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Biomedical subjects

K Laake

Publications and source records attributed to K Laake.

At least 19 recordsLinked to original sources
PubMed1992

The Mini-Mental State Examination: identifying the most efficient variables for detecting cognitive impairment in the elderly.

OBJECTIVES: To study how well the scoring on each item of the MMSE relates to the sum-score when the purpose is to identify persons with cognitive impairment, and to identify an equally effective subset of MMSE items for predicting cognitive impairment. DESIGN: Retrospective survey of MMSE data for 850 elderly. SETTING: A variety of clinical settings. PARTICIPANTS: Mean age 82 years (range 54 to 99), 74% women. The subjects were of three different categories: geriatric in-patients, patients living under supervision, and elderly people living independently at home. RESULTS: Five of the binomial ("State," "Town," "Name a pencil," "Name a watch," "Read and obey") and one of the polychotomous MMSE variables ("Learn three words and repeat immediately") had low sensitivity and gave high percentages of misclassifications versus the sumscore dichotomized at the cut-point 23/24. Univariate logistic regression indicated that the three remaining polychotomous variables ("Spell backwards," "Recall three words," and "Three-stage command") can be scored binomially. Two factors were identified on factor analysis. Logistic regression analysis showed that 12 of the original 20 items predicted the sumscore dichotomized at 23/24 with only 3% misclassifications. Validation against the psychogeriatrician's diagnosis showed that this 12-items MMSE derivative performs as well as the full MMSE. CONCLUSIONS: Six of the 20 MMSE variables perform poorly regarding sensitivity and misclassifications versus the sumscore at cut-point 23/24. Two additional items did not contribute to the prediction of a low/high sumscore. The remaining 12 MMSE items can all be scored binomially and produce a sumscore which is equally as effective as the sumscore of the full MMSE when the purpose is to identify elderly patients with cognitive impairment.

Activities of Daily Living↗
PubMed1991

[Testing of a simple information program to improve elderly patients' knowledge about their medication].

The programme, which was provided as a supplement to the standard information on the patient's medication upon discharge from hospital, consisted of oral information about which drugs to use and how to take them, a medication card, and one page of general information on how to take drugs. The programme was tested in an open, controlled manner in 24 test and 23 control patients, mean age 80 years. The results revealed that the patients' knowledge about their medication was generally good at follow-up four weeks later. The test group achieved a significantly higher score on questions about the technique for taking oral medication and why this is important. It is concluded that this type of information should be supplied when elderly patients are discharged from hospital.

Age Factors↗
PubMed1991

Absorption of paracetamol from suppositories in geriatric patients with fecal accumulation in the rectum.

The bioavailability of paracetamol from suppositories was studied in 16 geriatric in-patients in stable clinical condition; 9 had significant amounts of feces in the rectum. Rectal accumulation of feces reduced the peak plasma paracetamol concentration by 32% (p = 0.05) and the AUC0-8h by 27% (p = 0.04). The peak concentration, however, appeared earlier among patients with rectal accumulation of feces. Compared to findings in 6 healthy young controls, geriatric patients had higher plasma concentrations of the main paracetamol metabolites.

Acetaminophen↗
PubMed1990

[Medication among pensioners in homes for the aged and nursing homes].

The prescribing of drugs was studied in 378 patients living in 12 homes for the aged in the county of Aust-Agder, Norway. The mean number of regular drugs was 4.7. Out of a total of 378 patients, more than 8 drugs were prescribed to one out of four and only 13 received no drugs at all. 30% of the prescriptions referred to over-the-counter drugs. Laxatives (10.4%), vitamins (9.0%), and pscychotropics (8.2%) were the three most commonly prescribed classes of drugs. Multiple linear regression analysis showed that the most significant predictor of the number of drugs prescribed to a patient is the doctor in charge.

Aged↗
PubMed1990

[What do health care institutions do to inform the aged and train them in the correct use of drugs?].

