Journal of the American Medical Directors Association最新文献

{"title":"Life-Space Activities and Incident Dementia Among Older Adults: Insights From a Cohort Study","authors":"Takehiko Doi PhD,&nbsp;Keitaro Makino PhD,&nbsp;Kouki Tomida PhD,&nbsp;Kota Tsutsumimoto PhD,&nbsp;Fumio Sakimoto PhD,&nbsp;Soichiro Matsuda PhD,&nbsp;Hiroyuki Shimada PhD","doi":"10.1016/j.jamda.2024.105416","DOIUrl":"10.1016/j.jamda.2024.105416","url":null,"abstract":"<div><h3>Objectives</h3><div>This study examined the association between life-space activities and incident dementia among older adults.</div></div><div><h3>Study Design</h3><div>A prospective study.</div></div><div><h3>Setting and Participants</h3><div>This study included 2740 older adults (mean age 74.4 years; SD ± 6.2 years; range 65–99 years; 58.8% women).</div></div><div><h3>Methods</h3><div>Life-space activities were assessed using the Active Mobility Index (AMI). Incident dementia was determined using medical insurance data and long-term care insurance data (mean follow-up, 53.7 months).</div></div><div><h3>Results</h3><div>During the follow-up period, 326 participants (11.9%) had incident dementia. Participants were classified into 3 groups based on AMI score tertiles: tertile 1, ≤52; tertile 2, 53–77; and tertile 3, ≥78. The Cox proportional hazards model was used to examine the association between AMI scores and incident dementia. Individuals with higher scores had lower hazard ratios (HRs) (tertile 1: reference; tertile 2: adjusted HR, 0.76, 95% CI, 0.59–0.97, <em>P</em> = .027; tertile 3: adjusted HR, 0.49, 95% CI, 0.36–0.68, <em>P</em> &lt; .001; <em>P</em> for trend: &lt;.001). Both the physical and social AMI sub-scores were associated with dementia (<em>P</em> for trend: &lt;.001).</div></div><div><h3>Conclusions and Implications</h3><div>Restricted life-space activity, as assessed using the AMI, was associated with the risk of dementia. In addition, both the physical and social sub-scores were associated with dementia.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105416"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142837148","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":"The Impact of Pay-for-Performance Care on the Mortality and Cardiovascular Outcomes in Older Adults with Newly Diagnosed Type 2 Diabetes: A Nationwide Population-Based Cohort Study","authors":"Fu-Shun Yen MD ,&nbsp;James Cheng-Chung Wei MD, PhD ,&nbsp;Shih-Yi Lin MD ,&nbsp;Jeffrey Hsu BS ,&nbsp;Yun-Kai Yeh MD ,&nbsp;Yu-Han Huang MS ,&nbsp;Tzu-Ju Hsu MS ,&nbsp;Der-Yang Cho MD ,&nbsp;Chii-Min Hwu MD ,&nbsp;Chih-Cheng Hsu DrPH","doi":"10.1016/j.jamda.2024.105382","DOIUrl":"10.1016/j.jamda.2024.105382","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the long-term effects of pay-for-performance (P4P) care in the geriatric population with newly diagnosed type 2 diabetes (T2D).</div></div><div><h3>Design</h3><div>Retrospective longitudinal cohort study.</div></div><div><h3>Setting and Participants</h3><div>A total of 6607 propensity score-matched pairs of patients with newly diagnosed T2D who received either P4P care or standard care as identified from the National Health Insurance Research Database in Taiwan between January 1, 2000, and December 31, 2019.</div></div><div><h3>Methods</h3><div>Cox regression models were used to assess differences in risk of outcomes between P4P and non-P4P care. Primary outcomes and measures include all-cause mortality, hospital admissions due to cardiovascular events, dialysis initiation, severe hyperglycemia, and severe hypoglycemia. Multivariable Cox regression models were performed to calculate hazard ratios among and within groups.</div></div><div><h3>Results</h3><div>The multivariable-adjusted model showed that patients with P4P care had a significantly lower risk of all-cause mortality [adjusted hazard ratio (aHR), 0.37; 95% CI, 0.35–0.39], stroke (aHR, 0.80 95% CI, 0.72–0.88), myocardial infarction (aHR, 0.57; 95% CI, 0.48–0.67), heart failure (aHR, 0.75; 95% CI, 0.69–0.81), and dialysis (aHR, 0.66; 95% CI, 0.53–0.82) compared with those not receiving P4P care. However, there were no significant differences in the risk of severe hyperglycemia (aHR, 0.92; 95% CI, 0.82–1.03) and severe hypoglycemia (aHR, 1.04; 95% CI, 0.92–1.17) between the 2 groups.