Journal of the American Geriatrics Society最新文献

{"title":"Losses to Follow-Up in a Nationally Representative Study of Community-Living Older Americans: Two Approaches to Censoring and Implications for Mortality Outcomes.","authors":"Thomas M Gill, Jingchen Liang, Robert D Becher, Kendra Davis-Plourde","doi":"10.1111/jgs.70093","DOIUrl":"https://doi.org/10.1111/jgs.70093","url":null,"abstract":"<p><strong>Background: </strong>In the National Health and Aging Trends Study (NHATS), use of its Sensitive files leads to incomplete ascertainment of mortality, largely because of losses to follow-up. To account for these losses, we compared two censoring approaches for evaluating mortality.</p><p><strong>Methods: </strong>In a hybrid approach, most participants were censored at the time of last contact, while the remainder were censored at the time of last completed interview. In the other approach, all participants were censored at the time of last completed interview (LCI). All-cause mortality was evaluated among 7608 and 7498 community-living members of the 2011 (over 10 years) and 2015 (over 5 years) cohorts based on the Sensitive files, with linked Medicare data serving as the reference standard.</p><p><strong>Results: </strong>Using the hybrid and LCI approaches, the median (IQR) follow-up times among nondecedents were 7.7 (5.9-8.7) and 8.8 (6.3-9.9) years shorter for the Sensitive files than Medicare data in the 2011 cohort. The corresponding values in the 2015 cohort were 2.9 (1.8-3.8) and 4.0 (2.2-4.9) years. For both cohorts, cumulative mortality based on the Sensitive files relative to the Medicare data was modestly lower for the hybrid approach but comparable for the LCI approach. The incidence rate ratios (95% CI) for the Sensitive files relative to the Medicare data in the 2011 and 2015 cohorts, respectively, were 0.89 (0.87, 0.91) and 0.89 (0.86, 0.93) for the hybrid approach and 0.98 (0.95, 1.00) and 0.97 (0.94, 1.00) for the LCI approach. However, the numbers of participants at risk for death overtime were considerably smaller for the latter than the former approach.</p><p><strong>Conclusions: </strong>When evaluating mortality using the NHATS Sensitive files, investigators should consider censoring all participants who are lost to follow-up at the time of the last completed interview, recognizing potential trade-offs in terms of reductions in power and precision.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031513","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":"Physical Resilience After Hip Fracture: Unpacking the Roles of Resistance and Recovery.","authors":"Jianhong Xu, Yanxin Wang, Graciela Muniz-Terrera, Qian-Li Xue, Chenkai Wu","doi":"10.1111/jgs.70088","DOIUrl":"https://doi.org/10.1111/jgs.70088","url":null,"abstract":"<p><strong>Background: </strong>Physical resilience-the ability to withstand, recover, or adapt after a stressor-is critical in older adults facing acute insults. We conceptualize physical resilience to comprise two distinct but related components: resistance (immediate physiological response to the stressor) and recovery (subsequent health changes). These two components were used to evaluate how individuals respond to hip fracture-a common and severe geriatric stressor.</p><p><strong>Methods: </strong>Using data from nearly 5000 hip fracture participants, we used linear mixed-effects models to characterize a composite health status, derived from electronic health record diagnoses, 1 year before and after hip fracture. Resistance was assessed as the abrupt change in composite health status immediately after the fracture, whereas recovery represented the subsequent rate of change. We used Cox and Fine-Gray models to identify the associations of resistance and recovery with all-cause and cause-specific mortality, respectively.</p><p><strong>Findings: </strong>We observed a significant and sharp decline in the composite health measure at the time of hip fracture. Following the fracture, the rate of health deterioration accelerated compared to the pre-fracture period. Lower resistance was associated with a 7% increase in mortality (95% CI = 1.06, 1.08); slower recovery was associated with a more than 2-fold increase in mortality (HR = 2.23, 95% CI = 2.05, 2.44). Lower resistance was associated with increased neurodegenerative mortality, whereas lower recovery was associated with increased mortality across most causes of death.</p><p><strong>Conclusions: </strong>Physical resilience is a complex and dynamic process strongly linked to mortality outcomes post-hip fracture. Identifying individuals with lower resilience may improve clinical interventions to enhance recovery and reduce mortality.