Journal of the American Geriatrics Society最新文献

{"title":"Obesity and Transition to Assisted Living Services in Older Adults: An Analysis From the National Health and Aging Trends Study","authors":"Rashmi Muthukkumar,&nbsp;Christian Haudenschild,&nbsp;Hillary B. Spangler,&nbsp;Todd A. MacKenzie,&nbsp;David H. Lynch,&nbsp;John A. Batsis","doi":"10.1111/jgs.19608","DOIUrl":"10.1111/jgs.19608","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The prevalence of obesity in older adults is increasing. Though body mass index (BMI) is often used as a measure of obesity, waist circumference (WC) may be a better reflection of obesity in older adults. While many factors contribute to transitioning to assisted living services (TALS), the relationship between obesity and TALS has demonstrated inconsistent results. This study aims to further understand the relationship between these anthropometric measures and incident TALS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This analysis is based on longitudinal data from the National Health and Aging Trends Study (NHATS). Obesity was defined as BMI ≥ 30 kg/m² and WC ≥ 88 cm in women or ≥ 102 cm in men, and further classified as class 1 (BMI 30–34.9 kg/m²), class 2 (35–39.9), and class 3 (40+) TALS was determined based on changes to residence throughout up to 10 study rounds. Participants without BMI or WC available and those in nursing homes or residential care facilities at the onset of the study were excluded. Separate proportional hazards models evaluated the risk of TALS using BMI and WC as primary predictors, after adjusting for demographics and comorbidities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The resultant analytic cohorts included <i>n</i> = 11,111 and <i>n</i> = 10,374 participants with BMI and WC data, respectively. Rates of TALS were 25.7% in the entire study cohort: 24.9% in the BMI and 23.9% in the WC cohort. Using BMI, adjusted risk of TALS was HR 1.31 (95% CI: 0.95–1.79) for underweight, HR 0.74 (0.65–0.85) for overweight, HR 0.71 (0.59–0.85) for class 1 obesity, HR 0.58 (0.42–0.80) for those with class 2 obesity, and HR 0.69 (0.44–1.08) for those with class 3 obesity or higher. With elevated WC, TALS risk was HR 0.98 (0.86–1.12).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Overweight, class 1, and class 2 obesity using BMI criteria were protective against TALS. Further study is needed to elucidate the underlying reasons for this protective effect against TALS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 9","pages":"2768-2779"},"PeriodicalIF":4.5,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369902","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":"Telemedicine Urgent Care for Older Adults: Insights From a Large EHR Aggregated Dataset","authors":"Jared Silberlust,&nbsp;Priyanka Solanki,&nbsp;Eduardo Iturrate","doi":"10.1111/jgs.19551","DOIUrl":"10.1111/jgs.19551","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 9","pages":"2931-2934"},"PeriodicalIF":4.5,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334691","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":"Treatment Burden Among Older Adults in the United States, 2022","authors":"Audrey D. Zhang,&nbsp;Emily A. Wolfson,&nbsp;Kenneth J. Mukamal,&nbsp;Mara A. Schonberg,&nbsp;Bruce E. Landon","doi":"10.1111/jgs.19603","DOIUrl":"10.1111/jgs.19603","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Treatment burden refers to the patient-perceived effort of managing health and health care, which impacts quality of life and engagement in care. International studies of treatment burden have found high rates of treatment burden among adults with chronic conditions. However, the scope of treatment burden among US older adults is unknown. We described the prevalence of and characteristics associated with treatment burden among US adults age ≥ 50 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a cross-sectional study of 1795 adult respondents to the 2022 Health and Retirement Study (HRS) Treatment Burden Questionnaire (TBQ), a random sub-sample from a nationally-representative panel study of community-dwelling US adults age ≥ 50 years. The primary outcome was total treatment burden score (15 items each scored 0–10, total 0–150; threshold ≥ 59 for high burden). We used multivariable linear regression to examine the association between log-transformed total treatment burden score and sociodemographic, health, and functional status characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The mean age of 1795 respondents was 68.5 (SD 8.5) years, 56% were female, and the median TBQ score was 12 (IQR 5–25). Overall, 87% (<i>n</i> = 1550) reported treatment burden (TBQ score ≥ 1); 5% reported high burden. The most common sources of treatment burden were reminders of health problems (61%) and administrative (53%) and financial burdens (46%). Adults age ≥ 65 years were both less likely to report treatment burden and reported lower burden than adults age 50–64 years. Factors associated with greater burden included a higher number of chronic conditions, vision or hearing impairment, ADL/IADL difficulty, and mobility difficulty.