The Journals of Gerontology Series A: Biological Sciences and Medical Sciences最新文献_第2页

A Preliminary Usability Evaluation of an Artificial Intelligence-based, motion-detecting Wearable device: the Geriatric Functional Assessment System

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Pub Date : 2025-03-05 DOI: 10.1093/gerona/glaf044

John A Batsis, Rishank Singh, Jennifer Poole, Paige Bramblett, Danae Gross, Meredith Gilliam, Chaterlee Pamintuan, Beckham Nora, David H Lynch, Xiaohui Liang

{"title":"A Preliminary Usability Evaluation of an Artificial Intelligence-based, motion-detecting Wearable device: the Geriatric Functional Assessment System","authors":"John A Batsis, Rishank Singh, Jennifer Poole, Paige Bramblett, Danae Gross, Meredith Gilliam, Chaterlee Pamintuan, Beckham Nora, David H Lynch, Xiaohui Liang","doi":"10.1093/gerona/glaf044","DOIUrl":"https://doi.org/10.1093/gerona/glaf044","url":null,"abstract":"Background Physical function is a key determinant of independence among older adults. Yet, there are barriers to assessing physical function in clinic. We developed a wearable geriatric functional assessment system (GFAS) that quickly and effortlessly evaluates physical function. Methods A single-arm, non-randomized, mixed-methods, usability study evaluated the design, ergonomics, and usability of the GFAS. Participants aged &gt;65 years with multiple chronic conditions were recruited and wore the GFAS about the clinic for 15-minutes. We assessed walking speed, 30-second sit-to-stand, and evaluated postural balance using a Footscan pressure plate system. In addition to transcribed exit-interviews and a Willingness to Pay questionnaire, the USE, Technology Acceptance, and System Usability Scales were evaluated. Results Of the 37 participants screened, 21 were recruited, enrolled, and consented, whose mean age was 76.6±5.45 years (52.4% female), with 28.6% non-White, 19% were on Medicaid, and 52.4% were classified as having a robust Fried frailty status. Participants favored the prototype and its existing functionality (7.14±2.35) and would wear it if recommended by their clinician (7.62±2.50, median 8.0). All felt it was easy to use, 74% of comments outlined they would use it again, and 81% noted it was comfortable. System Usability score was 78.2 ± 14.5, USE was 5.83 ± 3.59, and Technology Acceptance demonstrated satisfaction of 7.05 ± 2.18 in using the device. Conclusions The GFAS prototype shows considerable promise in evaluating physical function in older adults and that additional steps are needed to maximize usability.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Using computational video analysis in ageing mice to evaluate the effects of chronic monotherapy, polypharmacy and deprescribing over time

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Pub Date : 2025-03-05 DOI: 10.1093/gerona/glaf049

Kenji Fujita, John Mach, Sarah N Hilmer

{"title":"Using computational video analysis in ageing mice to evaluate the effects of chronic monotherapy, polypharmacy and deprescribing over time","authors":"Kenji Fujita, John Mach, Sarah N Hilmer","doi":"10.1093/gerona/glaf049","DOIUrl":"https://doi.org/10.1093/gerona/glaf049","url":null,"abstract":"Background In clinical studies of older adults, polypharmacy (use of ≥ 5 drugs) and the Drug Burden Index (DBI; measures exposure to anticholinergic and sedative drugs) are associated with impaired physical function and frailty. We used computational video analysis of aging mice to examine the impact of medications on morphometric and gait function. Methods Middle-aged (12 month) male mice were administered therapeutic doses of medications in polypharmacy regimens with different DBI scores or monotherapy with medications from the High DBI polypharmacy regimen. At age 21 months, half of the treated animals had their medications deprescribed (discontinued). Open field videos and mouse clinical frailty index were recorded at 12, 15, 18, 21 and 24 months. After applying open-source neural networks to the videos, the gained features were analysed to detect differences between the treatment groups and control over time using a state-space model with change point detection. Results We measured 49 morphometric and gait features for 278 mice. The sum of effects of constituent monotherapies did not equal the effects of polypharmacy. Consistent with clinical data, greater gait and posture changes were observed with polypharmacy regimens with increasing DBI scores. Deprescribing effects varied between medications, consisting of reversible, irreversible and novel changes. Different medication exposures had different effects on gait, posture and the prediction of frailty. Conclusion Computational video analysis of preclinical data is a promising tool for high-throughput, sensitive detection of medication effects in aging.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Expanding Geroscience to Vulnerable Populations in mid-late life: Medicaid home- and community-based service users and formerly incarcerated individuals

