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Article ; Online: Dissemination of Coronary Care Units Versus Geriatric Units.

St John, Philip D

2018 Volume 131, Issue 3, Page(s) e111

MeSH term(s)	Aged ; Coronary Care Units ; Heart ; Hospital Medicine ; Hospital Units ; Humans
Language	English
Publishing date	2018-02-14
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80015-6
ISSN	1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
ISSN (online)	1555-7162 ; 1873-2178
ISSN	0002-9343 ; 1548-2766
DOI	10.1016/j.amjmed.2017.09.018
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Article: Patterns of Functional Impairment over Time Amongst Older Men-the Manitoba Follow-up Study.

St John, Philip D / Swift, Audrey U / Tate, Robert B

Canadian geriatrics journal : CGJ

2021 Volume 24, Issue 2, Page(s) 144–150

Abstract: Background: To determine the incidence and prevalence patterns of activity of daily living (ADL) impairments in ageing men.: Methods: 3,983 men were enrolled in the Manitoba Follow-up Study (MFUS) cohort study in 1948. From 1996 onwards, functional ... ...

Abstract	Background: To determine the incidence and prevalence patterns of activity of daily living (ADL) impairments in ageing men. Methods: 3,983 men were enrolled in the Manitoba Follow-up Study (MFUS) cohort study in 1948. From 1996 onwards, functional status was measured. We classified basic (BADL) and instrumental (IADL) into mutually exclusive categories as a time dependant factor after the second survey wave as: First survey response; no limitation; incident (first episode of disability); persistent (limitation which was seen on all questionnaires after the incident episode); resilient (noted in previous surveys but not present); and recurrent (noted in present survey, and limitations noted as present and absent in previous surveys). Results: There were 1,745 participants in 1996 at a mean age of 76 years. Incident BADL limitations increased substantially with age: from 1% at age 75 to 15% at age 95. Similarly, persistent limitations increased with age: from 0.4% at age 75 to 18% at age 95. However, BADL function was fluid, with many individuals grouped within the resilient and recurrent patterns. Similar age effects and variability were noted in IADLs. Conclusion: New and persistent disabilities are highly associated with age. However, there is considerable change in functional status over time.
Language	English
Publishing date	2021-06-01
Publishing country	Canada
Document type	Journal Article
ISSN	1925-8348
ISSN	1925-8348
DOI	10.5770/cgj.24.453
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Article ; Online: Life Course Predictors of Young Men Surviving to Age 90 in a Cohort Study: The Manitoba Follow-up Study.

Tate, Robert B / Swift, Audrey U / Thompson, Edward H / St John, Philip D

Canadian journal on aging = La revue canadienne du vieillissement

2022 Volume 42, Issue 1, Page(s) 13–19

Abstract: The purpose of this study was to identify factors at various time points in life that are associated with surviving to age 90. Data from men enrolled in a cohort study since 1948 were considered in 12-year intervals. Logistic regression models were ... ...

Abstract	The purpose of this study was to identify factors at various time points in life that are associated with surviving to age 90. Data from men enrolled in a cohort study since 1948 were considered in 12-year intervals. Logistic regression models were constructed with the outcome of surviving to age 90. Factors were: childhood illness, blood pressure (BP), body mass index (BMI), chronic diseases, and electrocardiogram (ECG) findings. After 1996, the Short Form-36 was added. A total of 3,976 men were born in 1928 or earlier, and hence by the end of our study window in 2018, each had the opportunity of surviving to age 90. Of these, 721 did live to beyond his 90th birthday.The factors in 1948 which predicted surviving were: lower diastolic BP, lower BMI, and not smoking. In 1960, these factors were: lower BP, lower BMI, not smoking, and no major ECG changes. In 1972, these factors were lower BP, not smoking, and fewer disease states. In 1984, these factors were lower systolic BP, not smoking, ECG changes, and fewer disease states. In 1996, the factors were fewer disease states and higher physical and mental health functioning. In 2008, only higher physical functioning predicted survival to the age of 90. In young adulthood, risk factors are important predictors of surviving to age 90; in mid-life, chronic illnesses emerge, and in later life, functional status becomes predominant.
MeSH term(s)	Male ; Humans ; Aged, 80 and over ; Young Adult ; Adult ; Child ; Cohort Studies ; Follow-Up Studies ; Life Change Events ; Manitoba ; Blood Pressure/physiology ; Risk Factors
Language	English
Publishing date	2022-07-06
Publishing country	Canada
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	632851-9
ISSN	1710-1107 ; 0714-9808
ISSN (online)	1710-1107
ISSN	0714-9808
DOI	10.1017/S0714980822000186
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Article ; Online: Applying Strategies From Pediatrics to the Treatment of Hospitalized Adults.

