Journal of the American Medical Directors Association最新文献

{"title":"Are the Recommended Levels of Moderate-to-Vigorous Aerobic Activity and Resistance Training Inversely Associated with Frailty and Mortality?","authors":"Andrea Mayo PhD ,&nbsp;Jack Quach MScRR ,&nbsp;Myles W. O'Brien PhD ,&nbsp;Judith Godin PhD ,&nbsp;Dustin S. Kehler PhD ,&nbsp;Derek S. Kimmerly PhD ,&nbsp;Olga Theou PhD","doi":"10.1016/j.jamda.2025.105620","DOIUrl":"10.1016/j.jamda.2025.105620","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the association of meeting the moderate-to-vigorous physical activity (MVPA) and resistance training (RT) components of the physical activity guidelines with frailty and mortality and to determine if these associations vary by age and sex.</div></div><div><h3>Design</h3><div>Observational study.</div></div><div><h3>Setting and Participants</h3><div>Secondary analysis of 17,716 community-dwelling individuals [46 ± 19 years (range: 20-85 years), 52.2% female] from the National Health and Nutrition Examination Survey (NHANES) (cycles 1999-2006) who had available Frailty Index, mortality, and self-reported physical activity data.</div></div><div><h3>Methods</h3><div>Self-reported MVPA (≥150 minutes/wk) and RT (≥2 days/wk) levels were used to divide participants into Combined (both met), MVPA Only, RT Only, or Inactive (neither met) groups. Frailty was measured with a 46-item Frailty Index (FI), and all-cause mortality was obtained using National Death Index data. Group differences were explored using analyses of variance. Associations between MVPA and/or RT with (1) frailty and (2) mortality used covariate-adjusted multiple linear regression and Cox proportional hazards models, respectively.</div></div><div><h3>Results</h3><div>A total of 1878 (10.6%) people were included in the Combined group, 3741 (21.1%) in the MVPA Only group, 1257 (7.1%) in the RT Only group, and 10,840 (61.2%) in the Inactive group. Older females needed to engage in MVPA to experience a beneficial effect on frailty, whereas males benefited from engaging in either or both types of activity regardless of age. Females at the lowest frailty level [hazard ratio (HR) 0.65, 95% CI 0.46-0.93] and frail males (HR 0.72, 95% CI 0.59-0.88) in the Combined group had a lower risk of mortality compared to the Inactive group.</div></div><div><h3>Conclusions and Implications</h3><div>There is a lower association with frailty and mortality when achieving MVPA or RT guidelines alone, although sex and age differences demonstrate that MVPA is especially critical as females age.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 7","pages":"Article 105620"},"PeriodicalIF":4.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006199","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":"Assessing Facility, Resident, and Financial Characteristics Associated with HUD 232–Sponsored Loan Participation in Nursing Homes","authors":"Robert Tyler Braun PhD ,&nbsp;David Rosenkranz PhD ,&nbsp;Rahul Fernandez MS ,&nbsp;David G. Stevenson PhD ,&nbsp;David C. Grabowski PhD ,&nbsp;Dunc Williams PhD ,&nbsp;Luz Jimenez BS ,&nbsp;John Bowblis PhD","doi":"10.1016/j.jamda.2025.105630","DOIUrl":"10.1016/j.jamda.2025.105630","url":null,"abstract":"<div><h3>Objectives</h3><div>Many nursing homes require significant modernization to enhance resident quality of life, yet access to capital remains a critical barrier, especially for those dependent on Medicaid funding. The Housing and Urban Development (HUD) 232–sponsored loan program helps insure low-interest financing to nursing homes, but its impact on capital accessibility and quality improvement remains unclear. This study examines nursing home characteristics associated with receiving HUD 232–sponsored loans.</div></div><div><h3>Design</h3><div>Linear probability model to assess facility, resident, financial, and county-level characteristics predicting HUD 232 loan likelihood.</div></div><div><h3>Setting and Participants</h3><div>We analyzed nursing homes from 2012 to 2021, with the HUD 232 cohort spanning 2013 to 2020, using a comprehensive data set combining HUD 232–sponsored loan data, CMS Nursing Home Compare, LTCFocus, and Medicare Cost Reports.</div></div><div><h3>Methods</h3><div>We used a linear probability model to evaluate the relationship between facility characteristics and the likelihood of receiving a HUD 232–sponsored loan, focusing on factors such as ownership type, financial stability, staffing levels, and resident demographics.</div></div><div><h3>Results</h3><div>Nursing homes with higher operating margins, higher proportions of Medicare residents, and in rural locations were significantly more likely to receive HUD 232–sponsored loans (<em>P</em> &lt; .01). In contrast, not-for-profits were underrepresented among loan recipients (<em>P</em> &lt; .01). There was no significant association between quality measures, such as overall star ratings and health deficiencies, and loan uptake.