Journal of the American Geriatrics Society最新文献

{"title":"Cover","authors":"Dana E. Bisson MSN,&nbsp;Shannon C. Clancy Burgess MSN,&nbsp;Michelle E. Gamache BSN,&nbsp;Maureen P. Dunn MLIS,&nbsp;Aimee B. Valeras PhD, LICSW,&nbsp;Lyn S. Lindpaintner BSN, MD","doi":"10.1111/jgs.18434","DOIUrl":"https://doi.org/10.1111/jgs.18434","url":null,"abstract":"<p><b>Cover caption</b>: Examples of the Attention and Awareness Through Movement intervention for delirium in hospitalized older patients, depicting exaggerated and sustained sensory and motor touch and sustained positional movement. See the related article by Bisson et al., pages 1008-1016.\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 4","pages":"C1"},"PeriodicalIF":4.3,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.18434","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770011","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":"Mahip Acharya PhD,&nbsp;Corey J. Hayes PharmD, PhD, MPH,&nbsp;Cari A. Bogulski PhD,&nbsp;Mir M. Ali PhD,&nbsp;Hari Eswaran PhD","doi":"10.1111/jgs.18432","DOIUrl":"https://doi.org/10.1111/jgs.18432","url":null,"abstract":"<p><b>Cover caption</b>: Trend and Trajectories of Remote Patient Monitoring (RPM) Use for Hypertension Management in Medicare Fee-For-Service Data (2018–2021). For full details, see “Attrition of remote patient monitoring use for hypertension management in Medicare fee-for-service beneficiaries (2018–2021)” on page 966.\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 3","pages":"C1"},"PeriodicalIF":4.3,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.18432","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622415","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":"Pulling Back the Curtain on Deprescribing Interventions","authors":"Jerry H. Gurwitz","doi":"10.1111/jgs.19408","DOIUrl":"10.1111/jgs.19408","url":null,"abstract":"&lt;p&gt;Older adults living with dementia commonly experience polypharmacy and exposure to high-risk medications [&lt;span&gt;1, 2&lt;/span&gt;]. According to findings from the National Health and Aging Trends Study, among people with dementia, 1 in 5 believe that they may be taking one or more medicines they no longer need, nearly 9 in 10 are willing to stop one or more of their medications, and half are uncomfortable taking five or more medications [&lt;span&gt;3&lt;/span&gt;]. This underscores the need for tailored medication optimization strategies, including carefully designed, evidence-based deprescribing interventions.&lt;/p&gt;&lt;p&gt;ALIGN (Aligning Medications with What Matters Most) was a pragmatic, pharmacist-led telehealth deprescribing pilot study to support primary care providers in addressing polypharmacy in people living with dementia, who were age ≥ 65 and who were prescribed &gt; 7 medications [&lt;span&gt;4, 5&lt;/span&gt;]. The intervention consisted of a deprescribing educational brochure, a telehealth visit by a pharmacist with the patient-care partner dyad to discuss the patient's medications in the context of their goals and preferences, and deprescribing recommendations from the pharmacist conveyed to the primary care provider via the electronic health record. The primary goal of the intervention was to reduce total medication burden and regimen complexity by focusing on what matters most to patients and care partners. With the primary care provider's approval, the pharmacist was able to implement recommended medication changes. The intervention pharmacists held PharmD degrees with board certification in Geriatric Pharmacy. Pharmacist recommendations could include both stopping medications and starting medications; 73% of patients received a recommendation to stop a medication, or reduce the dose or frequency, while 42% received a recommendation to start a medication, or increase the dose or frequency.&lt;/p&gt;&lt;p&gt;In this issue of the &lt;i&gt;Journal of the American Geriatrics Society&lt;/i&gt;, Green and colleagues complement the findings of the ALIGN study by reporting on an analysis of audio-recorded conversations between the intervention pharmacists and the patient-care partner dyads [&lt;span&gt;5&lt;/span&gt;]. By characterizing these conversations, the authors aimed to provide new insights to guide the future development of deprescribing interventions. This qualitative study specifically focused on how elicitation of medication-related priorities from people with dementia and their care partners shaped discussions with the pharmacists.