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Biomedical subjects

J M Prendergast

Publications and source records attributed to J M Prendergast.

15 recordsLinked to original sources
PubMed2001

A randomized trial of exercise programs among older individuals living in two long-term care facilities: the FallsFREE program.

OBJECTIVE: To use two different exercise programs over a 2-year period to reduce falls and their sequelae among residents of two long-term care facilities. DESIGN: Randomized, controlled trial. SETTING: The study took place at two long-term care facilities with services ranging from independent living to skilled nursing. PARTICIPANTS: One hundred and ten participants whose average age was 84 and who were capable of ambulating with or without assistive devices and could follow simple directions. INTERVENTION: Participants were randomized to one of two exercise groups (resistance/endurance plus basic enhanced programming or tai chi plus basic enhanced programming) or to a control group (basic enhanced programming only). Exercise classes were held three times per week throughout the study. MEASUREMENTS: Participants were evaluated for cognitive and physical functioning at baseline and 6, 12, and 24 months. Falls were determined from incident reports filed by the nursing staffs at the facilities. RESULTS: Time to first fall, time to death, number of days hospitalized, and incidence of falls did not differ among the treatment and control groups (P>.05). Among all participants, those who fell had significantly lower baseline Folstein Mini-Mental State Examination and instrumental activities of daily living scores and experienced significantly greater declines in these measures over the 2-year program. CONCLUSION: There were no significant differences in falls among the two exercise groups and the control group. Lack of treatment differences and low adherence rates suggest that residents of long-term care facilities may require individualized exercise interventions that can be adapted to their changing needs.

Accidental Falls↗
PubMed1993

A low-level strength training exercise program for frail elderly adults living in an extended attention facility.

Little is known about low-level, mildly progressive, strength training programs for frail elderly adults who live in extended attention housing. To study the effects of a low-level strength training program, a group of 12 frail elderly adults, aged 70 to 93 years, residing in an extended attention facility, participated in a strength training exercise program using ankle and wrist weights. Baseline measurements of elbow and knee flexor and extensor muscle strength were taken with a handheld dynamometer prior to initiation of the strength training program, and every three weeks during the 12-week period of exercise with weights. Muscle strength of elbow and knee flexors improved significantly by the end of the 12-week period (p < 0.05). Elbow and knee extensors did not show significant increases in muscle strength, but were maintained. It is concluded that muscle strength can be maintained or improved in adults over 70 who live in an extended attention facility using a low-level, mildly progressive, resistive exercise program. The program is safe, inexpensive, practical and can be used in clinical as well as community settings.

Aged↗
PubMed1990

Progress in the development of a nutritional risk index.

The development of a 16-item nutritional risk index (NRI) is chronicled from its inception through its application in three studies designed to assess its reliability and validity. Study I involved a survey of 401 community-dwelling elderly in St. Louis, Missouri who were interviewed at baseline, 4-5 mo later, and 1 yr later. Study II involved a cross-sectional survey of 377 male outpatients attending two clinics at the St. Louis Veterans Administration Medical Center. Study III involved a cross-sectional survey of 424 community-dwelling elderly in Houston, Texas. Internal consistency reliability coefficients ranged between 0.47 and 0.60, and test-retest reliability coefficients ranged between 0.65 and 0.71. Validity was established by using the NRI to predict the use of health services, as well as by correlating it with a variety of anthropometric, laboratory, and clinical markers of nutritional status. The utility of the NRI for future applications is discussed.

Aged↗
PubMed1989

Clinical validation of a nutritional risk index.

This research assessed the clinical validity of a nutritional risk index (NRI). Subjects were 377 male veterans, aged 55+, attending general medicine and geriatric outpatient clinics. Data were collected by personal interviews, anthropometric measurements, laboratory assay of nutritional parameters, three-day food records, and medical record reviews. Although the results showed that the NRI correlated significantly with only two nutritional measures (body mass index, total energy intake), critical values or threshold levels of NRI were identified that significantly discriminated low risk from high risk patients on four nutritional parameters (body mass index, total energy intake, laboratory risk, and medications risk). It was concluded that the NRI is a valid measure of health status and contains a nutritional dimension.

Aged↗
PubMed1986

Immunologic modulation by vitamin C in the elderly.

Aging is associated with a decline in both humoral-mediated and cellular-mediated immunity. These aberrations may contribute to morbidity and mortality in the elderly. Since we have previously shown that vitamin C enhances in vitro and in vivo immune functions in young healthy volunteers, we studied the effects of vitamin C on certain immunologic parameters in an elderly population. In vitro lymphocyte proliferation to the mitogen concanavalin-A was significantly less when compared to a young control group. When lymphocytes from the elderly were pre-incubated overnight and cultured in the presence of 10 micrograms/ml of vitamin C, mitogen-stimulated lymphocyte proliferation was similar to that from controls without vitamin C in culture. Having demonstrated significant in vitro immunoenhancement with vitamin C, we next studied the effects of oral ingestion of 2 g of vitamin C daily on certain in vitro and in vivo immunologic parameters in the elderly. When compared with a placebo-treated group, 3 weeks of vitamin C treatment did not effect in vitro mitogen-stimulated lymphocyte proliferation or in vivo reactivity to common skin test antigens. The augmenting effects of in vitro vitamin C suggest that this essential vitamin may be an effective agent in modulating aberrant immunologic functions in the elderly. The clinical significance of these findings requires further study.