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Most US adults age ≥ 50 years report treatment burden, though there is wide variation in the degree of burden reported. Reducing treatment burden within the US may require reducing administrative and financial burdens of care and addressing factors that impair patient capacity to manage health and health care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 9","pages":"2757-2767"},"PeriodicalIF":4.5,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334701","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":"Cause-Specific Frailty Trajectories at the End of Life: Implications for Personalized Care in Older Adults","authors":"Pan Liu,&nbsp;Lina Ma","doi":"10.1111/jgs.19586","DOIUrl":"10.1111/jgs.19586","url":null,"abstract":"<p>Cause-specific variations in frailty trajectories and end-of-life care.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </p>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 9","pages":"2651-2653"},"PeriodicalIF":4.5,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://agsjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19586","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144319043","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":"Comparative Effectiveness of Two Methods for Assigning Care Coordinators to People Living With Dementia","authors":"Lisa M. Kern,&nbsp;Catherine Riffin,&nbsp;Veerawat Phongtankuel,&nbsp;Samprit Banerjee,&nbsp;Joanna B. Ringel,&nbsp;Joselyne E. Aucapina,&nbsp;Jonathan N. Tobin,&nbsp;Semhar Fisseha,&nbsp;Helena Meiri,&nbsp;Jessica Han,&nbsp;Kelly Wu,&nbsp;Jamie Bialor,&nbsp;Sigall K. Bell,&nbsp;Paul N. Casale","doi":"10.1111/jgs.19579","DOIUrl":"10.1111/jgs.19579","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We sought to determine the comparative effectiveness of two strategies for assigning care coordinators to people living with dementia (PLWD) and their caregivers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a pragmatic randomized clinical trial embedded in a Medicare accountable care organization (ACO) in New York, NY in 2022–2024. We included community-dwelling PLWD ≥ 65 years who were attributed to the ACO and had highly fragmented ambulatory care in the previous year (reversed Bice-Boxerman Index ≥ 0.86). The trial compared usual care (assigning care coordinators to PLWD after hospital discharge) to usual care plus proactive outreach, which assigned care coordinators to PLWD if they or their caregivers reported difficulty with care coordination on a telephone survey. Participants were followed for the combined outcome of emergency department (ED) visit or hospitalization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 385 PLWD in the trial, the mean age was 82.6 years (SD 6.9), and 56.4% were female. Overall, participants had had a mean of 14.9 ambulatory visits to 8.9 different providers the previous year. The acceptance rate of care management was higher in the control group (73.7%) than in the intervention group (38.0%). Care coordinators were ultimately assigned to 14 of 192 PLWD in the control group (7.3%) and 19 of 193 PLWD in the intervention group (9.8%). The intention-to-treat analysis (<i>N</i> = 385) found a trend toward fewer ED visits in the intervention group (0.14 ED visits per 100 person-days alive vs. 0.18 ED visits per 100 person-days alive, <i>p</i> = 0.07) but no difference in the combined outcome of ED visit or hospitalization (<i>p</i> = 0.71).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although the particular intervention we tested was not more effective than usual care, this trial is novel in that it used highly fragmented care as an inclusion criterion and shows that more work is needed to address fragmented care among PLWD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 9","pages":"2707-2716"},"PeriodicalIF":4.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295532","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":"NOTICE-ED: Nurse or Technician Insights Into Cognitive Evaluations in the Emergency Department","authors":"Sarah J. Nessen,&nbsp;Anita N. Chary,&nbsp;Annika R. Bhananker,&nbsp;K. Jane Muir,&nbsp;Lauren T. Southerland,&nbsp;Kyra O'Brien,&nbsp;Ari B. Friedman","doi":"10.1111/jgs.19578","DOIUrl":"10.1111/jgs.19578","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Several strategies have been proposed to increase chronic cognitive impairment (CI) screening in the emergency department (ED). Our goal was to assess the feasibility and acceptability of implementing specific CI screening tools and strategies in the ED from an ED registered nurse and technician perspective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed a qualitative study using semi-structured interviews with a purposive sample of ED nurses and ED technicians (EDTs). Participants worked at an urban academic hospital and were interviewed between November 2023 and March 2024. Interviews assessed participants' opinions on the feasibility and acceptability of CI screening and the use of machine learning (ML) tools to identify high-risk patients for targeted CI screening, tablet-based screenings, and two validated CI screenings: the Ottawa 3DY (O3DY) and Short Blessed Test (SBT). We used the Consolidated