We reviewed the routines for providing information on drugs, and for training in the use of drugs and aids to medication in hospital and nursing homes by interviewing 11 ward supervisors. We found that little attention was given to systematic training in the use of drugs, training and aids to medication as part of the patient rehabilitation. All wards informed the patients about the type and dosage of drugs to be taken after discharge. However, printed information from the Norwegian Medicines Control Authority was not used to any significant extent. Lack of time was stated as the major reason for not providing more systematic information and training on drug usage as part of the rehabilitation programme for elderly inpatients.

Aged↗
PubMed1990

Lower mortality of demented nursing home residents. A two-year survival study.

The mortality of 318 patients residing permanently in a nursing home was analyzed over two years in a retrospective study. Survival analysis showed that age was significantly associated with increased mortality, and dementia with decreased mortality. The results may to some extent explain the large percentage of demented patients in nursing homes, and provide some support for the hypothesis that demented patients accumulate in the nursing homes, partly due to inappropriate community services for these patients, leading to a relatively early institutionalization.

Age Factors↗
PubMed1988

Prevalence of dementia in a Norwegian sample aged 75 years and over and living at home.

The prevalence of dementia in the age group 75 and over was studied in a random sample of elderly living at home. The MMS and the GMS were used as screening instruments, supplemented by medical history and a physical examination. The dementia diagnosis was confirmed by psychogeriatric assessment and a follow-up after 18 months. The prevalence of dementia in this sample was 10.5%; for severe dementia 3.8%, and for mild dementia 6.7%. Its occurrence was found to be unrelated to gender, marital status, domestic status, and duration of schooling.

Aged↗
PubMed1986

Pharmacokinetics of temazepam in geriatric patients.

A single dose of temazepam 10 mg, as a solution in soft gelatin capsules, was given to 10 fasting geriatric in-patients (mean age 83 years) in a stable clinical condition. The mean peak plasma concentration was 306 ng/ml, with a median time of 0.75 h to peak concentration. Temazepam was eliminated from plasma in a biexponential manner, with a distribution phase (mean t1/2 alpha = 0.7 h) predominating for 3 h. The drug had a mean elimination half-life of 8.7 h. In a chronic study, in which temazepam 10 mg p.o. was given nightly to 13 patients, the plasma concentrations on Days 3, 5, 8, 12 and 15 were not significantly different from each other, showing rapid attainment of steady state levels and the lack of drug accumulation.

Aged↗
PubMed1985

On the problem of measuring the distance between distribution functions: analysis of hospitalization versus mortality.

The relationship between hospitalization, as a measure of morbidity, and mortality is examined. The difference between age at hospitalization in a general medical department and age at death in Oslo, Norway, is studied. The problem is transferred to the one of examining the difference between two cumulative distribution functions F and G. For this purpose, a quantile distance function based on the inverses of the distribution functions is applied. We give the natural estimate of the quantile distance function, and some asymptotic properties of the corresponding empirical process. For the particular situation where one of the distribution functions is known, a confidence band for the quantile distance function is derived. Applying these results, we show that there are reasons to believe that age at hospitalization and age at death are equally distributed, apart from a constant shift.

Adult↗
PubMed1984

Side-effects of piroxicam (Feldene). A one-year material of 103 reports from Norway.

In the first year after registration, 103 reports on suspected adverse reaction to piroxicam (Feldene) were submitted to the Norwegian Adverse Drug Reaction Committee. Eighty-three reactions were classified as probable side-effects, and 73 of these were related to the upper gastrointestinal tract. Peptic ulcer and upper gastrointestinal haemorrhages predominated. Two deaths were classified as probably due to piroxicam. There were 8 life-threatening reactions, all due to haemorrhages. No severe cutaneous reactions were reported. A significant fraction of the gastrointestinal reactions occurred in patients with a previous history of peptic ulcer disease. Nearly every fourth patient with proven ulcer or haematemesis/melaena had simultaneously been taking other drugs with the propensity of causing gastrointestinal haemorrhage. The gastrointestinal adverse reactions to piroxicam can probably be reduced by a more accurate selection of patients.

Aged↗