Journal of the American Medical Directors Association最新文献

{"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, Hisashi Kawai PhD, 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":"Linking Cognitive Screening Tests in Community-Dwelling Older Adults: Crosswalk between the Montreal Cognitive Assessment-Basic and the Mini-Mental State Examination","authors":"Siqi Cheng MD ,&nbsp;Jiafan Qin MM ,&nbsp;Chengbei Hou PhD ,&nbsp;Yue Wu MD ,&nbsp;Xinyan Du MM ,&nbsp;Hongjun Liu BMed ,&nbsp;Shaoyuan Lei PhD ,&nbsp;Rui Li BMed ,&nbsp;Xiaolin Yue MPH ,&nbsp;Yansu Guo PhD","doi":"10.1016/j.jamda.2025.105550","DOIUrl":"10.1016/j.jamda.2025.105550","url":null,"abstract":"<div><h3>Objective</h3><div>To develop the crosswalk between the Montreal Cognitive Assessment-Basic (MoCA-B) and Mini-Mental Status Examination (MMSE) based on a community-dwelling older population to facilitate data synthesis and comparison.</div></div><div><h3>Design</h3><div>A cross-sectional study.</div></div><div><h3>Setting and Participants</h3><div>We used baseline data of 2170 subjects with total MoCA-B and MMSE scores from an ongoing prospective cohort study, the Beijing Longitudinal Disability Survey in Community Elderly (BLINDSCE).</div></div><div><h3>Methods</h3><div>The MoCA-B and MMSE were administered by trained assessors. Equipercentile equating was used to develop the conversion table between MoCA-B and MMSE scores in the total sample and subgroups by age, sex, residency, and education level. The mean absolute error (MAE), intraclass correlation coefficient (ICC), and Bland-Altman plot were used to evaluate the linking performance.</div></div><div><h3>Results</h3><div>MoCA-B and MMSE scores converted bi-directionally for the overall sample and subgroups, with small standardized MAE (SMAE) and high ICC. The linking results between MoCA-B and MMSE scores were consistent across the total sample and the age and sex subgroups, while a 2-score difference was observed within the residency and education subgroups.</div></div><div><h3>Conclusions and Implications</h3><div>This study provides easy-to-use crosswalks between measures of MoCA-B and MMSE with precision among community-dwelling older adults. Our results help to compare and pool data across studies using either of the 2 cognitive screening tests and provide a useful reference to clinicians for better evidence-based practice in patients evaluated using different cognitive tests.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 5","pages":"Article 105550"},"PeriodicalIF":4.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143657599","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":"Workforce Dementia Training Needs and Preferences for Residential Aged Care","authors":"Hannah Gulline BBiomedSci, GradCertProjMgt, MPH ,&nbsp;Lauren Bruce D Psych (Health) ,&nbsp;Marta Woolford BHSc (Hons), PhD ,&nbsp;Phillipa Horsman MEng (Hons) ,&nbsp;Niluksha Morawaka BNurs, MHA ,&nbsp;Silvia Alberti BA, SSW, MSW ,&nbsp;Darshini Ayton BBiomedSci (Hons), MPH, PhD","doi":"10.1016/j.jamda.2025.105495","DOIUrl":"10.1016/j.jamda.2025.105495","url":null,"abstract":"<div><h3>Objective</h3><div>To explore residential aged care (RAC) staff and volunteers' needs and preferences for dementia training.</div></div><div><h3>Design</h3><div>A mixed methods action research study was conducted to codesign a new Dementia Model of Care for RAC homes provider Baptcare. This paper reports on one component of model development and implementation: understanding the training that staff and volunteers receive about dementia, and subsequently, through a needs assessment process, identifying their needs and preferences for dementia training.</div></div><div><h3>Setting and Participants</h3><div>Staff and volunteers from 8 RAC homes participated in a survey (staff n = 275; volunteers n = 11), with a 77.5% completion rate (n = 241). Forty-five staff and 5 volunteers completed focus groups/interviews about their dementia knowledge, current training, future training preferences, and factors influencing access to training.</div></div><div><h3>Methods</h3><div>The survey included the Confidence in Dementia (CODE) Scale and Dementia Knowledge Assessment Scale (DKAS) validated tools and additional training content and delivery questions. Survey data were analyzed descriptively. Transcripts were analyzed thematically and then mapped to training topics/approaches identified from the data.