</div></div><div><h3>Conclusions and Implications</h3><div>The findings suggest that although the HUD 232–sponsored loan program improves access to capital for financially stable nursing homes, it may exclude others in need of funding, such as not-for-profits and nursing homes serving fewer Medicare residents. Policy makers should consider reforms to better align the program with its goal of supporting modernization across the entire nursing home sector, particularly for those facilities that are financially disadvantaged.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 7","pages":"Article 105630"},"PeriodicalIF":4.2,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078831","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":"Association between Dementia and Early Rehabilitation in Older Inpatients with Internal Medical Conditions","authors":"Naho Kawasaki MPH,&nbsp;Atsushi Miyawaki MD, PhD,&nbsp;Yuya Kimura MD, MPH,&nbsp;Yuichiro Matsuo MD, MPH,&nbsp;Kiyohide Fushimi MD, PhD,&nbsp;Hideo Yasunaga MD, PhD","doi":"10.1016/j.jamda.2025.105595","DOIUrl":"10.1016/j.jamda.2025.105595","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 6","pages":"Article 105595"},"PeriodicalIF":4.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975056","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":"Impact of Polypharmacy on Self-Rated Health in Community-Dwelling Older Adults: A 3-Year SONIC Study","authors":"Yuko Yoshida PhD ,&nbsp;Tatsuro Ishizaki MD, PhD, MPH ,&nbsp;Takumi Hirata MD, PhD ,&nbsp;Yukie Masui PhD ,&nbsp;Hiroki Inagaki PhD ,&nbsp;Yuri Miura PhD ,&nbsp;Madoka Ogawa PhD ,&nbsp;Kae Ito MD, PhD ,&nbsp;Yasumichi Arai MD, PhD ,&nbsp;Kei Kamide MD, PhD ,&nbsp;Kazunori Ikebe DDS, PhD ,&nbsp;Yasuyuki Gondo PhD","doi":"10.1016/j.jamda.2025.105621","DOIUrl":"10.1016/j.jamda.2025.105621","url":null,"abstract":"<div><h3>Objectives</h3><div>Previous studies have reported that polypharmacy (PP) is associated with objective health indicators, such as falls or a decline in physical function. However, few studies have examined the relationship between PP and subjective health indicators, such as self-rated health (SRH). Therefore, this study examined the association between PP and SRH in older adults.</div></div><div><h3>Design</h3><div>Prospective study.</div></div><div><h3>Setting and Participants</h3><div>Participants from the longitudinal cohort study of the SONIC were included in this study.</div></div><div><h3>Methods</h3><div>Among the participants who completed the baseline and 3-year follow-up surveys, 1103 with complete items were included in the analysis. Multiple medication use was categorized into 4 categories: 0, 1–4, 5–9 (PP), and ≥10 (hyper-PP). SRH was categorized into 2 groups according to the responses: good (excellent/good) and poor (not good/poor). Multivariable logistic regression analysis was performed to assess the prospective relationship between PP at baseline and SRH 3 years later after adjusting for age, sex, economic status, instrumental activities of daily living, depressive mood, and the number of chronic conditions.</div></div><div><h3>Results</h3><div>The multivariable logistic regression analysis showed that PP [adjusted odds ratio (aOR), 3.159; 95% confidence interval (CI), 1.479–6.747] and hyper-PP (aOR, 5.000; 95% CI, 1.884–13.27) were significantly associated with poor SRH.</div></div><div><h3>Conclusions and Implications</h3><div>An increase in the number of medications was strongly associated with poor SRH. Older people with PP need to be regularly observed and reviewed not only for the disease being treated but also for various aspects of their health, including SRH and the adverse effects of their medication.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 7","pages":"Article 105621"},"PeriodicalIF":4.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006220","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":"Pre-death Grief Increases Post-death Grief among Dementia Caregivers","authors":"Isha Chaudhry MSc,&nbsp;Ellie Bostwick Andres PhD,&nbsp;Louisa Poco PhD,&nbsp;Ishwarya Balasubramanian PhD,&nbsp;Chetna Malhotra MD, MPH","doi":"10.1016/j.jamda.2025.105622","DOIUrl":"10.1016/j.jamda.2025.105622","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 7","pages":"Article 105622"},"PeriodicalIF":4.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041599","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":"Factors Associated with Mood Transitions among Older Canadian Long-Term Care Residents: A Multistate Transition Model","authors":"Reem T. Mulla PhD, MCM, MHM, MBBS ,&nbsp;John P. Hirdes PhD, CM FRSC, FCAHS ,&nbsp;Carrie McAiney PhD ,&nbsp;George Heckman MD, MSc, FRCPC","doi":"10.1016/j.jamda.2025.105612","DOIUrl":"10.1016/j.jamda.2025.105612","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examines the complex transitions between the different mood states and absorbing states out of long-term care settings, as well as the factors affecting those transitions.</div></div><div><h3>Design</h3><div>A retrospective longitudinal analysis of older residents in Canadian long-term care homes in 3 provinces.</div></div><div><h3>Setting and Participants</h3><div>Residents residing in long-term care homes in 3 Canadian provinces (Alberta, British Columbia, and Ontario) over a 10-year period from January 2010 to February 2020, with an age of at least 65.