Scholars@Duke
Kenneth Edwin Schmader

Kenneth Edwin Schmader

Professor of Medicine
Medicine, Geriatrics and Palliative Care
kenneth.schmader@duke.edu
Duke Box 3003, Center for Aging, Durham, NC 27710
Duke University Medical Center, 508 Fulton St, Durham, NC 27705

Selected Publications

Adopting Principles to Guide Pathways: The Best Model for Geriatric Pain Management.

Journal Article Clin Geriatr Med · February 2026 Older adults experience the highest burden of chronic pain and pain-related disability. Existing pathways-multimodal, stepped, and stratified prove useful pieces but do not fully account for the complexity of geriatric care. This article argues for princip ... Full text Link to item Cite

Can Pharmacogenetics Be Used to Predict the Response to Fesoterodine Fumarate?

Journal Article Urogynecology (Phila) · January 1, 2026 IMPORTANCE: Pharmacogenetics could address the challenge of predicting an individual's response to anticholinergic medications for urgency urinary incontinence (UUI). OBJECTIVES: Our objectives were to evaluate whether the metabolizer status of cytochrome ... Full text Link to item Cite

Immunogenicity of mRNA COVID-19 vaccine with either simultaneous or sequentially administered inactivated influenza vaccines: a randomized clinical trial.

Journal Article Vaccine · December 10, 2025 BACKGROUND: A U.S. multisite trial was conducted and explored whether blunting of mRNA COVID-19 vaccine immunogenicity occurred when administered simultaneously with influenza vaccine. METHODS: Persons ≥5 years of age received either quadrivalent inactivat ... Full text Link to item Cite

Pulmonary Disease in the Older Adult: A Review of Interstitial Lung Disease.

Journal Article Clin Geriatr Med · November 2025 Interstitial lung diseases (ILDs) are a group of diverse conditions of critical importance to the care of the older adult that can cause pulmonary fibrosis, respiratory failure, and death. Aging and geriatric principles are key factors in the epidemiology, ... Full text Link to item Cite

Have We Forgotten About Therapeutic Failure in Older Adults?

Journal Article J Am Geriatr Soc · August 2025 BACKGROUND: Three types of adverse drug events have been identified in studies of medication-related harms among older adults: adverse drug reactions, adverse drug withdrawal events, and therapeutic failures (TFs). METHODS: In this narrative review of medi ... Full text Link to item Cite

Medication Use Quality and Safety in Older Adults: 2023 Update.

Journal Article J Am Geriatr Soc · June 2025 Improving the quality of medication use and medication safety are important priorities for healthcare providers who care for older adults. The objective of this article was to identify four exemplary articles with this focus in 2023. We selected high-quali ... Full text Link to item Cite

Polypharmacy and potentially inappropriate medication (PIM) use among older veterans with idiopathic pulmonary fibrosis (IPF) - a retrospective cohort study.

Journal Article BMC Pulm Med · April 21, 2025 BACKGROUND: Idiopathic pulmonary fibrosis (IPF) is a deadly respiratory disease of older patients. IPF therapies (antifibrotics) are efficacious in slowing disease progression, but they are critically underutilized. Potential barriers to antifibrotic use a ... Full text Link to item Cite

Neutralizing Antibody Immune Correlates for a Recombinant Protein Vaccine in the COVAIL Trial.

Journal Article Clin Infect Dis · February 5, 2025 For COVAIL recipients of a coronavirus disease 2019 (COVID-19) Sanofi booster vaccine, neutralizing antibody titers were assessed as a correlate of risk (CoR) of COVID-19. Peak and exposure-proximal titers were inverse CoRs with covariate-adjusted hazard r ... Full text Link to item Cite

Population Pharmacokinetics of Meropenem Across the Adult Lifespan.

Journal Article Clin Pharmacokinet · February 2025 BACKGROUND AND OBJECTIVE: We conducted an opportunistic pharmacokinetic study to evaluate the population pharmacokinetics of meropenem, an antimicrobial commonly used to treat Gram-negative infections in adults of different ages, including older adults, an ... Full text Link to item Cite

Vaccinations in older adults: Optimization, strategies, and latest guidelines.

Journal Article J Am Geriatr Soc · January 2025 This article is a summary of the first AGS Symposium entitled "Update on Vaccination Strategies for Older Adults: Matching the Approach to the Individual and the Care Setting." Given declines in host defenses and immune function with aging, vaccinations pl ... Full text Link to item Cite

Safety of Simultaneous vs Sequential mRNA COVID-19 and Inactivated Influenza Vaccines: A Randomized Clinical Trial.

Journal Article JAMA Netw Open · November 4, 2024 IMPORTANCE: Limited randomized clinical trial data exist on the safety of simultaneous administration of COVID-19 and influenza vaccines. OBJECTIVE: To compare the reactogenicity, safety, and changes in health-related quality of life (HRQOL) after simultan ... Full text Link to item Cite

Impact of Veterans Affairs Geriatric Research, Education, and Clinical Centers: Incubators of innovation in geriatrics.

Journal Article J Am Geriatr Soc · November 2024 Since their inception in 1975, the Department of Veterans Affairs Geriatric Research, Education, and Clinical Centers (GRECCs) have served as incubators of innovation in geriatrics. Their contributions to the VA mission were last reviewed in 2012. Herein, ... Full text Link to item Cite

Predictive Energy Equations Inaccurately Estimate Metabolic Demands of Older Adult Trauma Patients.

Journal Article J Surg Res · October 2024 INTRODUCTION: Suboptimal nutrition promotes unfavorable outcomes in trauma patients, particularly among those aged 60 and over. While many institutions employ predictive energy equations to determine patients' energy requirements, mounting evidence shows t ... Full text Link to item Cite

Methods for pragmatic randomized clinical trials of pain therapies: IMMPACT statement.

Journal Article Pain · October 1, 2024 Pragmatic, randomized, controlled trials hold the potential to directly inform clinical decision making and health policy regarding the treatment of people experiencing pain. Pragmatic trials are designed to replicate or are embedded within routine clinica ... Full text Link to item Cite

Safety of Simultaneous Vaccination With Adjuvanted Zoster Vaccine and Adjuvanted Influenza Vaccine: A Randomized Clinical Trial.

Journal Article JAMA Netw Open · October 1, 2024 IMPORTANCE: Quadrivalent adjuvanted inactivated influenza vaccine (aIIV4) and adjuvanted recombinant zoster vaccine (RZV) contain novel adjuvants. Data are limited on the comparative safety, reactogenicity, and health-related quality of life (HRQOL) effect ... Full text Link to item Cite

Performance of Urinalysis Parameters in Predicting Urinary Tract Infection: Does One Size Fit All?

Journal Article Clin Infect Dis · September 26, 2024 In a multihospital cohort study of 3392 patients, positive urinalysis parameters had poor positive predictive value for diagnosing urinary tract infection (UTI). Combined urinalysis parameters (pyuria or nitrite) performed better than pyuria alone for ruli ... Full text Open Access Link to item Cite

Factors influencing central nervous system medication deprescribing and behavior change in hospitalized older adults.

Journal Article J Am Geriatr Soc · August 2024 BACKGROUND: Central nervous system (CNS) medications are linked to higher morbidity and mortality in older adults. Hospitalization allows for deprescribing opportunities. This qualitative study investigates clinician and patient perspectives on CNS medicat ... Full text Link to item Cite

A Phase 2 Clinical Trial to Evaluate the Safety, Reactogenicity, and Immunogenicity of Different Prime-Boost Vaccination Schedules of 2013 and 2017 A(H7N9) Inactivated Influenza Virus Vaccines Administered With and Without AS03 Adjuvant in Healthy US Adults.

Journal Article Clin Infect Dis · June 14, 2024 INTRODUCTION: A surge of human influenza A(H7N9) cases began in 2016 in China from an antigenically distinct lineage. Data are needed about the safety and immunogenicity of 2013 and 2017 A(H7N9) inactivated influenza vaccines (IIVs) and the effects of AS03 ... Full text Link to item Cite

Central nervous system medication use around hospitalization.

Journal Article J Am Geriatr Soc · June 2024 BACKGROUND: Central nervous system (CNS) medication use is common among older adults, yet the impact of hospitalizations on use remains unclear. This study details CNS medication use, discontinuations, and user profiles during hospitalization periods. METH ... Full text Link to item Cite

Medication use quality and safety in older adults: 2022 update.

Journal Article J Am Geriatr Soc · May 2024 Improving the quality of medication use and medication safety are important priorities for healthcare providers who care for older adults. The objective of this article was to identify four exemplary articles with this focus in 2022. We selected high-quali ... Full text Link to item Cite

Proposing the "Continuum of UTI" for a Nuanced Approach to Diagnosis and Management of Urinary Tract Infections.

Journal Article J Urol · May 2024 PURPOSE: Patients with suspected UTIs are categorized into 3 clinical phenotypes based on current guidelines: no UTI, asymptomatic bacteriuria (ASB), or UTI. However, all patients may not fit neatly into these groups. Our objective was to characterize clin ... Full text Link to item Cite

Systematic Literature Review of Health-Related Quality-of-Life Measures for Caregivers of Older Adult Trauma Patients.

Journal Article J Surg Res · May 2024 INTRODUCTION: As the older adult population increases, hospitals treat more older adults with injuries. After leaving, these patients suffer from decreased mobility and independence, relying on care from others. Family members often assume this responsibil ... Full text Link to item Cite

Bacteremia From a Presumed Urinary Source in Hospitalized Adults With Asymptomatic Bacteriuria.

Conference JAMA Netw Open · March 4, 2024 IMPORTANCE: Guidelines recommend withholding antibiotics in asymptomatic bacteriuria (ASB), including among patients with altered mental status (AMS) and no systemic signs of infection. However, ASB treatment remains common. OBJECTIVES: To determine preval ... Full text Link to item Cite

New approaches for understanding the potential role of microbes in Alzheimer's disease.

Journal Article Brain Behav Immun Health · March 2024 Alzheimer's disease (AD) involves a complex pathological process that evolves over years, and its etiology is understood as a classic example of gene-environment interaction. The notion that exposure to microbial organisms may play some role in AD patholog ... Full text Link to item Cite

Immunogenicity and safety of varying dosages of a fifth-wave influenza A/H7N9 inactivated vaccine given with and without AS03 adjuvant in healthy adults.

Journal Article Vaccine · January 12, 2024 BACKGROUND: Human infections with the avian influenza A(H7N9) virus were first reported in China in 2013 and continued to occur in annual waves. In the 2016/2017 fifth wave, Yangtze River Delta (YRD) lineage viruses, which differed antigenically from those ... Full text Link to item Cite

Association of prior treatment with nitrogen-containing bisphosphonates on outcomes of COVID-19 positive patients.

Journal Article Osteoporos Int · January 2024 UNLABELLED: COVID-19 infection has resulted in significant morbidity and mortality globally, especially among older adults. Repurposed drugs have demonstrated activity in respiratory illnesses, including nitrogen-containing bisphosphonates. In this retrosp ... Full text Link to item Cite

Inpatient clinicians' approach to diagnosis of urinary tract infections in older adults using the COM-B model: a qualitative assessment.

Journal Article Antimicrob Steward Healthc Epidemiol · 2024 Our interviews of inpatient clinicians (physicians, physician assistants) modeled after the Capability, Opportunity, and Motivation Model of Behavior model revealed opportunity and motivation as important drivers for overdiagnosis and overprescribing for a ... Full text Link to item Cite

Ageing and physical resilience after health stressors.

Journal Article Stress Health · September 2023 The objectives of this article are to introduce a conceptual framework for physical resilience in the context of ageing and to discuss key elements and challenges in the design of studies of physical resilience after health stressors. Advancing age is asso ... Full text Link to item Cite

Comparison of bivalent and monovalent SARS-CoV-2 variant vaccines: the phase 2 randomized open-label COVAIL trial.

Journal Article Nat Med · September 2023 Vaccine protection against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection wanes over time, requiring updated boosters. In a phase 2, open-label, randomized clinical trial with sequentially enrolled stages at 22 US sites, we assessed ... Full text Link to item Cite

An Analysis of How Herpes Zoster Pain Affects Health-related Quality of Life of Placebo Patients From 3 Randomized Phase III Studies.

Journal Article Clin J Pain · August 1, 2023 OBJECTIVES: Herpes zoster (HZ) is a painful condition caused by the reactivation of the varicella-zoster virus, negatively affecting the lives of patients. In this post hoc analysis, we describe the impact of HZ pain on the health-related quality of life ( ... Full text Link to item Cite

Immunogenicity of adjuvanted versus high-dose inactivated influenza vaccines in older adults: a randomized clinical trial.

Journal Article Immun Ageing · July 1, 2023 BACKGROUND: Adjuvanted inactivated influenza vaccine (aIIV) and high-dose inactivated influenza vaccine (HD-IIV) are U.S.-licensed for adults aged ≥ 65 years. This study compared serum hemagglutination inhibition (HAI) antibody titers for the A(H3N2) and A ... Full text Link to item Cite

Research objectives and general considerations for pragmatic clinical trials of pain treatments: IMMPACT statement.

Journal Article Pain · July 1, 2023 Many questions regarding the clinical management of people experiencing pain and related health policy decision-making may best be answered by pragmatic controlled trials. To generate clinically relevant and widely applicable findings, such trials aim to r ... Full text Link to item Cite

Pragmatic evaluation of events and benefits of lipid lowering in older adults (PREVENTABLE): Trial design and rationale.

