Journal of the American Medical Directors Association最新文献

{"title":"Trends in End-of-Life Hospitalizations of Nursing Home Residents between 2011 and 2020: Analyses of German Health Insurance Data","authors":"Kathrin Wandscher MSc ,&nbsp;Hannes Jacobs PhD ,&nbsp;Anna Völkel MSc ,&nbsp;Tanja Schleef MPH ,&nbsp;Jona Theodor Stahmeyer PhD ,&nbsp;Birte Burger MSc ,&nbsp;Anna Levke Brütt PhD ,&nbsp;Stephanie Stiel PhD ,&nbsp;Falk Hoffmann PhD","doi":"10.1016/j.jamda.2025.105540","DOIUrl":"10.1016/j.jamda.2025.105540","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate trends in end-of-life hospitalizations among nursing home residents between 2011 and 2020.</div></div><div><h3>Design</h3><div>A retrospective cohort study was conducted.</div></div><div><h3>Setting and Participants</h3><div>Using German claims data of the statutory health and long-term care insurance fund AOK Niedersachsen, all residents aged ≥65 years who were newly admitted to a nursing home between January 1, 2011, and December 31, 2020, and became deceased in the calendar year of admission were included.</div></div><div><h3>Methods</h3><div>Proportions of deceased nursing home residents dying in hospital and being hospitalized in the last 7 and 30 days of life were analyzed and stratified by 2-year periods. Multiple logistic regressions were performed to examine changes over time, adjusting for covariates.</div></div><div><h3>Results</h3><div>A total of 26,359 decedents were included (mean age, 84.0 years; 61.0% female). Proportions of nursing home residents dying in hospital decreased from 32.0% to 27.4% (odds ratio [OR], 0.88; 95% CI, 0.81–0.96), being hospitalized in the last 7 days decreased from 42.5% to 36.3% (OR, 0.84; 95% CI, 0.77–0.91), and being hospitalized in the last 30 days decreased from 61.6% to 56.7% (OR, 0.88; 95% CI, 0.82–0.96) between 2011–2012 and 2019–2020. Male sex, lower care dependency, and younger age (aged ≤94 years) were associated with an increased likelihood of end-of-life hospitalizations in all analyses. Of the 7923 terminal hospitalizations, mean length of hospital stay was 9.1 days and 33.4% lasted up to 3 days, with no changes over time.</div></div><div><h3>Conclusion and Implications</h3><div>End-of-life hospitalizations of German nursing home residents have decreased over the years, but are still common. Because more policies have been introduced globally in recent years aimed at improving end-of-life care in nursing homes, longitudinal studies investigating trends with more recent data are needed.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 5","pages":"Article 105540"},"PeriodicalIF":4.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Restless Legs Syndrome Improves Agitation and Sleep in Persons with Dementia: A Randomized Trial","authors":"Kathy C. Richards PhD, RN ,&nbsp;Liam M. Fry MD ,&nbsp;Alicia J. Lozano MS ,&nbsp;Wenyan Ji MA ,&nbsp;Janet D. Morrison PhD, RN ,&nbsp;Katherine C. Britt PhD, RN ,&nbsp;Donald L. Bliwise PhD ,&nbsp;Nalaka S. Gooneratne MD, MSc ,&nbsp;Alexandra L. Hanlon PhD","doi":"10.1016/j.jamda.2025.105485","DOIUrl":"10.1016/j.jamda.2025.105485","url":null,"abstract":"<div><h3>Objectives</h3><div>Restless legs syndrome (RLS), a common, treatable, sensorimotor disorder of nighttime uncomfortable leg sensations that interfere with sleep, may prompt nighttime agitation in persons with dementia.</div></div><div><h3>Design</h3><div>This randomized trial was double-blind and placebo-controlled. Participants received a Food and Drug Administration–approved drug for RLS, gabapentin enacarbil (GEn) (Horizant) or placebo.</div></div><div><h3>Setting and Participants</h3><div>Older adults (N = 147) with dementia due to Alzheimer's disease, nighttime agitation, and RLS, residing in long-term care or at home, participated.</div></div><div><h3>Methods</h3><div>The primary outcome was change from baseline to 8 weeks in nighttime agitation between 5 <span>pm</span> and 7 <span>am</span> on the Cohen-Mansfield Agitation Inventory Index, Direct Observation. Multivariable linear mixed effects regression models based on multiply imputed data were estimated on nighttime agitation and sleep, with treatment group, week, the 2-way interaction of group and week as predictors, and mean arterial pressure as a covariate based on baseline group imbalances.</div></div><div><h3>Results</h3><div>Mean age ± SD was 83.4 ± 9.1 years. Most were female (72.0%), white (92.3%), non-Hispanic (84.6%), and lived in nursing homes (76.9%). Nighttime agitation, by group over time, was significant at 8 weeks (estimate, −1.67; <em>P</em> = .003) and 2 weeks. Total sleep time (actigraphy) by group over time was significant at 8 weeks (estimate, 48.45; <em>P</em> = .026). Observed nighttime wake by group over time was significant at 2 (estimate, −12.54; <em>P</em> = .006) and 8 weeks (estimate, −11.12; <em>P</em> = .015). The number having ≥1 adverse events was 60 in the GEn group (81.1%) and 50 in the placebo group (68.5%); with 12 serious adverse events in placebo and 10 in the GEn group. The GEn group had a trend toward more falls (<em>P</em> = .066).