</div></div><div><h3>Methods</h3><div>We used a 1-step Markov multistate transition model to examine transitions in mood over time as well as the factors affecting those transitions using the standardized interRAI MDS 2.0 comprehensive health assessment. The MDS 2.0 assessments are completed by trained assessors within 2 weeks of the resident's admission.</div></div><div><h3>Results</h3><div>Our results showed that 46% of residents initially present with no mood disturbance on admission and 31% with mild mood disturbance on admission and 23% with moderate/severe mood disturbance on admission. Factors associated with worsening of mood include aggressive behavior; health instability; impaired cognition; major comorbidities; pain or poor sleep; conflict with family, friends, or other residents; and anxiety. Of the facility-level attributes, Alberta was associated with worsening of mood.</div></div><div><h3>Conclusions and Implications</h3><div>Our study identified key factors influencing mood transitions, highlighting pain and aggressive behavior as significant contributors to worsening mood, both of which are modifiable through targeted interventions. The findings suggest substantial opportunities for mood improvement in long-term care settings.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 7","pages":"Article 105612"},"PeriodicalIF":4.2,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006201","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 PhD ,&nbsp;Ping Yu PhD ,&nbsp;Minmu Yang BS","doi":"10.1016/j.jamda.2025.105577","DOIUrl":"10.1016/j.jamda.2025.105577","url":null,"abstract":"<div><h3>Objective</h3><div>The aim of this scoping review was to examine the scope and characteristics of the published literature related to the Electronic Frailty Index (eFI).</div></div><div><h3>Design</h3><div>Scoping review.</div></div><div><h3>Setting and Participants</h3><div>Original studies related to the eFI in older adults.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions and Implications</h3><div>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.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 6","pages":"Article 105577"},"PeriodicalIF":4.2,"publicationDate":"2025-05-14","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":"Days at Home for Older Adults Receiving a Remote Monitoring Intervention Compared with Usual Home Care Recipients","authors":"Christine Salahub PhD ,&nbsp;Peter C. Austin PhD ,&nbsp;Li Bai PhD ,&nbsp;Noah M. Ivers MD, PhD ,&nbsp;Aaron Jones PhD ,&nbsp;Mina Tadrous PharmD, PhD ,&nbsp;Jake Tran MSc, PhDC ,&nbsp;Lauren Lapointe-Shaw MD, PhD","doi":"10.1016/j.jamda.2025.105611","DOIUrl":"10.1016/j.jamda.2025.105611","url":null,"abstract":"<div><h3>Objectives</h3><div>Many older adults will experience physical and or cognitive decline, limiting their ability to live independently. To better support these individuals, remote monitoring programs use technology to track patient falls, location, and medication adherence. Our main objective was to compare outcomes of patients enrolled in a remote monitoring program with matched individuals who received home care.</div></div><div><h3>Design</h3><div>Propensity score–matched cohort study.</div></div><div><h3>Setting and Participants</h3><div>Toronto, Ontario, Canada. Older adults (aged 65 or older) in a remote monitoring program (N = 1587) compared with a control group of older adults initiating a new episode of home care (N = 33,207).</div></div><div><h3>Methods</h3><div>The primary outcome was days spent at home in the following 100 days. Additional outcomes included days in different health care settings, days alive, and health care costs.</div></div><div><h3>Results</h3><div>Before matching, patients enrolled in the remote monitoring program (946 female) were younger [mean (SD) = 80.1 years (8.2) vs 82.4 (8.5), standardized mean difference 0.21] than those in the home care group (20,877 female). After matching, there were 1494 individuals in each group. In the 100 days following the index date, those in the remote monitoring group spent 3.4 more days at home than the home care group (92.3 vs 88.9 days, 95% CI, 1.9–5.0 days; rate ratio, 1.04; 95% CI, 1.02–1.06). This was attributable to more days alive (98.6 vs 96.4 days; 95% CI, 1.3–3.1 days; rate ratio, 1.03; 95% CI, 1.01–1.03). In addition, the remote monitoring group had lower health care costs overall (difference of $1635.54 CAD, 95% CI, $228.83–$3087.11).</div></div><div><h3>Conclusions and Implications</h3><div>Individuals enrolled in a remote monitoring program spent more days at home compared with those who received home care services, mainly attributed to more days alive. Further study is needed to confirm our findings; however, remote monitoring is a promising solution to support older adults with high care needs.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 7","pages":"Article 105611"},"PeriodicalIF":4.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942362","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":"Multimorbidity, Muscle Strength, and Falls among Older Mexican Americans","authors":"Alondra Uribe MS ,&nbsp;Soham Al Snih MD, PhD","doi":"10.1016/j.jamda.2025.105613","DOIUrl":"10.1016/j.jamda.2025.105613","url":null,"abstract":"<div><h3>Objectives</h3><div>Multimorbidity is linked with an increased risk of falls in older adults. The study objective is to determine the relationship of multimorbidity and muscle strength in falls among older Mexican Americans without a history of falls at baseline.