Journal Article J Am Geriatr Soc · June 2023 Whether initiation of statins could increase survival free of dementia and disability in adults aged ≥75 years is unknown. PREVENTABLE, a double-blind, placebo-controlled randomized pragmatic clinical trial, will compare high-intensity statin therapy (ator ... Full text Link to item Cite

Optimizing reflex urine cultures: Using a population-specific approach to diagnostic stewardship.

Journal Article Infect Control Hosp Epidemiol · February 2023 BACKGROUND: Clinicians and laboratories routinely use urinalysis (UA) parameters to determine whether antimicrobial treatment and/or urine cultures are needed. Yet the performance of individual UA parameters and common thresholds for action are not well de ... Full text Link to item Cite

Safety and Immunogenicity of Influenza A/H5N8 Virus Vaccine in Healthy Adults: Durability and Cross-reactivity of Antibody Responses.

Journal Article Clin Infect Dis · January 5, 2023 BACKGROUND: Influenza A/H5N8 viruses infect poultry and wild birds in many countries. In 2021, the first human A/H5N8 cases were reported. METHODS: We conducted a phase I, cohort-randomized, double-blind, controlled trial of inactivated influenza A/H5N8 va ... Full text Link to item Cite

Population Pharmacokinetics of Piperacillin/Tazobactam Across the Adult Lifespan.

Journal Article Clin Pharmacokinet · January 2023 BACKGROUND AND OBJECTIVE: Piperacillin/tazobactam is one of the most frequently used antimicrobials in older adults. Using an opportunistic study design, we evaluated the pharmacokinetics of piperacillin/tazobactam as a probe drug to evaluate changes in an ... Full text Link to item Cite

Using the COM-B model to identify barriers to and facilitators of evidence-based nurse urine-culture practices.

Journal Article Antimicrob Steward Healthc Epidemiol · 2023 Our surveys of nurses modeled after the Capability, Opportunity, and Motivation Model of Behavior (COM-B model) revealed that opportunity and motivation factors heavily influence urine-culture practices (behavior), in addition to knowledge (capability). Un ... Full text Open Access Link to item Cite

Partnering to cope with pain: A pilot study of a caregiver-assisted pain coping skills intervention for patients with cognitive impairment and dementia.

Journal Article Palliat Support Care · December 2022 OBJECTIVE: To develop a new caregiver-assisted pain coping skills training protocol specifically tailored for community-dwelling persons with cognitive impairment and pain, and assess its feasibility and acceptability. METHOD: In Phase I, we conducted inte ... Full text Link to item Cite

Natural History of Herpes Zoster in the Placebo Groups of Three Randomized Phase III Clinical Trials.

Journal Article Infect Dis Ther · December 2022 INTRODUCTION: The risk of herpes zoster (HZ) is associated with a decline in immune system function, linked to aging and/or immunocompromising or immunosuppressive diseases or therapies. In this post hoc analysis we describe the incidence of HZ, rash chara ... Full text Link to item Cite

Clin-Star corner: What's new at the interface of geriatrics, infectious diseases, and antimicrobial stewardship.

Journal Article J Am Geriatr Soc · August 2022 Antibiotics are among the leading causes of adverse drug events in older adults. Short-course antibiotic therapy has been shown to work as well as the traditional longer durations for many types of infections. Antibiotic stewardship interventions including ... Full text Link to item Cite

Medication use quality and safety in older adults: 2020 update.

Journal Article J Am Geriatr Soc · February 2022 Improving the quality of medication use and medication safety are important priorities for prescribers who care for older adults. The objective of this article was to identify four exemplary articles with this focus in 2020. We selected high-quality studie ... Full text Link to item Cite

Differential CD4+ T-Cell Cytokine and Cytotoxic Responses Between Reactivation and Latent Phases of Herpes Zoster Infection.

Journal Article Pathog Immun · 2022 BACKGROUND: CD4+ T cells are a critical component of effective immune responses to varicella zoster virus (VZV), but their functional properties during the reactivation acute vs latent phase of infection remain poorly defined. METHODS: Here we assessed the ... Full text Link to item Cite

The Urinary Microbiome in Postmenopausal Women with Recurrent Urinary Tract Infections.

Journal Article J Urol · November 2021 PURPOSE: The etiology of postmenopausal recurrent urinary tract infection (UTI) is not completely known, but the urinary microbiome is thought to be implicated. We compared the urinary microbiome in menopausal women with recurrent UTIs to age-matched contr ... Full text Link to item Cite

A template for physical resilience research in older adults: Methods of the PRIME-KNEE study.

Journal Article J Am Geriatr Soc · November 2021 BACKGROUND: Older adults with similar health conditions often experience widely divergent outcomes following health stressors. Variable recovery after a health stressor may be due in part to differences in biological mechanisms at the molecular, cellular, ... Full text Link to item Cite

Does a lack of vaccine side effects correlate with reduced BNT162b2 mRNA vaccine response among healthcare workers and nursing home residents?

Journal Article Aging Clin Exp Res · November 2021 BACKGROUND: The BNT162b2 SARS-CoV-2 mRNA vaccination has mitigated the burden of COVID-19 among residents of long-term care facilities considerably, despite being excluded from the vaccine trials. Data on reactogenicity (vaccine side effects) in this popul ... Full text Link to item Cite

Vaccine-induced ICOS+CD38+ circulating Tfh are sensitive biosensors of age-related changes in inflammatory pathways.

Journal Article Cell Rep Med · May 18, 2021 Humoral immune responses are dysregulated with aging, but the cellular and molecular pathways involved remain incompletely understood. In particular, little is known about the effects of aging on T follicular helper (Tfh) CD4 cells, the key cells that prov ... Full text Link to item Cite

Recombinant Zoster Vaccine Is Efficacious and Safe in Frail Individuals.

Journal Article J Am Geriatr Soc · March 2021 BACKGROUND/OBJECTIVES: Frail participants are often under-represented in randomized trials, raising questions about outcomes of interventions in real-world settings. Frailty is strongly associated with vulnerability to illness and adverse health outcomes. ... Full text Link to item Cite

Impact of Reactogenicity After Two Doses of Recombinant Zoster Vaccine Upon Physical Functioning and Quality of Life: An Open Phase III Trial in Older Adults.

Journal Article J Gerontol A Biol Sci Med Sci · February 25, 2021 BACKGROUND: Herpes zoster may significantly impact quality of life (QoL) in older adults. The recombinant zoster vaccine (RZV) is efficacious in adults aged ≥50 and older and is associated with increased reactogenicity compared to placebo. We report here o ... Full text Link to item Cite

Immunogenicity and safety of different dose schedules and antigen doses of an MF59-adjuvanted H7N9 vaccine in healthy adults aged 65 years and older.

Journal Article Vaccine · February 22, 2021 BACKGROUND: The number of human influenza A (H7N9) infections has escalated since 2013 with high resultant mortality. We conducted a phase II, randomized, partially-blinded trial to evaluate the safety and immunogenicity of an MF59-adjuvanted inactivated, ... Full text Link to item Cite

Medication Use Quality and Safety in Older Adults: 2019 Update.

Journal Article J Am Geriatr Soc · February 2021 Improving the quality of medication use and medication safety are important priorities for prescribers who care for older adults. The objective of this article was to identify four exemplary articles with this focus in 2019. We selected high-quality studie ... Full text Link to item Cite

Safety, Reactogenicity, and Health-Related Quality of Life After Trivalent Adjuvanted vs Trivalent High-Dose Inactivated Influenza Vaccines in Older Adults: A Randomized Clinical Trial.

Journal Article JAMA Netw Open · January 4, 2021 IMPORTANCE: Trivalent adjuvanted inactivated influenza vaccine (aIIV3) and trivalent high-dose inactivated influenza vaccine (HD-IIV3) are US-licensed for adults aged 65 years and older. Data are needed on the comparative safety, reactogenicity, and health ... Full text Link to item Cite

Embedding and Sustaining a Focus on Function in Specialty Research and Care.

Journal Article J Am Geriatr Soc · January 2021 Function and the independent performance of daily activities are of critical importance to older adults. Although function was once a domain of interest primarily limited to geriatricians, transdisciplinary research has demonstrated its value across the sp ... Full text Link to item Cite

Considering Frailty in SARS-CoV-2 Vaccine Development: How Geriatricians Can Assist.

Journal Article Clin Interv Aging · 2021 The COVID-19 pandemic has disproportionately impacted frail older adults, especially residents of long-term care (LTC) facilities. This has appropriately led to prioritization of frail older adults and LTC residents, and those who care for them, in the vac ... Full text Link to item Cite

Two Approaches to Classifying and Quantifying Physical Resilience in Longitudinal Data.

Journal Article J Gerontol A Biol Sci Med Sci · March 9, 2020 BACKGROUND: Approaches for quantifying physical resilience in older adults have not been described. METHODS: We apply two conceptual approaches to defining physical resilience to existing longitudinal data sets in which outcomes are measured after an acute ... Full text Link to item Cite

Age matters: older age as a risk factor for CMV reactivation in the CMV serostatus-positive kidney transplant recipient.

Journal Article Eur J Clin Microbiol Infect Dis · March 2020 Evaluate risk factors for cytomegalovirus (CMV) reactivation during the first year after kidney transplantation in the CMV-seropositive older recipient. Retrospective single-center study. Between 2011 and 2015, 91 patients ≥ 65 years received a kidney tran ... Full text Link to item Cite

Discharge Information and Support for Patients Discharged from the Emergency Department: Results from a Randomized Controlled Trial.

Journal Article J Gen Intern Med · January 2020 BACKGROUND: Little research has been done on primary care-based models to improve health care use after an emergency department (ED) visit. OBJECTIVE: To examine the effectiveness of a primary care-based, nurse telephone support intervention for Veterans t ... Full text Link to item Cite

Impact of Location of Acquisition of Gram-Positive Bloodstream Infections on Clinical Outcomes Among Patients Admitted to Community Hospitals.

Journal Article Infect Drug Resist · 2020 PURPOSE: We investigated the association between location of acquisition (LOA) of gram-positive (GP) bloodstream infections (BSI) in community hospitals and clinical outcomes. METHODS: We performed a multicenter cohort study of adult inpatients with GP BSI ... Full text Link to item Cite

Impact of Supervised Exercise on One-Year Medication Use in Older Veterans with Multiple Morbidities.

Journal Article Gerontol Geriatr Med · 2020 Exercise is touted as the ideal prescription to treat and prevent many chronic diseases. We examined changes in utilization and cost of medication classes commonly prescribed in the management of chronic conditions following participation in 12-months of s ... Full text Link to item Cite

Medication Use Quality and Safety in Older Adults: 2018 Update.

Journal Article J Am Geriatr Soc · December 2019 Improving the quality of medication use and medication safety is an important priority for prescribers who care for older adults. The objective of this article was to identify key articles from 2018 that address these issues. In addition, we selected four ... Full text Link to item Cite

Measuring Underuse and Overuse of Medications.

Journal Article J Am Geriatr Soc · November 2019 Full text Link to item Cite

Solid organ transplantation in older adults. Infectious and other age-related considerations.

Journal Article OBM Transplant · November 2019 In the U.S., older adults aged 65 or above comprise nearly one quarter of the solid organ transplant (SOT) waitlists, and the number of transplants performed in this age group continues to increase. There are no specific guidelines for the assessment and f ... Full text Link to item Cite

The Effect of Age on the Immunogenicity of the Live Attenuated Zoster Vaccine Is Predicted by Baseline Regulatory T Cells and Varicella-Zoster Virus-Specific T Cell Immunity.

Journal Article J Virol · August 1, 2019 Older age is associated with increased infectious morbidity and decreased immune responses to vaccines, but the mechanisms that mediate this effect are incompletely understood. The efficacy and immunogenicity of the live attenuated zoster vaccine (ZVL) hav ... Full text Link to item Cite

The Impact of Reactogenicity After the First Dose of Recombinant Zoster Vaccine on the Physical Functioning and Quality of Life of Older Adults: An Open-Label, Phase III Trial.

Journal Article J Gerontol A Biol Sci Med Sci · July 12, 2019 BACKGROUND: Herpes zoster and its related complications are associated with significant medical burden, which negatively affects quality of life and daily functioning of the patients. The recently licensed recombinant zoster vaccine (RZV) offers high effic ... Full text Link to item Cite

Age-related changes in B cell metabolism.

Journal Article Aging (Albany NY) · July 8, 2019 Antibody responses to vaccinations or infections decline upon aging. In this study we tested if metabolic changes in B cells may contribute to attenuation of responses to influenza vaccination in aged humans. Our data show that aging affects mitochondrial ... Full text Link to item Cite

Infections after kidney transplantation. Does age matter?

Journal Article Clin Transplant · April 2019 Infections threaten successful outcomes after kidney transplantation. Our aim was to determine if the number, types of infections and the risk factors for common infections differed between older compared to younger kidney transplant (KT) recipients in the ... Full text Link to item Cite

Pathways, Contributors, and Correlates of Functional Limitation Across Specialties: Workshop Summary.

Journal Article J Gerontol A Biol Sci Med Sci · March 14, 2019 Traditional clinical care models focus on the measurement and normalization of individual organ systems and de-emphasize aspects of health related to the integration of physiologic systems. Measures of physical, cognitive and sensory, and psychosocial or e ... Full text Link to item Cite

Influenza Virus Vaccination Elicits Poorly Adapted B Cell Responses in Elderly Individuals.

