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Biomedical subjects

L G Branch

Publications and source records attributed to L G Branch.

At least 109 records · Page 6Linked to original sources
PubMed1985

Home care is the answer: what is the question?

The purposes of this article are three. First, to emphasize a basic implication of the common demographic summaries and projections as they apply to long-term care, namely that we need to age-adjust utilization projections. Second, to discuss an example in which the Health Care Financing Administration reminded the rest of us several years ago of the requirement to age-adjust long-term care utilization projections, but presently are ignoring their own counsel in their waivered programs which require a constant absolute level of long-term care utilization over time (and constant absolute levels by definition are not age-adjusted). Third, to pose a question for which home care might be the answer, but the question must be phrased very carefully.

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PubMed1985

Health practices and incident disability among the elderly.

This investigation examines the relationships between certain personal health practices and point-incident physical limitations over a five-year period among initially physically robust elders living in the communities. Slowed down physical activities (for elderly women) and a history of cigarette smoking (for elderly men) achieved associations with subsequent physical limitations; no firm associations between current lifestyle practices and onset of disability could be demonstrated.

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PubMed1985

Rehospitalization and spinal cord injury: cross-sectional survey of adults living independently.

A cross-sectional survey of 96 people living independently with spinal cord injuries (SCI) in Eastern Massachusetts shows that 57% had been hospitalized at least once in the year before the survey. Sample means were 1.0 admissions and 16.0 days/person/year. Eight percent of the sample (eight persons) accounted for 22% of admissions and 59% of total hospital days. For those hospitalized, the mean was 1.7 admissions and 45.1 days/person/year. Mean length-of-stay was 34.7 days/admission. Multiple regression analysis shows that three variables appear to be independently related to increased numbers of admissions: self-assessment of health; place of residence; and age (younger respondents at higher risk). One variable is independently associated with total days of hospitalization: leaving home at least once daily (as opposed to less frequently) is associated with lower risk. There were no statistically significant relationships between either numbers of hospitalizations or total days hospitalized and ADL or IADL status, education, employment, medical insurance, household composition, gender, age at onset of disability, time since onset of disability, substance use (alcohol, cannabis, or tobacco), level of SCI lesion, or social supports.

Activities of Daily Living↗
PubMed1984

Personal health practices and mortality among the elderly.

Research on young and middle-aged adults has demonstrated a correlation between certain personal health practices and reduced mortality. This investigation examines the generalizability of these findings to elders who have survived into their seventh and eighth decades. Using data from the Massachusetts Health Care Panel Study, we examined the association of physical activity, cigarette smoking, hours of sleep, alcohol consumption, and number of meals with five-year mortality rates. For elderly women, never having smoked cigarettes is the only personal health practice that achieves a statistically significant multivariate relationship with lower mortality. None of the personal health practices are related significantly to mortality among elderly men.

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PubMed1984

A prospective study of functional status among community elders.

A six-year prospective study provides estimates of functional status (independent, dependent, nursing home resident, or deceased) according to age, gender, and previous functional status for Caucasian elders initially living in the community. Half the cohort had sustained independence for the six years; of those dependent at the beginning, one-fourth to one-third regained independent function within 15 months, and one-fifth regained self-sufficiency within five years.

Activities of Daily Living↗
PubMed1984

Musculoskeletal impairment among the non-institutionalized aged.

This study examines musculoskeletal impairment among 711 community elders living in Massachusetts; all are over 70 years of age, most are Caucasian (99%) and female (65%). Impairment was assessed by having trained interviewers ask participants to perform 10 standardized range-of-motion patterns. Findings reveal a high degree of musculoskeletal ability in this very aged sample. In only 3 of 10 movement patterns do more than 25% of the sample display any sign of impairment.

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PubMed1984

Independent living outcomes in spinal cord injury: multivariate analyses.

This paper presents results of a study designed to isolate those medical, personal, and environmental factors that best predict a spinal cord injured (SCI) person's ability to live independently following discharge from medical rehabilitation. A formal research model is used to identify the most promising dependent and independent variables. The principal data source is an extensive data file of 111 persons with SCI who were discharged from 10 medical rehabilitation centers across the nation. The two main independent living (IL) outcome variables are (1) a person's ability to live in a less restrictive environment, and (2) a person's ability to live productively--not only in terms of gainful employment but also in terms of other contributions to community and family life. Using multiple regression analysis, the paper reports that approximately 63% of the variance in IL outcome can be explained. The most important predictors of IL outcome are marital status, education, transportation barriers, economic disincentives, and the severity of a person's disability as measured by the Barthel index. All predictors are statistically significant. The paper concludes with implications for medical rehabilitation practice and disability policy.