</div></div><div><h3>Conclusions and Implications</h3><div>Our findings suggest a novel approach for nighttime agitation in persons with dementia: assessing for RLS and initiating interventions. Larger and longer trials are needed.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 5","pages":"Article 105485"},"PeriodicalIF":4.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and Facilitators to Successful Outbreak Management of Viral Respiratory Tract Infections in Long-Term Care Facilities: A Qualitative Interview Study.","authors":"Iris R van der Horst, Daisy Kolk, Meriam Janssen, Sascha R Bolt, Martin Smalbrugge, Sarah Janus, Cees M P M Hertog, Laura W van Buul","doi":"10.1016/j.jamda.2025.105575","DOIUrl":"https://doi.org/10.1016/j.jamda.2025.105575","url":null,"abstract":"<p><strong>Objectives: </strong>Effective management of COVID-19 and influenza outbreaks in nursing homes (NHs) depends on preparation by the NH organization and the rightful execution of infection prevention and control (IPC) measures by NH staff. To be better prepared for future outbreaks and pandemics, we need a better understanding of barriers and facilitators to the execution of measures. This study aims to investigate which barriers and facilitators were perceived by Dutch NH staff during the execution of IPC measures to control outbreaks of COVID-19 and influenza in the COVID-19 pandemic end stage.</p><p><strong>Design: </strong>Qualitative interview study.</p><p><strong>Setting: </strong>Nursing homes where COVID-19 and/or influenza outbreaks (defined as at least 2 confirmed cases on an NH unit) occurred between February 2023 and April 2023.</p><p><strong>Methods: </strong>We monitored 24 COVID-19 and influenza outbreaks in 14 Dutch NH organizations in the pandemic end stage. Purposive sampling was used to select a variety of outbreaks for more extensive monitoring, including qualitative interviews with NH staff involved in the management of the outbreak. During the interviews, participants reflected on the management of monitored outbreaks as well as previous outbreaks. Interview transcripts were thematically analyzed to identify determinants of IPC strategy execution.</p><p><strong>Results: </strong>Determinants of IPC execution were clustered according to themes: motivations and attitudes; appropriateness of measures; guidance and cooperation of NH staff; communication; knowledge and skills; architectural features of the NH location; and availability of resources.</p><p><strong>Conclusions and implications: </strong>The current study provides in-depth insight into which determinants facilitated and impeded IPC execution during COVID-19 and influenza outbreaks pandemic end stage. These findings may help NHs to better prepare for the management of future outbreaks and pandemics, and provide insights into what determinants to consider for developing IPC strategies.</p>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":" ","pages":"105575"},"PeriodicalIF":4.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development, Validation, and Application of the Electronic Frailty Index: A Scoping Review.","authors":"Jiaying Zheng, Ping Yu, Minmu Yang","doi":"10.1016/j.jamda.2025.105577","DOIUrl":"https://doi.org/10.1016/j.jamda.2025.105577","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this scoping review was to examine the scope and characteristics of the published literature related to the Electronic Frailty Index (eFI).</p><p><strong>Design: </strong>Scoping review.</p><p><strong>Setting and participants: </strong>Original studies related to the eFI in older adults.</p><p><strong>Methods: </strong>Six databases were searched for articles published between March 2016 and August 2024: PubMed, Web of Science, Cochrane Library, Scopus, China National Knowledge Infrastructure (CNKI), and Wanfang Database. Data extracted included the publication year, country, sample size, data sources for developing an eFI, number of items included in the eFI, performance of the eFI, and application of the eFI.</p><p><strong>Results: </strong>Of the 424 articles initially retrieved, this scoping review included 50 studies for analysis. Thirty-nine (78%) of these studies were conducted after the year 2019. Moreover, we identified 8 distinct eFIs. Twelve studies assessed the performance of eFIs, whereas 30 studies used them. The eFIs covered 4 key domains: diseases, functional information, laboratory tests and measures, and symptoms and signs. The most common outcome examined was mortality. Furthermore, the eFIs were applied for diverse purposes, including exploring the relationship between frailty and health outcomes.</p><p><strong>Conclusions and implications: </strong>This scoping review revealed that eFIs can be developed using various electronic health care data sources, and they have been extensively employed for various population-level purposes. The observed associations between the eFIs, existing frailty assessment tools, and health outcomes highlight their utility in evaluating the care needs of an aging population.</p>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":" ","pages":"105577"},"PeriodicalIF":4.