concentration, vessel width, absolute severity of the stenosis, and vessel orientation. While no single factor appeared to seriously affect human accuracy, computer readings were significantly influenced by the tilt of the vessel in relation to the x-ray beam. Various potential sources of error including beam hardening, stenosis geometry, and scattering are discussed and appropriate algorithm corrections suggested. The importance of the availability of a reliable and accurate method to quantify vascular stenosis and volume of stenotic material is stressed.

Absorptiometry, Photon↗