Aged↗
PubMed1986

Further assessment of the reliability and validity of a Nutritional Risk Index: analysis of a three-wave panel study of elderly adults.

This paper reports on the further assessment of the reliability and validity of a short (16-item), portable method for assessing nutritional risk which is easily administered in the typical social survey setting. Data were obtained from a three-wave panel study of 401 randomly selected, noninstitutionalized elderly persons (age 65 and over) in St. Louis. Reliability was assessed by both internal consistency and test-retest methods. Reliability coefficients (internal consistency) of .603, .544, and .515 were obtained at T-1, T-2, and T-3, respectively. Cross-panel intercorrelations (test-retest) ranged between .67 and .71. Validity was assessed using factor analysis and various outcome measure comparisons for those at risk versus those not at risk. A five-factor orthogonally rotated solution explained 47.9 percent of the variance in the 16 items. Individuals with higher risk scores had significantly poorer health as measured by other standard indexes, and used significantly more health services than those with lower risk scores. These results underscore the potential of the Nutritional Risk Index (NRI) as a screening device for use among the elderly.

Activities of Daily Living↗
PubMed1985

Correlates of change in subjective well-being among the elderly.

This study examines two related issues concerning the subjective well-being of elderly adults: change over time and correlates of that change. Data come from a three-wave panel study of 401 elderly residents in St. Louis. Residualized change score regression analyses indicate: there is change in subjective well-being over 4-5 months and over 12 months; the 4-5 month and 12 month changes are remarkably similar; the effect of subjective well-being over time indicates regression to the mean; and, only socioeconomic status is a significant predictor of change in subjective well-being (net of the effects of subjective well-being itself). The implications of these results for our understanding of subjective well-being in the elderly are discussed, as are the policy implications of the positive effect of socioeconomic status on changes in the subjective well-being of the elderly.

Aged↗
PubMed1984

Measurement of the global and functional dimensions of health status in the elderly.

Data from a two-stage random sample of 401 noninstitutionalized elderly individuals residing in 18 census tracts in south-central metropolitan St. Louis were used to examine the relationships among seven measures of health status. Factor analyses revealed two pristine dimensions: (a) a global health status dimension, on which perceived health status, nutritional risk, perceived sensory functions, and mental health all load significantly; and, (b) a functional dimension on which the Activities of Daily Living, Instrumental Activities of Daily Living, and mental orientation measures all load significantly. These two factors explain 56% of the variance in the seven health status measures, and, using an oblique rotational procedure, they were found to be correlated only modestly (r = .37). The implications for the measurement of health status of elderly adults as well as the use of such measures in predicting health services utilization are discussed, and recommendations for the inclusion of items tapping both dimensions in future studies are presented.

Activities of Daily Living↗
PubMed1982

Faculty resources for teaching geriatric medicine.

Self-administered questionnaires were sent to all faculty and staff members of the departments of internal medicine and psychiatry in a school of medicine. The questionnaires asked for information about personal characteristics, practice characteristics, and interest in teaching geriatrics. Included also were measures of knowledge about aging and attitudes toward the elderly. Responses were received from 25 per cent of the faculty. Results indicated that 40 per cent wanted no involvement in teaching geriatrics. Of the remainder, most preferred a consultant's role on a clinical service. Despite extensive experience with elderly patients, respondents showed modest scores on knowledge, but there was little stereotyping of elderly patients. Implications for establishing a training program in geriatrics are discussed.

Adult↗
PubMed1982

Attitudes and health promoting behavior of medical and law students.

An entering class of medical students is compared with an entering class of law students on attitudes toward self-responsibility for health and reported health behaviors. Students' health behavior patterns are contrasted with those of practicing physicians and lawyers. Data were collected by self-administered questionnaires. Results indicated that medical students were stronger on self-responsibility and also reported more often engaging in health promoting behavior than law students. The same pattern of differences was reported for practicing physicians and lawyers.

Adult↗
PubMedDate not supplied

A preliminary validation of a nutritional risk measure for the elderly.

We used data from a two-stage random sample of 401 noninstitutionalized elderly individuals residing in 18 census tracts in south-central metropolitan St. Louis to establish the reliability and validity of a 16-item nutritional risk measure. Reliability analysis yielded a Cronbach's alpha of 0.603. Concurrent predictive validity was demonstrated by the prediction of physician, emergency room, and hospital use. Individuals with high scores displayed a consistent pattern of higher rates of known nutrition-related problems and their sequelae than did those with low scores, providing evidence of known groups validity. Statistical correlations with components of an established theoretical model of the elderly's health and illness behavior demonstrate preliminary support for construct validity. The advantages of our nutritional risk measure include its ease of administration and telephone portability.

Aged↗