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Journal of the American Geriatrics Society

Xitong Xu, Jie Chen, Meijie Chen, Zhuqin Gu, Shaozhen Ji, Shuying Liu, Piu Chan
OBJECTIVES: We sought to assess associations of postural tremor with gait and balance impairments among community-dwelling older people in both cross-sectional and longitudinal analyses. DESIGN: A prospective cohort study. SETTING: Communities in Beijing, China. PARTICIPANTS: This study included 7075 individuals aged 55 years or older. MEASUREMENTS: Postural tremor was assessed using a two-step method (tremor screening followed by a confirmation examination of positive cases) at baseline...
February 19, 2019: Journal of the American Geriatrics Society
Carla Perissinotto, Julianne Holt-Lunstad, Vyjeyanthi S Periyakoil, Ken Covinsky
Loneliness and social isolation are strongly associated with several adverse health outcomes in older persons including death and functional impairments. The strength of these associations has been compared with smoking. Accordingly, loneliness and isolation have significant public health implications. Despite the adverse impacts of loneliness and social isolation on quality of life, and their strong association with health outcomes, the evaluation of loneliness and isolation have not been integrated into medical care...
February 14, 2019: Journal of the American Geriatrics Society
Emily Reeve, Lee-Fay Low, Sarah N Hilmer
BACKGROUND/OBJECTIVES: Use of harmful and/or unnecessary medications in older adults is common. Understanding older adult and caregiver attitudes toward deprescribing will contribute to medication optimization in practice. The aims of this study were to capture the attitudes and beliefs of older adults and caregivers toward deprescribing and determine what participant characteristics and/or attitudes (if any) predicted reported willingness to have a medication deprescribed. DESIGN: Self-completed questionnaire...
February 13, 2019: Journal of the American Geriatrics Society
Lisa M McCarthy, Jessica D Visentin, Paula A Rochon
As originally defined, the term "prescribing cascade" describes a sequence of events that begins when an adverse drug event (ADE) occurs, is misinterpreted as a new medical condition, and a subsequent drug is then inadvertently prescribed to treat the new condition. We refine the definition to encompass both recognized and unrecognized ADEs because they can both contribute to problematic prescribing practices. In addition, we discuss that although prescribing cascades are most commonly viewed as problematic, they may be appropriate and therapeutically beneficial in certain clinical situations...
February 12, 2019: Journal of the American Geriatrics Society
Barbara J Zarowitz, James E Tisdale
BACKGROUND: The exponential increase in the number of medications associated with clinically important prolongation of the heart rate-corrected QT interval (QTc) places older adults at increased risk of arrhythmias including life-threatening torsade de pointes (TdP) and sudden death. Risk factors, other than age older than 65 years and female sex, include multiple concurrent drugs that prolong QTc and a variety of underlying predisposing conditions. Although electronic medical records and pharmacy dispensing systems can alert clinicians to the risk of QTc-prolonging therapy, more than 95% of safety alerts are overridden, and many systems have deactivated QTc drug interaction alerts...
February 12, 2019: Journal of the American Geriatrics Society
Melissa A Hornor, Victoria L Tang, Julia Berian, Thomas N Robinson, JoAnn Coleman, Mark R Katlic, Ronnie A Rosenthal, Kataryna Christensen, Tracey Baker, Emily Finlayson, Sandhya A Lagoo-Deenadaayalan, Clifford Y Ko, Marcia M Russell
BACKGROUND: The American College of Surgeons Coalition for Quality in Geriatric Surgery is a multidisciplinary stakeholder group that aims to systematically improve the surgical care of older adults by establishing a verifiable quality improvement program with standards based on best evidence. Prior work confirmed the validity of a preliminary set of 308 standards to improve the quality of geriatric surgery, but concerns exist as to whether the standards are feasible for hospitals to implement...
February 12, 2019: Journal of the American Geriatrics Society
Margaret G O'Connor, Haley Duncanson, Ann M Hollis
OBJECTIVES: To examine the association between performance on subtests of the Mini-Mental State Examination (MMSE) and driving competence in people with cognitive impairment (CI) as well as those with no cognitive impairment (NCI). DESIGN: Retrospective observational study. SETTING: Participants referred for a DriveWise evaluation at Beth Israel Deaconess Medical Center in Boston, Massachusetts, were included in the study. PARTICIPANTS: A total of 419 participants referred for a DriveWise evaluation was studied...
February 8, 2019: Journal of the American Geriatrics Society
Paul Rousseau
No abstract text is available yet for this article.
February 8, 2019: Journal of the American Geriatrics Society
Abraham A Brody, Alicia I Arbaje, Linda V DeCherrie, Alex D Federman, Bruce Leff, Albert L Siu
BACKGROUND: Hospital at home (HaH) is a model of care that provides acute-level services in the home. HaH has been shown to improve quality and patient satisfaction, and reduce iatrogenesis and costs. Uptake of HaH in the United States has been limited, and little research exists on how to implement it successfully. OBJECTIVES: This study examined facilitators and barriers to implementation of an HaH program. DESIGN: A HaH program that included a 30-day transitional care bundle following the acute stay was implemented through a Centers for Medicare & Medicaid Services Innovations Award...