Framework for Implementation Research (CFIR) to develop our interview guide and performed a rapid analysis with deductive and inductive codes based on CFIR constructs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four major themes related to CI screening tools arose: (1) Benefits of CI screening; (2) feasibility of integrating screening tools into existing workflows; (3) professional role limitations; and (4) implementation requirements. Participants perceived CI screening as important for allocating limited ED resources. Shorter, less specific testing, including the O3DY, was seen as feasible during triage, while longer, more specific screening, including the SBT, was seen as more feasible in roomed care areas. Both ED nurses and EDTs identified the need for electronic health record tools and dedicated screening teams to facilitate implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>ED nurses and EDTs support chronic CI screening if screening techniques and clinical teams can be optimized to make workflows feasible.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 8","pages":"2503-2511"},"PeriodicalIF":4.5,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://agsjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19578","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295533","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":"Household Wealth and Potentially Inappropriate Medications in Persons With Dementia: Role of Comorbidities and Caregivers","authors":"W. James Deardorff,&nbsp;Bocheng Jing,&nbsp;Matthew E. Growdon,&nbsp;Brian Motmans,&nbsp;W. John Boscardin,&nbsp;Leah J. Blank,&nbsp;Kenneth S. Boockvar,&nbsp;Michael A. Steinman","doi":"10.1111/jgs.19585","DOIUrl":"10.1111/jgs.19585","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The association between lower socioeconomic status and increased potentially inappropriate medications (PIMs) among older adults, as seen in some studies, is infrequently studied in persons with dementia (PWD). This association may additionally be impacted by multimorbidity and caregiver support in PWD. Thus, we examined the association between wealth and PIMs in PWD and the effects of comorbidities and caregivers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We included community-dwelling adults aged ≥ 66 with dementia in the Health and Retirement Study (2008–2018). PIMs included sedative-hypnotics, strongly anticholinergics, and medications from 2019 Beers and STOPP-Version 2 criteria. The primary outcome was a prescription for ≥ 1 PIM. We used logistic regression with national survey weights to examine the association between household wealth (above vs. below sample median) and ≥ 1 PIM through 4 models: (1) unadjusted, (2) adjusted for demographics (age, sex, race/ethnicity), 3) Model 2 + comorbidity count (range 0–7), (4) Model 3 + caregiver type (no caregiver, paid caregiver, unpaid caregiver only).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cohort consisted of 1475 PWD (median age 84, 67% female, 15% Black, median household wealth $86,000 (IQR 2000-315,000), 49% with unpaid caregiver only, 23% with paid caregiver). Overall, 76% received ≥ 1 PIM. Adjusting for demographics, PWD with below median wealth showed increased odds of receiving ≥ 1 PIM (OR = 1.44, 95% CI = 1.07–1.93). This association was not statistically significant after adjusting for comorbidity count (OR = 1.26, 95% CI = 0.93–1.70). In a stratified analysis by comorbidity count adjusting for demographics and wealth, paid caregiver presence was associated with increased odds of PIMs among individuals with ≤ 2 chronic conditions (OR = 2.60, 95% CI = 1.44–4.69) but not with ≥ 3 chronic conditions (OR = 0.90, 95% CI = 0.50–1.62) (<i>p</i> = 0.02 for interaction).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Among PWD, the association between lower wealth and increased odds of PIMs was no longer statistically significant after adjusting for comorbidity count. Caregiving status had a complex relationship with PIMs based on comorbidity burden.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 9","pages":"2727-2737"},"PeriodicalIF":4.5,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144277093","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":"Exploring Antipsychotic Initiation Among Persons Living With Dementia in a Comprehensive Dementia Care Program","authors":"David R. Lee,&nbsp;Grace Sassana-Khadka,&nbsp;Tahmineh Romero,&nbsp;Betsy Yang,&nbsp;Katherine Sy Serrano,&nbsp;Andrea Centeno,&nbsp;David B. Reuben","doi":"10.1111/jgs.19569","DOIUrl":"10.1111/jgs.19569","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Antipsychotic medications (APMs) are frequently prescribed for persons living with dementia despite limited benefits and increased risks. This study examined patient characteristics of those prescribed APMs, indications for initiation, and survival outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective cohort study of community-dwelling patients enrolled in a comprehensive dementia care program (2012–2014) focused on 190 patients not on an APM at baseline, with survival analyses including 200 additional patients on an APM at program entry. Patients were followed for 2 years for APM initiation and until January 2024 for mortality. Baseline measures included patient and caregiver demographics, Mini-Mental State Exam (MMSE), Functional Activities Questionnaire (FAQ), Modified Caregiver Strain Index (MCSI), caregiver Patient Health Questionnaire-9 (PHQ-9), and Neuropsychiatric Inventory Questionnaire (NPI-Q). Indications for APM initiation were abstracted from electronic health records. Logistic regression models examined associations between baseline characteristics and APM initiation. Survival was assessed using Kaplan–Meier estimates and Cox proportional hazards models.