Activities of Daily Living↗
PubMed1983

Active life expectancy.

This study was designed to demonstrate the feasibility of forecasting functional health for the elderly. Using life-table techniques, we analyzed the expected remaining years of functional well-being, in terms of the activities of daily living, for noninstitutionalized elderly people living in Massachusetts in 1974. The expected years, or active life expectancy, showed a decrease, from 10 years for those aged 65 to 70 years to 2.9 for those 85 or older. Active life expectancy was shorter for the poor than for others, and women had a longer average duration of expected dependence than men. The measure of active life expectancy provides important information about health at a given population level, in terms other than death. This information can be used for actuarial purposes in planning and policy making. It is also useful in identifying high-risk populations for which preventive health care and medical care can compress morbidity during the last years of life.

Activities of Daily Living↗
PubMed1983

Targeting community services to high-risk elders: toward preventing long-term care institutionalization.

Data from a probability sample of 1,625 elderly participants in the Massachusetts Health Care Panel Study were used to identify elders at high risk of long-term care (LTC) institutionalization. Advancing age, living alone, using assistance to perform basic and instrumental ADL, using an ambulation aid, and mental disorientation were significant predictors of entering a LTC facility during the six-year study period. A comparison of selected characteristics from the Massachusetts sample with a random sample of Massachusetts' Home Care Corporation recipients showed that the statewide approach to delivering home care successfully targeted services to high-risk elders. Future research should examine the extent to which targeting services to high-risk elders actually prevents or delays LTC institutionalization.

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PubMed1982

A prospective study of long-term care institutionalization among the aged.

A statewide probability sample of 1,625 elders living in Massachusetts are studied prospectively to identify key determinants of long-term care (LTC) institutionalization. One-hundred forty-seven elders, 9 per cent of the original cohort, entered a LTC institution during the six-year investigation. Using logistic multiple regression, we examine the predictive power of 19 independent variables grouped into six categories: demographic characteristics, attitude, social context, long-term care needs, physical disability, and mental/emotional disability. Five variables are significantly related to institutionalization: advancing age, using ambulatory aids, mental disorientation, living alone, and using assistance to perform "instrumental" ADL (activities of daily living). These results may be helpful to those trying to target non-institutional services to elders for use as substitutes for institutional long-term care. They may also help explain why recent experimental tests of substituting non-institutional care for institutional services have been less than successful.

Activities of Daily Living↗
PubMed1981

Targeting home care services to vulnerable elders: Massachusetts' Home Care Corporations.

This investigation evaluates how successfully the Massachusetts model of home care targets services to vulnerable elders. It compares data from a random sample of home care recipients with a probability sample of non-institutionalized elders in Massachusetts. The data indicate that the Massachusetts statewide system developed under minimum regulation and decentralized management has successfully reached the vulnerable elders, particularly those living alone and the widowed. The demand for home services exists but is neither excessive nor uncontrollable. These findings support the continued use of a social model of home care delivery instead of a more restrictive medical model.

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PubMed1981

The Framingham Disability Study: I. Social disability among the aging.

The Framingham Disability Study (FDS), a recent component of the Heart Disease Epidemiological Study in Framingham, Massachusetts, was designed to investigate the nature and magnitude of disability among mon-institutionalized aging adults. From September 1976, through November 1978, 2,654 individuals aged 55 to 84 years from the original cohort were interviewed in person or by telephone (94 per cent of the potential participant pool). This paper reports results on the prevalence social disability in five areas: housekeeping, transportation, social interaction, food preparation, and grocery shopping. Only 6 per cent of the sample have existing unmet needs in one or more of these five areas. The magnitude of social disability increases with advancing age. Women, in general, report a higher degree of unmet social needs than men. These findings are compared with other epidemiological investigations of social disability among the elderly.

Activities of Daily Living↗
PubMed1981

The Framingham Disability Study: II. Physical disability among the aging.

The Framingham Disability Study (FDS), a recent component of the Heart Disease Epidemiological Study in Framingham, Massachusetts, was designed to investigate the nature and magnitude of disability among non-institutionalized elderly. From September 1976 through November 1978, 2,654 individuals aged 55 to 84 years from the original Framingham cohort were interviewed in person or by telephone (94 per cent of the potential participant pool). The findings support the well known relationship between physical disability and age. The magnitude of disability, however, is not as great as conventional wisdom might suggest. This paper presents the physical disability prevalence findings and compares these results to earlier epidemiological investigations of disability in the elderly.

Activities of Daily Living↗