</div></div><div><h3>Conclusions and Implications</h3><div>This nationwide cohort study suggests that the P4P program may reduce the risk of cardiovascular events, dialysis needs, and mortality in older patients with T2D without increasing the risk of severe hypoglycemia. P4P may be an effective management strategy for older patients with T2D.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105382"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142790694","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":"Long-Term Care Needs Assessment: From Frameworks to Practice","authors":"Pablo Villalobos Dintrans DrPH","doi":"10.1016/j.jamda.2024.105409","DOIUrl":"10.1016/j.jamda.2024.105409","url":null,"abstract":"<div><h3>Objectives</h3><div>Identify and describe instruments used by countries to perform functional ability assessment as eligibility for their long-term care systems and compare them to existing healthy aging frameworks proposed by the World Health Organization (intrinsic capacity and functionality).</div></div><div><h3>Design</h3><div>Descriptive, case studies.</div></div><div><h3>Setting and Participants</h3><div>Country-level long-term care systems in 27 countries.</div></div><div><h3>Methods</h3><div>Selection of countries with long-term care systems in place and with expected increase in long-term care needs. For each country, data regarding the country features, as well as information of the long-term care systems, and the instruments to assess long-term care needs (functional ability) were collected. Features of the assessment tools were compared with the World Health Organization's intrinsic capacity and functionality domains, identifying the specific activities evaluated and the way the assessment is used to classify people and define benefits.</div></div><div><h3>Results</h3><div>Countries were classified into those with a long-term care system and a standardized instrument for assessing long-term care needs (group 1; n = 6), those that have long-term care initiatives do not have a standardized instrument to identify needs (group 2; n = 8), and those with no information on their systems or instruments for identify long-term care needs (group 3; n = 13). When looking at countries with standardized tools, instruments include several activities related to intrinsic capacity domains such as cognition, mobility, and psychological capacity; for functional ability, all domains except the ability to “contribute” are covered by the instruments.</div></div><div><h3>Conclusions and Implications</h3><div>Long-term care needs assessment is a complex but necessary task to be performed by long-term care systems. Countries embarking in the design and redesign of their systems can use the existing instruments, frameworks, and the experience from other countries to better adapt this process to their own needs and contexts.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105409"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829148","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":"Over- and Underuse of Proton Pump Inhibitors in Nursing Homes: A Multisite Longitudinal Cohort Study","authors":"Nasir Wabe PhD, MScEpid, MScClinPharm, BPharm ,&nbsp;Rachel Urwin PhD, MPH ,&nbsp;Isabelle Meulenbroeks PhD, MPH, BPhysio ,&nbsp;Karla Seaman PhD, MClinEpi, BPharm ,&nbsp;Magdalena Z. Raban PhD, MIPH, BPharm ,&nbsp;Sangita Neupane MPH ,&nbsp;Amy Nguyen PhD, Grad Cert (Research Management and Commercialisation), BMedSc ,&nbsp;Sandun M. Silva PhD, BSc ,&nbsp;Andrea Timothy PhD, MPhil, ProfCertCR, PGDipSc, BSc, DipLaw ,&nbsp;Narjis Batool DPharm, MPhil (Pharm) ,&nbsp;Lisa Pont PhD, MSC, BSc, BPharm ,&nbsp;Johanna I. Westbrook PhD, MHA, GradDipAppEpid, BAppSc","doi":"10.1016/j.jamda.2024.105393","DOIUrl":"10.1016/j.jamda.2024.105393","url":null,"abstract":"<div><h3>Objectives</h3><div>Proton pump inhibitors (PPIs) are used to manage excess stomach acid production and provide gastroprotection from bleeding risk-increasing drugs (BRIDs). We aimed to determine the prevalence of potentially inappropriate PPI use in nursing homes and associated factors.