Journal Article Cell Host Microbe · March 13, 2019 Influenza is a leading cause of death in the elderly, and the vaccine protects only a fraction of this population. A key aspect of antibody-mediated anti-influenza virus immunity is adaptation to antigenically distinct epitopes on emerging strains. We exam ... Full text Link to item Cite

Pharmacotherapy in Older Adults with Cardiovascular Disease: Report from an American College of Cardiology, American Geriatrics Society, and National Institute on Aging Workshop.

Journal Article J Am Geriatr Soc · February 2019 OBJECTIVES: To identify the top priority areas for research to optimize pharmacotherapy in older adults with cardiovascular disease (CVD). DESIGN: Consensus meeting. SETTING: Multidisciplinary workshop supported by the National Institute on Aging, the Amer ... Full text Link to item Cite

Persistence of Varicella-Zoster Virus Cell-Mediated Immunity After the Administration of a Second Dose of Live Herpes Zoster Vaccine.

Journal Article J Infect Dis · January 7, 2019 Protection against zoster conferred by zoster vaccine live (ZVL; Zostavax) wanes over time. We compared varicella-zoster virus cell-mediated immunity (VZV-CMI) of adults ≥70 years who received a second dose of ZVL ≥10 years after the initial dose with de n ... Full text Link to item Cite

Single-center analysis of infectious complications in older adults during the first year after kidney transplantation.

Journal Article Eur J Clin Microbiol Infect Dis · January 2019 Infections are among the top three causes of death of older adults in the first year after kidney transplantation (KT). Our aim was to describe infectious complications among KT recipients aged ≥ 65 during the first 12 months post-transplant. Single-center ... Full text Link to item Cite

Evaluation of two frailty indices, with practical application in a vaccine clinical trial.

Journal Article Hum Vaccin Immunother · 2019 Frail older adults are at increased risk of poor clinical outcomes. Frailty assessment is therefore important in clinical trials to understand the benefits and harms of interventions. However, consensus is lacking on how frailty should be assessed.We devel ... Full text Link to item Cite

Herpes Zoster.

Journal Article Ann Intern Med · December 18, 2018 Full text Link to item Cite

Update on Medication Use Quality and Safety in Older Adults, 2017.

Journal Article J Am Geriatr Soc · December 2018 Improving the quality of medication use and medication safety in older adults is an important public health priority and is of paramount importance for clinicians who care for them. We selected four important articles from 2017 that address these issues to ... Full text Link to item Cite

Disproportionate Use of Inpatient Care by Older Adults With Kidney Stones.

Journal Article Urology · October 2018 OBJECTIVE: To describe variation in utilization and costs of inpatient care for patients with kidney stones, examining associations with older age. MATERIALS AND METHODS: Using the Nationwide Inpatient Sample we examined inpatient discharges with stone dia ... Full text Link to item Cite

Infections in Older Adults: A Case-Based Discussion Series Emphasizing Antibiotic Stewardship.

Journal Article MedEdPORTAL · September 21, 2018 INTRODUCTION: Compared with younger populations, adults 65 years and older are more likely to suffer infection-related morbidity and mortality, experience antibiotic-related adverse events, and acquire multidrug-resistant organisms. We developed a series o ... Full text Open Access Link to item Cite

Herpes Zoster.

Journal Article Ann Intern Med · August 7, 2018 Primary care providers and hospitalists frequently encounter older or immunocompromised patients with herpes zoster accompanied by debilitating pain. Atypical presentations and zosteriform herpes simplex may present diagnostic challenges to clinicians. Thi ... Full text Link to item Cite

Poor Immunogenicity, Not Vaccine Strain Egg Adaptation, May Explain the Low H3N2 Influenza Vaccine Effectiveness in 2012-2013.

Journal Article Clin Infect Dis · July 18, 2018 BACKGROUND: Influenza vaccination aims to prevent infection by influenza virus and reduce associated morbidity and mortality; however, vaccine effectiveness (VE) can be modest, especially for subtype A(H3N2). Low VE has been attributed to mismatches betwee ... Full text Link to item Cite

A New Community Health Center/Academic Medicine Partnership for Medicaid Cost Control, Powered by the Mega Teaching Health Center.

Journal Article Acad Med · March 2018 Community health centers (CHCs), a principal source of primary care for over 24 million patients, provide high-quality affordable care for medically underserved and lower-income populations in urban and rural communities. The authors propose that CHCs can ... Full text Link to item Cite

Meta-analysis of Interventions to Reduce Adverse Drug Reactions in Older Adults.

Journal Article J Am Geriatr Soc · February 2018 OBJECTIVES: To examine the effect of interventions to optimize medication use on adverse drug reactions (ADRs) in older adults. DESIGN: Systematic review and meta-analysis. EMBASE, PubMed, OVID, Cochrane Library, Clinicaltrials.gov, and Google Scholar were ... Full text Link to item Cite

Immune response to influenza vaccination in the elderly is altered by chronic medication use.

Journal Article Immun Ageing · 2018 BACKGROUND: The elderly patient population is the most susceptible to influenza virus infection and its associated complications. Polypharmacy is common in the aged, who often have multiple co-morbidities. Previous studies have demonstrated that commonly u ... Full text Link to item Cite

Integrating Frailty Research into the Medical Specialties-Report from a U13 Conference.

Journal Article J Am Geriatr Soc · October 2017 Although the field of frailty research has expanded rapidly, it is still a nascent concept within the clinical specialties. Frailty, conceptualized as greater vulnerability to stressors because of significant depletion of physiological reserves, predicts p ... Full text Link to item Cite

Risk stratification for return emergency department visits among high-risk patients.

Journal Article Am J Manag Care · August 1, 2017 OBJECTIVES: To compare 2 methods of identifying patients at high-risk of repeat emergency department (ED) use: high Care Assessment Need (CAN) score (≥90), derived from a model using Veterans Health Administration (VHA) data, and "Super User" status, defin ... Link to item Cite

Recent Literature Update on Medication Risk in Older Adults, 2015-2016.

Journal Article J Am Geriatr Soc · July 2017 Medications can pose considerable risk in older adults. This article annotates four articles addressing this concern from 2016. The first provides national data on the use of specific prescription, over-the-counter and dietary supplements in older adults a ... Full text Link to item Cite

The effect of timing of influenza vaccination and sample collection on antibody titers and responses in the aged.

Journal Article Vaccine · June 27, 2017 Antibody responses, B cell subset distribution in blood and the blood transcriptome were analyzed in younger and aged human subjects before and after vaccination with the inactivated influenza vaccine. In the aged, but not the younger, individuals we saw a ... Full text Link to item Cite

Aging, the Medical Subspecialties, and Career Development: Where We Were, Where We Are Going.

Journal Article J Am Geriatr Soc · April 2017 Historically, the medical subspecialties have not focused on the needs of older adults. This has changed with the implementation of initiatives to integrate geriatrics and aging research into the medical and surgical subspecialties and with the establishme ... Full text Link to item Cite

Successive annual influenza vaccination induces a recurrent oligoclonotypic memory response in circulating T follicular helper cells.

Journal Article Sci Immunol · February 2017 T follicular helper (Tfh) CD4 cells are crucial providers of B cell help during adaptive immune responses. A circulating population of CD4 T cells, termed cTfh, have similarity to lymphoid Tfh, can provide B cell help, and responded to influenza vaccinatio ... Full text Link to item Cite

Race-related differences in antibody responses to the inactivated influenza vaccine are linked to distinct pre-vaccination gene expression profiles in blood.

Journal Article Oncotarget · September 27, 2016 We conducted a 5-year study analyzing antibody and B cell responses to the influenza A virus components of the inactivated influenza vaccine, trivalent (IIV3) or quadrivalent (IIV4) in younger (aged 35-45) and aged (≥65 years of age) Caucasian and African ... Full text Link to item Cite

Applying a Lifespan Developmental Perspective to Chronic Pain: Pediatrics to Geriatrics.

Journal Article J Pain · September 2016 UNLABELLED: An ideal taxonomy of chronic pain would be applicable to people of all ages. Developmental sciences focus on lifespan developmental approaches, and view the trajectory of processes in the life course from birth to death. In this article we prov ... Full text Link to item Cite

Deconstructing Chronic Low Back Pain in the Older Adult-Step by Step Evidence and Expert-Based Recommendations for Evaluation and Treatment: Part X: Sacroiliac Joint Syndrome.

Journal Article Pain Med · September 2016 OBJECTIVE: To present an algorithm of sequential treatment options for managing sacroiliac joint (SIJ) pain in the setting of chronic low back pain (CLBP) in the older adult. This is the tenth part in a series, and includes an illustrative clinical case. M ... Full text Link to item Cite

Herpes Zoster.

Journal Article Clin Geriatr Med · August 2016 Herpes zoster causes significant suffering owing to acute and chronic pain or postherpetic neuralgia (PHN). Varicella-zoster virus-induced neuronal destruction and inflammation causes the principal problems of pain, interference with activities of daily li ... Full text Link to item Cite

Physical Resilience in Older Adults: Systematic Review and Development of an Emerging Construct.

Journal Article J Gerontol A Biol Sci Med Sci · April 2016 BACKGROUND: Resilience has been described in the psychosocial literature as the capacity to maintain or regain well-being during or after adversity. Physical resilience is a newer concept that is highly relevant to successful aging. Our objective was to ch ... Full text Link to item Cite

Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.

Journal Article Am J Infect Control · March 1, 2016 We describe a course in the Veterans Affairs (VA) Employee Education System designed to engage nursing staff working in VA long-term care facilities as partners in antimicrobial stewardship. We found that the course addressed an important knowledge gap. Ou ... Full text Link to item Cite

Recent Literature on Medication Errors and Adverse Drug Events in Older Adults.

Journal Article J Am Geriatr Soc · February 2016 Medication errors and adverse drug events are common in older adults, but locating literature addressing these issues is often challenging. The objective of this article is to summarize recent studies addressing medication errors and adverse drug events in ... Full text Link to item Cite

Herpes Zoster Vaccination: Controversies and Common Clinical Questions.

Journal Article Gerontology · 2016 Herpes zoster, clinically referred to as shingles, is an acute, cutaneous viral infection caused by reactivation of the varicella zoster virus, the same virus that causes chickenpox. The incidence of herpes zoster and its complications increase with declin ... Full text Link to item Cite

Cellular and Humoral Responses to a Second Dose of Herpes Zoster Vaccine Administered 10 Years After the First Dose Among Older Adults.

Journal Article J Infect Dis · January 1, 2016 BACKGROUND: Herpes zoster vaccine (ZV) was administered as a second dose to 200 participants ≥ 70 years old who had received a dose of ZV ≥ 10 years previously (NCT01245751). METHODS: Varicella zoster virus (VZV) antibody titers (measured by a VZV glycopro ... Full text Link to item Cite

Alternative Medications for Medications in the Use of High-Risk Medications in the Elderly and Potentially Harmful Drug-Disease Interactions in the Elderly Quality Measures.

Journal Article J Am Geriatr Soc · December 2015 The National Committee for Quality Assurance (NCQA) and the Pharmacy Quality Alliance (PQA) use the American Geriatrics Society (AGS) Beers Criteria to designate the quality measure Use of High-Risk Medications in the Elderly (HRM). The Centers for Medicar ... Full text Link to item Cite

A shortened interval between vaccinations with the trivalent inactivated influenza vaccine increases responsiveness in the aged.

Journal Article Aging (Albany NY) · December 2015 We tested antibody responses to the trivalent inactivated influenza vaccine (TIV) in 34 aged individuals (>65 yrs) during the 2012/13 vaccination seasons. Nearly all had been vaccinated the previous year although the time interval between the two vaccine d ... Full text Link to item Cite

Deconstructing chronic low back pain in the older adult--Step by step evidence and expert-based recommendations for evaluation and treatment part III: Fibromyalgia syndrome.

Journal Article Pain Med · September 2015 OBJECTIVE: To present the third in a series of articles designed to deconstruct chronic low back pain (CLBP) in older adults. The series presents CLBP as a syndrome, a final common pathway for the expression of multiple contributors rather than a disease l ... Full text Link to item Cite

BTLA expression declines on B cells of the aged and is associated with low responsiveness to the trivalent influenza vaccine.

Journal Article Oncotarget · August 14, 2015 Virus-neutralizing antibody and B cell responses to influenza A viruses were measured in 35 aged and 28 middle-aged individuals following vaccination with the 2012 and 2013 trivalent inactivated influenza vaccines. Antibody responses to the vaccine strains ... Full text Link to item Cite

Deconstructing Chronic Low Back Pain in the Older Adult-Step by Step Evidence and Expert-Based Recommendations for Evaluation and Treatment: Part II: Myofascial Pain.

Journal Article Pain Med · July 2015 OBJECTIVE: To present an algorithm of sequential treatment options for managing myofascial pain (MP) in older adults, along with a representative clinical case. METHODS: A modified Delphi process was used to synthesize evidence-based recommendations. A mul ... Full text Link to item Cite

Long-term persistence of zoster vaccine efficacy.

Journal Article Clin Infect Dis · March 15, 2015 BACKGROUND: The Shingles Prevention Study (SPS) demonstrated zoster vaccine efficacy through 4 years postvaccination. A Short-Term Persistence Substudy (STPS) demonstrated persistence of vaccine efficacy for at least 5 years. A Long-Term Persistence Substu ... Full text Link to item Cite

Knowledge, beliefs, and confidence regarding infections and antimicrobial stewardship: a survey of Veterans Affairs providers who care for older adults.