St John, Philip D

Annals of internal medicine

2015 Volume 163, Issue 12, Page(s) 959

MeSH term(s)	Child, Hospitalized/psychology ; Hospitalization ; Humans ; Stress, Psychological/prevention & control
Language	English
Publishing date	2015-12-15
Publishing country	United States
Document type	Comment ; Letter
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/L15-5178
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Article ; Online: Developing a question prompt list for family caregivers concerning the progression and palliative care needs of nursing home residents living with dementia.

Thompson, Genevieve N / Hack, Thomas F / Chochinov, Harvey Max / Roger, Kerstin / St John, Philip D / McClement, Susan E

PEC innovation

2023 Volume 2, Page(s) 100160

Abstract: Objective: Communication around a palliative approach to dementia care often is problematic or occurs infrequently in nursing homes (NH). Question prompt lists (QPLs), are evidence-based lists designed to improve communication by facilitating ... ...

Abstract	Objective: Communication around a palliative approach to dementia care often is problematic or occurs infrequently in nursing homes (NH). Question prompt lists (QPLs), are evidence-based lists designed to improve communication by facilitating discussions within a specific population. This study aimed to develop a QPL concerning the progression and palliative care needs of residents living with dementia. Methods: A mixed-methods design in 2 phases. In phase 1, potential questions for inclusion in the QPL were identified using interviews with NH care providers, palliative care clinicians and family caregivers. An international group of experts reviewed the QPL. In phase 2, NH care providers and family caregivers reviewed the QPL assessing the clarity, sensitivity, importance, and relevance of each item. Results: From 127 initial questions, 30 questions were included in the first draft of the QPL. After review by experts, including family caregivers, the QPL was finalized with 38 questions covering eight content areas. Conclusion: Our study has developed a QPL for persons living with dementia in NHs and their caregivers to initiate conversations to clarify questions they may have regarding the progression of dementia, end of life care, and the NH environment. Further work is needed to evaluate its effectiveness and determine optimal use in clinical practice. Innovation: This unique QPL is anticipated to facilitate discussions around dementia care, including self-care for family caregivers.
Language	English
Publishing date	2023-05-03
Publishing country	Netherlands
Document type	Journal Article
ISSN	2772-6282
ISSN (online)	2772-6282
DOI	10.1016/j.pecinn.2023.100160
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Article: Changes in Intensity and Duration of Walking among Older Adults from In-Patient Geriatric Rehabilitation to Home.

Webber, Sandra C / St John, Philip D

Physiotherapy Canada. Physiotherapie Canada

2019 Volume 70, Issue 4, Page(s) 341–348

Abstract: Purpose: ...

Abstract	Purpose:
Language	English
Publishing date	2019-02-11
Publishing country	Canada
Document type	Journal Article
ZDB-ID	639189-8
ISSN	1708-8313 ; 0300-0508
ISSN (online)	1708-8313
ISSN	0300-0508
DOI	10.3138/ptc.2017-55
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Article ; Online: Multimorbidity in Canadians living in the community: Results from the Canadian Longitudinal Study of Aging.

St John, Philip D / Menec, Verena / Tyas, Suzanne L / Tate, Robert / Griffith, Lauren

Canadian family physician Medecin de famille canadien

2021 Volume 67, Issue 3, Page(s) 187–197

Abstract: Objective: To determine the mean number of chronic diseases in Canadians aged 45 to 85 years who are living in the community, and to characterize the association of multimorbidity with age, sex, and social position.: Design: An analysis of data from ... ...

