Journal of the American Geriatrics Society最新文献

{"title":"RETRACTION: The Prevalence of Dementia in Older People in an Urban Population of Korea: The Seoul Study.","authors":"","doi":"10.1111/jgs.19574","DOIUrl":"https://doi.org/10.1111/jgs.19574","url":null,"abstract":"<p><strong>Retraction: </strong>D. Y. Lee MD, PhD, J. H. Lee MD, PhD, Y-S. Ju MD, PhD, K. U. Lee PhD, K. W. Kim MD, PhD, J. H. Jhoo MD, J. C. Yoon MD, J. Ha RN, J. I. Woo MD, PhD. The Prevalence of Dementia in Older People in an Urban Population of Korea: The Seoul Study, Journal of the American Geriatrics Society 50, no. 7 (2002): 1233-1239, https://doi.org/10.1046/j.1532-5415.2002.50310.x The above article, published online on 7 August 2002, on Wiley Online Library (wileyonlinelibrary.com), has been retracted by agreement between the journal Editor-in-Chief, Joseph G. Ouslander; the American Geriatrics Society; and Wiley Periodicals LLC. The retraction has been agreed because the authors had not obtained permission to use the primary instrument of research reported in the article. The authors were contacted for comment, but did not respond.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546678","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}

{"title":"Medicare Advantage Networks for Postacute Care Facilities.","authors":"Jeffrey Marr, Mark K Meiselbach","doi":"10.1111/jgs.19612","DOIUrl":"https://doi.org/10.1111/jgs.19612","url":null,"abstract":"<p><p>Some medicare advantage plans have narrow networks for post-acute care facilities.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532096","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}

{"title":"Social Engagement and Mortality in Older Adults: Methodological Insights, Unanswered Questions, and Future Directions.","authors":"Yimao Wu, Yalun Liang, Jintao Liang","doi":"10.1111/jgs.19618","DOIUrl":"https://doi.org/10.1111/jgs.19618","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532098","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}

{"title":"Older Patient Preferences, Comfort, and Challenges With Telemedicine Physician Visits.","authors":"Jennifer Meddings, Jason M Engle, David Ratz, Latoya Kuhn, Nathan Houchens","doi":"10.1111/jgs.19600","DOIUrl":"https://doi.org/10.1111/jgs.19600","url":null,"abstract":"<p><p>Older adult comfort with virtual visit technologies.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532097","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}

