Journal of the American Geriatrics Society最新文献

{"title":"Cover","authors":"Colin Farrelly PhD","doi":"10.1111/jgs.18428","DOIUrl":"https://doi.org/10.1111/jgs.18428","url":null,"abstract":"<p><b>Cover caption</b>: A new care pathway to overcome care connections gaps between hospitals and community services in the Emergency Department. For full details, see “A public health/hospital partnership to improve Emergency Department transitions of care for vulnerable older adults” on page 243.\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 1","pages":"C1"},"PeriodicalIF":4.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.18428","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143115251","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":"Hats off to Peruvian elders.","authors":"Jeffrey M Levine","doi":"10.1111/jgs.18504","DOIUrl":"10.1111/jgs.18504","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":"3927"},"PeriodicalIF":4.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9817212","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 portrait of older adults in naturally occurring retirement communities in Ontario, Canada: A population-based study","authors":"Rachel D. Savage PhD,&nbsp;Tai Huynh MDes, MBA,&nbsp;Shoshana Hahn-Goldberg PhD,&nbsp;Lavina Matai PharmD, MScPH,&nbsp;Alexa Boblitz MPH,&nbsp;Azmina Altaf MSc,&nbsp;Susan E. Bronskill PhD,&nbsp;Kevin A. Brown PhD,&nbsp;Patrick Feng PhD,&nbsp;Samantha E. Lewis-Fung MHSc,&nbsp;Maya S. Sheth BMSc,&nbsp;Christina Yu BScH,&nbsp;Jen Recknagel MDes,&nbsp;Paula A. Rochon MD, MPH","doi":"10.1111/jgs.19278","DOIUrl":"10.1111/jgs.19278","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Naturally occurring retirement communities (NORCs) are geographical areas that have naturally become home to a large concentration of older adults. This density means that NORCs have the potential to become a pillar for aging in place strategies, but at present, there is limited data on residents and their health needs. Our objective was to describe and compare the health and healthcare use of older adults living in high-rise NORC buildings to those in all other housing types in the community.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a population-based descriptive study of community-dwelling older adults aged ≥65 years by linking a provincial NORC registry in Ontario, Canada with health administrative records. Individuals were classified as NORC residents if their residential postal code on January 1, 2020 matched the NORC registry. Sociodemographic, clinical, and healthcare use characteristics were compared by NORC status using standardized differences (STD) and stratified by rurality, and further by age and sex in urban settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Overall, 219,995 (7.7%) of 2,869,706 older adults were NORC residents. Compared to community-dwelling older adults, NORC residents were older (mean 77.4 vs 74.6 years; STD 0.34), and more were female (61.8% vs 52.2%; STD 0.19) and had low income (16.0% vs 9.3%; STD 0.11). NORC residents also had more active chronic conditions (mean 1.9 vs 1.5; STD 0.27), medications (mean 3.4 vs 2.8; STD 0.21), home care use (15.3% vs 9.8%; STD 0.17), and primary care visits (mean 9.7 vs 7.6 visits in prior 2 years; STD 0.22). Findings were robust across rurality, age, and sex.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our findings suggest that NORC residents have greater health needs than other older adults living in the community and underscore NORCs as important targets for equity-focused strategies to support aging in place.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 1","pages":"74-87"},"PeriodicalIF":4.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734102/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775896","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":"Accelerating the pace of elder justice policy to meet the needs of a growing aging population","authors":"Kristin Lees Haggerty PhD,&nbsp;Rebecca Jackson Stoeckle BA,&nbsp;Randi Campetti BA,&nbsp;Ruthann Froberg MPA,&nbsp;Olanike Ojelabi MS, MPP,&nbsp;M. T. Connolly JD,&nbsp;Gary Epstein-Lubow MD,&nbsp;Laura Mosqueda MD,&nbsp;Kathy Greenlee JD,&nbsp;Laini Tuboku-Metzger BS,&nbsp;Junyue Liao MPH,&nbsp;Terry Fulmer PhD","doi":"10.1111/jgs.19257","DOIUrl":"10.1111/jgs.19257","url":null,"abstract":"<p>Policy measures designed to address elder abuse, neglect, and exploitation date back to decades, including the Older Americans Act of 1965. Over the years, various legislative actions have aimed to address elder mistreatment, culminating in the Elder Justice Act of 2010. Despite these efforts, policy changes lag behind need, and government funding appropriation is woefully inadequate. On November 29, 2023, the National Collaboratory to Address Elder Mistreatment convened 76 experts from research, clinical practice, policymaking, federal and state agencies, and national organizations to develop strategies for accelerating policy action to address elder mistreatment. Key