&lt;/p&gt;&lt;p&gt;Importantly, the investigator team has described what actually happened during the telehealth visits with patients and their care partners, including the actual language used by the pharmacists to explain their recommendations. This is a refreshing step forward beyond the usual “sterile” results reported out from most deprescribing intervention trials, which rarely ever extend beyond tables and figures summarizing mean total numbers of medications in the i","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 4","pages":"1002-1004"},"PeriodicalIF":4.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19408","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627226","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":"What Comes Next for Vitamin D Supplementation and Trials in Older Adults?","authors":"Jatupol Kositsawat,&nbsp;Ariela Orkaby","doi":"10.1111/jgs.19390","DOIUrl":"10.1111/jgs.19390","url":null,"abstract":"&lt;p&gt;Vitamin D, or calciferol, is a fat-soluble hormone essential to many body functions. Naturally, it is present in some foods though it is largely synthesized endogenously through ultraviolet rays from sunlight exposure. Vitamin D deficiency has become increasingly common, and research studies have been undertaken to prove the benefits of vitamin D supplementation. However, benefits of vitamin D supplements have not been supported in rigorously conducted randomized controlled trials (RCTs) and meta-analyses [&lt;span&gt;1-5&lt;/span&gt;]. Three recent RCTs have examined the role of vitamin D supplementation in community dwelling, generally healthy older adults: the American based VITAL (&lt;b&gt;VIT&lt;/b&gt;amin D and Omeg&lt;b&gt;A&lt;/b&gt;-3 Tria&lt;b&gt;L&lt;/b&gt;), European DO-HEALTH (Vitamin&lt;b&gt;D&lt;/b&gt;3-&lt;b&gt;O&lt;/b&gt;mega3-&lt;b&gt;H&lt;/b&gt;ome &lt;b&gt;E&lt;/b&gt;xercise-He&lt;b&gt;ALTH&lt;/b&gt;y Aging and Longevity Trial) [&lt;span&gt;6&lt;/span&gt;], and Australian D-Health trial [&lt;span&gt;7&lt;/span&gt;]. Each trial has been largely null for the role of supplemental vitamin D for primary outcomes of cardiovascular disease, cancer, fractures, and other health outcomes.&lt;/p&gt;&lt;p&gt;In this issue of the Journal, Eggimann et al. report post hoc findings from DO-HEALTH, a 2 × 2 × 2 factorial design RCT of vitamin D supplementation, omega-3 fatty acid supplementation, and home-based exercise programs for the prevention of incident sarcopenia and muscle loss in ambulatory community-dwelling healthy adults aged 70 years and older. Similar to the primary findings that supplementation with vitamin D did not impact incident nonvertebral fractures, functional decline, blood pressure, cognition, or infections, this secondary analysis did not find a protective effect of supplemental vitamin D on sarcopenia or muscle loss. Despite this, this study makes significant contributions to continue moving the field forward for research in this area and geriatric practice.&lt;/p&gt;&lt;p&gt;The results of this study have several implications for ongoing research in this area. First, even though epidemiological evidence has repeatedly demonstrated that low vitamin D levels are associated with multiple medical chronic conditions, including musculoskeletal health [&lt;span&gt;8-11&lt;/span&gt;], results from RCTs have been disappointing. Are we targeting the wrong population, or must we provide higher dosages? Notably, currently established normal 25-hydroxyvitamin D (25(OH)D) levels may not apply to various population groups with different characteristics. The data remain unclear for specific populations such as those with obesity and Black Americans [&lt;span&gt;12&lt;/span&gt;], populations requiring higher doses of vitamin D for adequate replenishment. Like any other trial, this study used one vitamin D supplementation dosage in all participants. However, heterogeneity in vitamin D responsiveness may dictate different dosages needed to show the benefits of vitamin D replacement in all study participants.&lt;/p&gt;&lt;p&gt;Another consideration regarding the benefits of vitamin D is the role of inflammation. Given long","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 4","pages":"1005-1007"},"PeriodicalIF":4.