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Pub Date : 2025-03-04 DOI: 10.1093/gerona/glaf040

Richard H Fortinsky, Iman M Al-Naggar, Lisa C Barry, Ellis C Dillon, George A Kuchel, Julie Robison

{"title":"Expanding Geroscience to Vulnerable Populations in mid-late life: Medicaid home- and community-based service users and formerly incarcerated individuals","authors":"Richard H Fortinsky, Iman M Al-Naggar, Lisa C Barry, Ellis C Dillon, George A Kuchel, Julie Robison","doi":"10.1093/gerona/glaf040","DOIUrl":"https://doi.org/10.1093/gerona/glaf040","url":null,"abstract":"A wide range of geroscience-guided interventions, or gerotherapeutics, including repurposed drugs, natural products, and lifestyle changes are now being tested in small-scale proof-of-concept studies. If successful, these efforts may help maintain or restore function across numerous health-related domains, thus extending human healthspan. To date, little attention has been paid to exploring the potential of gerotherapeutics to improve healthspan-related outcomes in vulnerable populations that have accumulated experiences detrimental to health in adulthood and later life. We contend that two vulnerable populations that have been especially overlooked are mid-late life adults receiving Medicaid-funded home- and community-based services (HCBS), and previously incarcerated individuals. Published data on Medicaid HCBS users shows ample evidence of racial, ethnic, and health-related heterogeneity, with opportunities for gerotherapeutics to stop or slow the progression of disability. Previously incarcerated individuals show evidence of accelerated biological aging, leading to geriatric conditions and hospitalizations greater than among matched counterparts not experiencing incarceration. We present ethical, equity, and clinical trial design considerations relevant to these vulnerable populations, including the possibility of implementing co-design procedures that might make gerotherapeutic interventions more attractive to individuals in these populations. We also discuss advocacy and service-related networks that could be tapped to help enhance the recruitment of these vulnerable populations into gerotherapeutic clinical trials.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predictors of bi-directional transitions from mild cognitive impairment in a diverse cohort

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Pub Date : 2025-03-04 DOI: 10.1093/gerona/glaf041

Mitzi M Gonzales, Roman Fernandez, Sarah Kremen, Zaldy S Tan, Amy E Werry, Xueqiu Jian, John Hart, Donald Royall, Gladys Maestre, Sara Espinoza, Sudha Seshadri, Jonathan Gelfond, Chen-Pin Wang

{"title":"Predictors of bi-directional transitions from mild cognitive impairment in a diverse cohort","authors":"Mitzi M Gonzales, Roman Fernandez, Sarah Kremen, Zaldy S Tan, Amy E Werry, Xueqiu Jian, John Hart, Donald Royall, Gladys Maestre, Sara Espinoza, Sudha Seshadri, Jonathan Gelfond, Chen-Pin Wang","doi":"10.1093/gerona/glaf041","DOIUrl":"https://doi.org/10.1093/gerona/glaf041","url":null,"abstract":"Trajectories following a diagnosis of mild cognitive impairment (MCI) are varied and may fluctuate over time. Among diverse ethnic and racial groups, social factors, medical comorbidities, and biases in assessment procedures may contribute to greater heterogeneity in the MCI diagnostic category and affect its prognostic significance for dementia. The study goal was to evaluate the frequency and variables associated with MCI transitions among non-Hispanic White (NHW) and Latinx older adults. Multistate Markov models characterized transitions across diagnostic states (cognitively unimpaired (CU), MCI, dementia) over ten years. Variables associated with transitions were assessed using hazard ratios (HR) and 95% confidence intervals (CIs). The study included 413 participants (58% female, mean age 72+8, 52% Latinx ethnicity). Following an MCI diagnosis, the likelihood of converting to dementia versus reverting to CU were equally probable. Older age, NHW ethnicity, APOE ε4, diabetes, lower BMI, and higher neuropsychiatric symptoms associated with elevated risk for dementia conversion, whereas younger age and lower neuropsychiatric symptoms associated with CU reversion. Above other factors, higher baseline serum glial fibrillary acidic protein (HR=1.762 (95% CI: 1.367-2.271)) and neurofilament light (HR=1.467 (95% CI: 1.152-1.69)) associated with increased dementia risk. Trajectories following an MCI diagnosis were highly variable with lower dementia conversion rates among Latinx relative to NHW adults, highlighting the need for strong diverse representation in research to capture the range of exposures shaping risk and resilience for cognitive decline. Well-validated blood-based biomarkers are likely to be instrumental for further improving personalized dementia risk predictions.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Age-Related Cognitive Decline and Dementia: Interface of Microbiome-Immune-Neuronal Interactions

