<h3>PURPOSE</h3> Depression commonly accompanies diabetes, resulting in reduced adherence to medications and increased risk for morbidity mortality. The objective of this study was examine whether a simple, brief integrated approach depression type 2 diabetes mellitus (type diabetes) treatment improved oral hypoglycemic agents antidepressant medications, glycemic control, among primary care patients. <h3>METHODS</h3> We undertook randomized controlled trial conducted from April 2010 through...

Objectives. Depression in late life may be difficult to identify, and older adults often do not accept depression treatment offered. This article describes the methods by which we combined an investigator-defined definition of with a person-derived order understand how their primary care providers overlapped diverged ideas about depression.

We sought to test our a priori hypothesis that depressed patients with diabetes in practices implementing depression management program would have decreased risk of mortality compared usual-care practices.We used data from the multisite, practice-randomized, controlled Prevention Suicide Primary Care Elderly: Collaborative Trial (PROSPECT), patient recruitment May 1999 August 2001, supplemented search National Death Index. Twenty primary care participated greater metropolitan areas New York...

This study compared time to first remission for elderly depressed patients in primary care practices that implemented a management model versus those providing usual care. In addition, it sought identify risk factors nonremission could guide treatment planning and referral managers or specialists.Prevention of Suicide Primary Care Elderly: Collaborative Trial (PROSPECT) data were analyzed. Participants older (> =60 years) selected following screening 9,072 randomly identified patients. The...

Background: Few studies have tested the effects of a depression intervention on risk for death associated with depression. Objective: To test whether an to improve care can modify death. Design: Practice-based, randomized, controlled trial. Setting: 20 primary practices in New York, and Philadelphia Pittsburgh, Pennsylvania. Patients: 1226 randomly sampled patients identified through 2-stage, age-stratified (60 74 years ≥75 years) screening. Intervention: Depression manager working...

<b>Objective</b> To investigate whether an intervention to improve treatment of depression in older adults primary care modified the increased risk death associated with depression. <b>Design</b> Long term follow-up multi-site practice randomized controlled trial (PROSPECT—Prevention Suicide Primary Care Elderly: Collaborative Trial). <b>Setting</b> 20 practices New York City, Philadelphia, and Pittsburgh, USA, or usual care. <b>Participants</b> 1226 participants identified between May 1999...

Objective: To determine whether subjective memory complaints (SMCs) are associated with performance on objective cognitive measures and psychological factors in healthy, community-dwelling older adults. Method: The cohort was composed of adults, 65 years no clinical evidence impairment (n = 125). Participants were administered: CogState computerized neurocognitive battery, Prospective Retrospective Memory Questionnaire, personality meaning-in-life measures. Results: SMCs poorer executive...

Public libraries are not usually included in discussions about improving population health. They are, however, well positioned to be partners building a culture of health through programming that addresses the social determinants The Healthy Library Initiative, partnership between University Pennsylvania and Free Philadelphia (the public library system serves city), has undertaken such efforts Philadelphia. In this article we report findings from an assessment how ten highly subscribed...

<b>PURPOSE</b> We wanted to examine whether integrating depression treatment into care for hypertension improved adherence antidepressant and antihypertensive medications, outcomes, blood pressure control among older primary patients. <b>METHODS</b> Older adults prescribed pharmacotherapy from physicians at a large practice in West Philadelphia were randomly assigned an integrated intervention or usual care. Outcomes assessed baseline, 2, 4, 6 weeks using the Center Epidemiologic Studies...

Burden emerged as an important concept among older adults in a study of how interact with their families around care. The authors conducted 50 semistructured interviews than the age 65 years and spouse or adult child. sample was stratified by ethnicity thus giving opportunity to explore both ethnic similarities differences. Older who expressed burden were more likely be White compared did not express burden. respondents discussed relation wanting complicate busy lives children, guilt about...

Purpose The purpose of this study was to examine whether integrating depression treatment into care for type 2 diabetes mellitus among older African Americans improved medication adherence, glycemic control, and outcomes. Methods Older prescribed pharmacotherapy from physicians at a large primary practice in west Philadelphia were randomly assigned an integrated intervention or usual care. Adherence assessed baseline, 2, 4, 6 weeks using the Medication Event Monitoring System assess...

Stages of activity limitation based on activities daily living (ADLs) and instrumental (IADLs) have been found to predict mortality in persons aged 70 years older but not examined Medicare beneficiaries 65 using data that are routinely collected.To examine the association between functional stages items ADLs IADLs with 3-year older, accounting for baseline sociodemographics, health status, smoking, subjective health, psychological well-being.A cohort study Current Beneficiary Survey (MCBS)...

OBJECTIVES: To examine the relationship between urinary incontinence (UI) and psychological distress in older adults. We hypothesized that persons with UI associated condition‐specific functional loss would be most likely to report distress. DESIGN: A population‐based longitudinal survey. SETTING: Continuing participants a study of community‐dwelling adults who were initially living East Baltimore 1981. PARTICIPANTS: Persons aged 50 (n = 781) at follow‐up interviews conducted 1993 1996 for...

Objectives: To determine the incidence and epidemiologic characteristics of cardiac arrests among tracheal intubations in PICUs. Design: Retrospective cohort study prospectively collected data. Setting: Twenty-five diverse Patients: Critically ill children requiring intubation Interventions: Tracheal quality improvement data were for all initial 25 PICUs from July 2010 to March 2014 using National Emergency Airway Registry Children registry. Measurements Main Results: intubation–associated...

Positive and negative affect data are often collected over time in psychiatric care settings, yet no generally accepted means available to relate these useful diagnoses or treatments. Latent class analysis attempts reduction by classifying subjects into one of K unobserved classes based on observed data. models have recently been extended accommodate longitudinally We extend approaches a Bayesian framework trajectories both continuous discrete consider whether latent might be used...

<h3>Background</h3> Black Americans are more likely to obtain mental health care from a primary physician than specialist. We investigated the association of ethnicity with identification and active management depression among older patients. <h3>Methods</h3> Cross-sectional survey 355 adults without significant depressive symptoms. At index visit, physician's ratings reports were obtained on 341 patients who completed in-home interviews. <h3>Results</h3> Older black less white be identified...

Objectives: We sought to examine the relationship between depressive symptoms and subjective memory problems. hypothesized that poor functioning is mediated by negative cognitive bias associated with hopelessness, a wish die low self-esteem. Methods: Complete data were available for 299 older adults without significant who screened in primary care offices invited participate, completed baseline in-home assessment. Subjective psychological status was assessed commonly used, validated standard...