</div></div><div><h3>Results</h3><div>Although staff and volunteers felt “somewhat confident” to care for residents living with dementia, gaps in dementia knowledge were identified. Staff and volunteers addressed this knowledge gap through internal training modules or external informal or formal training. Survey comments resulted in 3 key desired training topics identified: person-centered care, dementia knowledge and behavior management, and understanding the resident's experience. Four approaches to training were recognized: in-person over online training, self-directed learning, peer-to-peer learning, and training new staff/volunteers during onboarding.</div></div><div><h3>Conclusions and Implications</h3><div>Additional staff and volunteer training is required to address knowledge gaps and promote the delivery of quality care. Considering staff and volunteers' needs and preferences as well as addressing barriers to training is crucial to building workforce capacity and improving dementia care provision in RAC.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 5","pages":"Article 105495"},"PeriodicalIF":4.2,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536648","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":"Kinematic Insights Into Older Adult Fall-Related Head Impacts: Boundary Conditions and Injury Risk","authors":"Nicole E.-P. Stark PhD ,&nbsp;Ethan S. Henley ,&nbsp;Brianna A. Reilly ,&nbsp;Damon R. Kuehl MD ,&nbsp;Steve Rowson PhD","doi":"10.1016/j.jamda.2025.105545","DOIUrl":"10.1016/j.jamda.2025.105545","url":null,"abstract":"<div><h3>Objectives</h3><div>To quantify real-world impact conditions of falls, which cause 50% to 90% of older adult traumatic brain injuries, and reconstruct them using dummy headforms to analyze kinematics and injury outcomes.</div></div><div><h3>Design</h3><div>Mixed-methods: Observational and experimental.</div></div><div><h3>Setting and Participants</h3><div>An open-access dataset of 118 videos of head impacts at long-term care facilities was used.</div></div><div><h3>Methods</h3><div>Videos were analyzed to determine head impact occurrence, and for each video with a head impact, fall characteristics were recorded. Perpendicular view fall videos were analyzed using validated model-based image-matching software to track head impact velocities. From the tracked videos, falls were reconstructed with a Hybrid III headform mounted on an inverted pendulum to capture impact kinematics.</div></div><div><h3>Results</h3><div>Of the 118 fall videos with head impacts, we tracked 29 videos, finding a normal velocity of 1.76 ± 1.02 m/s and a tangential velocity of 1.27 ± 0.95 m/s. Twenty-three of these impacts were reconstructed, producing peak linear acceleration (PLA) 50.2 ± 36.4 g and peak rotational acceleration (PRA) 2.91 ± 2.16 krad/s². Impacts that occurred against the floor had a 38% higher PLA and a 25% higher PRA compared with wall impacts. Compared with backward and forward falls, lateral falls resulted in 46 and 52 g higher PLA and 3.12 and 4.66 krad/s² higher PRA, respectively.</div></div><div><h3>Conclusions and Implication</h3><div>Fall direction and impact surface influenced head impact accelerations, with certain fall configurations, such as lateral falls against tile, posing a greater risk for traumatic brain injuries. These findings provide critical insights into the biomechanics of older adult head impact falls and highlight the need for targeted fall prevention strategies, such as interventions that reduce the occurrence of lateral falls. In addition, this work offers foundational data for designing protective equipment, including headgear and energy-absorbing flooring, optimized for these specific kinematics.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 5","pages":"Article 105545"},"PeriodicalIF":4.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634151","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 Effects of Commercial Conversational Agents on Older Adults' Mental Health: A Scoping Review.","authors":"Jolene Zi Tong Teo, Si Qi Yoong, Yi Xuan Chan, Ying Jiang","doi":"10.1016/j.jamda.2025.105523","DOIUrl":"https://doi.org/10.1016/j.jamda.2025.105523","url":null,"abstract":"<p><strong>Objectives: </strong>With increasing life expectancy, more older adults are experiencing poor mental health because of the significant life transitions they face. Commercial conversational agents (CAs) are emerging devices that can potentially support older adults' mental well-being. However, limited literature has evaluated the influence of commercial CAs on older adults' mental health. This study aims to examine what is known about the effects of commercial CAs on older adults' mental health and the associated features.</p><p><strong>Design: </strong>This scoping review was conducted in accordance with Arksey and O'Malley's framework.</p><p><strong>Setting and participants: </strong>The review primarily focused on community-dwelling older adults aged 60 and above who used any commercial CAs.