Kay Khaing MMed, Xenia Dolja-Gore PhD, Balakrishnan R. Nair MD, Julie Byles PhD, John Attia PhD
{"title":"Cover","authors":"Kay Khaing MMed, Xenia Dolja-Gore PhD, Balakrishnan R. Nair MD, Julie Byles PhD, John Attia PhD","doi":"10.1111/jgs.17875","DOIUrl":"https://doi.org/10.1111/jgs.17875","url":null,"abstract":"<p><b>Cover caption</b>: Anxiety and increased risk of dementia. See the related article by Khaing et al., pages 3327–3334.\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":"72 11","pages":"C1"},"PeriodicalIF":4.3,"publicationDate":"2024-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.17875","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142664650","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":"Introduction for the 2024 Chinese Congress on Gerontology and Health Industry (CCGI) Abstracts","authors":"Sean X. Leng MD, PhD, Xiao-Ying Li MD","doi":"10.1111/jgs.19221","DOIUrl":"10.1111/jgs.19221","url":null,"abstract":"<p>It is once again with great pleasure that we introduce the research work to be presented at the 2024 Chinese Congress on Gerontology and Health Industry (CCGI), which is published in abstract form in this issue of the Journal of the American Geriatrics Society (JAGS). The 2024 CCGI conference is the continuation of the annual national geriatrics and gerontology conference co-organized and co-sponsored by a number of major Chinese professional healthcare organizations including the Chinese Medical Association (CMA) Geriatrics Branch and China Health Promotion Foundation. This year's CCGI conference will be held on November 1–3. 2024 in the city of Haikou, China's island province Hainan. We have 115 quality abstracts to be included in this issue.</p><p>While COVID-19 pandemic is largely behind us, its impact on world economy and scientific conferences continues to be palpable. The current economic downturn and overseas regional conflicts create additional challenges. Despite these difficulties, the 2024 CCGI conference will be held in person and the research work to be presented at the conference is as robust as that presented at previous years' CCGI conferences. Similar to the previous 11 years, the work to be presented at this year's CCGI conference encompasses many important areas of geriatrics and gerontology, from basic aging research to geriatric syndromes; from clinical observation and large epidemiological studies to clinical trials; and from biological investigations to social and behavioral research. Unique to this year, it emphasizes palliative care, cardiovascular aging and diseases, systems approach for senior health, as well as socioeconomic determinants of aging care. It also includes a broad range of studies of basic and translational aging research, such as investigation into chronic cytomegalovirus (CMV) infection as a potential contributing factor to immunosenescence and age-related chronic inflammation, longitudinal cohort studies, mechanistic studies in animal models, and other types of studies including clinical trials for the prevention and treatment of common geriatric syndromes and age-related diseases. Moreover, almost 20% of the abstracts are submitted by researchers from other countries and regions including the United States, European countries (Germany, UK), South Korea, Macao, etc., demonstrating a robust international representation. The work described here will be presented in the form of oral presentation or poster at the conference. The conference will have similar number of symposia with individual symposium on translational aging research, common geriatric syndromes, prevention, rehabilitation, nutrition, geriatric nursing, traditional Chinese medicine, community geriatrics care, and long-term care, and so on. Publication of such exemplary work in geriatrics and gerontology in this supplement issue of JAGS will further enhance scientific and scholarly exchanges between colleagues in China and geriatrics and g","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"72 S4","pages":"S3-S5"},"PeriodicalIF":4.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549854","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":"Abstracts for JGS Chinese Supplement","authors":"","doi":"10.1111/jgs.19222","DOIUrl":"10.1111/jgs.19222","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"72 S4","pages":"S6-S68"},"PeriodicalIF":4.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549855","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}
Rachel O'Conor PhD, MPH, Andrea M. Russell PhD, Allison Pack PhD, MPH, Dianne Oladejo BA, Sarah Filec MPH, Emily Rogalski PhD, Darby Morhardt PhD, Lee A. Lindquist MD, MPH, MBA, Michael S. Wolf PhD, MPH