Journal Article Am J Infect Control · March 1, 2015 We conducted an anonymous survey of providers who care for older adults from 10 Veterans Affairs long-term-care facilities to assess their knowledge, beliefs, and confidence toward treating infections and antimicrobial stewardship. The average score on 5 q ... Full text Link to item Cite

Chronic wound repair and healing in older adults: current status and future research.

Journal Article J Am Geriatr Soc · March 2015 Older adults are more likely to have chronic wounds than younger people, and the effect of chronic wounds on quality of life is particularly profound in this population. Wound healing slows with age, but the basic biology underlying chronic wounds and the ... Full text Link to item Cite

Advisory committee on immunization practices recommended immunization schedule for adults aged 19 years or older--United States, 2015.

Journal Article MMWR Morb Mortal Wkly Rep · February 6, 2015 In October 2014, the Advisory Committee on Immunization Practices (ACIP) approved the Recommended Immunization Schedule for Adults Aged 19 Years or Older, United States, 2015. This schedule provides a summary of ACIP recommendations for the use of vaccines ... Link to item Cite

Epidemiology of drug-disease interactions in older veteran nursing home residents.

Journal Article J Am Geriatr Soc · January 2015 OBJECTIVES: To describe the prevalence of and factors associated with drug-disease interactions (DDIs) in older nursing home residents according to the American Geriatrics Society 2012 Beers Criteria. DESIGN: Cross-sectional. SETTING: Fifteen Veterans Affa ... Full text Link to item Cite

Chronic wound repair and healing in older adults: current status and future research.

Journal Article Wound Repair Regen · 2015 The incidence of chronic wounds is increased among older adults, and the impact of chronic wounds on quality of life is particularly profound in this population. It is well established that wound healing slows with age. However, the basic biology underlyin ... Full text Link to item Cite

Discharge information and support for veterans Receiving Outpatient Care in the Emergency Department: study design and methods.

Journal Article Contemp Clin Trials · November 2014 BACKGROUND: An explicit goal of Patient Aligned Care Teams (PACTs) within the Veterans Health Administration is to promote continuity of care in primary care clinics and thereby reduce Emergency Department (ED) utilization; however, there has been little r ... Full text Link to item Cite

Impact of body mass index on immunogenicity of pandemic H1N1 vaccine in children and adults.

Journal Article J Infect Dis · October 15, 2014 Obesity emerged as a risk factor for morbidity and mortality related to 2009 pandemic influenza A (H1N1) infection. However, few studies examine the immune responses to H1N1 vaccine among children and adults of various body mass indices (BMI). Pooling data ... Full text Link to item Cite

Circulating CXCR5+PD-1+ response predicts influenza vaccine antibody responses in young adults but not elderly adults.

Journal Article J Immunol · October 1, 2014 Although influenza vaccination is recommended for all adults annually, the incidence of vaccine failure, defined as weak or absent increase in neutralizing Ab titers, is increased in the elderly compared with young adults. The T follicular helper cell (Tfh ... Full text Link to item Cite

Medication misadventures in older adults: literature from 2013.

Journal Article J Am Geriatr Soc · October 2014 The objective of this paper is to review articles published in 2013 examining drug-related problems in the elderly and comment on their potential impact on clinical practice. To identify articles, we did a systematic search of the English-language literatu ... Full text Link to item Cite

Designing therapeutic clinical trials for older and frail adults with cancer: U13 conference recommendations.

Journal Article J Clin Oncol · August 20, 2014 A majority of cancer diagnoses and deaths occur in patients age ≥ 65 years. With the aging of the US population, the number of older adults with cancer will grow. Although the coming wave of older patients with cancer was anticipated in the early 1980s, wh ... Full text Link to item Cite

Designing therapeutic clinical trials for older and frail adults with cancer: U13 conference recommendations.

Journal Article J Clin Oncol · August 20, 2014 A majority of cancer diagnoses and deaths occur in patients age ≥ 65 years. With the aging of the US population, the number of older adults with cancer will grow. Although the coming wave of older patients with cancer was anticipated in the early 1980s, wh ... Link to item Cite

Diabetes and cardiovascular disease in older adults: current status and future directions.

Journal Article Diabetes · August 2014 The prevalence of diabetes increases with age, driven in part by an absolute increase in incidence among adults aged 65 years and older. Individuals with diabetes are at higher risk for cardiovascular disease, and age strongly predicts cardiovascular compl ... Full text Link to item Cite

A framework for crafting clinical practice guidelines that are relevant to the care and management of people with multimorbidity.

Journal Article J Gen Intern Med · April 2014 Many patients of all ages have multiple conditions, yet clinicians often lack explicit guidance on how to approach clinical decision-making for such people. Most recommendations from clinical practice guidelines (CPGs) focus on the management of single dis ... Full text Link to item Cite

Advisory Committee on Immunization Practices recommended immunization schedule for adults aged 19 years or older - United States, 2014.

Journal Article MMWR Morb Mortal Wkly Rep · February 7, 2014 Vaccines are recommended for adults on the basis of their age, prior vaccinations, health conditions, lifestyle, occupation, and travel. Reasons for current low levels of vaccination coverage for adult vaccines are multifactorial and include limited awaren ... Link to item Cite

Effect of nosocomial bloodstream infections on mortality, length of stay, and hospital costs in older adults.

Journal Article J Am Geriatr Soc · February 2014 OBJECTIVES: To quantify the effect of nosocomial bloodstream infection (BSI) on older adults, including mortality, length of stay (LOS), and costs attributed to BSI. DESIGN: Retrospective cohort study. SETTING: Eight acute care hospitals (7 community hospi ... Full text Link to item Cite

Bloodstream infections in community hospitals in the 21st century: a multicenter cohort study.

Journal Article PLoS One · 2014 BACKGROUND: While the majority of healthcare in the US is provided in community hospitals, the epidemiology and treatment of bloodstream infections in this setting is unknown. METHODS AND FINDINGS: We undertook this multicenter, retrospective cohort study ... Full text Open Access Link to item Cite

Varicella-zoster virus-specific antibody responses in 50-59-year-old recipients of zoster vaccine.

Journal Article J Infect Dis · November 1, 2013 Prevaccination and 6-week postvaccination samples from the immunogenicity substudy (n = 2269) of the zoster vaccine (ZV) efficacy trial (N = 22 439) in 50-59-year-old subjects were examined for varicella-zoster virus-specific antibody responses to vaccinat ... Full text Link to item Cite

The medication appropriateness index at 20: where it started, where it has been, and where it may be going.

Journal Article Drugs Aging · November 2013 Potentially inappropriate prescribing for older adults is a major public health concern. While there are multiple measures of potentially inappropriate prescribing, the medication appropriateness index (MAI) is one of the most common implicit approaches pu ... Full text Link to item Cite

Health services use of older veterans treated and released from veterans affairs medical center emergency departments.

Journal Article J Am Geriatr Soc · September 2013 OBJECTIVES: To determine predictors of repeat health service use in older veterans treated and released from the emergency department (ED). DESIGN: Retrospective cohort study. SETTING: Veterans Affairs Medical Center (VAMC) EDs. PARTICIPANTS: Nationally re ... Full text Link to item Cite

Safety of zoster vaccine in elderly adults following documented herpes zoster.

Journal Article J Infect Dis · August 15, 2013 BACKGROUND: After completion of the Shingles Prevention Study (SPS; Department of Veterans Affairs Cooperative Studies Program Number 403), SPS participants who had initially received placebo were offered investigational zoster vaccine without charge. This ... Full text Link to item Cite

Transitional Care Partners: a hospital-to-home support for older adults and their caregivers.

Journal Article J Am Assoc Nurse Pract · August 2013 PURPOSE: To describe the development, implementation, and preliminary results of the Transitional Care (TLC) Partners, a clinical demonstration program that supports the transition from hospital to home of older veterans. DATA SOURCES: Hospital records of ... Full text Link to item Cite

Increased T-bet is associated with senescence of influenza virus-specific CD8 T cells in aged humans.

Journal Article J Leukoc Biol · June 2013 Aged individuals have increased morbidity and mortality following influenza and other viral infections, despite previous exposure or vaccination. Mouse and human studies suggest increased senescence and/or exhaustion of influenza virus-specific CD8 T cells ... Full text Link to item Cite

Vaccination against herpes zoster in developed countries: state of the evidence.

Journal Article Hum Vaccin Immunother · May 2013 Although progress has been made in the treatment of herpes zoster (HZ) and postherpetic neuralgia (PHN), available therapeutic options are only partially effective. Given evidence that a live-attenuated varicella-zoster-virus vaccine is effective at reduci ... Full text Link to item Cite

B cell responses to the 2011/12-influenza vaccine in the aged.

Journal Article Aging (Albany NY) · March 2013 Antibody and B cell responses to influenza A viruses were measured over a period of 2 months in 30 aged and 15 middle-aged individuals following vaccination with the 2011/12 trivalent inactivated influenza vaccine by micro-neutralization assays, ELISAs, EL ... Full text Link to item Cite

Functional status after lung transplantation in older adults in the post-allocation score era.

Journal Article Am J Transplant · January 2013 This manuscript describes the functional status trajectory of older (age 65 or older) and younger (age 18-64) adults after lung transplantation (LT). After the implementation of the lung allocation score (LAS) in 2005, older adults became the fastest growi ... Full text Link to item Cite

Delays in appropriate antibiotic therapy for gram-negative bloodstream infections: a multicenter, community hospital study.

Journal Article PLoS One · 2013 BACKGROUND: Gram-negative bacterial bloodstream infection (BSI) is a serious condition with estimated 30% mortality. Clinical outcomes for patients with severe infections improve when antibiotics are appropriately chosen and given early. The objective of t ... Full text Open Access Link to item Cite

Vaccine-induced boosting of influenza virus-specific CD4 T cells in younger and aged humans.

Journal Article PLoS One · 2013 Current yearly influenza virus vaccines induce strain-specific neutralizing antibody (NAb) responses providing protective immunity to closely matched viruses. However, these vaccines are often poorly effective in high-risk groups such as the elderly and ch ... Full text Link to item Cite

A randomized, controlled study to assess the effect of silk-like textiles and high-absorbency adult incontinence briefs on pressure ulcer prevention.

Journal Article Ostomy Wound Manage · December 2012 Pressure ulcer prevention is an important aspect of nursing home care. A 20-week, unblinded, randomized, controlled trial was conducted to compare the rate of nursing home-acquired pressure ulcers and adverse events between residents managed using: 1) a si ... Link to item Cite

Persistence of the efficacy of zoster vaccine in the shingles prevention study and the short-term persistence substudy.

Journal Article Clin Infect Dis · November 15, 2012 BACKGROUND: The Shingles Prevention Study (SPS; Department of Veterans Affairs Cooperative Study 403) demonstrated that zoster vaccine was efficacious through 4 years after vaccination. The Short-Term Persistence Substudy (STPS) was initiated after the SPS ... Full text Link to item Cite

Solid-organ transplantation in older adults: current status and future research.

Journal Article Am J Transplant · October 2012 An increasing number of patients older than 65 years are referred for and have access to organ transplantation, and an increasing number of older adults are donating organs. Although short-term outcomes are similar in older versus younger transplant recipi ... Full text Link to item Cite

Role of pain medications, consultants, and other services in improved pain control of elderly adults with cancer in geriatric evaluation and management units.

Journal Article J Am Geriatr Soc · October 2012 OBJECTIVES: To determine whether pain medication use and inpatient consultations and services were associated with significantly better pain control. DESIGN: Secondary data analysis from a randomized two-by-two factorial trial. Hospitalized, frail individu ... Full text Link to item Cite

Older veterans and emergency department discharge information.

Journal Article BMJ Qual Saf · October 2012 BACKGROUND: Study goals were to assess older veterans' understanding of their emergency department (ED) discharge information and to determine the association between understanding discharge information and patient assessment of overall quality of care. ME ... Full text Link to item Cite

Reply to arroyo

Journal Article Clinical Infectious Diseases · September 1, 2012 Full text Cite

Department of Veterans Affairs Geriatric Research, Education and Clinical Centers: translating aging research into clinical geriatrics.

Journal Article J Am Geriatr Soc · July 2012 Department of Veterans Affairs (VA) Geriatric Research, Education and Clinical Centers (GRECCs) originated in 1975 in response to the rapidly aging veteran population. Since its inception, the GRECC program has made major contributions to the advancement o ... Full text Link to item Cite

Biological, clinical, and psychosocial correlates at the interface of cancer and aging research.

Journal Article J Natl Cancer Inst · April 18, 2012 In September 2010, the Cancer and Aging Research Group, in collaboration with the National Cancer Institute and the National Institute on Aging, conducted the first of three planned conferences to discuss research methodology to generate the highest qualit ... Full text Link to item Cite

Efficacy, safety, and tolerability of herpes zoster vaccine in persons aged 50-59 years.

Journal Article Clin Infect Dis · April 2012 BACKGROUND: Herpes zoster (HZ) adversely affects individuals aged 50-59, but vaccine efficacy has not been assessed in this population. This study was designed to determine the efficacy, safety, and tolerability of zoster vaccine for preventing HZ in perso ... Full text Link to item Cite

Employment related productivity loss associated with herpes zoster and postherpetic neuralgia: a 6-month prospective study.

