Journal of the American Geriatrics Society最新文献

{"title":"Cover","authors":"Achamyeleh Birhanu Teshale,&nbsp;Htet Lin Htun,&nbsp;Mor Vered,&nbsp;Alice J. Owen,&nbsp;Joanne Ryan,&nbsp;Kevan R. Polkinghorne,&nbsp;Monique F. Kilkenny,&nbsp;Andrew Tonkin,&nbsp;Rosanne Freak-Poli","doi":"10.1111/jgs.18438","DOIUrl":"https://doi.org/10.1111/jgs.18438","url":null,"abstract":"<p><b>Cover caption</b>: Conceptual framework: Social determinants and traditional risk factors impacting cardiovascular disease. See the related article by Teshale et al., pages 1797-1807.\u0000\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 6","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.18438","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144503149","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":"Cover","authors":"Paula A. Rochon MD, MPH,&nbsp;Joyce Li MSc,&nbsp;Haley Warren MHSC,&nbsp;Razan Rawdat MHSC,&nbsp;Surbhi Kalia MSc","doi":"10.1111/jgs.18436","DOIUrl":"https://doi.org/10.1111/jgs.18436","url":null,"abstract":"<p><b>Cover caption</b>: Examples of Conditions that Affect Women Uniquely, Disproportionately, or Differently. See the related article by Rochon et al., pages 1645-1647.\u0000\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 5","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.18436","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118199","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":"Correction to “Changes in Skilled Nursing and Home Health Admissions Associated With Medicare Payment Reforms and the COVID-19 Pandemic”","authors":"","doi":"10.1111/jgs.19531","DOIUrl":"10.1111/jgs.19531","url":null,"abstract":"&lt;p&gt;R. A. Prusynski, N. E. Leland, A. Humbert, A. Dahal, C. Brown, H. Amaravadi, D. Saliba, T. M. Mroz, “Changes in Skilled Nursing and Home Health Admissions Associated With Medicare Payment Reforms and the COVID-19 Pandemic,” &lt;i&gt;Journal of the American Geriatrics Society&lt;/i&gt; 73, no. 2 (2025): 592–601, https://doi.org/10.1111/jgs.19322.&lt;/p&gt;&lt;p&gt;The authors have noticed that some inpatient rehabilitation stays were not removed from the hospital cohort. This requires a change to all descriptive statistics and analytic results.&lt;/p&gt;&lt;p&gt;\u0000 &lt;b&gt;Abstract&lt;/b&gt;\u0000 &lt;/p&gt;&lt;p&gt;\u0000 &lt;b&gt;Methods:&lt;/b&gt; Using 100% of Medicare fee-for-service data, we conducted adjusted interrupted time series analyses of 30,507,466 hospital stays.&lt;/p&gt;&lt;p&gt;\u0000 &lt;b&gt;Results:&lt;/b&gt; At baseline, an average 18.3% of hospitalized beneficiaries were admitted to SNFs and 14.2% to HHAs. Post-COVID, admissions to SNF declined to 15.8% of patients being discharged from hospitals and HHA admissions increased to 18.6%.&lt;/p&gt;&lt;p&gt;\u0000 &lt;b&gt;RESULTS&lt;/b&gt;\u0000 &lt;/p&gt;&lt;p&gt;Our sample included 30,507,466 Medicare fee-for-service acute hospital stays between January 2018 and October 2021. Of the 785,626 average monthly hospital discharges during the baseline period, 18.3% were admitted to SNF within 3 days and 14.2% were admitted to HHA within 14 days (Figure 1). During the COVID-19 period, SNF admissions decreased to an average of 15.8% and HHA admissions increased to 18.6%. PDPM implementation in October 2019 was associated with an immediate 0.29 pp decline in SNF admissions (95% CI −0.43, −0.16). However, the negative baseline trend reversed, resulting in 0.36 pp more SNF admissions per month after PDPM compared to baseline trends, for a 0.43pp-increase in SNF admissions by the end of Period 2 compared to the projected rate based on pre-PDPM trends.&lt;/p&gt;&lt;p&gt;COVID-19 was associated with an immediate 2.89 pp reduction in SNF admissions (95% CI −3.08, −2.69) compared to the baseline projected rate, and was not significantly associated with any trend changes in SNF admissions.&lt;/p&gt;&lt;p&gt;For HHA admissions, the baseline trend was an adjusted monthly increase of 0.04 pp (95% CI 0.01, 0.06). PDPM was significantly associated with a 0.34 pp immediate decline (95% CI −0.49, −0.18) and a 0.38 pp monthly decline in HHA admissions, for a total 1.01 pp reduction in HHA admissions by the end of Period 2 compared to the baseline projection. There was no immediate change in HHA admissions the month after PDGM implementation. However, PDGM was associated with a 1.10 pp monthly increase in HHA admissions compared to baseline, for a total 0.90 pp higher rate at the end of Period 3 compared to the projection from baseline. COVID-19 was associated with an immediate 3.66 pp increase in HHA admissions (95% CI 3.42, 3.99) but was not significantly associated with any trend changes compared to baseline projections.&lt;/p&gt;&lt;p&gt;\u0000 &lt;b&gt;Tables&lt;/b&gt;\u0000 &lt;/p&gt;&lt;p&gt;In the revised Table 1, all descripti","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 6","pages":"1992-1998"},"PeriodicalIF":4.