{"title":"Cover","authors":"Rachel O'Conor PhD, MPH, Andrea M. Russell PhD, Allison Pack PhD, MPH, Dianne Oladejo BA, Sarah Filec MPH, Emily Rogalski PhD, Darby Morhardt PhD, Lee A. Lindquist MD, MPH, MBA, Michael S. Wolf PhD, MPH","doi":"10.1111/jgs.17872","DOIUrl":"https://doi.org/10.1111/jgs.17872","url":null,"abstract":"<p><b>Cover caption</b>: Summary of Medication Management Responsibilities by Severity of Cognitive Impairment. For full details, see “Managing medications among individuals with mild cognitive impairment and dementia: Patient-caregiver perspectives” on page 3011.\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":"72 10","pages":"C1"},"PeriodicalIF":4.3,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.17872","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142429507","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}
Ranak Trivedi PhD, Victoria Ngo PhD, Trevor Lee BS, Marika Blair Humber PhD, Rashmi Risbud MA, Josephine C. Jacobs PhD, Karl Lorenz MD, MSHS, Steven M. Asch MD, MPH, Dolores Gallagher-Thompson PhD, Luci K. Leykum MD, MBA, MSc, the Elizabeth Dole Center of Excellence for Veteran and Caregiver Research
{"title":"Barriers to accessing home and community-based services among family caregivers of Veterans","authors":"Ranak Trivedi PhD, Victoria Ngo PhD, Trevor Lee BS, Marika Blair Humber PhD, Rashmi Risbud MA, Josephine C. Jacobs PhD, Karl Lorenz MD, MSHS, Steven M. Asch MD, MPH, Dolores Gallagher-Thompson PhD, Luci K. Leykum MD, MBA, MSc, the Elizabeth Dole Center of Excellence for Veteran and Caregiver Research","doi":"10.1111/jgs.19051","DOIUrl":"10.1111/jgs.19051","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Department of Veterans Affairs (VA) has long recognized the importance of having a rich complement of home and community-based resources for the Veteran population. For Veterans experiencing disability-related impairments, home- and community-based services (HCBS) facilitate aging in place and alleviate family caregivers' burden. However, even in the enriched VA context, HCBS are underutilized. Our objective was to understand unmet needs and barriers to accessing HCBS from the perspectives of Veterans' family caregivers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This multi-method study recruited family caregivers of Veterans seen within a major VA Health Care System. Eligible caregivers provided care for at least 8 h/week in the prior 6 months, to a Veteran with 1+ impairments in instrumental activities of daily living. Recruitment was conducted via flyers, physician referrals, registries, and chart reviews. Participants completed 1-h semi-structured interviews to assess unmet psychosocial needs and barriers to accessing VA and non-VA HCBS. Interviews were analyzed using a thematic analysis approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 23 caregivers (62.9 + 13.5 years; 74% women; 52.2% White; 26.1% Black; 95.2% pre-9/11) provided 8.4 ± 6.3 h of daily care. Most had provided care for more than 1 year; nine had cared for their Veteran for 5+ years. The following themes were identified: (1) need for clear, accurate, timely information about HCBS; (2) lack of time, amplified by COVID-19 restrictions; (3) need for respite to manage their own health and other caregiving responsibilities; and (4) perceived difference in care needs that can strain caregivers' relationship with the care recipient.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In addition to known barriers including lack of timely knowledge, service delays, and caregiver stress, Veteran–caregiver disagreements emerged as a novel barrier to using HCBS. A multi-pronged approach that addresses these barriers may increase timely access to HCBS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"72 11","pages":"3541-3550"},"PeriodicalIF":4.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335359","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":"Family caregiver lived experience matters in home- and community-based services","authors":"Nathan A. Boucher DrPH, PA, MS, MPA, CPHQ","doi":"10.1111/jgs.19120","DOIUrl":"10.1111/jgs.19120","url":null,"abstract":"<p>In this issue of the Journal, Trivedi et al. (<i>not sure about final citation</i>) use in-depth interviews with family caregivers of Veterans to identify novel intervention targets to help the field improve awareness, access, and use of home- and community-based services (HCBS) among family caregivers. The authors now help me make a clarion call for the importance of engaging family caregivers—those family (sometimes friends/neighbors) bearing the joys and burdens of community-based care and support. Optimal support for aging adults and those living with disabilities in our community pivots on the awareness, willingness, skills, and time of family caregivers.