Journal Article Vaccine · March 9, 2012 We conducted a prospective multi-center study to assess productivity loss associated with herpes zoster (HZ) and postherpetic neuralgia (PHN). From 10/2005 to 07/2006, we recruited immunocompetent subjects aged ≥50 years with HZ within 14 days of rash onse ... Full text Link to item Cite

Economic burden of herpes zoster among skilled nursing facility residents in the United States.

Journal Article J Am Med Dir Assoc · January 2012 OBJECTIVES: To evaluate health care resource use and direct medical costs attributable to herpes zoster (HZ) among elderly residents of skilled nursing facilities (SNF). METHODS: This was a retrospective matched cohort study using data from 300 SNF in the ... Full text Link to item Cite

Health care utilization before and after an outpatient ED visit in older people.

Journal Article Am J Emerg Med · January 2012 BACKGROUND: Older adults in the United States receive a significant amount of care in the emergency department (ED), yet the associations between ED and other types of health care utilization have not been adequately studied in this population. OBJECTIVES: ... Full text Link to item Cite

Geriatric inpatient units in the care of hospitalized frail adults with a history of heart failure

Journal Article International Journal of Gerontology · January 1, 2012 Background: Frail hospitalized older adults are at risk for adverse outcomes. Previous studies have suggested benefits for inpatient geriatric management (GEM). We sought to determine whether hospitalized patients with a history of heart failure (HF) benef ... Full text Cite

Association between prodromal pain and the severity of acute herpes zoster and utilization of health care resources.

Journal Article Eur J Pain · November 2011 BACKGROUND: Herpes zoster results from the reactivation of the varicella-zoster virus, which is often accompanied by a prodrome of dermatomal pain. Little is known about the burden of prodromal pain. OBJECTIVES: (1) Describe the frequency, severity and dur ... Full text Link to item Cite

Emergency department visits in Veterans Affairs medical facilities.

Journal Article Am J Manag Care · June 1, 2011 OBJECTIVE: To identify the frequency of, and risk factors for, repeat emergency department (ED) visits and hospitalizations following a treat-andrelease ED visit in patients from Veterans Affairs Medical Centers (VAMCs). STUDY DESIGN: Retrospective cohort ... Link to item Cite

Emergency department visits in veterans affairs medical facilities

Journal Article American Journal of Managed Care · June 1, 2011 Objective: To identify the frequency of, and risk factors for, repeat emergency department (ED) visits and hospitalizations following a treat-and-release ED visit in patients from Veterans Affairs Medical Centers (VAMCs). Study Design: Retrospective cohort ... Cite

Do geriatric conditions increase risk of adverse drug reactions in ambulatory elders? Results from the VA GEM Drug Study.

Journal Article J Gerontol A Biol Sci Med Sci · April 2011 BACKGROUND: Many clinicians prescribe cautiously to older adults with common geriatric conditions for fear of causing adverse drug reactions (ADRs). However, little is known about the association between these conditions and risk of ADRs. METHODS: Using da ... Full text Link to item Cite

Predictors of nosocomial bloodstream infections in older adults.

Journal Article J Am Geriatr Soc · April 2011 OBJECTIVES: To identify predictors and construct a prediction model for nosocomial bloodstream infection (BSI) in older adults. DESIGN: Retrospective case-control study. SETTING: Hospitals belonging to the Duke Infection Control Outreach Network. PARTICIPA ... Full text Link to item Cite

Emergency Department Discharge Information: What is Provided and Do Patients Understand?

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2011 Link to item Cite

Older Veterans Treated and Released from VAMC Emergency Departments.

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2011 Link to item Cite

Older patients' understanding of emergency department discharge information and its relationship with adverse outcomes.

Journal Article J Patient Saf · March 2011 OBJECTIVES: To describe older patients' understanding of emergency department (ED) discharge information and to explore the relationship between understanding of ED discharge information and adverse outcomes. METHODS: Telephone interviews were conducted wi ... Full text Link to item Cite

Goodbyes, hellos, and changes

Journal Article American Journal Geriatric Pharmacotherapy · February 1, 2011 Full text Cite

Acute kidney injury in older adults.

Journal Article J Am Soc Nephrol · January 2011 Aging kidneys undergo structural and functional changes that decrease autoregulatory capacity and increase susceptibility to acute injury. Acute kidney injury associates with duration and location of hospitalization, mortality risk, progression to chronic ... Full text Link to item Cite

Herpes zoster and postherpetic neuralgia

Journal Article · January 1, 2011 Full text Cite

Geriatric Pharmacotherapy and Polypharmacy

Journal Article · December 27, 2010 Full text Cite

The impact of herpes zoster and postherpetic neuralgia on health-related quality of life: a prospective study.

Journal Article CMAJ · November 9, 2010 BACKGROUND: Vaccination against herpes zoster is being considered in many countries. We conducted a multicentre prospective study to describe the impact of herpes zoster and postherpetic neuralgia on health-related quality of life. METHODS: From October 20 ... Full text Link to item Cite

Predictors of postherpetic neuralgia among patients with herpes zoster: a prospective study.

Journal Article J Pain · November 2010 UNLABELLED: Postherpetic neuralgia (PHN) is the most common complication of herpes zoster (HZ). The main objectives of this study were to: 1) estimate the severity and duration of PHN; and 2) identify the predictors of PHN. From October, 2005 to July, 2006 ... Full text Link to item Cite

Exploring patterns of health service use in older emergency department patients.

Journal Article Acad Emerg Med · October 2010 OBJECTIVES: Study objectives were to identify groups of older patients with similar patterns of health care use in the 12 months preceding an index outpatient emergency department (ED) visit and to identify patient-level predictors of group membership. MET ... Full text Link to item Cite

A prospective study of the herpes zoster severity of illness.

Journal Article Clin J Pain · October 2010 OBJECTIVE: MASTER, a multicenter prospective study, was conducted to provide a thorough understanding of the burden of herpes zoster (HZ) and postherpetic neuralgia (PHN). Objectives are to: (1) describe the herpes zoster severity-of-illness (HZSOI), a com ... Full text Link to item Cite

Effect of a zoster vaccine on herpes zoster-related interference with functional status and health-related quality-of-life measures in older adults.

Journal Article J Am Geriatr Soc · September 2010 OBJECTIVE: To determine the efficacy of a zoster vaccine on herpes zoster (HR)-related interference with activities of daily living (ADLs) and health-related quality of life (HRQL). DESIGN: Randomized double-blind placebo controlled trial. SETTING: Twenty- ... Full text Link to item Cite

Workshop on idiopathic pulmonary fibrosis in older adults.

Journal Article Chest · September 2010 Idiopathic pulmonary fibrosis (IPF), a heterogeneous disease with respect to clinical presentation and rates of progression, disproportionately affects older adults. The diagnosis of IPF is descriptive, based on clinical, radiologic, and histopathologic ex ... Full text Link to item Cite

Performance of diagnostic tests to detect respiratory viruses in older adults.

Journal Article Diagn Microbiol Infect Dis · July 2010 The performance of 4 laboratory methods for diagnosis of viral respiratory tract infections (RTI) in older adults was evaluated. Seventy-four nasopharyngeal (NP) swab specimens were obtained from 60 patients with RTI at a long-term care facility over 2 res ... Full text Link to item Cite

How much do older americans know about shingles?

Journal Article Annals of Long Term Care · July 1, 2010 Cite

The impact of herpes zoster and post-herpetic neuralgia on quality-of-life.

Journal Article BMC Med · June 21, 2010 BACKGROUND: The potentially serious nature of herpes zoster (HZ) and the long-term complication post-herpetic neuralgia (PHN) are often underestimated. One in four people will contract herpes zoster in their lifetime, with this risk rising markedly after t ... Full text Link to item Cite

What types of inappropriate prescribing predict adverse drug reactions in older adults?

Journal Article Ann Pharmacother · June 2010 Adverse drug events happen all too often in older adults, but we still do not have a clear understanding of potentially modifiable risk factors, with the exception of polypharmacy. This paper critiques the article in this issue of The Annals entitled, "Ina ... Full text Link to item Cite

Safety of herpes zoster vaccine in the shingles prevention study: a randomized trial.

Journal Article Ann Intern Med · May 4, 2010 BACKGROUND: The herpes zoster vaccine is effective in preventing herpes zoster and postherpetic neuralgia in immunocompetent older adults. However, its safety has not been described in depth. OBJECTIVE: To describe local adverse effects and short- and long ... Full text Link to item Cite

Workshop on immunizations in older adults: identifying future research agendas.

Journal Article J Am Geriatr Soc · April 2010 Goals for immunization in older adults may differ from those in young adults and children, in whom complete prevention of disease is the objective. Often, reduced hospitalization and death but also averting exacerbation of underlying chronic illness, funct ... Full text Link to item Cite

Treatment considerations for patients with neuropathic pain and other medical comorbidities.

Journal Article Mayo Clin Proc · March 2010 The efficacy of drugs for neuropathic pain has been established in randomized controlled trials that have excluded patients with comorbid conditions and those taking complex medications. However, patients with neuropathic pain frequently present with compl ... Full text Link to item Cite

Recommendations for the pharmacological management of neuropathic pain: an overview and literature update.

Journal Article Mayo Clin Proc · March 2010 The Neuropathic Pain Special Interest Group of the International Association for the Study of Pain recently sponsored the development of evidence-based guidelines for the pharmacological treatment of neuropathic pain. Tricyclic antidepressants, dual reupta ... Full text Link to item Cite

Treatment considerations for elderly and frail patients with neuropathic pain.

Journal Article Mayo Clin Proc · March 2010 Currently, an estimated 38 million individuals 65 years or older live in the United States, and more than 11 million of these individuals are 80 years or older. Older people are at high risk of neuropathic pain because many diseases that cause neuropathic ... Full text Link to item Cite

Poor functional status is an independent predictor of surgical site infections due to methicillin-resistant Staphylococcus aureus in older adults.

Journal Article J Am Geriatr Soc · March 2010 BACKGROUND: Methicillin-resistant Staphylococcus aureus (MRSA) has become a common surgical site infection (SSI) pathogen, particularly in older adults. Risk factors for MRSA SSI in elderly patients have not been described. METHODS: A nested case-control s ... Full text Link to item Cite

Ranolazine-related dyspnea on exertion.

Journal Article Am J Geriatr Pharmacother · February 2010 BACKGROUND: Ranolazine is increasingly being prescribed for the treatment of chronic stable angina. This report describes an adverse effect that may be related to ranolazine. CASE SUMMARY: A 77-year-old white man with chronic renal insufficiency was evalua ... Full text Link to item Cite

American Journal Geriatric Pharmacotherapy: Editorial

Journal Article American Journal Geriatric Pharmacotherapy · January 1, 2010 Full text Cite

Clinical and financial outcomes due to methicillin resistant Staphylococcus aureus surgical site infection: a multi-center matched outcomes study.

Journal Article PLoS One · December 15, 2009 BACKGROUND: The clinical and financial outcomes of SSIs directly attributable to MRSA and methicillin-resistance are largely uncharacterized. Previously published data have provided conflicting conclusions. METHODOLOGY: We conducted a multi-center matched ... Full text Link to item Cite

Age and persistent use of cardiovascular medication after acute coronary syndrome: results from medication applied and sustained over time.

Journal Article J Am Geriatr Soc · November 2009 OBJECTIVES: To describe the persistent use of evidence-based cardiovascular medications (EBCMs) 3 months after discharge from an acute coronary syndrome (ACS) event and patient-reported reasons for nonpersistence across age groups. DESIGN: Medication Appli ... Full text Link to item Cite

Varicella-zoster virus-specific immune responses to herpes zoster in elderly participants in a trial of a clinically effective zoster vaccine.

Journal Article J Infect Dis · October 1, 2009 BACKGROUND: The objectives of this study were to evaluate the association between varicella-zoster virus (VZV)-specific humoral and cell-mediated immunity (CMI) to herpes zoster (HZ) and protection against HZ morbidity and to compare immune responses to HZ ... Full text Link to item Cite

Underuse of indicated medications among physically frail older US veterans at the time of hospital discharge: results of a cross-sectional analysis of data from the Geriatric Evaluation and Management Drug Study.

Journal Article Am J Geriatr Pharmacother · October 2009 BACKGROUND: Medication underutilization, or the omission of a potentially beneficial medication indicated for disease management, is common among older adults but poorly understood. OBJECTIVES: The aims of this work were to assess the prevalence of medicat ... Full text Link to item Cite

Development and pilot testing of computerized order entry algorithms for geriatric problems in nursing homes.

Journal Article J Am Geriatr Soc · September 2009 OBJECTIVES: To develop order entry algorithms for five common nursing home problems and to test their acceptance, use, and preliminary effect on nine quality indicators and resource utilization. DESIGN: Pre-post, quasi-experimental study. SETTING: Two Depa ... Full text Link to item Cite

A real-time PCR assay to identify and discriminate among wild-type and vaccine strains of varicella-zoster virus and herpes simplex virus in clinical specimens, and comparison with the clinical diagnoses.

Journal Article J Med Virol · July 2009 A real-time PCR assay was developed to identify varicella-zoster virus (VZV) and herpes simplex virus (HSV) DNA in clinical specimens from subjects with suspected herpes zoster (HZ; shingles). Three sets of primers and probes were used in separate PCR reac ... Full text Link to item Cite

Prediction, progression, and outcomes of chronic kidney disease in older adults.