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 190 patients (mean [SD] age, 81.2 [8.4] years; 60% female, and 80% Alzheimer's or dementia not otherwise specified) who were not on APMs at program enrollment, 65 (34%) initiated and 125 (66%) did not initiate an APM. NPI-Q severity (AOR 1.10, 95% CI 1.04–1.16) and NPI-Q distress (AOR 1.06, 95% CI 1.02–1.10) were associated with APM initiation. Agitation and psychotic symptoms were the most common indications, with quetiapine being the most frequently prescribed APM. Median survival was 37.8 months (IQR 19.3–63.2) for patients on an APM at baseline, 63.1 months (IQR 28.4–86.8) for patients initiating an APM, and 68.9 months (IQR 50–97.9) for patients not initiating an APM (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>APM initiation was common despite enrollment in a comprehensive dementia care program that prioritizes non-pharmacologic strategies. Survival differences underscore the need for risk–benefit discussions of APMs and goals of care discussions with caregivers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 8","pages":"2475-2484"},"PeriodicalIF":4.5,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251657","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":"Ambulatory Care Sensitive Hospitalizations and Disparities Among Older Adults With Dementia Before and During the Pandemic","authors":"Shubing Cai,&nbsp;Qiuyuan Qin,&nbsp;Peter Veazie,&nbsp;Yeates Conwell,&nbsp;Helena Temkin-Greener","doi":"10.1111/jgs.19573","DOIUrl":"10.1111/jgs.19573","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Older adults with Alzheimer's disease and related dementias (ADRD) are frequently hospitalized with ambulatory care-sensitive conditions (ACSCs). Disparities in ACSC hospitalizations have been documented, but the impact of the COVID-19 pandemic on ACSC hospitalizations and disparities of older adults with ADRD is unclear, particularly, across different racial, ethnic, and socioeconomic groups. This study examined changes in ACSC hospitalizations among community-dwelling older adults with ADRD before and during the pandemic and how these changes vary by race, ethnicity, and Medicare-Medicaid dual eligibility status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This observational study linked Medicare data with publicly available sources. The study sample included Medicare fee-for-service community-dwelling older adults aged 65 and older with ADRD in 2019 or 2021. The primary outcome was whether an individual had any ACSC hospitalizations in a given year (0/1). Secondary outcomes included any non-COVID-19-related hospitalizations and death (0/1). We used linear probability models with zip-code random effects, accounting for individual and community characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 2.35 million beneficiaries in 2019 and 1.85 million in 2021. Non-COVID-19-related hospitalizations decreased from 24.0% in 2019 to 20.4% in 2021, while ACSC hospitalizations fell from 23.0% to 19.0% among those who were hospitalized. In 2019, Black and Hispanic individuals had 2.0 and 1.6 percentage points higher probabilities of ACSC hospitalization (<i>p</i> &lt; 0.001), respectively, compared to White individuals, and dual-eligibles had a 2.8 percentage-point higher probability than non-dual-eligibles (<i>p</i> &lt; 0.001). During the pandemic, overall hospitalizations and ACSC hospitalizations decreased, with dual-eligibles experiencing an additional 2.1 percentage-point reduction in ACSC hospitalizations(<i>p</i> &lt; 0.001). Meanwhile, dual-eligibles experienced a 1.5 percentage-point increase in mortality rate in 2021 compared to 2019 (<i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Racial and ethnic minorities and the socioeconomically disadvantaged older adults with ADRD were more likely to experience ACSC hospitalizations compared to their counterparts before the pandemic.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 8","pages":"2494-2502"},"PeriodicalIF":4.5,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251656","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":"AGE-PAIRS: Pilot of an Aging Education Mentorship Program Between Older Medical School Alumni and Medical Students","authors":"Micayla N. Flores,&nbsp;Louise Aronson,&nbsp;Andrea Wershof Schwartz","doi":"10.1111/jgs.19556","DOIUrl":"10.1111/jgs.19556","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 8","pages":"2641-2644"},"PeriodicalIF":4.5,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251655","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}