February 8, 2019: Journal of the American Geriatrics Society
Catherine M P Dawson, Leo M Cooney
Inability to climb stairs safely can lead older adults to miss desired medical appointments. To facilitate adequate access to routine medical care for older adults, affordable transportation assistance up and down stairs should be available.
February 6, 2019: Journal of the American Geriatrics Society
Kathy C Richards, Nalaka Gooneratne, Barry Dicicco, Alexandra Hanlon, Stephen Moelter, Fannie Onen, Yanyan Wang, Amy Sawyer, Terri Weaver, Alicia Lozano, Patricia Carter, Jerry Johnson
BACKGROUND/OBJECTIVES: Obstructive sleep apnea (OSA) has been linked to an increased risk for Alzheimer's disease (AD), but little prospective evidence exists on the effects of OSA treatment in preclinical AD. The objective was to determine if continuous positive airway pressure (CPAP) treatment adherence, controlling for baseline differences, predicts cognitive and everyday function after 1 year in older adults with mild cognitive impairment (MCI) and to determine effect sizes for a larger trial...
February 6, 2019: Journal of the American Geriatrics Society
Robert Briggs, Daniel Carey, Paul Claffey, Triona McNicholas, Orna Donoghue, Sean P Kennelly, Rose Anne Kenny
BACKGROUND/OBJECTIVES: There is growing interest in the association between gait disturbance and depression in later life. The aim of this study is to clarify the longitudinal relationship between specific gait parameters and incident depression within a population-representative sample of older people. DESIGN: Longitudinal analysis of spatiotemporal gait parameters at baseline (wave 1) and incident depression at 2 and 4 years (waves 2/3). Logistic regression models were used to assess the relationship between tertiles of gait parameters and incident depression...
February 5, 2019: Journal of the American Geriatrics Society
Ling Wei, Huang Yi, Zhao Hai-Lu
No abstract text is available yet for this article.
February 5, 2019: Journal of the American Geriatrics Society
Flavia Cristina Drumond Andrade, Ligiana Pires Corona, Yeda Aparecida de Oliveira Duarte
OBJECTIVES: To investigate the differences in life expectancy with and without cognitive impairment (CI) by educational levels and sex in Brazil. DESIGN: Longitudinal observational study. SETTING: The sample was drawn from three waves (2000, 2006, and 2010) of the Health, Well-Being, and Aging Study (Saúde, bem-estar e envelhecimento; SABE) collected in São Paulo, Brazil. PARTICIPANTS: Adults aged 60 years and older (N = 2116)...
February 4, 2019: Journal of the American Geriatrics Society
Alenka Gugger, Alex Marzel, E John Orav, Walter C Willett, Bess Dawson-Hughes, Robert Theiler, Gregor Freystätter, Andreas Egli, Heike A Bischoff-Ferrari
OBJECTIVES: To test the effect of monthly high-dose vitamin D supplementation on mental health in pre-frail older adults. DESIGN: Ancillary study of a 1-year double-blind randomized clinical trial conducted in Zurich, Switzerland. SETTING AND PARTICIPANTS: A total of 200 community-dwelling adults 70 years and older with a prior fall event in the last year. Participants were randomized to receive 24 000 IU vitamin D3 (considered standard of care), 60 000 IU vitamin D3 , or 24 000 IU vitamin D3 plus 300 μg calcifediol per month...
February 1, 2019: Journal of the American Geriatrics Society
Camille Ouvrard, José Alberto Avila-Funes, Jean-François Dartigues, Hélène Amieva, Maturin Tabue-Teguo
No abstract text is available yet for this article.
February 1, 2019: Journal of the American Geriatrics Society
Roman Ayele, Jacqueline Jones, Amy Ladebue, Emily Lawrence, Patricia Valverde, Chelsea Leonard, Ethan Cumbler, Rebecca Allyn, Robert E Burke
BACKGROUND/OBJECTIVE: Older adults frequently receive post-acute care (PAC) after hospital discharge, but little is known about how perceived costs influence PAC choices. This research study sought to understand how clinicians, patients, and their caregivers evaluate the cost of skilled nursing facility (SNF) care in their decisions about whether to utilize SNFs after hospital discharge. DESIGN: Guided by principles of social constructivist theory, we conducted a qualitative interpretative study using semistructured interviews with clinicians, patients, and caregivers...
February 1, 2019: Journal of the American Geriatrics Society
Joseph G Ouslander, Mandi Sehgal
No abstract text is available yet for this article.
February 1, 2019: Journal of the American Geriatrics Society
Melisa L Wong, Harvey Jay Cohen
No abstract text is available yet for this article.
February 1, 2019: Journal of the American Geriatrics Society
Moon Jeong Lee, Jennifer A Deal, Pradeep Y Ramulu, A Richey Sharrett, Alison G Abraham
OBJECTIVE: To determine the prevalence of retinal microvascular signs and associations between retinal signs and cognitive status. DESIGN: Cross-sectional analysis of visit 5 (2011-2013) of the Atherosclerosis Risk in Communities (ARIC) cohort. Data analysis took place November 30, 2017, to May 1, 2018. SETTING: Biracial population-based cohort from four US communities. PARTICIPANTS: A total of 2624 participants with a mean age of 76 years (SD = 5 years) (19% African American) with data on cognitive status and complete retinal examination...
February 1, 2019: Journal of the American Geriatrics Society
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