Journal Article J Am Soc Nephrol · June 2009 Chronic kidney disease is a large and growing problem among aging populations. Although progression of chronic kidney disease to end-stage renal disease (ESRD) is a costly and important clinical event with substantial morbidity, it appears less frequently ... Full text Link to item Cite

A randomized, placebo-controlled trial of oxycodone and of gabapentin for acute pain in herpes zoster.

Journal Article Pain · April 2009 Although acute pain in patients with herpes zoster can be severe and has a substantial impact on health-related quality of life, there have been no randomized clinical trials of oral medications specifically for its ongoing treatment. A randomized clinical ... Full text Link to item Cite

Respiratory syncytial virus outbreak in a long-term care facility detected using reverse transcriptase polymerase chain reaction: an argument for real-time detection methods.

Journal Article J Am Geriatr Soc · March 2009 OBJECTIVES: To report an outbreak of respiratory synctyial virus (RSV) in a long-term care facility (LTCF) during ongoing routine respiratory illness surveillance. DESIGN: Rapid antigen testing, viral culture, direct fluorescent antibody (DFA) testing, and ... Full text Link to item Cite

The Performance of Geriatric Inpatient Units in the Care of Frail Adults with Heart Failure

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · March 1, 2009 Link to item Cite

The effect of surgical site infection on older operative patients.

Journal Article J Am Geriatr Soc · January 2009 OBJECTIVES: To determine the effect of surgical site infection (SSI) on mortality, duration of hospitalization, and hospital cost in older operative patients. DESIGN: Retrospective matched-outcomes study. SETTING: Eight hospitals, including Duke University ... Full text Link to item Cite

Clinical and financial outcomes due to methicillin resistant staphylococcus aureus surgical site infection: A multi-center matched outcomes study

Journal Article PLoS ONE · 2009 Background: The clinical and financial outcomes of SSIs directly attributable to MRSA and methicillin-resistance are largely uncharacterized. Previously published data have provided conflicting conclusions. Methodology: We conducted a multi-center matched ... Full text Cite

Poor functional status as a risk factor for surgical site infection due to methicillin-resistant Staphylococcus aureus.

Journal Article Infect Control Hosp Epidemiol · September 2008 OBJECTIVE: To identify risk factors for surgical site infection (SSI) due to methicillin-resistant Staphylococcus aureus (MRSA). DESIGN: Prospective case-control study. SETTING: One tertiary and 6 community-based institutions in the southeastern United Sta ... Full text Link to item Cite

Aging and infectious diseases: workshop on HIV infection and aging: what is known and future research directions.

Journal Article Clin Infect Dis · August 15, 2008 Highly active antiretroviral treatment has resulted in dramatically increased life expectancy among patients with HIV infection who are now aging while receiving treatment and are at risk of developing chronic diseases associated with advanced age. Similar ... Full text Link to item Cite

Frequency and predictors of adverse health outcomes in older Medicare beneficiaries discharged from the emergency department.

Journal Article Med Care · August 2008 BACKGROUND: Older adults who are discharged from the emergency department (ED) may be at risk for subsequent adverse outcomes; however, this has not been fully investigated in national, population-based samples. The goal of this study was to determine the ... Full text Link to item Cite

Post-hospital clinic for older patients and their family caregivers

Journal Article Annals of Long Term Care · May 1, 2008 As a complementary service to our Geriatric Evaluation and Management Clinic, the geriatrics Post-Hospital Clinic (PHC) was recently established for prompt follow-up assessment and care of our geriatric patients and their caregivers after hospital discharg ... Cite

Quality of pharmacotherapy and outcomes for older veterans discharged from the emergency department.

Journal Article J Am Geriatr Soc · May 2008 OBJECTIVES: To determine whether suboptimal pharmacotherapy increases the risk of adverse outcomes in older adults discharged from the emergency department (ED). DESIGN: Retrospective, cohort study. SETTING: Academically affiliated Veterans Affairs Medical ... Full text Link to item Cite

Does lack of social support lead to more ED visits for older adults?

Journal Article Am J Emerg Med · May 2008 OBJECTIVE: The goals of this study were to (1) determine whether level of social support and living situation predicted emergency department (ED) use among older adults and (2) identify correlates of ED visits according to whether the patient was admitted ... Full text Link to item Cite

Underuse of necessary medications among frail elderly veterans at hospital discharge

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2008 Link to item Cite

Risk factors for bloodstream infections in older hospitalized patients: A multi-center study

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2008 Link to item Cite

Varicella-zoster virus-specific immune responses in elderly recipients of a herpes zoster vaccine.

Journal Article J Infect Dis · March 15, 2008 BACKGROUND: A double-blind, placebo-controlled trial that involved 38,546 subjects > or =60 years old demonstrated efficacy of a high-potency live-attenuated Oka/Merck varicella-zoster virus (VZV) vaccine. The trial included an immunology substudy to deter ... Full text Link to item Cite

Vaccination against Herpes Zoster and Postherpetic Neuralgia.

Journal Article J Infect Dis · March 1, 2008 BACKGROUND: Herpes zoster (HZ) and postherpetic neuralgia (PHN) cause significant morbidity in older adults. The incidence and severity of HZ and PHN increase with age in association with an age-related decline in varicella-zoster virus (VZV)-specific cell ... Full text Link to item Cite

The epidemiological, clinical, and pathological rationale for the herpes zoster vaccine.

Journal Article J Infect Dis · March 1, 2008 Worldwide, herpes zoster (HZ) affects millions of patients (particularly older adults) annually and causes significant suffering due to acute and chronic pain, or postherpetic neuralgia (PHN). The objective of this article is to explain the rationale for t ... Full text Link to item Cite

Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations.

Journal Article J Pain · February 2008 UNLABELLED: A consensus meeting was convened by the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) to provide recommendations for interpreting clinical importance of treatment outcomes in clinical trials of the efficac ... Full text Link to item Cite

Diagnosis and assessment of pain associated with herpes zoster and postherpetic neuralgia.

Journal Article J Pain · January 2008 UNLABELLED: Accurate evaluation of pain plays a critical role in identifying new interventions for the treatment and prevention of herpes zoster and postherpetic neuralgia (PHN). Different types of pain and other sensory symptoms are found in patients with ... Full text Link to item Cite

Natural history and treatment of herpes zoster.

Journal Article J Pain · January 2008 UNLABELLED: The objective of this article is to provide an overview of the natural history and treatment of herpes zoster, with a focus on pain management. Herpes zoster has the highest incidence of all neurological diseases, occurring annually in approxim ... Full text Link to item Cite

Adverse health outcomes after discharge from the emergency department--incidence and risk factors in a veteran population.

Journal Article J Gen Intern Med · November 2007 BACKGROUND: An Emergency Department (ED) visit represents a time of significant risk for an older adult; however, little is known about adverse outcomes after an ED visit in the VA system. OBJECTIVES: 1) To describe the frequency and type of adverse health ... Full text Link to item Cite

Monoclonal antibodies as targeted therapy in hematologic malignancies in older adults.

Journal Article Am J Geriatr Pharmacother · September 2007 BACKGROUND: Biological agents are proving to be increasingly useful and exciting additions to the antineoplastic armamentarium, but many clinicians are unfamiliar with the properties of these types of agents. OBJECTIVES: This review focuses on monoclonal a ... Full text Link to item Cite

The quality of pharmacotherapy in older veterans discharged from the emergency department or urgent care clinic.

Journal Article J Am Geriatr Soc · September 2007 OBJECTIVES: To determine the prevalence and type of suboptimal pharmacotherapy that older veterans discharged from the emergency department (ED) or urgent care clinic (UCC) receive and to examine factors associated with suboptimal pharmacotherapy in this p ... Full text Link to item Cite

Prevention strategies: herpes zoster, post-herpetic neuralgia and immunogenicity.

Journal Article Herpes · September 2007 Herpes zoster is a common condition that can have a significant impact on quality of life among older adults. A significant proportion of older subjects with herpes zoster develop post-herpetic neuralgia (PHN), a chronic condition that is difficult to trea ... Link to item Cite

Herpes zoster and postherpetic neuralgia in older adults.

Journal Article Clin Geriatr Med · August 2007 Herpes zoster (HZ) afflicts millions of older adults annually and causes significant suffering from acute and chronic pain, or postherpetic neuralgia (PHN). HZ is caused by the reactivation of varicella-zoster virus (VZV) in sensory ganglia in the setting ... Full text Link to item Cite

Appropriate prescribing in elderly people: how well can it be measured and optimised?

Journal Article Lancet · July 14, 2007 Prescription of medicines is a fundamental component of the care of elderly people, and optimisation of drug prescribing for this group of patients has become an important public-health issue worldwide. Several characteristics of ageing and geriatric medic ... Full text Link to item Cite

Does a recent herpes zoster episode preclude vaccination?

Journal Article Consultant · April 1, 2007 Cite

Adverse outcomes among older adults discharged from the emergency department.

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2007 Link to item Cite

Gram negative bloodstream infections (GN-BSI) lead to poor outcomes in older adults.

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2007 Link to item Cite

An interdisciplinary expert consensus statement on assessment of pain in older persons.

Journal Article Clin J Pain · January 2007 This paper represents an expert-based consensus statement on pain assessment among older adults. It is intended to provide recommendations that will be useful for both researchers and clinicians. Contributors were identified based on literature prominence ... Full text Link to item Cite

The impact of acute herpes zoster pain and discomfort on functional status and quality of life in older adults.

Journal Article Clin J Pain · 2007 OBJECTIVES: To describe the interference of herpes zoster (HZ) pain and discomfort with activities of daily living (ADLs) and health-related quality of life (HRQL) during the acute rash phase, and to quantify the relationship between acute HZ pain and disc ... Full text Link to item Cite

Recommendations for the management of herpes zoster.

Journal Article Clin Infect Dis · January 1, 2007 The objective of this article is to provide evidence-based recommendations for the management of patients with herpes zoster (HZ) that take into account clinical efficacy, adverse effects, impact on quality of life, and costs of treatment. Systematic liter ... Full text Link to item Cite

Clinically important drug-disease interactions and their prevalence in older adults.

Journal Article Clin Ther · August 2006 BACKGROUND: Older adults may have decreased homeostatic reserve, have multiple chronic diseases, and take multiple medications. Therefore, they are at risk for adverse outcomes after receiving a drug that exacerbates a chronic disease. OBJECTIVES: The aims ... Full text Link to item Cite

Surgical site infection in the elderly following orthopaedic surgery. Risk factors and outcomes.

Journal Article J Bone Joint Surg Am · August 2006 BACKGROUND: Risk factor and outcomes data pertaining to surgical site infection in the elderly following orthopaedic operations are lacking. The aim of this study was to identify risk factors for surgical site infections and to quantify the impact of these ... Full text Link to item Cite

Incidence and predictors of all and preventable adverse drug reactions in frail elderly persons after hospital stay.

Journal Article J Gerontol A Biol Sci Med Sci · May 2006 BACKGROUND: Adverse drug reactions (ADR) negatively impact life quality and are sometimes fatal. This study examines the incidence and predictors of all and preventable ADRs in frail elderly persons after hospital discharge, a highly vulnerable but rarely ... Full text Link to item Cite

Does social support predict emergency department utilization in older adults?

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2006 Link to item Cite

Risk factors for surgical site infections in older people.

Journal Article J Am Geriatr Soc · March 2006 OBJECTIVES: To identify risk factors for surgical site infection (SSI) in older people and to test a priori hypotheses regarding particular variables and SSI risk. DESIGN: Case-control study. SETTING: Duke University Medical Center and seven community hosp ... Full text Link to item Cite

Herpes zoster, cellulitis, and scabies

Chapter · January 1, 2006 Herpes zoster is a neurocutaneous disease caused by the reactivation of varicella-zoster virus (VZV) from a latent infection of dorsal sensory or cranial nerve ganglia. Nearly all elderly adults in the United States are latently infected with VZV and at ri ... Cite

Therapeutic failure-related hospitalisations in the frail elderly.

Journal Article Drugs Aging · 2006 BACKGROUND AND OBJECTIVE: Although therapeutic failure may be a common cause of drug-related morbidity in older adults, few studies have focused on this problem. The study objective was to determine the frequency and types of, and the factors associated wi ... Full text Link to item Cite

Postherpetic pain: more than sensory neuralgia?

Journal Article Pain Med · 2006 OBJECTIVE: To describe a series of older adult patients with postherpetic myofascial pain, a heretofore rarely described complication of herpes zoster. DESIGN: Case series. SETTING: Outpatient older adult pain clinic. PATIENTS: Five older adults are presen ... Full text Link to item Cite

Dementia and Alzheimer's disease in community-dwelling elders taking vitamin C and/or vitamin E.

Journal Article Ann Pharmacother · December 2005 BACKGROUND: Since increased oxidative stress may impair cognition and be a risk factor for dementia, there has been interest in determining whether use of antioxidants could protect against such events. OBJECTIVE: To determine whether supplement use of vit ... Full text Link to item Cite

End-of-year note of thanks

Journal Article American Journal Geriatric Pharmacotherapy · December 1, 2005 Full text Cite

Herpes Zoster and Postherpetic Neuralgia

Journal Article · December 1, 2005 Full text Cite

Unnecessary drug use in frail older people at hospital discharge.

Journal Article J Am Geriatr Soc · September 2005 OBJECTIVES: To determine the prevalence and predictors of unnecessary drug use at hospital discharge in frail elderly patients. DESIGN: Cross-sectional. SETTING: Eleven Veterans Affairs Medical Centers. PARTICIPANTS: Three hundred eighty-four frail older p ... Full text Link to item Cite

A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults.