Abstract	Objective: To determine the mean number of chronic diseases in Canadians aged 45 to 85 years who are living in the community, and to characterize the association of multimorbidity with age, sex, and social position. Design: An analysis of data from the Canadian Longitudinal Study on Aging. The number of self-reported chronic diseases was summed, and then the mean number of chronic health problems was standardized to the 2011 Canadian population. Analyses were conducted stratified on sex, age, individual income, household income, and education level. Setting: Canada. Participants: A total of 21 241 community-living Canadians aged 45 to 85 years. Main outcome measures: Overall, 31 chronic diseases (self-reported from a list) were considered, as were risk factors that were not mental health conditions or acute in nature. Age, sex, education, and household and individual incomes were also self-reported. Results: Multimorbidity was common, and the mean number of chronic illnesses was 3.1. Women had a higher number of chronic illnesses than men. Those with lower income and less education had more chronic conditions. The number of chronic conditions was strongly associated with age. The mean number of conditions was 2.1 in those aged 45 to 54; 2.9 in those 55 to 64; 3.8 in those aged 65 to 74, and 4.8 in those aged 75 and older ( Conclusion: Multimorbidity is common in the Canadian population and is strongly related to age.
MeSH term(s)	Aging ; Canada/epidemiology ; Chronic Disease ; Cross-Sectional Studies ; Female ; Humans ; Longitudinal Studies ; Male ; Multimorbidity
Language	English
Publishing date	2021-03-16
Publishing country	Canada
Document type	Journal Article
ZDB-ID	603565-6
ISSN	1715-5258 ; 0008-350X
ISSN (online)	1715-5258
ISSN	0008-350X
DOI	10.46747/cfp.6703187
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Article ; Online: Protective effects of prior third dose mRNA vaccination in rural nursing home residents during SARS-CoV-2 outbreaks.

Rhynold, Elizabeth S / Quan, Samuel / Orr, Pamela H / LaBine, Lisa / Singer, Alexander / St John, Philip D

Journal of the American Geriatrics Society

2022 Volume 70, Issue 11, Page(s) 3245–3249

Abstract: Background: In Canada, mortality due to SARS-CoV-2 disproportionately impacted residents of nursing homes (NH). In November 2021, NH residents in the Canadian province of Manitoba became eligible to receive three doses of mRNA vaccine but coverage with ... ...

Abstract	Background: In Canada, mortality due to SARS-CoV-2 disproportionately impacted residents of nursing homes (NH). In November 2021, NH residents in the Canadian province of Manitoba became eligible to receive three doses of mRNA vaccine but coverage with three doses has not been universal. The objective of this study was to compare the protection from infection conferred by one, two, and three doses of COVID-19 mRNA vaccine compared to no vaccination among residents of nursing homes experiencing SARS-CoV-2 outbreaks. Methods: Infection Prevention and Control reports from 8 rural nursing homes experiencing outbreaks of SARS-CoV-2 between January 6, 2022, and March 5, 2022, were analyzed. Attack rates and the number needed to vaccinate (NNV) were calculated. Results: SARS-CoV-2 attack rate was 65% among NH residents not vaccinated, 58% among residents who received 1-2 doses of mRNA COVID-19 vaccine, and 28% among residents who had received 3 vaccine doses. The NNV to prevent one nursing home resident from SARS-CoV-2 infection during an outbreak was 3 for a vaccination with 3 doses and 14 for 1-2 doses of COVID-19 mRNA vaccine. The superiority of receiving the third dose was statistically significant compared to 1-2 doses (Chi-Squared, p < 0.00001). Conclusions: Nursing home residents who received three doses of COVID-19 mRNA vaccine were at lower risk of SARS-CoV-2 infection compared to those who received 1-2 doses. Our analyses lend support to the protective effects of the third dose of mRNA vaccine for NH residents in the event of a SARS-CoV-2 outbreak.
MeSH term(s)	Humans ; SARS-CoV-2 ; COVID-19 Vaccines ; COVID-19/epidemiology ; COVID-19/prevention & control ; RNA, Messenger ; Canada ; Disease Outbreaks/prevention & control ; Nursing Homes ; mRNA Vaccines
Chemical Substances	COVID-19 Vaccines ; RNA, Messenger
Language	English
Publishing date	2022-08-08
Publishing country	United States
Document type	Journal Article
ZDB-ID	80363-7
ISSN	1532-5415 ; 0002-8614
ISSN (online)	1532-5415
ISSN	0002-8614
DOI	10.1111/jgs.17996
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Article ; Online: Polypharmacy and Potentially Inappropriate Medication Use in Older Adults With Systemic Lupus Erythematosus.

Séguin, Dale Jean-Guy / Peschken, Christine A / Dolovich, Cassandra / Grymonpre, Ruby E / St John, Philip D / Tisseverasinghe, Annaliese

Arthritis care & research

2022 Volume 75, Issue 2, Page(s) 356–364

Abstract: Objective: To assess the prevalence and potential risk factors for polypharmacy and prescribing of the potentially inappropriate medications, opioids and benzodiazepines/Z-drugs, in older adults with systemic lupus erythematosus (SLE).: Methods: The ... ...