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Pub Date : 2025-03-04 DOI: 10.1093/gerona/glaf038

Santosh Kumar Prajapati, Shalini Jain, Hariom Yadav

引用次数: 0

Ferroptosis activation contributes to kidney aging in mice by promoting tubular cell senescence

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Pub Date : 2025-03-04 DOI: 10.1093/gerona/glaf042

Zheng Wang, Yue Dai, Rui Jin, Dexiameng Mo, Qingyang Hu, Yi Huang, Le Zhang, Cuntai Zhang, Hongyu Gao, Qi Yan

{"title":"Ferroptosis activation contributes to kidney aging in mice by promoting tubular cell senescence","authors":"Zheng Wang, Yue Dai, Rui Jin, Dexiameng Mo, Qingyang Hu, Yi Huang, Le Zhang, Cuntai Zhang, Hongyu Gao, Qi Yan","doi":"10.1093/gerona/glaf042","DOIUrl":"https://doi.org/10.1093/gerona/glaf042","url":null,"abstract":"Kidney aging is the strongest independent risk factor for chronic kidney disease. Ferroptosis, a recently discovered form of cell death mediated by iron overload and lipid peroxidation accumulation, has an unclear role in kidney aging. To determine the pathophysiological role of ferroptosis during kidney aging, we employed immunofluorescence, western blotting, and qRT‒PCR to analyze renal cells and tissues in natural aging and accelerated aging mouse models. We investigated the activation of ferroptosis during aging and examined the effects of the ferroptosis inhibitor ferrostatin-1 and the ferroptosis inducer erastin on age-related renal interstitial fibrosis in aged model mice. We found that both naturally aged and stress-aged renal tubular cells and tissues presented extensive abnormalities in ferroptosis-related genes. This included increased expression of ACSL4 and decreased expression of GPX4. Additionally, these abnormalities were accompanied by elevated free iron concentrations; increased expression of iron import proteins, and iron storage proteins; and downregulated expression of the iron export protein Fpn. We further discovered that ferrostatin-1 inhibited, whereas erastin increased, age-related renal interstitial fibrosis in aged mouse kidneys. Finally, our study revealed that aged renal tubular cells exhibit characteristics of ferroptosis and are highly sensitive to ferroptosis, as demonstrated by the activation of ferroptosis-related genes, accumulation of lipid peroxides. Ferrostatin-1 inhibited, whereas erastin increased, D-galactose induced, renal tubular cell senescence in vitro. These findings suggest that ferroptosis exacerbates renal tubular cell senescence and age-related renal interstitial fibrosis. Managing ferroptosis may represent a novel strategy for reversing kidney aging.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Roles of genetic predisposition and mediation of biological age acceleration in the association between air pollution and dementia

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Pub Date : 2025-02-28 DOI: 10.1093/gerona/glaf046

Zhou Jiang, Yu Yan, Jike Qi, Yuxin Liu, Yuchen Jiang, Hao Zhang, Hao Chen, Xinying Guan, Pan Zhang, Ting Wang, Ping Zeng