</div></div><div><h3>Design</h3><div>Longitudinal cohort study using 8 years of electronic data.</div></div><div><h3>Setting and Participants</h3><div>The study included 6439 permanent residents aged ≥65 years from 34 homes managed by 2 aged care providers in New South Wales.</div></div><div><h3>Method</h3><div>Continuous PPI use (&gt;12 weeks) in the absence of long-term BRID (&gt;30 days) use was deemed inappropriate overuse whereas long-term BRID use without concomitant PPI for gastroprotection was classified as inappropriate underuse. Binary logistic regression was used to determine factors associated with PPI overuse.</div></div><div><h3>Results</h3><div>Fifty-four percent of residents (n = 3478) received a PPI, with a median duration of 46 weeks, whereas 58.5% (n = 3770) were long-term BRID users. Four of 5 PPI users (83.6%, n = 2906) used PPIs for &gt;12 weeks, and after accounting for BRID use, the prevalence of inappropriate PPI overuse was 27.1% (n = 944). PPI overuse was 4 times more likely in residents in provider A compared with residents in provider B [odds ratio (OR) 4.08, 95% CI 2.73–6.09]. The prevalence of PPI underuse was 38.5% (n = 1452).</div></div><div><h3>Conclusions and Implications</h3><div>One in 4 PPI users exceeded the clinically recommended duration, whereas 2 in 5 long-term BRID users did not receive a PPI for gastroprotection. There is a pressing need for tailored interventions, such as medication reviews and deprescribing initiatives, to improve PPI prescribing.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105393"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792049","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":"Adult Day Care in South Carolina: Identification of Need and Opportunity","authors":"LaNaya A. Martin MPH,&nbsp;Janet O'Connor MA,&nbsp;FNU Rubaiya MS,&nbsp;Linda E. Kelemen ScD","doi":"10.1016/j.jamda.2024.105395","DOIUrl":"10.1016/j.jamda.2024.105395","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate pre- and post-pandemic demographic profiles of attendees at adult day care (ADC) facilities in the US South, and survey providers for their experience during the pandemic.</div></div><div><h3>Design</h3><div>Retrospective analysis and prospective interviews and survey.</div></div><div><h3>Setting and Participants</h3><div>We received administrative data for South Carolina Medicaid recipients in 2019 (pre-pandemic, n = 21,969) and 2022 (post-pandemic, n = 25,118), prospectively interviewed 6 facility owners and surveyed 62 of 82 ADC facilities in South Carolina (75.6% response).</div></div><div><h3>Methods</h3><div>We compared age, sex, race, and county distributions between Medicaid recipients who attended facilities in 2019 and 2022. We summarized interviews qualitatively. We assessed attendee and provider profiles using a 55-item survey.</div></div><div><h3>Results</h3><div>In 2019, 2398 (10.9%) of Medicaid recipients attended ADC facilities at least 24 times, decreasing significantly to 1745 (6.9%) in 2022 (<em>P</em> &lt; .001). Attendees’ median age fell from 62 years in 2019 to 59 years in 2022 (<em>P</em> &lt; .001). Attendance was highest among Black or African American individuals (71.0% in 2019 and 62.2% in 2022, <em>P</em> &lt; .001). Eleven of 46 counties, all rural, did not have a facility. A median of 25 miles was the farthest distance traveled one way by attendees to a facility (range, 4–60). ADC facility nurses were the primary source of medical oversight and COVID-19 information during the 3-month shutdown. More than 90.0% of facilities served adults who had cognitive impairment, multiple chronic conditions, or intellectual or developmental disabilities. Most facilities (53.2%) received government funding during the pandemic. Staffing shortages, decreased attendance, and increased costs were major challenges faced by ADCs post-pandemic.