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19390","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627330","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":"Is Frailty the Geriatric Troponin?","authors":"Jacqueline M. McMillan,&nbsp;Julian Falutz","doi":"10.1111/jgs.19423","DOIUrl":"10.1111/jgs.19423","url":null,"abstract":"&lt;p&gt;The incorporation of serum highly sensitive cardiac troponin (hs-cTn) testing into diagnostic strategies identifying persons with a high probability of an acute coronary event is effective for risk stratification of chest pain syndromes [&lt;span&gt;1&lt;/span&gt;]. Similarly, in older adults, given the heterogeneity of health status based on chronologic age alone, various tools have been investigated for their utility as risk stratifiers [&lt;span&gt;2&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Frailty is a familiar term in geriatric medicine. It describes a state of vulnerability causing an impaired ability to maintain homeostasis due to reduced physiologic reserve. Frailty is associated with disability, multimorbidity, cognitive impairment, institutionalization, and mortality [&lt;span&gt;3&lt;/span&gt;]. Analogous to troponin testing, frailty assessment has been used to risk stratify older adults.&lt;/p&gt;&lt;p&gt;The utility of assessing frailty beyond the field of geriatrics has been carefully investigated in other areas, including surgery [&lt;span&gt;4&lt;/span&gt;], general internal medicine, and several of its subspecialties. In the United Kingdom, the National Health Service (NHS) requires persons ≥ 65 to be assessed for frailty by their primary care providers [&lt;span&gt;5&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;Given the increasing interest and understanding of frailty, it is opportune to update its role in the care of selected older persons. The recent narrative review by Singh and colleagues summarizes the current range of frailty integration into various internal medicine subspecialties and highlights knowledge gaps to guide future research supporting its integration into clinical care. Across all subspecialties, the authors note a bidirectional association between particular diseases and frailty. Frailty assessment is integrated into the assessment of candidate patients for transthoracic aortic valvuloplasty, candidates for liver transplantation, and persons over 65 with malignancies [&lt;span&gt;6-8&lt;/span&gt;]. They demonstrate that in various medical conditions, frailty is associated with impaired clinical status, poorer response to usual management, and increased risk of treatment-related toxicities.&lt;/p&gt;&lt;p&gt;Their findings support frailty as both a risk stratifier and prognosticator. In chronic obstructive pulmonary disease, frailty is associated with reduced exercise capacity, quality of life, and mortality [&lt;span&gt;9&lt;/span&gt;]. In cardiology, frailty predicts cardiac events and adverse outcomes after invasive procedures [&lt;span&gt;10&lt;/span&gt;]. In rheumatology, frailty is associated with organ damage, disability, and mortality [&lt;span&gt;11&lt;/span&gt;]. In end-stage renal disease, frail patients on dialysis have a twofold increased risk of death [&lt;span&gt;12&lt;/span&gt;]. In gastroenterology, frailty is a predictor of rehospitalization and mortality in inflammatory bowel disease [&lt;span&gt;13&lt;/span&gt;]. In oncology, frail older adults demonstrate lower treatment tolerance, greater treatment discontinuation, increased health care use, shorter progression-free survival, and ","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 4","pages":"999-1001"},"PeriodicalIF":4.3,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19423","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607511","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":"Inspiring Undergraduate Student Training in Alzheimer's Research (USTAR): Training the Next Generation of Aging Scientists","authors":"Robin Casten,&nbsp;Megan Kelley,&nbsp;Hakeem Lawal,&nbsp;Bernard L. Lopez,&nbsp;Susan Parks,&nbsp;Erin Perchiniak,&nbsp;Barry Rovner","doi":"10.1111/jgs.19400","DOIUrl":"10.1111/jgs.19400","url":null,"abstract":"<div>\u0000 \u0000 <p>Inspiring Undergraduate Student Training in Alzheimer's Research (USTAR) aims to provide Underrepresented Minority (URM) undergraduate students with mentored didactic, clinical, and research experiences to stimulate interest in research related to Alzheimer's