</p><p>Inquiries such as this from Trivedi et al. are both timely and important. Their work reflects adherence to tenets of person-centeredness and community engagement trumpeted by recent reports such as the U.S. Department of Health and Human Services' Interagency Coordinating Committee on Healthy Aging and Age-Friendly Communities in May 2024, which explicitly calls out the role of family caregivers in community-based care.<span><sup>1</sup></span> The voices of family caregivers in the provision of HCBS need to be amplified as US health care and payment for that care are rebalanced toward community-based solutions and away from facility-based care.<span><sup>2</sup></span></p><p>The authors studied a critical context: family caregivers supporting Veterans served by the largest comprehensive healthcare system in the United States, the Veterans Administration (VA). Importantly, the VA pushes innovations in health systems research attuned to aging, disability, and caregiver inclusion,<span><sup>3-6</sup></span> but, as Trivedi et al. note, HCBS continue to be underutilized by Veterans and others. Complicating this, HCBS are under-resourced in many areas including direct care workers<span><sup>7</sup></span> who often work in tandem with family caregivers cobbling together ongoing services for the aging and those living with disabilities.<span><sup>1</sup></span> Well-supported family caregivers are crucial to the intended expansion in HCBS across populations.<span><sup>8, 9</sup></span></p><p>The authors bring to the readers of the Journal insights on barriers to optimal use of HCBS. They accomplish this by focusing not just on logistical issues—challenges known and persistent—but, more uniquely, psychosocial and interpersonal barriers to accessing VA and non-VA HCBS alike using two complementary research methods.</p><p>First, the authors conducted semi-structured interviews with caregivers. This was elegantly guided by Andersen's Behavioral Model of Health Services Use.<span><sup>10</sup></span> The first three resulting themes are not necessarily new but help bolster findings in the Veteran caregiver population where fewer studies reside. The authors found that caregivers experience gaps in accurate and timely information from the VA and community organizations; they lack time and expe","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"72 11","pages":"3296-3298"},"PeriodicalIF":4.3,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335360","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":"Dexmedetomidine for agitation in dementia: Current data and future direction.","authors":"Kayla S Murphy,Julia C Golden,Rajesh R Tampi","doi":"10.1111/jgs.19196","DOIUrl":"https://doi.org/10.1111/jgs.19196","url":null,"abstract":"BACKGROUNDThe incidence and prevalence of dementia, and thus dementia-related behavioral and psychological symptoms, are increasing significantly. Currently, there are limited safe and efficacious options for treating these symptoms. Dexmedetomidine has been used for agitation related to delirium and showed significant benefit in prior studies. This raises the question whether dexmedetomidine could also provide a safe and effective treatment for BPSD, including agitation related to dementia.METHODSOur team searched PubMed, Cochrane Database, and Ovid with the terms dexmedetomidine and dementia. Only studies published in English language journals, or with official English language translations, and human studies were included. All reports of dexmedetomidine for dementia were included regardless of study type.RESULTSNo completed studies on dexmedetomidine for agitation in dementia were identified. The TRANQUILITY study is in progress, although results are yet to be published.CONCLUSIONDexmedetomidine has shown benefit for hospital delirium and for agitation in schizophrenia and bipolar disorder. However, there are no completed studies published on dexmedetomidine for agitation in dementia. Controlled studies with larger sample sizes are needed to assess the efficacy, safety, and the best route of administration for this drug in managing BPSD including agitation.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"191 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251927","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}
Xin Li, Yichen Jin, Stefania Bandinelli, Luigi Ferrucci, Toshiko Tanaka, Sameera A. Talegawkar