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19531","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113196","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":"Moderate Impairment in Binocular Contrast Sensitivity Predicts Faster Mobility Decline in Cognitively Unimpaired Older Adults","authors":"Ashley Wells,&nbsp;Michael E. Miller,&nbsp;Haiying Chen,&nbsp;Paul J. Laurienti,&nbsp;Stephen B. Kritchevsky,&nbsp;Atalie C. Thompson","doi":"10.1111/jgs.19526","DOIUrl":"10.1111/jgs.19526","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Impaired contrast sensitivity (CS) commonly occurs in older adults but has been largely overlooked as a contributing factor to functional impairment and decline. We examined if CS impairment predicts decline in performance on the expanded short physical performance battery (eSPPB) over 30 months of follow-up in cognitively healthy older adults.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Single center prospective cohort study of 192 cognitively unimpaired older adults with good visual acuity and self-reported visual function. Linear mixed models examined the difference in the association of moderately impaired baseline CS (logCS &lt; 1.55) with performance on the eSPPB and its components–balance, 4 m gait speed, narrow walk, and chair pace–over 30 months. Multivariable models adjusted for the effect of age, race, and sex on the slopes over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>At baseline, the mean participant age was 76.5 ± 4.7 years, with 56.5% (<i>N</i> = 108) female and 9.4% (<i>N</i> = 18) black. Participants with moderately impaired CS at baseline had a significantly faster decline in eSPPB over a 30-month period (Beta: −0.115, 95% CI (−0.180, −0.050), <i>p</i> &lt; 0.001) compared with those with normal CS (Beta: −0.022, 95% CI (−0.044, −0.001), <i>p</i> = 0.042). There was a difference in slopes of −0.093 units/year ((95% CI, −0.161, −0.024), <i>p</i> = 0.009) between groups. This difference in slopes remained significant after adjusting for the effect of age, sex, and race (difference in slopes −0.086, 95% CI (−0.155, −0.016), <i>p</i> = 0.016). Impaired CS predicted significantly greater declines in balance over 30 months (difference in slopes −3.512 (−6.826, −0.199), <i>p</i> = 0.0378), but the differences in gait speed, narrow walk, and chair pace were not significant.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In cognitively intact older adults with good visual acuity, moderately impaired CS was associated with a significantly faster decline in eSPPB, especially balance, over 30 months of follow-up. A relatively simple test of vision may identify a subset of older adults without cognitive dysfunction who are at risk for mobility decline.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 6","pages":"1772-1778"},"PeriodicalIF":4.3,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103396","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":"Making It Count Twice: A Single Age-Friendly Deprescribing Workshop for Either Medical Residents or Geriatric Fellows","authors":"Chelsea E. Hawley,&nbsp;Laura K. Triantafylidis,&nbsp;Andrew A. Swanner,&nbsp;Sarah C. Phillips,&nbsp;Ryan Chippendale,&nbsp;Andrea Wershof Schwartz","doi":"10.1111/jgs.19529","DOIUrl":"10.1111/jgs.19529","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 6","pages":"1989-1991"},"PeriodicalIF":4.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096485","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":"Home- and Community-Based Service Use Among Veterans: The National Landscape","authors":"Katherine E. M. Miller,&nbsp;Megan Price,&nbsp;Katherine O'Malley,&nbsp;Sooyeon Song,&nbsp;Melissa M. Garrido","doi":"10.1111/jgs.19492","DOIUrl":"10.1111/jgs.19492","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Veteran population is aging rapidly, with already higher rates of disability compared to non-Veteran peers. Consequently, demand for home- and community-based long-term services and supports (HCBS) is increasing. Understanding who needs and uses HCBS is particularly important in the Veterans Health Administration (VHA)—a payer for HCBS. Our objective is to describe the characteristics of Veterans who use HCBS, how Veterans who use HCBS differ from those who do not use HCBS, and how Veterans who use different types of HCBS differ from each other.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We use administrative data for VHA-provided and VHA-purchased care for 2021–2023 in a cohort of Veterans aged 65+. We describe Veteran HCBS users versus nonusers, services used, and the association of Veteran demographic characteristics, health status, and prior health care use on the probability of receiving HCBS using generalized estimating equations with binomial family, logit link, and exchangeable correlation structure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One in 10 older Veterans uses at least one HCBS service, and this share is growing over time. Veterans use home health care and homemaker/home health aide services the most. Most Veterans receive one service. We find that Veterans who are female, Black, or diagnosed with dementia are more likely to use HCBS, while Veterans residing in rural areas are less likely.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Like the challenges facing the aging civilian population, the VHA faces the test of meeting the growing demand for HCBS. Understanding these dynamics is essential to ensuring that HCBS is both accessible and effective in supporting Veterans.