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OBJECTIVE The authors sought to determine whether integrated mental health services or enhanced referral to specialty mental health clinics results in greater engagement in mental health/substance abuse services by older primary care patients. METHOD This multisite randomized trial included 10 sites consisting of primary care and specialty mental(More)
We evaluated the occurrence and persistence of delirium in 325 elderly patients admitted to a teaching hospital from either a defined community or a long-term care facility. Of the study participants, 34 (10.5%) had Diagnostic and Statistical Manual of Mental Disorders, Third Edition--defined delirium at initial evaluation; of the remaining patients, 91(More)
We studied the serum albumin level within 48 hours of hospitalization for acute illness to predict in-hospital death, length of stay, and readmission in 15,511 patients older than 40 years. Patients with low serum albumin levels (less than 34 g/L), who made up 21% of the population, were more likely to die, had longer hospital stays, and were readmitted(More)
BACKGROUND Alcohol misuse is a growing public health concern for older adults, particularly among primary care patients. OBJECTIVES To determine alcohol consumption patterns and the characteristics associated with at-risk drinking in a large sample of elderly primary care patients. DESIGN Cross-sectional analysis of multisite screening data from 6 VA(More)
To study delirium in hospitalized elderly, a delirium symptom interview (DSI) was developed by an interdisciplinary group of investigators. This interview was administered in an acute care hospital to 50 patients who were over the age of 65 years. Results from the interview were compared to assessments of major symptoms of delirium made independently by a(More)
Using a structured instrument, 325 elderly patients admitted to a general hospital for an acute medical problem were evaluated daily in order to detect symptoms of delirium. Patients were scored for 'hyperactive' or 'hypoactive' symptoms, and then the 125 patients with DSM-III delirium were rated as 'hyperactive type' (15%), 'hypoactive type' (19%), 'mixed(More)
BACKGROUND Delirium has been hypothesized to be a central nervous system response to systemic inflammation during a state of blood-brain barrier compromise. The purpose of this study was to compare postoperative changes in groups of inflammatory markers in persons who developed delirium following cardiac surgery and matched controls without delirium. (More)
BACKGROUND Delirium is a common outcome after cardiac surgery. Delirium prediction rules identify patients at risk for delirium who may benefit from targeted prevention strategies, early identification, and treatment of underlying causes. The purpose of the present prospective study was to develop a prediction rule for delirium in a cardiac surgery cohort(More)
This paper provides a review of research issues and findings on the epidemiology of delirium. Despite the fact that research on this important geriatric syndrome has been conducted for many decades, several methodological issues make it difficult to compare findings across studies. In this paper we first discuss broadly methodological issues related to(More)
This paper is a qualitative study based on retrospective, unstructured, qualitative interviews with Mrs. Jones and other African-American, Chinese-American, Irish-American and Latino family caregivers in the Boston area. A narrative approach is used to show how family caregivers draw on their cultural and personal resources to create stories about the(More)