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Exercise Intervention on Functional Mobility among Older Adults with Cognitive Impairment: A Quantitative Evidence","authors":"Yanxia Chen MSc ,&nbsp;Tao Huang PhD ,&nbsp;Zhizhong Li MSc ,&nbsp;Peisi Wang MSc ,&nbsp;Zhihui Cheng MSc ,&nbsp;Chun Xie PhD ,&nbsp;Yuhan Zhang MSc ,&nbsp;Kun Wang PhD","doi":"10.1016/j.jamda.2025.105516","DOIUrl":"10.1016/j.jamda.2025.105516","url":null,"abstract":"<div><h3>Objectives</h3><div>This meta-analysis aimed to assess the effect of exercise interventions on functional mobility among older adults with cognitive impairments such as dementia or mild cognitive impairment, followed by further investigation on the possible moderators of exercise-induced effects on this outcome.</div></div><div><h3>Design</h3><div>A meta-analysis of controlled trials on exercise interventions reporting functional mobility outcomes was conducted. PubMed, Embase, EBSCO, SPORTDiscus, and Web of Science were searched for relevant studies published in English-language journals through July 2024.</div></div><div><h3>Setting and Participants</h3><div>Clinical and community settings across 15 countries, including a total of 1104 older adults with cognitive impairment, were involved in the study.</div></div><div><h3>Methods</h3><div>We computed pooled effect sizes based on standardized mean difference (SMD) using the random-effects models. The subgroup analyses and meta-regression were conducted for multiple moderating variables (eg, exercise, sample, and study characteristics). The study quality was evaluated using the Physiotherapy Evidence Database Scale.</div></div><div><h3>Results</h3><div>This meta-analysis finally included 22 studies. Results revealed that exercise interventions effectively improved functional mobility as compared with that of the control group (SMD, −0.42; 95% CI, −0.61 to −0.24; <em>P</em> &lt; .001). Exercise intervention characteristics (ie, weekly training frequency and session duration) and sample characteristic (ie, percentage of women) moderated the exercise-induced effects on this interesting outcome. Subgroup analyses showed intervention with low frequency (1–2 times/wk) (SMD, −0.71; 95% CI, −1.01 to −0.42; <em>P</em> &lt; .001) had a larger improvement in mobility, followed by medium frequency (SMD, −0.33; 95% CI, −0.56 to −0.10; <em>P</em> &lt; .01). In addition, interventions with a session duration of &gt; 60 minutes (SMD, −0.60; 95% CI, −0.84 to −0.36; <em>P</em> &lt; .001) and 45 to 60 minutes (SMD, −0.60; 95% CI, −0.91 to −0.29; <em>P</em> &lt; .001) had a significant improvement in mobility. Moreover, exercise training had a significant improvement in mobility for studies with a high percentage of women (SMD, −0.49; 95% CI, −0.67 to −0.31; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions and Implications</h3><div>Exercise intervention is a promising way to improve functional mobility among older adults with cognitive impairment. Further evidence suggests that larger effects were observed in exercise intervention features of more than 45-minute session duration 1 to 3 times a week for at least 6 weeks regardless of exercise type. In addition, women benefit more from exercise interventions than men. Our study highlights that health care providers should prioritize integrating structured exercise programs into routine care for this population.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 5","pages":"Article 105516"},"PeriodicalIF":4.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding PACE Benefits/Services to Naturally Occurring Retirement Communities and More.","authors":"Richard G Stefanacci","doi":"10.1016/j.jamda.2025.105501","DOIUrl":"10.1016/j.jamda.2025.105501","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":" ","pages":"105501"},"PeriodicalIF":4.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Acute Care Staff Perspectives of Changes Since the COVID-19 Pandemic.","authors":"Maggie Syme, Darby M Simon, Sandra Shi, Cari Levy, Ana-Maria Vranceanu, Evan Plys","doi":"10.1016/j.jamda.2025.105579","DOIUrl":"https://doi.org/10.1016/j.jamda.2025.105579","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":" ","pages":"105579"},"PeriodicalIF":4.2,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory Sarcopenia: Current Understanding of Concepts and Future Issues","authors":"Takeshi Kera PT, PhD,&nbsp;Hisashi Kawai PhD,&nbsp;Shuichi Obuchi PT, MS, PhD","doi":"10.1016/j.jamda.2025.105541","DOIUrl":"10.1016/j.jamda.2025.105541","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 5","pages":"Article 105541"},"PeriodicalIF":4.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Agreement of Medicare Part D and Minimum Data Set Reported Psychotropic Medication Use in Nursing Homes.","authors":"Tianwen Huan, Orna Intrator, Adam Simning, Kenneth Boockvar, David C Grabowski, Shubing Cai","doi":"10.1016/j.jamda.2025.105538","DOIUrl":"https://doi.org/10.1016/j.jamda.2025.105538","url":null,"abstract":"<p><strong>Objectives: </strong>Little evidence exists on the accuracy of the Minimum Data Set (MDS)-based medication items. We compared quarterly rates of antipsychotic, antidepressant, and hypnotic use between the MDS and Part D Event file (PDE) in 2018.