themes from the convening included the need for a unified and stronger infrastructure and messaging, the importance of data-driven policy and evidence-informed prevention and intervention practices, and expanding strategic engagements. Participants emphasized the need for a holistic and long-term approach, leveraging data to demonstrate outcomes, and building coalitions across related fields to address elder mistreatment. Action steps were identified for both national and state/local levels, focused on enhancing data-informed elder mistreatment prevention, intervention, and response programs. The broad cross-sector participation in the convening and the findings underscored the urgency of and potential for advancing elder justice policy. By leveraging existing initiatives, utilizing data emerging particularly in the past 5 years, building on decades of advocacy, and fostering new collaborations, there is a significant opportunity to improve prevention, intervention, and response to elder mistreatment.</p>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 1","pages":"223-231"},"PeriodicalIF":4.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740862","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":"Caring for older adults' social needs in emergency departments: Where to draw the line?","authors":"Elizabeth M. Goldberg MD, ScM,&nbsp;Elizabeth Bloemen MD,&nbsp;Daniel M. Lindberg MD","doi":"10.1111/jgs.19296","DOIUrl":"10.1111/jgs.19296","url":null,"abstract":"&lt;p&gt;The popular conception of emergency departments (EDs) is that they primarily care for critically ill patients with sudden illness. It is all gunshot wounds, heart attacks, and sepsis. EDs are exceptionally adept at treating these illnesses, and many emergency clinicians chose their specialty due to an interest in addressing these acute life threats. In reality, ED clinicians and staff also work to address social determinants of health and help patients navigate increasingly complex medical and social care systems. On any given ED shift, one is much more likely to meet a person unable to access primary care due to homelessness, addiction, or social challenges, as to diagnose a heart attack or treat a gunshot wound.&lt;/p&gt;&lt;p&gt;In EDs, social needs are essentially bottomless—to address them all would devastate the ED's ability to complete its core mission. For older adults who are both medically and socially complex, EDs may be expensive and inefficient solutions for unmet care needs. Others have suggested several solutions: creating geriatric certified EDs, embedding pharmacists and physical therapists in the ED,&lt;span&gt;&lt;sup&gt;1, 2&lt;/sup&gt;&lt;/span&gt; screening for social determinants of health, and using ED navigators&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; to help patients establish care with a clinic or primary care clinician. One currently popular approach, identifying social concerns and referring to external resources, has the advantage of minimal impact on the ED's core mission; however, it is often ineffective for older, vulnerable adults who face barriers to following up on referrals due to cognitive, hearing, visual, and other functional impairments.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;In this issue, Southerland et al. demonstrate the effectiveness of one approach to address the social needs of vulnerable elders.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; As a result of a unique partnership with the local Office on Aging (OA), they embedded OA case managers within their ED to connect vulnerable older adults to nutrition services, emergency response systems, transportation, and other services, as needed. In this model, OA case managers work with ED social workers to identify community-dwelling older patients and perform in-person intake assessments during daytime hours whereas older patients are in the ED. Case workers arrange needed community services, often starting them immediately.&lt;/p&gt;&lt;p&gt;The advantages of the program are twofold. First, by matching the right professional to the task, the program bypasses several known barriers to hospital-to-community transitions, such as: the ED clinicians forgetting to screen or refer, patients forgetting to reach out, and failure to engage family members.&lt;span&gt;&lt;sup&gt;6, 7&lt;/sup&gt;&lt;/span&gt; Second, the program eliminates inefficient communication between older adult patients and OA programs, as when successful service provision relies on the older adult to reach out for care, and to be available and willing to answer the phone when the OA worker calls.&lt;/p&gt;&lt;","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 1","pages":"3-5"},"PeriodicalIF":4.3,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741558","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":"The tip of the iceberg: A call to improve medical director presence, time, and training in US nursing facilities","authors":"Denise Zwahlen MD,&nbsp;Jay Luxenberg MD","doi":"10.1111/jgs.19270","DOIUrl":"10.1111/jgs.19270","url":null,"abstract":"&lt;p&gt;The 1974 federal requirement that skilled nursing facilities provide a physician medical director was partly a response to an investigation of a 1970 salmonella outbreak in a nursing facility.