</div></div><div><h3>Design</h3><div>Longitudinal study.</div></div><div><h3>Setting and Participants</h3><div>This 12-year prospective cohort study included 899 noninstitutionalized Mexican Americans aged ≥75 years residing in Arizona, California, Colorado, New Mexico, and Texas from the Hispanic Established Population for the Epidemiologic Study of the Elderly (HEPESE).</div></div><div><h3>Methods</h3><div>Measures include the following: sociodemographics, medical conditions, body mass index, disability, handgrip strength (HGS), depressive symptoms, pain, cognitive function, and multimorbidity (≥2 self-reported medical conditions). Participants at baseline were divided into the following 4 groups: high HGS and multimorbidity (n = 349), low HGS and multimorbidity (n = 263), high HGS and without multimorbidity (n = 181), and low HGS and without multimorbidity (n = 104). Generalized estimating equation models estimated the odds ratio (OR) and 95% CI for falls as a function of multimorbidity and HGS group, controlling for all covariates.</div></div><div><h3>Results</h3><div>The mean sample age ± SD was 81.0 ± 4.3 years, and 55.9% were female. The OR for falls was 0.70 (95% CI, 0.52–0.94) for those with multimorbidity and high HGS, 0.50 (95% CI, 0.32–0.80) for those without multimorbidity and high HGS, and 0.46 (95% CI, 0.29–0.74) for those without multimorbidity and low HGS, vs those with multimorbidity and low HGS, after controlling for all covariates.</div></div><div><h3>Conclusions and Implications</h3><div>Mexican American older adults with multimorbidity and high HGS had a 30% decreased risk of falls over time. Increasing muscle strength through exercise may help prevent falls among those with multimorbidity.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 7","pages":"Article 105613"},"PeriodicalIF":4.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143942363","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":"A Narrative Review of Physical Performance Changes in Dementia: Differences between Community and Nursing Home Setting","authors":"Selina Kasprzak MSc ,&nbsp;Charlotte B. Schmidt PhD ,&nbsp;George L. Burchell MSc ,&nbsp;Sietske A.M. Sikkes PhD ,&nbsp;Erik J.A. Scherder PhD","doi":"10.1016/j.jamda.2025.105614","DOIUrl":"10.1016/j.jamda.2025.105614","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate differences in longitudinal physical performance in individuals with dementia across care settings.</div></div><div><h3>Design</h3><div>Narrative review.</div></div><div><h3>Setting and Participants</h3><div>Older adults with moderate to severe dementia residing in the community or nursing home.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted in PubMed, Embase, and Web of Science. Included studies were longitudinal, with observational or care-as-usual control groups, with a follow-up ≥3 months, assessing physical performance in adults aged ≥65 years with dementia (Mini Mental State Examination score ≤20), in the community or nursing home setting. Eligibility screening and risk of bias were performed by 2 authors. We categorized physical performance-based tests into upper limb strength, lower limb strength, balance, endurance, flexibility, mobility, and combined physical performance. Physical performance changes were quantified within each study as percentage of change from baseline to follow-up, and were compared between community and nursing home setting using narrative synthesis.</div></div><div><h3>Results</h3><div>The search yielded 7813 studies, of which 20 were included (15 from nursing homes). Five of 20 studies were classified as having high risk of bias. In the nursing home setting, physical performance decline was observed across all domains (3- to 4-month follow-up: −6.1% to −7.7%, 5- to 7.5-month follow-up: −4.6% to −30.7%, 12- to 36-month follow-up: −27.3% to −68.2%). In the community setting, only combined physical performance declined (12–24 months: −18.6% to −33.8%).</div></div><div><h3>Conclusions and Implications</h3><div>Studies assessing longitudinal physical performance in the community and nursing home setting were identified and summarized. Physical performance declined after shorter follow-up periods across all domains in the nursing home setting, whereas in the community setting only combined physical performance declined. However, diversity in study characteristics, study populations and outcome measures, along with a deficiency of longer follow-up periods in the community setting, hamper interpretation. Future research should focus on physical performance trajectories in longitudinal within-group designs of community-dwelling individuals with dementia who transition to nursing homes.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 7","pages":"Article 105614"},"PeriodicalIF":4.2,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948481","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}