Journal Article N Engl J Med · June 2, 2005 BACKGROUND: The incidence and severity of herpes zoster and postherpetic neuralgia increase with age in association with a progressive decline in cell-mediated immunity to varicella-zoster virus (VZV). We tested the hypothesis that vaccination against VZV ... Full text Link to item Cite

Drug-drug interactions in older adults: which ones matter?

Journal Article Am J Geriatr Pharmacother · June 2005 Full text Link to item Cite

The effect of increasing age on the risk of surgical site infection.

Journal Article J Infect Dis · April 1, 2005 BACKGROUND: An increasing number of older persons undergo surgery, but the relationship between increasing age and risk of surgical site infection (SSI) has not been established. The objective of the present study was to determine the relationship between ... Full text Link to item Cite

Potential drug-disease interactions in frail, hospitalized elderly veterans.

Journal Article Ann Pharmacother · March 2005 BACKGROUND: Drugs can improve quality of life for many older people, but they may cause adverse health outcomes (eg, drug-disease interactions) if used inappropriately. OBJECTIVE: To determine the prevalence of potential drug-disease interactions as define ... Full text Link to item Cite

Surgical site infection in the elderly population.

Journal Article Clin Infect Dis · December 15, 2004 Surgical site infections (SSIs) account for 11% of nosocomial infections among older patients. This report reviews the available data and presents medical and surgical perspectives on the epidemiology, outcomes, and prevention of SSI in the elderly populat ... Full text Link to item Cite

Age-related changes in pharmacokinetics

Journal Article American Journal Geriatric Pharmacotherapy · December 1, 2004 Full text Cite

Histamine2 receptor antagonist use and decline in cognitive function among community dwelling elderly.

Journal Article Pharmacoepidemiol Drug Saf · November 2004 PURPOSE: Previous studies have reported mixed results regarding the use of histamine(2) receptor antagonist use and cognitive function. This study evaluated the relationship between the use of histamine(2) receptor antagonists and cognitive decline among c ... Full text Link to item Cite

Three articles concerning pain management in the elderly

Journal Article American Journal Geriatric Pharmacotherapy · September 1, 2004 Full text Cite

Development of a measure of the burden of pain due to herpes zoster and postherpetic neuralgia for prevention trials: adaptation of the brief pain inventory.

Journal Article J Pain · August 2004 UNLABELLED: In preparation for clinical trials of a vaccine against herpes zoster (HZ), we conducted a prospective, observational study to evaluate (1) the Zoster Brief Pain Inventory (ZBPI), an HZ-specific questionnaire to quantify HZ pain and discomfort, ... Full text Link to item Cite

Surgical-site infection due to Staphylococcus aureus among elderly patients: mortality, duration of hospitalization, and cost.

Journal Article Infect Control Hosp Epidemiol · June 2004 OBJECTIVES: To examine the impact of surgical-site infection (SSI) due to Staphylococcus aureus on mortality, duration of hospitalization, and hospital charges among elderly surgical patients and the impact of older age on these outcomes by comparing older ... Full text Link to item Cite

Impact of inappropriate drug use on health services utilization among representative older community-dwelling residents.

Journal Article Am J Geriatr Pharmacother · June 2004 BACKGROUND: There is limited objective information regarding the impact of drugs identified as inappropriate by drug utilization review (DUR) or the Beers drugs-to-avoid criteria on health service use. OBJECTIVE: The goal of this study was to examine the p ... Full text Link to item Cite

Completion of our first year

Journal Article American Journal Geriatric Pharmacotherapy · June 1, 2004 Full text Cite

Adverse drug reaction risk factors in older outpatients.

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2004 Link to item Cite

Effects of geriatric evaluation and management on adverse drug reactions and suboptimal prescribing in the frail elderly.

Journal Article Am J Med · March 15, 2004 PURPOSE: To determine if inpatient or outpatient geriatric evaluation and management, as compared with usual care, reduces adverse drug reactions and suboptimal prescribing in frail elderly patients. METHODS: The study employed a randomized 2 x 2 factorial ... Full text Link to item Cite

Inappropriate medication use among frail elderly inpatients.

Journal Article Ann Pharmacother · January 2004 BACKGROUND: Inappropriate prescribing in frail elderly inpatients has not received as much investigation as in frail elderly nursing home patients. OBJECTIVE: To determine the prevalence and predictors of inappropriate prescribing for hospitalized frail el ... Full text Link to item Cite

Herpes Zoster in the Long-Term Care Setting

Journal Article Annals of Long Term Care · January 1, 2004 This article reviews the epidemiology, clinical features, diagnosis, infection control, and treatment of herpes zoster (HZ) with special reference to the long-term care facility. HZ is caused by the reactivation of varicella-zoster virus (VZV) in sensory g ... Cite

A case series, reviews, and an approach to improving adherence in older patients with chronic heart failure

Journal Article American Journal Geriatric Pharmacotherapy · January 1, 2004 Full text Cite

Adverse drug reaction risk factors in older outpatients.

Journal Article Am J Geriatr Pharmacother · December 2003 BACKGROUND: Adverse drug reactions (ADRs) are common in older (age >or=65 years) outpatients (prevalence, 5%-35%), but there is no consensus on factors that put these patients at high risk for ADRs. Identifying a uniform set of risk factors would be helpfu ... Full text Link to item Cite

Advances in neuropathic pain: diagnosis, mechanisms, and treatment recommendations.

Journal Article Arch Neurol · November 2003 Chronic neuropathic pain, caused by lesions in the peripheral or central nervous system, comes in many forms. We describe current approaches to the diagnosis and assessment of neuropathic pain and discuss the results of recent research on its pathophysiolo ... Full text Link to item Cite

Is antioxidant use protective of cognitive function in the community-dwelling elderly?

Journal Article Am J Geriatr Pharmacother · September 2003 BACKGROUND: The role of oxidative stress in the pathogenesis of diseases such as macular degeneration, certain types of cancer, and Alzheimer's disease has received much attention. Thus, there is considerable interest in the potential contribution of antio ... Full text Link to item Cite

Treatment and prevention of postherpetic neuralgia.

Journal Article Clin Infect Dis · April 1, 2003 There have been 4 recent major advances in the treatment of postherpetic neuralgia (PHN) that are based on the results of randomized, controlled trials. These advances are the demonstrations that gabapentin, the lidocaine patch 5%, and opioid analgesics ar ... Full text Link to item Cite

Prevalence of drug-disease interactions in hospitalized elderly patients

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2003 Link to item Cite

Guidelines for case reports and review articles

Journal Article American Journal Geriatric Pharmacotherapy · January 1, 2003 Full text Cite

New era in geriatric pharmacotherapy

Journal Article American Journal Geriatric Pharmacotherapy · January 1, 2003 Full text Cite

HIV infection: treatment outcomes in older and younger adults.

Journal Article J Am Geriatr Soc · April 2002 OBJECTIVES: To determine the effect of antiretroviral therapy (ART) on the immunological and virological outcomes of older human immunodeficiency virus (HIV)-infected patients compared with younger HIV-infected patients. DESIGN: Matched (1:2) retrospective ... Full text Link to item Cite

Is antioxidant use protective for cognitive function among community dwelling elderly?

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · April 1, 2002 Link to item Cite

Impact of inappropriate drug use on mortality and functional status in representative community dwelling elders.

Journal Article Med Care · February 2002 BACKGROUND: The predictive validity of Drug Utilization Review (DUR) and drugs-to-avoid criteria in elders is unknown. OBJECTIVES: To evaluate the relationship between use of inappropriate drugs as determined by these explicit criteria and mortality and de ... Full text Link to item Cite

Epidemiology and impact on quality of life of postherpetic neuralgia and painful diabetic neuropathy.

Journal Article Clin J Pain · 2002 OBJECTIVE: This article reviews the prevalence, risk factors, natural history, and impact on quality of life of painful diabetic neuropathy (PDN) and postherpetic neuralgia (PHN). DISCUSSION: Diabetes mellitus afflicts more than 14 million persons in the U ... Full text Link to item Cite

Use of inappropriate prescription drugs by older people.

Journal Article J Am Geriatr Soc · January 2002 OBJECTIVES: To determine the prevalence and predictors of inappropriate drug prescribing defined by expert national consensus panel drug utilization review criteria for community-dwelling older people. DESIGN: Survey. SETTING: Five adjacent urban and rural ... Full text Link to item Cite

Herpes zoster in older adults.

Journal Article Clin Infect Dis · May 15, 2001 Herpes zoster (HZ) strikes millions of older adults annually worldwide and disables a substantial number of them via postherpetic neuralgia (PHN). Key age-related clinical, epidemiological, and treatment features of zoster and PHN are reviewed. HZ is cause ... Full text Link to item Cite

Reducing medication regimen complexity: a controlled trial.

Journal Article J Gen Intern Med · February 2001 OBJECTIVE: To determine if a visual intervention (medication grid) delivered to physicians can reduce medication regimen complexity. DESIGN: Nonrandomized, controlled trial. SETTING: Veterans Affairs medical center. PATIENTS/PARTICIPANTS: Eight hundred thi ... Full text Link to item Cite

Suboptimal prescribing in older inpatients and outpatients.

Journal Article J Am Geriatr Soc · February 2001 Investigators searched Medline and HealthSTAR databases from January 1, 1985 through June 30, 1999 to identify articles on suboptimal prescribing in those age 65 years and older. A manual search of the reference lists from identified articles and the autho ... Full text Link to item Cite

Impact of estrogen use on decline in cognitive function in a representative sample of older community-resident women.

Journal Article Am J Epidemiol · January 15, 2001 The authors investigated whether postmenopausal estrogen use helps to maintain cognitive function; a brief screen, the Short Portable Mental Status Questionnaire (SPMSQ), was used. Information was gathered from a stratified, random sample of 1,907 African- ... Full text Link to item Cite

Enhanced green fluorescent protein as a marker for localizing murine cytomegalovirus in acute and latent infection.

Journal Article J Virol Methods · September 2000 A recombinant murine cytomegalovirus (mCMV) that expresses enhanced green fluorescent protein (EGFP) under control of the native immediate-early 1/3 promoter was constructed to detect directly sites of viral activity in latent and reactivated infections. T ... Full text Link to item Cite

Inappropriate drug use among community-dwelling elderly.

Journal Article Pharmacotherapy · May 2000 This study examined inappropriate drug use defined by updated criteria among respondents in the second and third in-person waves of the Duke Established Populations for Epidemiologic Studies of the Elderly. Information about sociodemographics, health statu ... Full text Link to item Cite

Postherpetic neuralgia in older persons

Journal Article Annals of Long Term Care · January 1, 2000 Cite

Staphylococcus aureus bacteremia among elderly vs younger adult patients: comparison of clinical features and mortality.

Journal Article Arch Intern Med · June 14, 1999 BACKGROUND: Previous studies give conflicting results regarding the effect of age on outcomes in Staphylococcus aureus bacteremia (SAB). These studies have been limited by retrospective design or small sample size. METHODS: We conducted a prospective cohor ... Full text Link to item Cite

Herpes zoster in the elderly: issues related to geriatrics.

Journal Article Clin Infect Dis · April 1999 This article reviews specific clinical and research issues of herpes zoster related to geriatric medicine. Salient epidemiological and clinical issues include the increasing probability of zoster and postherpetic neuralgia with aging, age-related decline i ... Full text Link to item Cite

Benzodiazepine use and cognitive function among community-dwelling elderly.

Journal Article Clin Pharmacol Ther · December 1998 OBJECTIVE: To evaluate the relation between benzodiazepine use and cognitive function among community-dwelling elderly. METHODS: This prospective cohort study included 2765 self-reporting subjects from the Duke Established Populations for Epidemiologic Stu ... Full text Link to item Cite

Racial and psychosocial risk factors for herpes zoster in the elderly.

Journal Article J Infect Dis · November 1998 The effects of black race and psychologic stress on the risk of acquiring herpes zoster in late life were examined. Subjects were participants of a stratified probability sample of community-dwelling persons > or = 65 years old. A comprehensive health surv ... Full text Link to item Cite

Postherpetic neuralgia in immunocompetent elderly people.

Journal Article Vaccine · November 1998 The most menacing complication of herpes zoster in immunocompetent elderly people is chronic pain or postherpetic neuralgia (PHN). The cardinal epidemiological feature of PHN is its striking relationship to aging. Among zoster patients over 60 years old, e ... Full text Link to item Cite

The association of weight change in Alzheimer's disease with severity of disease and mortality: a longitudinal analysis.

Journal Article J Am Geriatr Soc · October 1998 OBJECTIVE: To describe weight loss in relation to the severity of Alzheimer's disease (AD), to identify confounders that might account for weight loss, and to investigate the association of weight change with mortality. METHODS: This study included 666 sub ... Full text Link to item Cite

Race and stress in the incidence of herpes zoster in older adults.

Journal Article J Am Geriatr Soc · August 1998 OBJECTIVES: To examine the effect of black race and acute (negative life events) and chronic (lack of social support) psychological stress on the risk of herpes zoster in late life. DESIGN: A population-based, prospective cohort study. SETTING: Central Nor ... Full text Link to item Cite

The prevalence and 3-year incidence of dementia in older Black and White community residents.