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; In 1987, the Omnibus Budget Reconciliation Act (OBRA) expanded the requirements to include a medical director in residential as well as skilled portions of nursing facilities. Forty-two CFR 483.70(g) Medical director and Appendix PP of the &lt;i&gt;State Operations Manual&lt;/i&gt; for F-Tag 841 Responsibilities of Medical Director outline the expectations for medical direction in nursing homes. The federal regulations state that the medical director is responsible for implementing resident care policies and coordinating medical care in the facility. Reporting of medical direction hours is now required through the federal Staffing Data Submission Payroll-Based Journal (PBJ) system.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Goldwein et al.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; provide excellent service through their descriptive study, which looks at the PBJ data on medical director hours. Their finding that more than a third of US nursing facilities report zero medical director time represents a wake-up call for enforcement of the federal mandate for medical direction. Surprisingly, they report that surveyors rarely cite deficiencies related to medical direction. This article should trigger a reevaluation of how CMS and state surveyors use the available PBJ data as part of the survey process.&lt;/p&gt;&lt;p&gt;Goldwein et al.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; use mean medical director minutes per day (MPD) to compare among different facility sizes. They then evaluated the facility's MPD by ownership type and found that government-owned facilities had significantly more medical director time. There was little difference between nonprofit and for-profit facilities. The analysis found considerable state-to-state variation with the majority of facilities in four states reporting no medical direction time at all. This raises serious questions about the adequate enforcement of reporting requirements including the CMS PBJ Policy mandate that the reported medical director data be auditable and verifiable.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Goldwein et al.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; recognize this problem by identifying the primary limitation of their study, which is the accuracy of the medical direction data. These findings of variability and significant numbers of facilities reporting no hours could reflect an alarming failure to have meaningful medical direction, inaccurate documentation of time, or a combination of the two. It is imperative that state surveyors and CMS step up and enforce current reporting regulations to improve the quality of this data.&lt;/p&gt;&lt;p&gt;The CMS “Nursing Home Compare” website (https://www.medicare.gov/nursinghomecompare) is a resource available for consumers to readily access pertinent information about competing nursing facilities to make an informed decision about which nursing ","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 1","pages":"6-7"},"PeriodicalIF":4.3,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19270","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142678135","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":"The art of aging gracefully","authors":"Antonio Yaghy MD","doi":"10.1111/jgs.19274","DOIUrl":"10.1111/jgs.19274","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 1","pages":"277-278"},"PeriodicalIF":4.3,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142645310","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":"Cover","authors":"Kay Khaing MMed,&nbsp;Xenia Dolja-Gore PhD,&nbsp;Balakrishnan R. Nair MD,&nbsp;Julie Byles PhD,&nbsp;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":"Motor signs and incident dementia with Lewy bodies in older adults with mild cognitive impairment","authors":"Ioannis Liampas MD, PhD,&nbsp;Vasileios Siokas MD, PhD,&nbsp;Polyxeni Stamati MD, PhD,&nbsp;Elli Zoupa BSc, MSc,&nbsp;Zisis Tsouris MD, PhD,&nbsp;Antonios Provatas MD, PhD,&nbsp;Zinovia Kefalopoulou MD, PhD,&nbsp;Elisabeth Chroni MD, PhD,&nbsp;Constantine G. Lyketsos MD, MHS,&nbsp;Efthimios Dardiotis MD, PhD","doi":"10.1111/jgs.19238","DOIUrl":"10.1111/jgs.19238","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Motor signs may herald incident dementia and allow the earlier detection of high-risk individuals and the timely implementation of preventive interventions. The current study was performed to investigate the prognostic properties of motor signs with respect to incident dementia with Lewy bodies (DLB) in older adults with mild cognitive impairment (MCI). Emphasis was placed on sex differences. The specificity of these associations was explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed data from