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Biomedical subjects

P Sloane

Publications and source records attributed to P Sloane.

17 recordsLinked to original sources
PubMed1999

Measurement of distal forearm bone mineral density: can different forearm segments be used interchangeably ?

Many different forearm sites have been used for the measurement of bone mineral density (BMD) and prediction of risk of future fracture among community dwelling populations. In populations where bone densitometry of peripheral sites may be the most cost effective and practical means of measuring BMD, such as the nursing home population, knowing the characteristics of forearm BMD measures would be beneficial. The purpose of this study was to assess the relationship of four common commercially available measures to each other and to estimate the inter- and intrarater reliability of the measures in a sample of nursing home residents as a first step toward identifying appropriate forearm measurement sites. These sites were the distal radius, the distal ulna, a composite of the distal radius and distal ulna, and the ultra distal radius. BMD measurements on 48 nursing home patients were obtained using single X-ray absorptiometry. Inter- and intrarater reliability was excellent at all four sites (interclass correlation coefficients > 0. 85). Moderate to high correlations (0.84-0.91) between the distal radius and ultra distal radius sites of the forearm suggest that these measures may be interchangeable. Although not directly assessed here, differences in bone composition among forearm sites may partially explain moderate rather than high correlations between sites and may affect the ability of each site to predict future fractures. Thus, different forearm sites may be used interchangeably for diagnostic purposes; however, the prognostic value of each site remains unknown.

Absorptiometry, Photon↗
PubMed1991

The relation of dizziness to functional decline.

OBJECTIVE: to assess the effect of dizziness on the probability that an older person will die or become functionally disabled within 2 years. Dizziness is a common symptom for which the prognosis is uncertain. This report compares the prognoses for dizzy and not-dizzy older people in order to assist clinicians who diagnose and treat these patients. DESIGN: a prospective study of a representative sample of elderly (70+) non-institutionalized Americans. Elderly subjects (n = 3,798) in the Longitudinal Study of Aging (LSOA) were asked questions about the presence of dizziness, medical conditions, and functional disability in 1984. The cohort was reinterviewed about functional disability in 1986. OUTCOME MEASURE: transition from functional ability to disability after 2 years. RESULTS: Bivariate analyses showed that dizziness predicts functional decline but not mortality. Multivariate models revealed that age, race, sensory impairment, vascular disease, and other morbidity are independent predictors of becoming disabled. Controlling for these potential confounders, dizziness does not predict an increased probability of becoming disabled. CONCLUSION: Elderly people who are dizzy should be evaluated for the presence of these related conditions.

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PubMed1989

Dizziness in a community elderly population.

Dizziness was studied in 1,622 community-dwelling adults aged 60 and older who were interviewed as part of the Duke Epidemiologic Catchment Area study. The lifetime prevalence of dizziness (defined as severe enough to see a physician, to take a medication, or to interfere with daily activities) was 29.3%; the 1-year prevalence was 18.2%. When the subgroup with dizziness was compared with those who never suffered dizziness, using logistic regression, four variables displayed the strongest associations: a constructed variable of risk for multiple neurosensory deficits, a cardiovascular risk score, a depression symptom inventory, and perception of self as a nervous person. In this population, dizziness was not associated with increased risk of death or institutionalization at the 1-year follow up.

Age Factors↗
PubMed1980

Nursing homes.

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PubMedDate not supplied

Professional environmental assessment procedure for special care units for elders with dementing illness and its relationship to the therapeutic environment screening schedule.

The Professional Environmental Assessment Procedure (PEAP) was developed as a global quality-assessment measure for use by trained professionals in special care units for older people in dementia units of nursing homes. The PEAP consists of nine ratings whose relationship to another assessment device, the Therapeutic Environment Screening Schedule (TESS), is reported. Although designed to be multidimensional, the PEAP as tested in 43 special care units seems to reflect primarily a single evaluative dimension. It correlates highly with the TESS and may be used either separately or in combination with the TESS.

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PubMedDate not supplied

Implementation of recommended health maintenance activities in geriatric care.

To determine the extent to which health screening and preventive measures are actually documented in family practice, a random sample of 216 charts of established patients over 65 in seven practices was audited. Overall, a high rate of documentation (greater than 95%) was observed for blood pressure measurement. Intermediate rates of documentation (35% to 75%) were observed for oral cavity examination, smoking history, and skin examination. Low rates (less than 30%) were present for tetanus immunization, influenza immunization, stool occult blood testing, visual screening, hearing screening, mental status testing, social support description, and discussion of care preferences (living will). Several diagnoses for which screening was infrequently documented were recorded at rates approaching expected community prevalence figures, a finding that suggests widespread performance of informal or undocumented health screening in these practices. Recommended measures to increase the performance and documentation of preventive care include changes in the medical record, alterations in reimbursement, and delegation to nonphysician office staff.

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