{"title":"Roles of genetic predisposition and mediation of biological age acceleration in the association between air pollution and dementia","authors":"Zhou Jiang, Yu Yan, Jike Qi, Yuxin Liu, Yuchen Jiang, Hao Zhang, Hao Chen, Xinying Guan, Pan Zhang, Ting Wang, Ping Zeng","doi":"10.1093/gerona/glaf046","DOIUrl":"https://doi.org/10.1093/gerona/glaf046","url":null,"abstract":"Background Air pollution exposure (both individual and joint) is associated with dementia, but its relation to early-onset dementia (EOD) and late-onset dementia (LOD) remains inconclusive. Meanwhile, the modification by genetic predisposition and mediation by accelerated biological aging are also unclear. Methods A cohort of 285,774 dementia-free participants from the UK Biobank was analyzed. Exposure levels of four major air pollutants (PM2.5, PM10, NO2 and NOx), two air pollution scores (APS1 and APS2) were obtained, and their associations with all-cause dementia (ACD), EOD and LOD were assessed via Cox models. Genetic predisposition to dementia was evaluated and the mediation role of PhenoAge-Accel was investigated under the counterfactual framework. Results During a median follow-up of 13.4 years, 3,898 participants developed ACD, including 231 with EOD and 3,650 with LOD. Per IQR increase of PM2.5, PM10, NO2, NOx, APS1 and APS2 was associated with 6.5% (95%CIs) (2.3~10.9%), 6.8% (2.2~11.5%), 4.6% (0~9.5%), 5.3% (0.7~10.0%), 6.8% (2.7~11.1%) or 6.7% (2.2~11.4%) higher risk of incident ACD, exhibiting a stronger effect on EOD than LOD. Participants with the highest polygenic risk score (PRS) and APSs possessed the greatest risk of ACD, EOD and LOD. PhenoAge-Accel moderately mediated the influence of air pollution exposure on ACD risk, especially among low genetic risk participants, with slightly lower mediation effects for EOD than LOD. Similar results were found when adopting KDMAge-Accel. Conclusions Long-term joint exposure to air pollutants exhibited stronger associations with EOD than LOD, and accelerated biological aging serves as a partial mediator in this adverse connection.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143546354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparing step counting algorithms for high-resolution wrist accelerometry data in older adults in the ARIC study

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Pub Date : 2025-02-17 DOI: 10.1093/gerona/glaf034

Sunan Gao, Xinkai Zhou, Lily Koffman, Amal A Wanigatunga, Jennifer A Schrack, Ciprian M Crainiceanu, John Muschelli

{"title":"Comparing step counting algorithms for high-resolution wrist accelerometry data in older adults in the ARIC study","authors":"Sunan Gao, Xinkai Zhou, Lily Koffman, Amal A Wanigatunga, Jennifer A Schrack, Ciprian M Crainiceanu, John Muschelli","doi":"10.1093/gerona/glaf034","DOIUrl":"https://doi.org/10.1093/gerona/glaf034","url":null,"abstract":"Background Step counting from wrist accelerometry data is widely used in physical activity research and practice. While several open-source algorithms can estimate steps from high-resolution accelerometry data, there is a critical need to compare these algorithms and provide practical recommendations for their use in older adults. Methods 1,282 Atherosclerosis Risk in Communities (ARIC) study participants (mean age 83.4, 60% female) wore ActiGraph GT9X wrist devices for 7 days, collecting 80Hz tri-axial accelerometry data. Five open-source step-counting algorithms (ADEPT, Oak, SDT, Verisense, and Stepcount) were applied to this data. Step count distributions and their cross-sectional associations with health outcomes were compared. Results The estimated mean daily step counts varied widely across algorithms, ranging from 988 for ADEPT to 23,607 for SDT. Pearson correlations across methods ranged from moderate (r=0.52) to very strong (r=0.96). All step counts were highly associated with age, with an estimated decline of 119.0 to 142.8 steps/year (all p&lt;0.001) with comparable trends observed across demographic subgroups. After z-score standardization (subtracting the population mean and dividing by the population standard deviation), the estimated steps from each algorithm exhibited similar directionality and magnitude of association with various metabolic, cardiovascular, physical performance, and cognitive outcomes (all p&lt;0.001). Conclusion The estimated step counts algorithms are highly correlated, and, after z-scoring, have similar and highly significant associations with health outcomes. Because the total number of steps varies widely across algorithms, interpretation and translation of results for health monitoring and clinical use in older adults depends on the choice of step counting algorithm.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143435085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multivariate Profiling of Physical Resilience in Older Adults After Total Knee Replacement Surgery: Results from a Prospective Observational Study

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Pub Date : 2025-02-15 DOI: 10.1093/gerona/glaf032

Qian-Li Xue, Thomas Laskow, Mallak K Alzahrani, Ravi Varadhan, Jeremy D Walston, Jennifer A Schrack, Anne B Newman, Frederick Sieber, Karen Bandeen-Roche