</p><p><strong>Design: </strong>Cross-sectional comparison.</p><p><strong>Setting and participants: </strong>All US Medicare- or Medicaid-certified nursing homes were included. Long-stay nursing home residents enrolled in Medicare Part D who were ≥65 years of age with psychiatric disorders or dementia identified in the MDS data (N = 580,340) were included. Two subcohorts included the following: residents with psychiatric disorders and no Alzheimer's disease and related dementias (ADRD), and residents with ADRD.</p><p><strong>Methods: </strong>Psychotropic medication use was assessed using the share of study participants who received the medication in the quarter identified by the MDS. We used Cohen kappa to assess agreement in the share of residents using psychotropic medications during the quarter and used PDE data as a reference to calculate validity parameters.</p><p><strong>Results: </strong>The MDS-reported and PDE-reported antipsychotic (MDS vs PDE: 34.0% vs 34.3%) or antidepressant (MDS vs PDE: 73.4% vs 71.3%) users have high concordance as measured by the kappa value (antipsychotic: 0.9; antidepressant: 0.83). Sensitivity, specificity, positive predictive value, and negative predictive value of MDS data compared with PDE were 96.7%, 92.8%, 96.3%, and 93.6% for antipsychotic, and 84.5%, 96.7%, 91.1%, and 94.0% for antidepressant. Only 3.7% of study participants identified in the MDS data, vs 32.6% of PDE-based users (kappa value: 0.1), used hypnotics. By combining antianxiety medications with hypnotics, the rates of MDS hypnotic or antianxiety users increased to 35.0% (kappa value: 0.74). Sensitivity, specificity, positive predictive value, and negative predictive value were 89.5%, 85.6%, 92.8%, and 79.8%, respectively.</p><p><strong>Conclusions and implications: </strong>Agreement between the MDS and PDE in antipsychotic and antidepressant use was high, suggesting that the MDS is a valid tool to measure antipsychotic and antidepressant use. Additional work is needed to understand the disagreements between MDS and PDE in hypnotic use.</p>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":" ","pages":"105538"},"PeriodicalIF":4.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Live Hospice Discharge of Individuals With Cognitive Disabilities: A Systematic Review.","authors":"Victoria M Winogora, Christine E DeForge, Kimberlee Grier, Patricia W Stone","doi":"10.1016/j.jamda.2025.105578","DOIUrl":"https://doi.org/10.1016/j.jamda.2025.105578","url":null,"abstract":"<p><strong>Objectives: </strong>To systematically review the evidence on live hospice discharge for individuals with cognitive disabilities.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Setting and participants: </strong>Adults with cognitive disabilities enrolled in hospice in the United States.</p><p><strong>Methods: </strong>Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, we searched for US-based, English-language, and peer-reviewed literature focused on live discharges from hospice for individuals with cognitive disabilities. We searched PubMed, CINAHL, and Web of Science for articles published between January 1, 2014, through August 1, 2024. We used the Joanna Briggs Institute Analytical Cross-Sectional Studies Appraisal Tool to assess study quality.</p><p><strong>Results: </strong>After screening 1543 titles and abstracts, we completed a full-text review of 30 articles, of which 8 met inclusion criteria. All included studies were cross-sectional analyses. The indications of cognitive disability varied (ie, dementia diagnosis, positive result on cognitive function assessment), but there were no studies focused on individuals with acquired brain injuries or intellectual and developmental disabilities, nor was the term cognitive disability used in any of the studies. In all studies, the indicator of cognitive disability was associated with live hospice discharge. Other risk factors included female sex (n = 4), minoritized race (n = 4), for-profit hospice ownership (n = 4), and delivery of hospice services at home (n = 2). In all studies, researchers found that individuals with cognitive disabilities had longer hospice lengths of stay.</p><p><strong>Conclusions and implications: </strong>This systematic review is the first to focus on live discharge from hospice for individuals with cognitive disabilities. All studies focused exclusively on individuals with dementias. Although the term cognitive disability was absent from the literature reviewed, cognitive disability was associated with live discharge. Future research should aim to include the greater cognitive disability community to assess hospice and other end-of-life outcomes to identify potential targets for future intervention.</p>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":" ","pages":"105578"},"PeriodicalIF":4.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143753292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}