Journal of the American Medical Directors Association最新文献

{"title":"Clinical Efficacy of Virtual Reality Cave Automatic Virtual Environments (CAVE) for Chronic Musculoskeletal Pain in Older Adults: A Randomized Controlled Trial","authors":"Hermione Hin Man Lo MPH, MScN ,&nbsp;Pak Yiu Hugo Fong MBBS, MSc ,&nbsp;Bo Wang EdD ,&nbsp;Cheryl Lok-Chee Fung BSocSc ,&nbsp;Samuel Yeung-Shan Wong MD, MPH, CCFP ,&nbsp;Regina Wing Shan Sit MD, MBBS, DCH, DPD, PDip, DipMed","doi":"10.1016/j.jamda.2024.105344","DOIUrl":"10.1016/j.jamda.2024.105344","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess whether tai chi assisted by the Cave Automatic Virtual Environment (CAVE), a novel virtual reality (VR) technology, was superior to tai chi alone in managing chronic pain in older adults. CAVE may offer a promising alternative to head-mounted displays in chronic pain treatment.</div></div><div><h3>Design</h3><div>The study was a 12-week, 2-arm, parallel, randomized controlled trial implemented in VR and non-VR groups (N = 80, each arm = 40). The VR group underwent an 8-week tai chi program in a 3-wall VR-CAVE with projections of nature scenes and music, whereas the control group received tai chi only.</div></div><div><h3>Setting and Participants</h3><div>Community-dwelling older adults with chronic musculoskeletal pain were randomized (1:1) to VR and non-VR groups.</div></div><div><h3>Measures</h3><div>Participants were assessed at baseline, posttreatment at 8 weeks, and 12 weeks. The primary outcome was the Brief Pain Inventory severity score at 8 weeks, modeled within an intention-to-treat framework using generalized estimating equations.</div></div><div><h3>Results</h3><div>Participants had a mean age of 65.1 ± 5.6 years, with 78.8% female and mean BPI-pain severity score of 4.4 ± 1.5. At 8 weeks, the VR group demonstrated a statistically significant improvement in BPI severity score compared with the non-VR group (β = −0.75, 95% CI −1.48 to −0.03, <em>P</em> = .043), with the effect sustained to 12 weeks (β = −1.18, 95% CI −1.90 to −0.46, <em>P</em> = .001). No major adverse events were reported.</div></div><div><h3>Conclusions and Implications</h3><div>VR-CAVE tai chi was superior to non-VR tai chi for chronic musculoskeletal pain. Future trials that are longer-term, larger in scale, and include other forms of exercise will further inform VR-CAVE's role in post-acute and long-term rehabilitation.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 1","pages":"Article 105344"},"PeriodicalIF":4.2,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605068","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":"Process Mining on National Health Care Data for the Discovery of Patient Journeys of Older Adults.","authors":"Tim R de Boer, Rebekka J Arntzen, René Bekker, Bianca M Buurman, Hanna C Willems, Rob D van der Mei","doi":"10.1016/j.jamda.2024.105333","DOIUrl":"https://doi.org/10.1016/j.jamda.2024.105333","url":null,"abstract":"<p><strong>Objective: </strong>Understanding the longitudinal patterns of health care utilization among older adults is crucial for designing effective patient journeys and enhancing care coordination across settings. This study aims to uncover the most common patient journeys of older adults.</p><p><strong>Design: </strong>This explorative study used process mining techniques to analyze national health care data from 2017 to 2019, focusing on patient care journeys of older adults (aged ≥65 years) in the Netherlands.</p><p><strong>Setting and participants: </strong>Data were sourced from Statistics Netherlands, encompassing all residents aged ≥65 years as of January 1, 2017. Health care usage declarations from various care settings during 2017-2019 were included. Patient journeys were exclusively selected if their initiation points were certain.</p><p><strong>Methods: </strong>Data underwent rigorous preprocessing, merging, and filtering to create a single event log file suitable for process mining. Patients were categorized by age and medication use, and differences in patient journeys were analyzed. Process mining techniques generated visualizations illustrating the connections between care forms and the impact of changes in one form on others.</p><p><strong>Results: </strong>The study included 3,177,203 individuals aged 65 years and older, with 44% experiencing 1 or more patient journeys totaling 2,469,663 journeys in 2017-2019. Most care journeys for older adults were simple and short. The top 10 most frequent journeys had 4 or fewer care forms, with 95% of journeys for the 65+ population and 90% for the 85+ population having 4 or fewer care transitions. Long-term care forms, such as home care, personal care, and long-term care, accounted for the majority of time spent in the system.