</p><p><strong>Methods: </strong>Quantitative, qualitative, mixed-method peer-reviewed studies and dissertations were included. Eleven databases were searched for relevant articles published from January 1, 2010, until April 9, 2024. Data extracted included the author(s), year, country, objective, population details, eligibility criteria, study design, commercial CA type, and findings related to research questions. Inductive basic content analysis was used for data synthesis.</p><p><strong>Results: </strong>Twenty-nine articles from 28 studies (n = 1017 older adults) were included. Five categories were synthesized: social wellness, emotional reactions, cognitive stimulation, autonomy, and depression. Common features impacting older adults' mental health were the CAs' conversational capacity and anthropomorphism, voice-activated functions, music, calling and other functions, and technological limitations. There were more positive than adverse effects on older adults' mental health categories.</p><p><strong>Conclusion and implications: </strong>Commercial CAs can potentially mitigate mental health in older adults, but the evidence is still very preliminary. Their effects must be verified in randomized controlled trials using objective and validated tools and through mixed-method studies.</p>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":" ","pages":"105523"},"PeriodicalIF":4.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743120","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 Hand Strength and Walking Speed Combined and in Isolation on the Prediction of Cognitive Decline and Dementia in Middle-Aged and Older Adults: A Systematic Review and Meta-Analysis.","authors":"Xiaojie Xie, Deli Li, Meng Zhou, Zhaojun Wang, Xueyan Zhang","doi":"10.1016/j.jamda.2025.105576","DOIUrl":"https://doi.org/10.1016/j.jamda.2025.105576","url":null,"abstract":"<p><strong>Objective: </strong>This review aims to further elucidate the relationship between reduced walking speed and grip function and cognitive decline.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Settings and participants: </strong>Adults without dementia.</p><p><strong>Methods: </strong>Six English databases were searched from inception to January 2025. Longitudinal studies that simultaneously investigate the relationship between a decline in grip strength or walking speed and cognitive impairment or dementia were eligible. The meta-analysis was conducted using Stata 17.0. The Newcastle-Ottawa Scale and Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach were used to assess the quality of evidence in the included studies.</p><p><strong>Results: </strong>A total of 2779 articles were identified through the search strategy. After removing duplicate titles and completing screening, 10 studies were included. Random effects analysis revealed that decreases in physical function (walking speed: hazard ratio [HR], 1.34; 95% CI, 1.13-1.60) and grip strength: HR, 1.30; 95% CI, 1.14-1.49) were significantly associated with decreases in cognitive ability, and this correlation became even more pronounced when pace and grip strength were assessed jointly (HR, 2.72; 95% CI, 1.20-6.17). The results of the subgroup analysis revealed that the study location, follow-up time, cognitive assessment method, sex ratio of the subjects, and other factors affected the results of the study.</p><p><strong>Conclusions and implications: </strong>This study suggests that grip strength and walking speed are important predictors of cognitive decline and dementia, and highlights the significance of the comprehensive assessment. Early intervention before middle-aged and older adults enter the clinical stage of dementia is needed, which requires standardized and rigorous assessment.The sequential relationships between hand strength and walking speed in relation to different developmental stages of dementia, as well as how they can be integrated with objective indicators to facilitate diagnosis, need to be further investigated.</p>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":" ","pages":"105576"},"PeriodicalIF":4.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743109","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 Effectiveness of Tai Chi Assisted by Virtual Environments for Chronic Musculoskeletal Pain.","authors":"Rui Wang, Hao-Yu Wang","doi":"10.1016/j.jamda.2025.105570","DOIUrl":"https://doi.org/10.1016/j.jamda.2025.105570","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":" ","pages":"105570"},"PeriodicalIF":4.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743117","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}