Journal of the American Medical Directors Association最新文献

{"title":"General Information","authors":"","doi":"10.1016/S1525-8610(26)00352-X","DOIUrl":"10.1016/S1525-8610(26)00352-X","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"27 8","pages":"Article 106462"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148731258","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 Falls and Fall-Related Hospitalization on Subsequent Vitality Decline Among Japanese Nursing Home Residents: A Longitudinal Fixed-Effects Analysis","authors":"Keiichi Shimatani PhD,&nbsp;Maiko Noguchi-Watanabe PhD,&nbsp;Kasumi Ikuta PhD,&nbsp;Juri Sawada MS,&nbsp;Ayumu Yoshie MS,&nbsp;Takuma Shiozawa PhD,&nbsp;Sakiko Fukui PhD","doi":"10.1016/j.jamda.2026.106190","DOIUrl":"10.1016/j.jamda.2026.106190","url":null,"abstract":"<div><h3>Objectives</h3><div>Falls in older adults are associated with injuries, functional decline, and psychological consequences, including fear of falling. The vitality index (VI) assesses behavioral motivation by observing engagement in activities, communication, and self-care. Little is known about how falls affect behavioral vitality, particularly among nursing home residents. The objective of this study was to examine the association between falls and subsequent VI changes among long-term care facility residents using longitudinal data.</div></div><div><h3>Design</h3><div>This was a retrospective cohort study.</div></div><div><h3>Setting and Participants</h3><div>Participants included 338 residents with mobility in 5 Japanese nursing homes, using monthly data from August 2022 to June 2024. Residents with severe care needs or a Barthel Index score of 0 were excluded.</div></div><div><h3>Methods</h3><div>Falls were documented from care charts, excluding bed-related falls. Fixed-effects linear probability models examined VI decline at 1-, 2-, and 3-month intervals after falls, with stratified analyses by dementia status.</div></div><div><h3>Results</h3><div>Among the 338 residents, 182 (53.8%) experienced falls. Overall, falls were not significantly associated with VI decline. Nonetheless, among residents without dementia, fall-related hospitalizations were associated with increased VI decline at 2 and 3 months (β = 0.070, <em>P</em> = .024; β = 0.082, <em>P</em> = .019, respectively). Exploratory analyses suggested that fall-related hospitalizations primarily affected on and off toilet at 3 months, whereas non–fall-related hospitalizations selectively reduced willingness to get out of bed at 2 months or rehabilitation/activity at 3 months. No significant associations were observed among the residents with dementia.</div></div><div><h3>Conclusions and Implications</h3><div>Fall-related hospitalization, rather than falls alone, may lead to a medium-term vitality decline among nursing home residents without dementia. Postdischarge monitoring and tailored interventions may be critical for maintaining daily functioning.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"27 8","pages":"Article 106190"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645776","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(26)00353-1","DOIUrl":"10.1016/S1525-8610(26)00353-1","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"27 8","pages":"Article 106463"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148739293","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":"Does Lower-Limb Segmentation of DXA Matter in Sarcopenia?","authors":"Sang Yoon Lee MD, PhD","doi":"10.1016/j.jamda.2026.106363","DOIUrl":"10.1016/j.jamda.2026.106363","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"27 8","pages":"Article 106363"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376157","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":"Dermatoporosis: Standardizing Mandarin Terminology and Primary Care Screening","authors":"Yin-Han Fang MD","doi":"10.1016/j.jamda.2026.106354","DOIUrl":"10.1016/j.jamda.2026.106354","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"27 8","pages":"Article 106354"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376168","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":"Beyond Association: Proposing a Clinically Actionable NLR-Sarcopenia Risk Stratification Tool for Post-Acute Care Settings","authors":"Maoqing You MBBS,&nbsp;Zhiyue Tang MBBS","doi":"10.1016/j.jamda.2026.106318","DOIUrl":"10.1016/j.jamda.2026.106318","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"27 8","pages":"Article 106318"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148376240","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 Relatively New Form of Elder Mistreatment in Nursing Homes: Social Media Abuse","authors":"Eilon Caspi PhD (Gerontologist, Elder Mistreatment Researcher)","doi":"10.1016/j.jamda.2026.106302","DOIUrl":"10.1016/j.jamda.2026.106302","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"27 8","pages":"Article 106302"},"PeriodicalIF":3.4,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148701645","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":"Paratonia in Advanced Dementia: Deconstructing Scientific, Regulatory, and Health System Barriers to Botulinum Toxin A (BoNT-A) Treatment of Involuntary Muscle Resistance","authors":"Galit Kleiner MD, FRCPC,&nbsp;Anthony E. Lang MD, FRCPC","doi":"10.1016/j.jamda.2026.106285","DOIUrl":"10.1016/j.jamda.2026.106285","url":null,"abstract":"<div><div>Paratonia, a movement disorder characterized by involuntary muscle resistance, affects nearly all people with advanced dementia and contributes to caregiver burden, hygiene complications, pressure injuries, and pain. With Alzheimer's disease and related dementias affecting 7.2 million Americans and projected to reach nearly 14 million by 2060, the clinical impact of paratonia will expand proportionally. Because the involuntary muscle resistance of paratonia is frequently misinterpreted as deliberate noncompliance, individuals may receive inappropriate pharmacologic management rather than targeted treatment of the underlying movement disorder. No treatments are currently approved specifically for paratonia-induced muscle postures. Passive motion therapy, which the Centers for Medicare &amp; Medicaid Services quality standards promote for contracture prevention in nursing homes, showed no benefit for paratonia in a randomized controlled trial of individuals with advanced dementia. Furthermore, passive movement therapy may paradoxically reinforce abnormal motor patterns by triggering increased involuntary resistance, the defining feature of paratonia. Botulinum toxin A, in therapeutic use since 1989, with Food and Drug Administration approval, is an established treatment for post-stroke spasticity and cervical dystonia. These conditions, like paratonia, arise from distinct central nervous system pathologies but share a peripheral manifestation of involuntary sustained muscle contraction. Preliminary clinical evidence suggests potential safety and efficacy for paratonia-induced muscle postures. Despite the therapeutic rationale and preliminary evidence for safety and efficacy, pharmaceutical companies have not pursued regulatory approval for the paratonia indication. This article examines barriers to clinical development, including scientific uncertainties, knowledge gaps, infrastructure limitations, therapeutic nihilism, policy barriers, and pharmaceutical industry considerations. We propose coordinated stakeholder action across research, education, policy, and regulatory domains to establish pathways toward further research and, if warranted, clinical implementation.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"27 7","pages":"Article 106285"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199457","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":"Charting a New Course in the Diagnosis and Treatment of Paratonia","authors":"Paul R. Katz MD, CMD","doi":"10.1016/j.jamda.2026.106286","DOIUrl":"10.1016/j.jamda.2026.106286","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"27 7","pages":"Article 106286"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148199460","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":"PALTmed Events and Product","authors":"","doi":"10.1016/S1525-8610(26)00285-9","DOIUrl":"10.1016/S1525-8610(26)00285-9","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"27 7","pages":"Article 106395"},"PeriodicalIF":3.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148523894","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}