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 6","pages":"1884-1894"},"PeriodicalIF":4.3,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144061221","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-Discharge COVID-19 Symptoms Predict 1-Year Functional Decline, Falls, and Emergency Department Visits: A Cohort Study","authors":"Murilo Bacchini Dias,&nbsp;Thiago J. Avelino-Silva,&nbsp;Eduardo Ferriolli,&nbsp;Leandro Utino Taniguchi,&nbsp;Wilson Jacob-Filho,&nbsp;Claudia Kimie Suemoto,&nbsp;Márlon Juliano Romero Aliberti,&nbsp;the CO-FRAIL Study Group for the COVID HCFMUSP Study Group","doi":"10.1111/jgs.19490","DOIUrl":"10.1111/jgs.19490","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Hospitalization frequently results in persistent symptoms among older adults, raising concerns about the long-term impacts of acute events—a problem amplified by COVID-19. We investigated the effects of persistent symptoms on functional decline and unplanned events over 1 year in older patients recovering from COVID-19 hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective cohort included patients aged ≥ 50 years who survived COVID-19 hospitalization between March and December 2020 as part of the CO-FRAIL study at Brazil's largest academic medical center. Persistent symptoms were defined as those reported at admission and continuously present at one-, three-, six-, nine-, and 12-month post-discharge, covering 16 symptoms. Outcomes included functional decline in basic activities of daily living (ADL), mobility activities, instrumental activities of daily living (IADL), number of falls, emergency department (ED) visits, and hospital readmissions. Associations between persistent symptoms and outcomes were examined using mixed-effects negative binomial regression models adjusted for sociodemographic, clinical, hospitalization-related factors, and post-discharge rehabilitation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1019 patients (mean age = 65 ± 10 years; women = 45%; White = 62%), 324 (32%) experienced persistent symptoms throughout the year. Fatigue (28%), myalgia (19%), and dyspnea (13%) were the most common. Patients with ≥ 2 symptoms had an increased risk of functional decline in mobility activities (IRR = 2.11; 95% CI = 1.50–2.96), IADL (IRR = 2.00; 95% CI = 1.44–2.79), falls (IRR = 2.56; 95% CI = 1.14–5.75), and ED visits (IRR = 2.69; 95% CI = 1.27–5.70), but not readmissions. Among women, ≥ 1 persistent symptom was associated with a twofold increased risk of ADL decline. One year after discharge, patients with ≥ 2 persistent symptoms developed 1.27 more new disabilities (3.26 vs. 1.99 on a 15-point functional scale) and had 31 more unplanned events per 100 person-years (54.3 vs. 23.2) than those without symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Persistent symptoms after hospitalization are common and contribute to functional decline, falls, and ED visits in older COVID-19 survivors. These findings suggest that greater attention to symptom burden may support risk identification and improve post-discharge care planning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 6","pages":"1722-1732"},"PeriodicalIF":4.3,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19490","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144035115","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":"Editing Geriatric Medicine Journals: Perspectives From the Editors-in-Chief of Age and Ageing, European Geriatric Medicine and the Journal of the American Geriatrics Society","authors":"Roy L. Soiza,&nbsp;Alfonso J. Cruz Jentoft,&nbsp;Joseph G. Ouslander","doi":"10.1111/jgs.19429","DOIUrl":"10.1111/jgs.19429","url":null,"abstract":"<div>\u0000 \u0000 <p>This article has been simultaneously published in <i>Journal of the American Geriatrics Society</i> (published by Wiley Periodicals LLC on behalf of The American Geriatrics Society), <i>Age and Ageing</i> (published by Oxford University Press on behalf of British Geriatrics Society), and <i>European Geriatric Medicine</i> (published by Springer on behalf of European Geriatric Medicine Society). All rights reserved. The articles are identical except for minor stylistic and spelling differences in keeping with each journal's style.</p>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 6","pages":"1975-1978"},"PeriodicalIF":4.3,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059015","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":"Waiting for the Other Shoe to Drop","authors":"John R. Burton","doi":"10.1111/jgs.19505","DOIUrl":"10.1111/jgs.19505","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 6","pages":"1940-1942"},"PeriodicalIF":4.3,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065548","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":"What Matters Most: Case Study of Successful Patient-Directed Gabapentin Taper to Improve Mentation, Mobility, and Medications","authors":"Michelle R. Paulsen,&nbsp;Reema Navalurkar,&nbsp;Jennifer Tunoa,&nbsp;Blake Bartlett,&nbsp;Katherine C. Ritchey","doi":"10.1111/jgs.19482","DOIUrl":"10.1111/jgs.19482","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 6","pages":"1985-1988"},"PeriodicalIF":4.3,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065550","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}