</div></div><div><h3>Conclusions and Implications</h3><div>These findings demonstrate the importance of ADC facilities to the health and well-being of Black or African American individuals, a population that was disproportionately burdened during the COVID-19 pandemic, and suggests potential underutilization of facilities and more resources allocated to one-on-one in-home care than might be economically feasible.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105395"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801343","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":"Response to Comment on “Adverse Lipid Profiles are Associated With Lower Dementia Risk in Older People”","authors":"Jakob L. Schroevers MD,&nbsp;Jan Willem van Dalen PhD","doi":"10.1016/j.jamda.2024.105377","DOIUrl":"10.1016/j.jamda.2024.105377","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105377"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142790643","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":"Building a Time-Series Model to Predict Hospitalization Risks in Home Health Care: Insights Into Development, Accuracy, and Fairness","authors":"Maxim Topaz PhD, RN ,&nbsp;Anahita Davoudi PhD ,&nbsp;Lauren Evans PhD ,&nbsp;Sridevi Sridharan MSc ,&nbsp;Jiyoun Song PhD, RN ,&nbsp;Sena Chae PhD, RN ,&nbsp;Yolanda Barrón MA ,&nbsp;Mollie Hobensack PhD, RN ,&nbsp;Danielle Scharp PhD, RN ,&nbsp;Kenrick Cato PhD, RN ,&nbsp;Sarah Collins Rossetti PhD, RN ,&nbsp;Piotr Kapela MSc ,&nbsp;Zidu Xu MSc, RN ,&nbsp;Pallavi Gupta PhD ,&nbsp;Zhihong Zhang PhD, RN ,&nbsp;Margaret V. Mcdonald MA ,&nbsp;Kathryn H. Bowles PhD, RN","doi":"10.1016/j.jamda.2024.105417","DOIUrl":"10.1016/j.jamda.2024.105417","url":null,"abstract":"<div><h3>Objectives</h3><div>Home health care (HHC) serves more than 5 million older adults annually in the United States, aiming to prevent unnecessary hospitalizations and emergency department (ED) visits. Despite efforts, up to 25% of patients in HHC experience these adverse events. The underutilization of clinical notes, aggregated data approaches, and potential demographic biases have limited previous HHC risk prediction models. This study aimed to develop a time-series risk model to predict hospitalizations and ED visits in patients in HHC, examine model performance over various prediction windows, identify top predictive variables and map them to data standards, and assess model fairness across demographic subgroups.</div></div><div><h3>Setting and Participants</h3><div>A total of 27,222 HHC episodes between 2015 and 2017.</div></div><div><h3>Methods</h3><div>The study used health care process modeling of electronic health records, including clinical notes processed with natural language processing techniques and Medicare claims data. A Light Gradient Boosting Machine algorithm was used to develop the risk prediction model, with performance evaluated using 5-fold cross-validation. Model fairness was assessed across gender, race/ethnicity, and socioeconomic subgroups.</div></div><div><h3>Results</h3><div>The model achieved high predictive performance, with an <em>F</em>1 score of 0.84 for a 5-day prediction window. Twenty top predictive variables were identified, including novel indicators such as the length of nurse-patient visits and visit frequency. Eighty-five percent of these variables mapped completely to the US Core Data for Interoperability standard. Fairness assessment revealed performance disparities across demographic and socioeconomic groups, with lower model effectiveness for more historically underserved populations.</div></div><div><h3>Conclusions and Implications</h3><div>This study developed a robust time-series risk model for predicting adverse events in patients in HHC, incorporating diverse data types and demonstrating high predictive accuracy. The findings highlight the importance of considering established and novel risk factors in HHC. Importantly, the observed performance disparities across subgroups emphasize the need for fairness adjustments to ensure equitable risk prediction across all patient populations.