</p><p><strong>Conclusions and implications: </strong>This pioneering study used process mining to show that most older adults tend to have a straightforward health care need, often involving the emergency department and hospitalizations. However, a smaller group among the population requires more complex and prolonged care, especially in the 85+ population. Reducing the number of transitions for this population, although impacting fewer people, might result in a larger effect on the overall system.</p>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":" ","pages":"105333"},"PeriodicalIF":4.2,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605075","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":"Spirituality and Religion as a Pillar in Multimodal Dementia Prevention.","authors":"Shi Ying Tan, Shyh Poh Teo","doi":"10.1016/j.jamda.2024.105343","DOIUrl":"10.1016/j.jamda.2024.105343","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":" ","pages":"105343"},"PeriodicalIF":5.4,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142605094","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":"Higher Magnesium Intake Is Associated with a Lower Risk of Frailty in Older Adults","authors":"Ligia J. Dominguez MD ,&nbsp;Diana M. Mérida MD ,&nbsp;Carolina Donat-Vargas PhD ,&nbsp;José R. Banegas MD ,&nbsp;Nicola Veronese MD ,&nbsp;Mario Barbagallo MD ,&nbsp;Fernando Rodríguez-Artalejo MD ,&nbsp;Pilar Guallar-Castillón MD, PhD","doi":"10.1016/j.jamda.2024.105335","DOIUrl":"10.1016/j.jamda.2024.105335","url":null,"abstract":"<div><h3>Objectives</h3><div>Magnesium deficiency is common in older adults and has been associated with reduced muscle functionality and several age-related diseases. Evidence of its relationship with frailty is scarce. We aimed to explore the association of magnesium intake with incident frailty in the Seniors-ENRICA-1 cohort.</div></div><div><h3>Design</h3><div>Prospective longitudinal cohort study.</div></div><div><h3>Setting and Participants</h3><div>The ENRICA study is a population-based study (N = 13,105) that includes a representative sample of the noninstitutionalized Spanish population aged 18 years and older. For the present analyses, we used data from the community-dwelling participants aged 60 years and older at baseline (n = 2519). After exclusions, we included data from 1900 participants of the Seniors-ENRICA-1 cohort (mean age 68.7 ± 6.4 years; 51.7% women).</div></div><div><h3>Methods</h3><div>Food consumption was assessed at baseline with a validated, computer-based, face-to-face dietary history (DH-ENRICA), from which magnesium intake was estimated. Frailty was defined as having 3 or more of Fried criteria: exhaustion, low physical activity, slow gait speed, weakness, and weight loss. Analyses were performed with logistic regression adjusted for potential confounders.</div></div><div><h3>Results</h3><div>During a mean follow-up of 3.5 years, 136 new cases (7.2%) of frailty occurred. Compared with the lowest sex-specific quartile of magnesium intake, the fully adjusted odds ratio (95% CI) for incident frailty across increasing quartiles of intake was 0.62 (0.36, 1.07), 0.53 (0.28, 0.98), and 0.43 (0.21, 0.86), respectively (<em>P</em>-trend = .016). Corresponding results for slow gait speed were 0.68 (0.47, 1.01), 0.58 (0.37, 0.89), and 0.52 (0.32-0.84), respectively (<em>P</em>-trend = .008). Other Fried criteria showed a similar tendency to reduced frailty incidence with increasing magnesium intake, without achieving statistical significance in the fully adjusted model.</div></div><div><h3>Conclusions and Implications</h3><div>Higher magnesium intake was inversely and independently associated with lower frailty risk, especially of slow gait speed, in community-dwelling older adults, suggesting that adequate intake of this vital ion could help prevent unhealthy aging.