the National Alzheimer's Coordinating Center Uniform Data Set. Participants 55 + years old with a diagnosis of MCI were included in the analysis. Those with Parkinson's disease (PD) or other parkinsonian disorders at baseline and those with PD dementia at follow-up were excluded. UPDRS III was used to assess the presence or absence of motor signs in nine domains: hypophonia; masked facies; resting tremor; action/postural tremor; rigidity; bradykinesia; impaired chair rise; impaired posture/gait; postural instability. Αdjusted Cox proportional hazards models featuring sex by motor sign interactions were estimated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Throughout the average follow-up of 3.7 ± 3.1 years, among 4623 individuals with MCI, 2211 progressed to dementia (66 of whom converted to DLB). Masked facies [HR = 4.21 (1.74–10.18)], resting tremor [HR = 4.71 (1.44–15.40)], and bradykinesia [HR = 3.43 (1.82–6.45)] exclusively increased the risk of DLB. The HR of DLB was approximately 15 times greater in women compared to men with masked facies. Impaired posture–gait (approximately 10 times) and resting tremor (approximately 8.5 times) exhibited a similar trend (prominent risk-conferring properties in women compared to men) but failed to achieve statistical significance. Rigidity and hypophonia elevated the risk of other dementia entities, as well. The remaining motor features were not related to incident dementia of any type.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Specific motor signs may herald DLB among individuals with MCI. Different associations may exist between masked facies, impaired posture–gait, resting tremor, and incident DLB in men versus women.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 1","pages":"50-62"},"PeriodicalIF":4.3,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584498","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":"Exploring geriatric assessment-driven rehabilitation referral patterns and its influence on functional outcomes and survival in older adults with advanced cancer","authors":"Rachelle Brick PhD, MSPH, OTR/L,&nbsp;Marielle Jensen-Battaglia PT, DPT,&nbsp;Brennan P. Streck PhD, RN, MPH,&nbsp;Lindsey Page PhD, MPH,&nbsp;Rachael Tylock MS,&nbsp;Jenna Cacciatore MS,&nbsp;Karen Mustian PhD, MPH,&nbsp;Jamil Khatri MD,&nbsp;Jeff Giguere MD,&nbsp;Elie G. Dib MD, MS,&nbsp;Supriya Mohile MD, MS,&nbsp;Eva Culakova PhD, MS","doi":"10.1111/jgs.19250","DOIUrl":"10.1111/jgs.19250","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Older adults with advanced cancer experience functional disability that warrants rehabilitation services; however, evidence indicates inconsistencies in referral. The purpose was to (1) identify predictors of geriatric assessment (GA)-driven referrals to rehabilitation services and (2) explore associations between referral and change in function, health-related quality of life (HRQoL), and overall survival among older adults with advanced cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a secondary analysis (NCT020107443, UG1CA189961) of a nationwide GA clinical trial. Patients were older adults with advanced cancer who had at least one GA-defined physical performance or functional status impairment. Primary outcomes were oncologist-initiated discussion about or referral to rehabilitation services after the GA (Aim 1) and decline in activities of daily living (ADL), Instrumental ADL (IADL), and HRQoL within 3 months, and overall survival at 1 year (Exploratory Aims). Analyses included multivariable logistic regression and Cox proportional hazards models. Demographic and clinical factors were controlled for by using 1:1 propensity score matching.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In total 265 patients were analyzed. After adjustment, impaired cognition (odds ratio [OR] = 2.25, <i>p</i> = 0.01), Karnofsky score indicating disability (OR = 2.86, <i>p</i> &lt; 0.01), and receipt of monoclonal antibodies (OR = 1.95, <i>p</i> = 0.04) were associated with higher odds of referral. In contrast, polypharmacy was associated with lower odds of referral (OR = 0.31, <i>p</i> &lt; 0.01). Referred patients were less likely to decline in ADL (OR 0.30, <i>p</i> = 0.07) and IADL (OR 0.64, <i>p</i> = 0.35), but more likely to decline in HRQoL (OR 1.20, <i>p</i> = 0.67) and have worse survival (HR 1.18, <i>p</i> = 0.62).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cancer treatment, polypharmacy, cognition, and disability status likely influence oncologists' decision to refer for rehabilitation. Referral was not independently associated with change in functional disability, HRQoL, or survival. Future studies should evaluate patients' utilization of rehabilitation services post-referral and determine whether dose/timing of rehabilitation services influence clinical outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 1","pages":"136-149"},"PeriodicalIF":4.3,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565408","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}