Disease and Related Dementias (ADRD). USTAR specifically focuses on social determinants of health (SDOH) as risk factors for ADRD minoritized populations. USTAR's scientific rationale is that URM undergraduates are less likely to enter the biomedical workforce. Addressing this disparity is important since minorities are disproportionally affected by ADRD, and URM scientists may deeply appreciate the sociocultural forces that create racial health disparities. USTAR unites faculty expertise from Thomas Jefferson University (TJU) and Delaware State University (DSU), a Historically Black College and University (HBCU). The faculty's work spans the full spectrum of ADRD research and care, including neuroscience, biology, gerontology, geriatrics, neurology, and geriatric psychiatry. The 20-month USTAR program will train two cohorts of 10 students. Across all USTAR activities, we emphasize the relationship between SDOH and cognition. USTAR's goals are to: (1) provide interdisciplinary ADRD-related research, educational, clinical, and community experiences; (2) enhance research skills via group research projects; (3) facilitate transition from undergraduate to graduate studies in science; and (4) evaluate USTAR's effectiveness. USTAR has the potential to increase diversity in the national workforce that conducts health disparities research pertaining to ADRD. This goal aligns with the National Institute on Aging's (NIA) mission to meet the nation's biomedical, behavioral, and clinical research needs and to ensure health equity for all Americans.</p>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 3","pages":"894-899"},"PeriodicalIF":4.3,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426888","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":"Ganesh M. Babulal","doi":"10.1111/jgs.18430","DOIUrl":"https://doi.org/10.1111/jgs.18430","url":null,"abstract":"<p><b>Cover caption</b>: The Alzheimer's disease Exposome for Brain Equity. For full details, see “Neighborhoods, Networks, and Neurodegeneration: A Call for Population-Level Policy and Advancing the Exposome” on page 340.\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 2","pages":"C1"},"PeriodicalIF":4.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.18430","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404330","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":"A Thank You to JAGS Reviewers","authors":"","doi":"10.1111/jgs.19387","DOIUrl":"https://doi.org/10.1111/jgs.19387","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 2","pages":"337-339"},"PeriodicalIF":4.3,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143404331","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":"Implementing in VA CLCs Is Complex, We Know!","authors":"Rhonda L. Toms,&nbsp;Courtney A. Huhn,&nbsp;Scotte R. Hartronft","doi":"10.1111/jgs.19380","DOIUrl":"10.1111/jgs.19380","url":null,"abstract":"&lt;p&gt;In the report of Mor et al. [&lt;span&gt;1&lt;/span&gt;] entitled “Implementing INTERACT in Veterans Health Administration Community Living Centers: A Pragmatic Randomized Trial”, the study found that INTERACT did not reduce rates of all-cause hospitalizations. This study offers valuable insights into improving care for our nation's Veterans in long-term care settings.&lt;/p&gt;&lt;p&gt;The INTERACT program represents a novel and commonsense approach to reducing potentially avoidable hospitalizations among nursing home residents. It includes four basic components: quality improvement, communication, decision support and advance care planning [&lt;span&gt;2&lt;/span&gt;]. In this article, they highlight the “stop and watch” methodology which encourages all employees to increase situational awareness of potential Veteran changes and use Situation, Background, Assessment, and Recommendation (SBAR) to communicate observations and changes in conditions across disciplines. In the day-to-day care of nursing home residents, the trees can obscure the view of the forest. INTERACT reminds us that all team members have a view and should participate in identifying resident changes.&lt;/p&gt;&lt;p&gt;At the Veterans Health Administration (VHA), our sacred duty is to care for those “who have borne the battle” [&lt;span&gt;3&lt;/span&gt;]. At Community Living Centers (CLCs), we care for those who have survived the battle and compounded with the added changes of age, disability, and disease. CLC residents are among our most vulnerable and are often more complex than those in Community Nursing Homes because of higher comorbidity, concurrent mental health conditions, and increased social needs [&lt;span&gt;4, 5&lt;/span&gt;]. The CLC provides transitional care, long term care, and hospice care.