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 1","pages":"Article 105335"},"PeriodicalIF":4.2,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569001","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":"PALTmed Events and Products","authors":"","doi":"10.1016/S1525-8610(24)00795-3","DOIUrl":"10.1016/S1525-8610(24)00795-3","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 11","pages":"Article 105373"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652663","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":"Enhancing the Effectiveness of Public Health Policies on the Health of Older Adults: The Crucial Role of Social Work","authors":"Afei Qin,&nbsp;Lingzhong Xu","doi":"10.1016/j.jamda.2024.105226","DOIUrl":"10.1016/j.jamda.2024.105226","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 11","pages":"Article 105226"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046773","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":"Emerging Digital Technologies Used for Fall Detection in Older Adults in Aged Care: A Scoping Review","authors":"Sriyani Padmalatha Konara Mudiyanselage RN, PhD ,&nbsp;Ching Teng Yao PhD ,&nbsp;Sujeewa Dilhani Maithreepala RN, MSc ,&nbsp;Bih O. Lee RN, PhD","doi":"10.1016/j.jamda.2024.105330","DOIUrl":"10.1016/j.jamda.2024.105330","url":null,"abstract":"<div><h3>Objective</h3><div>To explore a comprehensive overview of digital technologies used for fall detection in older adults, categorizing the types, functions, and usability of these systems.</div></div><div><h3>Design</h3><div>A scoping review was conducted to search across 5 databases [Embase, Medline (OVID), CINAHL, Coherence and IEEE Explore] from January 2013 to September 2023.</div></div><div><h3>Setting and Participants</h3><div>Studies in older adults living in nursing homes, care homes, residential homes, respite care homes, and all skilled and ambulatory care facilities (without context restrictions).</div></div><div><h3>Methods</h3><div>This review followed the 6 methodological stages: (1) identification of research question; (2) identification of relevant studies; (3) study selection; (4) charting the data; (5) collating, summarizing, and reporting the results; and an optional stage, (6) consulting with stakeholders regarding findings to explore pivotal concepts in emerging technology usage in long-term care for falls detection among older people. Data were extracted and categorized based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines.</div></div><div><h3>Results</h3><div>A total of 73 studies met the inclusion criteria. Four main categories of fall detection technologies were identified: motion and sensor technologies, imaging and visual systems, environmental sensors, and robotic and autonomous systems. Commonly used devices: wearable accelerometers, gyroscopes, infrared array sensors, and smart carpet pressure sensors. Data storage methods were wearable devices, cameras, and floor-mounted sensors. Communication technologies included Bluetooth, Wi-Fi, and GPS, and notification methods ranged from alarms and SMS to cloud communications. Various health care response teams, including caregivers, health care providers, and emergency services, were integral to the fall detection systems.</div></div><div><h3>Conclusions and Implications</h3><div>Most studies primarily focus on fall detection; however, we recommend further clinical research to emphasize both fall detection and, more importantly, fall prevention (both primary and secondary). Investigating the effectiveness of fall prevention technologies in real-world settings will be crucial for enhancing the safety and quality of life of the aging population.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 1","pages":"Article 105330"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568999","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 New Look at Diabetes Through the Revised 2024 Diabetes Clinical Practice Guideline","authors":"Barbara Resnick PhD, CRNP","doi":"10.1016/j.jamda.2024.105325","DOIUrl":"10.1016/j.jamda.2024.105325","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 11","pages":"Article 105325"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142623066","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":"General Information","authors":"","doi":"10.1016/S1525-8610(24)00793-X","DOIUrl":"10.1016/S1525-8610(24)00793-X","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 11","pages":"Article 105371"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652661","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":"Directions & Connections","authors":"","doi":"10.1016/S1525-8610(24)00794-1","DOIUrl":"10.1016/S1525-8610(24)00794-1","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 11","pages":"Article 105372"},"PeriodicalIF":4.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142652662","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}