{"title":"Cardiovascular health, measured using Life's Essential 8, is associated with reduced dementia risk among older men and women","authors":"Xin Li, Yichen Jin, Stefania Bandinelli, Luigi Ferrucci, Toshiko Tanaka, Sameera A. Talegawkar","doi":"10.1111/jgs.19194","DOIUrl":"https://doi.org/10.1111/jgs.19194","url":null,"abstract":"BackgroundDementia poses considerable challenges to healthy aging. Prevention and management of dementia are essential given the lack of effective treatments for this condition.MethodsA secondary data analysis was conducted using data from 928 InCHIANTI study participants (55% female) aged 65 years and older without dementia at baseline. Cardiovascular health (CVH) was assessed by the “Life's Essential 8” (LE8) metric that included health behaviors (diet, physical activity, smoking status, sleep duration) and health factors (body mass index, blood lipid, blood glucose, blood pressure). This new LE8 metric scores from 0 to 100, with categorization including “low LE8” (0–49), indicating low CVH, “moderate LE8 (50‐79)”, indicating moderate CVH, and “high LE8 (80‐100)”, indicating high CVH. Dementia was ascertained by a combination of neuropsychological testing and clinical assessment at each follow‐up visit. Cox proportional hazards models were used to examine associations between CVH at baseline and risk of incident dementia after a median follow‐up of 14 years.ResultsBetter CVH (moderate/high LE8 vs. low LE8) was inversely associated with the risk of incident dementia (hazard ratio [HR]: 0.61, 95% confidence interval [CI]: 0.46–0.83, <jats:italic>p</jats:italic> = 0.001). Compared with health factors, higher scores of the health behaviors (per 1 standard deviation [SD]), specifically weekly moderate‐to‐vigorous physical activity time (per 1 SD), were significantly associated with a lower risk of incident dementia (health behaviors: HR:0.84, CI:0.73–0.96, <jats:italic>p</jats:italic> = 0.01; physical activity: HR: 0.62, CI: 0.53–0.72, <jats:italic>p</jats:italic> < 0.001).ConclusionWhile longitudinal studies with repeated measures of CVH are needed to confirm these findings, improving CVH, measured by the LE8 metric, may be a promising dementia prevention strategy.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"65 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251625","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}
Jennifer Perloff, Alex Hoyt, Meera Srinivasan, Michelle Alvarez, Sam Sobul, Monica O'Reilly‐Jacob
{"title":"The quality of home‐based primary care delivered by nurse practitioners: A national Medicare claims analysis","authors":"Jennifer Perloff, Alex Hoyt, Meera Srinivasan, Michelle Alvarez, Sam Sobul, Monica O'Reilly‐Jacob","doi":"10.1111/jgs.19182","DOIUrl":"https://doi.org/10.1111/jgs.19182","url":null,"abstract":"BackgroundAs the US population ages, there is an increasing demand for home‐based primary care (HBPC) by those with Alzheimer's/dementia, multiple chronic conditions, severe physical limitations, or those facing end‐of life. Nurse practitioners (NPs) are increasingly providing HBPC, yet little is known about their quality of care in this unique setting.MethodsThis observational study uses Medicare claims data from 2018 to assess the quality of care for high‐intensity HBPC users (5 or more visits/year) based on provider type (NP‐only, physician (MD)‐only, or both NP and MDs). We employ 12 quality measures from 3 care domains: access and prevention, acute care utilization, and end‐of‐life. Analysis includes bivariate comparisons and logistic regression models that adjust for demographic, clinical, and geographic characteristics.ResultsAmong the 574,567 beneficiaries with 5 or more HBPC visits, 37% saw an NP, 37% saw a MD, and 27% saw both NPs and MDs. In multivariate models, those receiving HBPC from an NP or both NP‐MD are significantly more likely to receive a flu shot than the MD‐only group, but less likely to access preventive care. NP‐only care is associated with more acute care hospitalizations, avoidable ED visits, and fall‐related injuries, but significantly fewer avoidable admissions. For end‐of‐life care, those with NP‐only or both NP‐MD care are significantly more likely to have an advanced directive, be in hospice in the last 3 days of life, and more likely to die in hospice. The NP group is also more likely to die in the next year.ConclusionsHBPC patients are complex, with both palliative and curative needs. NPs provide almost half of HBPC in the Medicare program, to patients who are possibly sicker than those treated by physicians, with similar quality to MDs.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"15 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251626","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 alone and high risk: Supporting medication management in older adults living alone with cognitive impairment","authors":"Peter M. Hoang, Nathan M. Stall, Paula A. Rochon","doi":"10.1111/jgs.19186","DOIUrl":"https://doi.org/10.1111/jgs.19186","url":null,"abstract":"See related article by <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"https://doi.org/10.1111/jgs.19108\">Growdon et al</jats:ext-link>.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"3 1","pages":""},"PeriodicalIF":6.3,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252188","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}