&lt;/p&gt;&lt;p&gt;The authors found (a) a high rate of all cause readmission with a lower rate of inappropriate readmission and (b) difficulty implementing INTERACT. These findings highlight the challenges of caring for complex Veterans in an integrated health system. As an integrated health system, where CLCs are often co-located with inpatient hospitals, CLCs play a role in decompressing the system. For example, a Veteran with advanced cancer and low social supports might reside in the CLC between rounds of hospital-based chemotherapy. Readmissions are anticipated and scheduled with the Veteran's goals as the driving force. We understand the difficulty of implementing tools such as the INTERACT methods firsthand.&lt;/p&gt;&lt;p&gt;For background, VHA implemented the CLCs Ongoing National Center for Enhancing Resources and Training (CONCERT) program in 2017 with a train the trainer approach [&lt;span&gt;6&lt;/span&gt;]. CONCERT implements the LOCK bundle, a set of practices based on relational coordination theory, to create high-functioning, relationship-based teams [&lt;span&gt;7&lt;/span&gt;]. Such an implementation required significant investment from CLCs (personnel time, cultural shifts), regional (training, coordination), and national (expertise, phone support, webinars, and coordin","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 3","pages":"682-684"},"PeriodicalIF":4.3,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19380","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191683","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":"Racial and Ethnic Differences in Low-Value Care Among Older Adults in a Large Statewide Health System","authors":"Carlos Irwin A. Oronce,&nbsp;Ray Pablo,&nbsp;Susi Rodriguez Shapiro,&nbsp;Phyllis Willis,&nbsp;Ninez Ponce,&nbsp;John N. Mafi,&nbsp;Catherine Sarkisian","doi":"10.1111/jgs.19369","DOIUrl":"10.1111/jgs.19369","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>As value-based payment models incorporate both measures of health equity and low-value care (LVC), understanding how LVC varies by race is vital for interventions. Therefore, we measured racial differences in LVC in a contemporary sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional analysis of claims from adults ≥ 55 years receiving care at five academic medical centers in California from 2019 to 2021. Our sample included patients who received a service that could be classified as LVC. The primary outcome was whether a service was classified as LVC. Secondary outcomes included clinical categories of LVC (preventive screening, diagnostic testing, prescription drugs, and preoperative testing). We examined associations between race/ethnicity with outcomes using multivariable regression models adjusted for patient characteristics and medical center.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 15,720 members who received potentially LVC, non-Hispanic White older adults comprised 59% of the sample, followed by Asian (17%), unknown race (8%), Latino (8%), non-Hispanic Black (5%), other race (2%). In adjusted models, Asian (−4.9 percentage points [pp]; 95% CI −5.9, −3.8 pp), Black (−5.4 pp; 95% CI −8.0, −2.7 pp), and Latino (−2.5 pp; 95% CI −4.6, −0.4 pp) older adults were less likely to receive LVC compared to White older adults, specifically preventive and preoperative services. Asian, Black, and Latino older adults, however, were more likely to receive low-value prescriptions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These diverging racial patterns in LVC across different measures likely reflect differential mechanisms, underscoring the need to use clinically specific measures rather than composite measures, which obscure underlying heterogeneity and could lead to potentially harmful and inequity-producing interventions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 3","pages":"900-909"},"PeriodicalIF":4.3,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19369","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143082897","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}