{"title":"Associations of CT Muscle Area and Density With Functional Outcomes and Mortality Across Anatomical Regions in Older Men.","authors":"Megan Hetherington-Rauth, Tyler A Mansfield, Leon Lenchik, Ashley A Weaver, Peggy M Cawthon","doi":"10.1111/jgs.19583","DOIUrl":"10.1111/jgs.19583","url":null,"abstract":"<p><strong>Background: </strong>The automated segmentation of computed tomography (CT) images has made their opportunistic use more feasible, yet, the association of muscle area and density from multiple anatomical regions with functional outcomes and mortality risk in older adults has not been fully explored. We aimed to determine if muscle area and density at the L1 and L3 vertebra and right and left proximal thigh were similarly related to functional outcomes and 10-year mortality risk.</p><p><strong>Methods: </strong>Men from the Osteoporotic Fractures in Men (MrOS) study who had CT images, measures of grip strength, 6 m walking speed, and leg power (Nottingham Power Rig) at the baseline visit were included in the analyses (n = 3290, 73.7 ± 5.8 years). CT images were automatically segmented to derive muscle area and muscle density. Deaths were centrally adjudicated over a 10-year follow-up. Linear regression and proportional hazards were used to model relationships of CT muscle metrics with functional outcomes and mortality, respectively, while adjusting for covariates.</p><p><strong>Results: </strong>Muscle area and density were positively related to functional outcomes regardless of anatomical region, with the most variance explained in leg power (adjusted R² = 0.40-0.46), followed by grip strength (adjusted R² = 0.25-0.29) and walking speed (adjusted R² = 0.18-0.20). A one-unit SD increase in muscle area and density was associated with a 5%-13% and 8%-21% decrease in the risk of all-cause mortality, respectively, with the strongest associations observed at the right and left thigh.</p><p><strong>Conclusion: </strong>Automated measures of CT muscle area and density are related to functional outcomes and risk of mortality in older men, regardless of CT anatomical region.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12221209/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Age-Friendly Care and Mobility in Hospitalized Older Adults With Cognitive Impairment: A Feasibility Quality Improvement Initiative.","authors":"Jasmine K Vickers, Richard E Kennedy, Shari Harrell, David H James, Katrina Booth, Emily Simmons, Cynthia J Brown, Kellie L Flood","doi":"10.1111/jgs.19582","DOIUrl":"https://doi.org/10.1111/jgs.19582","url":null,"abstract":"<p><strong>Background: </strong>Hospitalized older adults with cognitive impairment (CI) have an increased risk for adverse outcomes. Acute Care for Elders (ACE) Units were developed to reduce functional decline in hospitalized older adults.</p><p><strong>Intervention: </strong>We developed a quality improvement (QI) initiative to disseminate ACE care processes to non-ACE units, converting them into \"Virtual ACE\" units. The aim of this evaluation is to examine the impact of this intervention on the mobilization of patients with CI.</p><p><strong>Population: </strong>Older adults with CI admitted to a study unit (ACE Unit or seven Virtual ACE units).</p><p><strong>Methods: </strong>We conducted a pre/post-intervention evaluation of the proportion of informed respondents answering \"yes\" to the Acute Care Mobility Assessment (ACMA) interview item: \"In the past 24 hours did the patient move from the bed to the chair, walk in the room, walk in the hallway?\"</p><p><strong>Results: </strong>There were no significant differences in patient demographics, baseline activities of daily living (ADL) performance, history of falls, or consults to physical or occupational therapy between the total pre- (n = 56) versus post- (n = 135) intervention cohorts. The ACE Unit patients were significantly older (82.9 ± 7.5 vs. 75.5 ± 7.7 years, p < 0.05) and significantly more impaired in baseline ADL performance based on Katz Index scores (6.4 ± 4.4 vs. 8.5 ± 4.4, p < 0.05) compared to patients on Virtual ACE units. The proportion of patients with CI reported on ACMA interview to have mobilized from bed to chair (29% vs. 51%, p < 0.05) and ambulated into the hallway (13% vs. 27%, p < 0.05) in the prior 24 hours significantly increased post-intervention. Similar benefits were seen in the ACE and Virtual ACE patients evaluated separately.</p><p><strong>Conclusion: </strong>This QI intervention demonstrated that disseminating ACE care processes to non-ACE units was associated with increased mobilization of hospitalized older adults with CI. Studies with larger sample sizes are needed to confirm findings.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532084","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}

{"title":"Advancing Age and Risk From the Elevated Atherogenic Index: Triglyceride (TG) to High-Density Cholesterol (HDL-C) Ratio.","authors":"Manish Kumar, Shangshu Zhao, Peter Robinson, George A Kuchel, Richard H Fortinsky, Ariela R Orkaby, Karen P Alexander, Paul D Thompson, John A Batsis, Chia-Ling Kuo","doi":"10.1111/jgs.19607","DOIUrl":"https://doi.org/10.1111/jgs.19607","url":null,"abstract":"<p><strong>Background: </strong>Low-density lipoprotein cholesterol (LDL-C) is associated with atherosclerotic cardiovascular disease (ASCVD), but this association diminishes with age. The triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C) ratio, also known as the atherogenic index, is a surrogate marker for small-density low-density lipoprotein cholesterol (sdLDL-C), a more specific LDL-C biomarker associated with ASCVD. It is unclear if age influences the association between the atherogenic index and incident ASCVD. We aimed to assess the influence of advancing age and an elevated atherogenic index on the risk of ASCVD.</p><p><strong>Methods: </strong>We included UK Biobank participants without self-reported, pre-existing ASCVD and with available lipid biomarkers. We then estimated the effect of age on the associations between TG: HDL-C quintiles and incident ASCVD using a nonlinear Cox regression model.</p><p><strong>Results: </strong>Data from 342,979 participants were analyzed. The mean age was 56 ± 8 years (55% females), and the mean duration of follow-up was 12.7 ± 2.8 years. Individuals who developed clinical ASCVD were older (mean age at baseline 60 vs. 56 years, p < 0.001) and had a higher mean TG to HDL-C ratio (3.72 vs. 3.03, p < 0.001). Higher quintiles of the TG/HDL-C ratio (Q2-Q5) were associated with an increased risk of ASCVD compared to the first quintile (Q1) across all age groups up to 65 years. However, there was a declining risk with advancing age, as indicated by the HR for Q5 versus Q1 at ages 45, 55, and 65, which were 1.60, 1.37, and 1.07, respectively.</p><p><strong>Conclusion: </strong>The association between the TG/HDL-C ratio (atherogenic index) and incident ASCVD steadily attenuates with age. In adults over 65, an elevated ratio may be associated with a lower risk of incident ASCVD. These findings may reflect changes in metabolic atherosclerotic risk or a survival effect associated with aging and require further investigation.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532083","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}