{"title":"Multivariate Profiling of Physical Resilience in Older Adults After Total Knee Replacement Surgery: Results from a Prospective Observational Study","authors":"Qian-Li Xue, Thomas Laskow, Mallak K Alzahrani, Ravi Varadhan, Jeremy D Walston, Jennifer A Schrack, Anne B Newman, Frederick Sieber, Karen Bandeen-Roche","doi":"10.1093/gerona/glaf032","DOIUrl":"https://doi.org/10.1093/gerona/glaf032","url":null,"abstract":"Background As individuals age, their ability to cope with and recovering from health challenges becomes vital for maintaining independence and quality of life. This study aims to develop a multivariate phenotype of physical resilience based on individual recovery dynamics before and after a physical stressor. Methods This prospective observational study included 104 individuals aged ≥ 60 who underwent elective total knee replacement (TKR) for degenerative joint disease between December 2, 2019, and January 4, 2023. A multivariate resilience phenotype was derived from physical function assessments over 12 months after TKR using the Short Physical Performance Battery, the Pittsburgh Fatigability Scale Physical Subscale, the Knee Injury and Osteoarthritis Outcome Quality of Life Score, and the 36-Item Short Form Health Survey Physical Component Score. Validation was performed using markers (i.e., frailty and self-reported health) and determinants (e.g., the Charlson Comorbidity Index (CCI)) of recovery potential. Results Distinct resilience profiles were identified across the four measures, showing varied baseline levels and/or change rates over 12 months. By combining and analyzing resilience profiles across measures, two distinct groups emerged: 33.7% were classified as non-resilient and 66.4% as resilient. The non-resilient group had a higher prevalence of frailty (37.1% vs. 10.1%, p&lt;0.01), poor or fair self-reported health (48.6% vs. 5.8%, p&lt;0.01), and moderate or severe comorbidity burden (CCI &gt;2; 28.6% vs. 10.1%, p=0.03). Conclusions Recovery trajectories after TKR revealed varying resilience levels that could not be fully explained by baseline health status. Understanding individual resilience can enhance patient care by promoting recovery and overall well-being.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Incremental Healthcare Costs of Dementia and Cognitive Impairment in Community-Dwelling Older Adults: A Prospective Cohort Study

The Journals of Gerontology Series A: Biological Sciences and Medical Sciences Pub Date : 2025-02-15 DOI: 10.1093/gerona/glaf030

Kerry M Sheets, Howard A Fink, Lisa Langsetmo, Allyson M Kats, John T Schousboe, Kristine Yaffe, Kristine E Ensrud

{"title":"Incremental Healthcare Costs of Dementia and Cognitive Impairment in Community-Dwelling Older Adults: A Prospective Cohort Study","authors":"Kerry M Sheets, Howard A Fink, Lisa Langsetmo, Allyson M Kats, John T Schousboe, Kristine Yaffe, Kristine E Ensrud","doi":"10.1093/gerona/glaf030","DOIUrl":"https://doi.org/10.1093/gerona/glaf030","url":null,"abstract":"Background Cognitive impairment and dementia are associated with higher healthcare costs; whether these increased costs are attributable to greater comorbidity burden is unknown. We sought to determine associations of cognitive impairment and dementia with subsequent total and sector-specific healthcare costs after accounting for comorbidities and to compare costs by method of case ascertainment. Methods Index examinations (2002-2011) of four prospective cohort studies linked with Medicare claims. 8,165 community-dwelling Medicare fee-for-service beneficiaries (4,318 women; 3,847 men). Cognitive impairment identified by self-or-proxy report of dementia and/or abnormal cognitive testing. Claims-based dementia and comorbidities derived from claims using Chronic Condition Warehouse algorithms. Annualized healthcare costs (2023 dollars) ascertained for 36 months following index examinations. Results 521 women (12.1%) and 418 men (10.9%) met criteria for cognitive impairment; 388 women (9%) and 234 men (6.1%) met criteria for claims-based dementia. After accounting for age, race, geographic region, and comorbidities, mean incremental costs of cognitive impairment versus no cognitive impairment in women (men) were $6,883 ($7,276) for total healthcare costs, $4,160 ($4,047) for inpatient costs, $1,206 ($1,587) for SNF costs, and $689 ($668) for HHC costs. Mean adjusted incremental total and inpatient costs associated with claims-based dementia were smaller in magnitude and not statistically significant. Mean adjusted incremental costs of claims-based dementia versus no claims-based dementia in women (men) were $759 ($1,251) for SNF costs and $582 ($535) for HHC costs. Conclusions Cognitive impairment is independently associated with substantial incremental total and sector-specific healthcare expenditures not fully captured by claims-based dementia or comorbidity burden.","PeriodicalId":22892,"journal":{"name":"The Journals of Gerontology Series A: Biological Sciences and Medical Sciences","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0