Journal Article J Clin Epidemiol · July 1998 OBJECTIVE: To determine the prevalence and 3-year incidence of dementia in Blacks and Whites age 65 and older in a five-county Piedmont area of North Carolina. DESIGN: Stratified random sample of members of the Duke Established Populations for Epidemiologi ... Full text Link to item Cite

Medication use patterns among demented, cognitively impaired and cognitively intact community-dwelling elderly people.

Journal Article Age Ageing · July 1998 OBJECTIVE: To determine whether medication use patterns in community-dwelling elderly people vary with level of cognitive function-dementia, cognitive impairment (but not dementia) and intact cognition. DESIGN: Cross-sectional survey. SETTING: A five-count ... Full text Link to item Cite

The cost-effectiveness of a clinical pharmacist intervention among elderly outpatients.

Journal Article Pharmacotherapy · 1998 We estimated the cost and cost-effectiveness of a clinical pharmacist intervention known to improve the appropriateness of drug prescribing. Elderly veteran outpatients prescribed at least five drugs were randomized to an intervention (105 patients) or con ... Link to item Cite

The cost-effectiveness of a clinical pharmacist intervention among elderly outpatients

Journal Article Pharmacotherapy · January 1, 1998 We estimated the cost and cost-effectiveness of a clinical pharmacist intervention known to improve the appropriateness of drug prescribing. Elderly veteran outpatients prescribed at least five drugs were randomized to an intervention (105 patients) or con ... Full text Cite

Viral infections in the elderly

Journal Article Bailliere S Clinical Infectious Diseases · January 1, 1998 Viral infections impair functional ability, threaten independence, lower quality of life and reduce survival in the elderly. The most common viruses to afflict the elderly include varicella-zoster virus, respiratory viruses and gastrointestinal viruses. Th ... Cite

Adverse events after discontinuing medications in elderly outpatients.

Journal Article Arch Intern Med · October 27, 1997 BACKGROUND: Discontinuation of drug therapy is an important intervention in elderly outpatients receiving multiple medications, but it may be associated with adverse drug withdrawal events (ADWEs). OBJECTIVE: To determine the frequency, types, timing, seve ... Link to item Cite

Adverse drug events in high risk older outpatients.

Journal Article J Am Geriatr Soc · August 1997 OBJECTIVE: To describe the prevalence, types, and consequences of adverse drug events (ADEs) in older outpatients with polypharmacy. DESIGN: A cohort study. SETTING: General Medicine Clinic at the Durham Veterans Affairs Medical Center. PATIENTS: A total o ... Full text Link to item Cite

Inappropriate prescribing and health outcomes in elderly veteran outpatients.

Journal Article Ann Pharmacother · May 1997 OBJECTIVE: To determine the relationship of inappropriate prescribing in the elderly to health outcomes. SETTING: General Medical Clinic of the Durham Veterans Affairs Medical Center. PATIENTS: A total of 208 veterans more than 65 years old who were each t ... Full text Link to item Cite

Reliability of a modified medication appropriateness index in ambulatory older persons.

Journal Article Ann Pharmacother · May 1997 OBJECTIVE: To evaluate the reliability of a medication appropriateness index (MAI) modified for elderly outpatients in a non-Veterans Affairs setting. DESIGN: Reliability study. SETTING: General community. PARTICIPANTS: Ten community-dwelling elderly (> 65 ... Full text Link to item Cite

Reliability of drug utilization evaluation as an assessment of medication appropriateness.

Journal Article Ann Pharmacother · May 1997 OBJECTIVE: To test the reliability of drug utilization evaluation (DUE) applied to medications commonly used by the ambulatory elderly. METHODS: A DUE model was developed for four domains: (1) justification for use, (2) critical process indicators, (3) com ... Full text Link to item Cite

Relation of prescription nonsteroidal antiinflammatory drug use to cognitive function among community-dwelling elderly.

Journal Article Ann Epidemiol · February 1997 PURPOSE: To evaluate the relationship of nonsteroidal antiinflammatory drug (NSAID) use to level of cognitive function in community-dwelling elderly persons. METHODS: The prospective cohort study included 2765 nonproxy subjects from the Duke University Est ... Full text Link to item Cite

Assessment of pain in herpes zoster: lessons learned from antiviral trials.

Journal Article Antiviral Res · January 1997 Pain typically accompanies acute herpes zoster and, in a proportion of patients, it persists well beyond rash healing. Pain must therefore be analyzed in trials of antiviral agents in herpes zoster, but different methods have been used to analyze pain in r ... Full text Link to item Cite

Attitudes of elderly patients and their families toward physician-assisted suicide.

Journal Article Arch Intern Med · October 28, 1996 OBJECTIVES: To examine and compare attitudes of elderly outpatients and their families toward physician-assisted suicide (PAS), explore sociodemographic and health correlates of these attitudes, assess family members' ability to predict patients' attitudes ... Link to item Cite

Reply

Journal Article Journal of Infectious Diseases · July 1, 1996 Full text Cite

Is medication use by community-dwelling elderly people influenced by cognitive function?

Journal Article Age Ageing · May 1996 To determine whether medication use differs by cognitive status among community dwelling elderly, a survey was made of a stratified random sample of 4110 black and white participants, aged 65 or older from the Duke Established Populations for Epidemiologic ... Full text Link to item Cite

A randomized, controlled trial of a clinical pharmacist intervention to improve inappropriate prescribing in elderly outpatients with polypharmacy.

Journal Article Am J Med · April 1996 PURPOSE: To evaluate the effect of sustained clinical pharmacist interventions involving elderly outpatients with polypharmacy and their primary physicians. PATIENTS AND METHODS: Randomized, controlled trial of 208 patients aged 65 years or older with poly ... Full text Link to item Cite

Weight change in Alzheimer's disease.

Journal Article J Am Geriatr Soc · March 1996 PURPOSE: To determine the natural history of weight change and the occurrence of clinically significant weight loss in subjects with Alzheimer's disease (AD). PATIENTS AND METHODS: Subjects with AD and cognitively normal older controls were recruited from ... Full text Link to item Cite

ADVERSE EVENTS AFTER DISCONTINUING MEDICATIONS IN ELDERLY OUTPATIENTS

Journal Article JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · September 1, 1995 Link to item Cite

Mouse cytomegalovirus reactivation in severe combined immune deficient mice after implantation of latently infected salivary gland.

Journal Article J Infect Dis · August 1995 The hypothesis that replication-competent mouse cytomegalovirus (MCMV) is detectable in severe combined immunodeficient (scid) mice after implantation of latently infected tissue was examined. Sections of latently infected salivary gland from 5 BALB/c mice ... Full text Link to item Cite

Apolipoprotein E, survival in Alzheimer's disease patients, and the competing risks of death and Alzheimer's disease.

Journal Article Neurology · July 1995 The apolipoprotein E (APOE) epsilon 4 allele carries an increased risk of a patient developing Alzheimer's disease (AD) while the epsilon 2 allele carries a decreased risk. We compared survival from the onset of AD in subjects with different numbers of eps ... Full text Link to item Cite

Racial differences in the occurrence of herpes zoster.

Journal Article J Infect Dis · March 1995 The purpose of this study was to determine if there are racial differences in the occurrence of herpes zoster (shingles). The study population was the Duke Established Populations for Epidemiologic Studies of the Elderly, a probability sample of community- ... Full text Link to item Cite

Management of herpes zoster in elderly patients

Journal Article Infectious Diseases in Clinical Practice · January 1, 1995 Full text Cite

The Role of the Caregiver in the Drug Treatment of Dementia

Journal Article CNS Drugs · January 1, 1995 Summary Although dementia is common among the institutionalised elderly, the majority of patients with dementia are cared for at home by nonprofessional caregivers, usually a spouse or adult child, As dementia progresses, the role of the caregiver expands ... Full text Cite

Apolipoprotein E and the epidemiology of Alzheimer's disease

Conference RESEARCH ADVANCES IN ALZHEIMER'S DISEASE AND RELATED DISORDERS · January 1, 1995 Link to item Cite

Assessing health-related quality of life in elderly outpatients: telephone versus face-to-face administration.

Journal Article J Am Geriatr Soc · December 1994 OBJECTIVE: While health-related quality of life (HRQOL) is increasingly being used as an outcome in clinical trials, it is unknown whether HRQOL assessments are influenced by the method of administration. Within the context of a randomized, controlled tria ... Full text Link to item Cite

Appropriateness of medication prescribing in ambulatory elderly patients.

Journal Article J Am Geriatr Soc · December 1994 OBJECTIVE: To assess the quality of medication prescribing in ambulatory elderly patients on multiple medications using the Medication Appropriateness Index (MAI). DESIGN: Cross-sectional study. SETTING: General Medical Clinic of the Durham VA Medical Cent ... Full text Link to item Cite

The accuracy of self-report of herpes zoster.

Journal Article J Clin Epidemiol · November 1994 The accuracy of self-report of herpes zoster was investigated in the Duke Established Populations for Epidemiological Studies of the Elderly, a longitudinal study of 4162 community-dwelling elderly persons residing in North Carolina, 1986-1993. The authors ... Full text Link to item Cite

A summated score for the medication appropriateness index: development and assessment of clinimetric properties including content validity.

Journal Article J Clin Epidemiol · August 1994 Inappropriate medication prescribing is an important problem in the elderly, but is difficult to measure. As part of a randomized controlled trial to evaluate the effectiveness of a pharmacist intervention among elderly veterans using many medications, we ... Full text Link to item Cite

Protective effect of apolipoprotein E type 2 allele for late onset Alzheimer disease.

Journal Article Nat Genet · June 1994 Gene dosage of the apolipoprotein E (APOE) epsilon 4 allele is a major risk factor for familial Alzheimer disease (AD) of late onset (after age 60). Here we studied a large series of 115 AD case subjects and 243 controls as well as 150 affected and 197 una ... Full text Link to item Cite

Compliance With Recommendations From an Outpatient Geriatric Consultation Team

Journal Article Journal of Applied Gerontology · January 1, 1994 For outpatient geriatric consultation to be effective, it is necessary, although n t sufficient, that recommendations made to patients are followed. This prospective cohort study describes the nature of, types of, and compliance with, recommendations made ... Full text Cite

Apolipoprotein E epsilon 4 allele distributions in late-onset Alzheimer's disease and in other amyloid-forming diseases.

Journal Article Lancet · September 18, 1993 The frequency of the allele for apolipoprotein E type 4 (epsilon 4) is increased in late-onset familial and sporadic Alzheimer's disease (AD). We have examined epsilon 4 frequencies in four distinct, normal, elderly control groups and, most importantly, in ... Full text Link to item Cite

Aging and reactivation of latent murine cytomegalovirus.

Journal Article J Infect Dis · December 1992 BALB/c mice were experimentally infected with murine cytomegalovirus (MCMV) to discover whether latent MCMV persisted in aging mice and to examine the effect of aging on MCMV reactivation. Latently infected mice received saline, cyclophosphamide, or alloge ... Full text Link to item Cite

A method for assessing drug therapy appropriateness.

Journal Article J Clin Epidemiol · October 1992 This study evaluated the reliability of a new medication appropriateness index. Using the index, independent assessments were made of chronic medications taken by 10 ambulatory, elderly male patients by a clinical pharmacist and an internist-geriatrician. ... Full text Link to item Cite

Comparing proxy and patients' perceptions of patients' functional status: results from an outpatient geriatric clinic.

Journal Article J Am Geriatr Soc · June 1992 OBJECTIVE: To compare ratings of patients referred for geriatric evaluation and their proxies with respect to patients' ability to perform activities of daily living. DESIGN: Retrospective chart audit. SETTING: University-based Outpatient Geriatric Clinic. ... Full text Link to item Cite

Murine cytomegalovirus gene amplification and culture after submaxillary salivary gland biopsy.

Journal Article Lab Anim Sci · October 1991 An important target tissue for murine cytomegalovirus (CMV) infection is the submaxillary salivary gland. Submaxillary salivary gland biopsy specimens from BALB/c mice latently infected with murine CMV were examined for murine CMV DNA by in vitro enzymatic ... Link to item Cite

An evaluation of a brief health status measure in elderly veterans.

Journal Article J Am Geriatr Soc · July 1991 OBJECTIVE: To examine the feasibility of a brief 36-item health status measure in elderly male veterans, by comparing it with the 136-item Sickness Impact Profile. DESIGN: Cross-sectional study in which all subjects completed both measures in a random orde ... Full text Link to item Cite

Are stressful life events risk factors for herpes zoster?

Journal Article J Am Geriatr Soc · November 1990 To determine if psychologically stressful life events are risk factors for herpes zoster, we conducted a case-control study of zoster and self-reported recent negative life events and major changes in spousal relationships. The subjects were 101 healthy co ... Full text Link to item Cite

Are current therapies useful for the prevention of postherpetic neuralgia? A critical analysis of the literature.

Journal Article J Gen Intern Med · 1989 STUDY OBJECTIVE: To determine whether current therapies are useful in preventing postherpetic neuralgia (PHN) by analysis of study designs and pooled results. DESIGN: Meta-analysis of all controlled studies investigating PHN prevention in the immunocompete ... Full text Link to item Cite

Epstein-Barr virus and the elderly host.

Journal Article Rev Infect Dis · 1989 The ability of the Epstein-Barr virus (EBV) to cause latent lifelong infection in the host and its capabilities of transformation may have important implications for the elderly host. Reports in the literature and hospital records were reviewed to determin ... Full text Link to item Cite