Abstract	Objective: To assess the prevalence and potential risk factors for polypharmacy and prescribing of the potentially inappropriate medications, opioids and benzodiazepines/Z-drugs, in older adults with systemic lupus erythematosus (SLE). Methods: The study population comprised adults age ≥50 years meeting American College of Rheumatology or Systemic Lupus International Collaborating Clinics classification criteria followed at a tertiary care rheumatology clinic. Information on prescriptions filled in the 4 months preceding chart review was obtained from the Manitoba Drug Program Information Network. Clinical data, including age, sex, Charlson Comorbidity Index (CCI) score, Systemic Lupus Erythematosus Disease Activity Index 2000 score, prednisone use, SLE duration, and rural residence were abstracted from electronic medical records. Logistic regression analyses were performed to assess any association between polypharmacy (using 2 definitions: ≥5 and ≥10 medications), potentially inappropriate medication use, and clinical features. Results: A total of 206 patients (mean age 62 years, 91% female, 36% rural) were included: 148 (72%) filled ≥5 medications, 71 (35%) filled ≥10 medications, 63 (31%) used benzodiazepines/Z-drugs, and 50 (24%) used opioids. Among the 77 patients age ≥65 years, 57 (74%) filled ≥5 medications, and 26 (34%) filled ≥10 medications, compared to 30% and 4%, respectively, of Manitobans age ≥65 years (National Prescription Drug Utilization Information System, 2016). The odds of polypharmacy were greater with prednisone use (adjusted odds ratio [OR] 3.70 [95% confidence interval (95% CI) 1.40-9.79] for ≥5 medications), CCI score (adjusted OR 1.62 [95% CI 1.20-2.17]), and rural residence (adjusted OR 2.05 [95% CI 1.01-4.18]). Odds of benzodiazepine/Z-drug use were increased with polypharmacy (adjusted OR 4.35 [95% CI 1.69-11.22]), and odds of opioid use were increased with polypharmacy (adjusted OR 6.75 [95% CI 1.93-23.69]) and CCI score (adjusted OR 1.29 [95% CI 1.08-1.54]). Conclusion: The prevalence of polypharmacy in this SLE cohort was higher than in the general Manitoban population. Polypharmacy is a strong marker for use of prescription benzodiazepines/Z-drugs and opioids.
MeSH term(s)	Humans ; Female ; Aged ; Middle Aged ; Male ; Potentially Inappropriate Medication List ; Polypharmacy ; Prednisone ; Analgesics, Opioid/adverse effects ; Benzodiazepines/adverse effects ; Lupus Erythematosus, Systemic/diagnosis ; Lupus Erythematosus, Systemic/drug therapy ; Lupus Erythematosus, Systemic/epidemiology
Chemical Substances	Prednisone (VB0R961HZT) ; Analgesics, Opioid ; Benzodiazepines (12794-10-4)
Language	English
Publishing date	2022-10-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	645059-3
ISSN	2151-4658 ; 0893-7524 ; 2151-464X
ISSN (online)	2151-4658
ISSN	0893-7524 ; 2151-464X
DOI	10.1002/acr.24766
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Zs.A 2446: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article: Self-Rated Health Predicts Mortality in Very Old Men-the Manitoba Follow-Up Study.

Hanson, Christian R / St John, Philip D / Tate, Robert B

Canadian geriatrics journal : CGJ

2019 Volume 22, Issue 4, Page(s) 199–204

Abstract: Background: Self-rated health (SRH) predicts death, but there are few studies over long-time horizons that are able to explore the effect age may have on the relationship between SRH and mortality.: Objectives: 1. To determine how SRH evolves over 20 ...

Abstract	Background: Self-rated health (SRH) predicts death, but there are few studies over long-time horizons that are able to explore the effect age may have on the relationship between SRH and mortality. Objectives: 1. To determine how SRH evolves over 20 years; and 2. To determine if SRH predicts death in very old men. Methods: We analyzed a prospective cohort study of men who were fit for air crew training in the Second World War. In 1996, a regular questionnaire was administered to the 1,779 surviving participants. SRH was elicited with a 5-point Likert Scale with the categories: excellent, very good, good, fair and poor/bad. We examined the age-specific distribution of SRH in these categories from the age of 75 to 95 years, to the end of the follow-up period in 2018. We constructed age-specific Cox proportional hazard models with an outcome of time to death. Results: SRH declined with age. The gradient in risk of death persisted across all ages; those with poor/fair/bad SRH had consistently higher mortality rates. However, the discrimination between good and excellent was less in those aged 85+. Conclusions: SRH declines with advancing age, but continues to predict death in older men.
Language	English
Publishing date	2019-12-30
Publishing country	Canada
Document type	Journal Article
ISSN	1925-8348
ISSN	1925-8348
DOI	10.5770/cgj.22.391
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