{"title":"Disparities in Respiratory Syncytial Virus Vaccine Uptake in the Medicare Fee-for-Service Population During 2023-2024 Season.","authors":"Austin Murphy, Zihao Liu, Heidi G De Souza, Erica Leigh Chilson, Robyn Moucka, Pete Kardel, Caitlin Sheetz, Reiko Sato","doi":"10.1111/jgs.19610","DOIUrl":"https://doi.org/10.1111/jgs.19610","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is a common cause of acute respiratory illness and can lead to serious morbidity and mortality in older adults. With the Food and Drug Administration approval and the Centers for Disease Control and Prevention (CDC) recommendation of RSV vaccines in 2023, this study describes first season vaccine uptake in adults ≥ 65 years.</p><p><strong>Methods: </strong>In a retrospective cohort of 100% Medicare Fee-for-Service (FFS) beneficiaries with Part D coverage, we examined RSV vaccination claims data from July 2023 to June 2024. Cumulative RSV vaccine uptake rates were evaluated by demographic, socioeconomic, and health characteristics, along with evaluation of vaccine coadministration. We reported descriptive statistics.</p><p><strong>Results: </strong>Among 15,841,938 Medicare FFS beneficiaries meeting inclusion criteria, 3,330,740 (21.0%) received the RSV vaccine in the first season. Uptake was highest among the 75-84 age group (23.6%) and those with at least one comorbidity (21.8%). Additionally, those with immunocompromising conditions (23.6%) and lung disease (21.3%) had the highest uptake. The lowest uptake was observed among beneficiaries ≥ 85 years (17.1%), beneficiaries with three or more comorbidities, (19.4%) and those in the southern census region (19.3%). The lowest uptake according to comorbidity status were those with liver disorders (17.1%) and neurologic or neuromuscular conditions (17.8%). Disparities were observed with only 6.8% of Hispanic, 12.6% of Black, 9.3% of those with a low-income subsidy (LIS), and 9.0% of dual Medicare-Medicaid eligible beneficiaries receiving the vaccine. Coadministration occurred in 38.4% of RSV vaccinations.</p><p><strong>Conclusions: </strong>Vaccination to prevent RSV disease began during the 2023-2024 season where less than a quarter of the Medicare FFS population was vaccinated. Disparities in uptake were observed by race and ethnicity, socioeconomic status, geography, comorbidity status, and by age group. These results highlight the need for more targeted public health efforts to improve vaccination among those at high risk for severe RSV disease.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510114","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}