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105417"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846946","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":"Oily Fish Intake Is Inversely Associated with Impaired Functionality: A Population-based Study in Frequent Fish Consumers Aged 60 years or More Living in Rural Ecuador","authors":"Oscar H. Del Brutto MD ,&nbsp;Denisse A. Rumbea MHA ,&nbsp;Emilio E. Arias MD ,&nbsp;Robertino M. Mera MD, PhD","doi":"10.1016/j.jamda.2024.105423","DOIUrl":"10.1016/j.jamda.2024.105423","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105423"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872421","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":"Transitions to Nursing Homes among Residents of Assisted Living and Community-Dwelling Home Care Recipients","authors":"Derek R. Manis PhD ,&nbsp;David Kirkwood MSc ,&nbsp;Stacey Fisher PhD ,&nbsp;Wenshan Li PhD ,&nbsp;Colleen Webber PhD ,&nbsp;Peter Tanuseputro MD, MHSc ,&nbsp;Nathan M. Stall MD, PhD ,&nbsp;Jennifer A. Watt MD, PhD ,&nbsp;Amy T. Hsu PhD ,&nbsp;Rachel D. Savage PhD ,&nbsp;Susan E. Bronskill PhD ,&nbsp;Andrew P. Costa PhD","doi":"10.1016/j.jamda.2024.105429","DOIUrl":"10.1016/j.jamda.2024.105429","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine transitions to a nursing home among residents of assisted living relative to community-dwelling home care recipients.</div></div><div><h3>Design</h3><div>Population-based retrospective cohort study emulating a target trial.</div></div><div><h3>Setting and Participants</h3><div>Linked, individual-level health system data were obtained from older adults (aged ≥65 years) who made an incident application for a bed in a nursing home in Ontario, Canada, between April 1, 2014, and March 31, 2019, and were followed until December 31, 2019.</div></div><div><h3>Methods</h3><div>Residency in assisted living was compared with only community-dwelling home care. Any long-stay (≥90 days) and short-stay (&lt;90 days) transitions to a nursing home were examined. Inverse probability weighted pooled logistic regression models were used to generate marginal cumulative incidence curves under each exposure status that were standardized by the covariates.</div></div><div><h3>Results</h3><div>This study included 10,012 residents of assisted living [mean (SD) aged 88.7 (6.26) years, 75% female] and 131,679 home care recipients [mean (SD) aged 84.8 (7.43) years, 63% female] who applied for a bed in a nursing home (N = 141,691; 95,744.6 person-years). There were 6049 transitions among applicants from assisted living and 85,190 transitions among applicants who were home care recipients to a nursing home. The 5-year absolute risk reduction was 110 transitions to a nursing home per 1000 older adult applicants if all applicants resided in assisted living (95% CI, 71–148). Residency in assisted living resulted in a 12.7% relative decrease in the 5-year risk of any transition to a nursing home had all applicants resided in assisted living (95% CI, 8.3%–17.1%).</div></div><div><h3>Conclusions and Implications</h3><div>Residents of assisted living were less likely to transition to a nursing home, despite equivalent clinical complexity and health care needs. The integration of assisted living into the continuum of care from the community to institutionalized nursing homes would better inform health system capacity and planning.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105429"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872425","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":"Hypoxia Indices in Old Patients with Obstructive Sleep Apnea: Contribution of Sex and Age","authors":"Tomoyuki Kawada MD, PhD","doi":"10.1016/j.jamda.2024.105434","DOIUrl":"10.1016/j.jamda.2024.105434","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105434"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142885889","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}