{"title":"Cost-Effectiveness of Family Conferences to Reduce Polypharmacy in Frail Older Adults.","authors":"Joseph Montalbo, Charalabos-Markos Dintsios, Jens Abraham, Eva Drewelow, Manuela Ritzke, Achim Mortsiefer, Birgitt Wiese, Petra Thürmann, Stefan Wilm, Andrea Icks","doi":"10.1111/jgs.19606","DOIUrl":"https://doi.org/10.1111/jgs.19606","url":null,"abstract":"<p><strong>Background: </strong>Cost-effectiveness of family conferences on deprescribing with joint prioritization of treatment goals in primary care has not been investigated so far. We assessed cost-effectiveness in the cluster-randomized controlled COFRAIL trial conducted with general practitioners and 521 older frail patients with polypharmacy cared for at home in Germany.</p><p><strong>Methods: </strong>Hospital admissions averted and quality-adjusted life years (QALYs) gained were associated with costs from the German Social Insurance perspective. We applied adjusted GLM regressions with specified distributions to estimate group differences on imputed data, plotted bootstrap cost-outcome pairs by simulated resampling of the study population to illustrate uncertainty and calculate the probability of cost-effectiveness given a willingness-to-pay threshold, and assessed robustness in sensitivity analyses.</p><p><strong>Results: </strong>Intervention-related costs were €391 (US$459) per capita. On 100 people, the COFRAIL intervention had about 7 more hospital admissions (95% CI: -12; 26), 2 QALYs gained (95% CI: -1; 6), and additional costs of €117,681 (95% CI: -28,838; 264,201)/US$138,027 (95% CI: -33,824; 309,880) or €124,866 (95% CI: -12,649; 262,380)/US$146,455 (95% CI: -14,836; 307,745) without or with hospital costs, respectively, compared to usual care. By bootstrapping, we observed the COFRAIL intervention to have higher costs and more hospital admissions with a relative frequency of 28%-78%, or in terms of QALYs 57%-91%. The COFRAIL intervention had additional costs of €50,966 (US$59.778) per QALY gained with a 46% probability of being cost-effective at a willingness to pay of €45,000/QALY (≈US$50,000/QALY).</p><p><strong>Conclusion: </strong>The COFRAIL intervention affected QALYs rather than hospital admissions after 12 months. The intervention tended to be associated with higher costs and QALYs but was less likely to be cost-effective than usual care at commonly used willingness-to-pay thresholds. Long-term cost-effectiveness should be assessed.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510153","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}

{"title":"A Multimodal Fall Prevention Intervention in the Setting of the Emergency Department.","authors":"Joshua D Niznik, Cassandra Small, Casey J Kelley, Jessica McMullen, Greta Anton, Ellen Roberts, Sophia Lourduraj, Martin F Casey, Jan Busby-Whitehead, Katie Davenport","doi":"10.1111/jgs.19613","DOIUrl":"https://doi.org/10.1111/jgs.19613","url":null,"abstract":"<p><strong>Background: </strong>The emergency department (ED) is an opportune setting for fall prevention interventions. We implemented and evaluated a multimodal falls prevention intervention addressing medications, mobility, and functional risk factors among older adults presenting to the ED for fall-related injuries.</p><p><strong>Methods: </strong>We implemented a quality improvement intervention at two hospitals among ED visits for adults aged 65 and older with a chief complaint of fall between May 2023 and June 2024. The intervention included: (1) medication review by a pharmacist; (2) assessment by physical therapy (PT); and (3) assessment by occupational therapy (OT). We conducted a retrospective evaluation of electronic health records and reported the proportion of patients that received screening along with risk factors, recommendations, adherence to recommendations, and return visits at 3 and 6 months. We used logistic regression to examine factors associated with return visits.</p><p><strong>Results: </strong>We identified 686 older adults who received ≥ 1 screening. Most patients received PT and OT evaluations (94.8% and 93.4%), while fewer (15.2%) received medication reviews. The most common problems identified by PT and OT were fall risk, decreased mobility, and impaired balance. Discharge to a skilled nursing facility was the most common recommendation (55.5% PT, 55.1% OT) followed by home care (33.1% PT, 31.2% OT). High-risk medications most often identified were anticoagulants, antidepressants, and gabapentin. The most common recommendation was to \"discuss with a primary care physician.\" Among those who received ≥ 1 intervention, 8.9% experienced a return visit within 3 months and 12.8% within 6 months. Inpatient admission was associated with increased likelihood of return visits compared to discharge from the ED.</p><p><strong>Conclusion: </strong>The most prevalent risk factors for falls among older adults presenting to the ED are likely modifiable through PT and OT intervention. Further research is needed to address uptake barriers and longitudinal impact on outcomes.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510152","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}