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145025115","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":"Multi-Component Prehabilitation Program for Older Adults Undergoing Major Elective Surgery: A Pilot and Feasibility Study.","authors":"Kuan-Yuan Wang, Kailin Xu, Yuchen Liu, Sussan Alshanniek, Natalie Newmeyer, Linda Mesnik, Vasundhara Prudhivi, Tulsi Chase, Valluvan Rangasamy, Stephanie M Sison, Sandra M Shi, Thomas G Travison, Balachundhar Subramaniam, Dae Hyun Kim","doi":"10.1111/jgs.70095","DOIUrl":"10.1111/jgs.70095","url":null,"abstract":"<p><strong>Background: </strong>Prehabilitation may help older adults recover after surgery, yet adherence has been variable. We assessed the feasibility of a multi-component prehabilitation program.</p><p><strong>Methods: </strong>This single-arm trial was conducted at an academic medical center to test the feasibility of an individualized prehabilitation program before major surgery. The program consisted of twice-weekly physical therapy, weekly dietician consultations with daily protein supplementation, and weekly group meditation for 3-4 weeks. The primary outcome was adherence, as measured by the proportion of completed sessions. Secondary outcomes included changes in gait speed, chair stands, and grip strength after intervention and Patient-Reported Outcomes Measurement Information System (PROMIS)-Physical Function scores at 90 days post-surgery.</p><p><strong>Results: </strong>Of 95 eligible patients, 30 (31.6%) were enrolled (mean [SD] age, 75.3 [6.6] years; 12 [40.0%] women; 19 cardiac and 11 non-cardiac procedures) and 28 began the intervention. Adherence was 91.3% (190/208 sessions completed) for physical therapy, 76.9% (80/104 sessions completed) for dietician consultation, and 68.3% (71/104 sessions completed) for meditation, with 67.9% of the participants completing at least 50% of each component. Among 25 participants (89.3%) who completed the intervention, mean walking speed increased (0.2 m/s; 95% CI: 0.0-0.4), and mean time to complete 5 chair stands decreased (3.4 s; 95% CI: -6.9 to 0.0), but mean grip strength did not change significantly (1.6 kg; 95% CI: -2.1 to 5.3). Among 22 out of 23 participants (95.7%) who underwent surgery, the mean PROMIS-Physical Function score improved by 4.4 points (95% CI: 3.0-5.9) at 90 days post-surgery compared to baseline. Adverse events included gastrointestinal discomforts (3 events), musculoskeletal pain (3 events), and dizziness (1 event).</p><p><strong>Conclusions: </strong>This study demonstrates the feasibility of multicomponent prehabilitation in older patients scheduled for major elective surgery.</p><p><strong>Trial registration: </strong>NCT05752474.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12453604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017004","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":"Training and Practice Gaps in Nursing Home Palliative Care: A Cross-Sectional Study.","authors":"Manali Saraiya, Molly A Nowels, Rose L Carlson, Jerad H Moxley, Catherine A Riffin, Evan Plys, M Carrington Reid, Isabella Hastings, Taimur Mirza, Ronald D Adelman, Daniel Shalev","doi":"10.1111/jgs.70089","DOIUrl":"https://doi.org/10.1111/jgs.70089","url":null,"abstract":"<p><strong>Background: </strong>Palliative care needs are prevalent among nursing home (NH) residents. However, access to and integration of palliative care services remain limited. NHs often rely on a workforce with varying levels of training and exposure to palliative care, which may influence care quality and consistency. Understanding the perspectives of NH personnel across disciplines about palliative care is essential to developing sustainable models of care.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey of clinical employees (N = 398) at seven NHs within a single integrated health system in New York State to (1) gauge attitudes toward and knowledge about palliative care, (2) estimate the extent of engagement with advance care planning, and (3) elicit perceptions of the most valuable components of palliative care for NH residents. Median regression and ordinal logistic regression were used to assess predictors of palliative care attitudes and of checking for advance care planning documents. Disciplines were grouped into six categories for analysis: MD/NP, RN, social work/case management, rehabilitation services (PT/OT/SLP), CNAs, and LPNs.</p><p><strong>Results: </strong>While most respondents believed that palliative care improves quality of life (Median = 5, IQR 4-5), only 68% correctly identified it as distinct from hospice. Prior exposure to palliative care and favorable attitudes were associated with more frequent checking for advance care planning documents (OR = 1.75 and OR = 1.50, respectively; both p < 0.05). Attitudes varied by discipline, with physical/occupational/speech therapists reporting less favorable views than other groups (B = -0.70, p = 0.005). Respondents prioritized pain management, psychiatric symptom management, and caregiver support as areas where palliative care specialists could offer the greatest help, and further training was most desired.</p><p><strong>Conclusions: </strong>Despite support for palliative care, gaps in knowledge and clinical engagement persist and vary by discipline. Discipline-tailored training and program design may improve palliative care delivery in NHs and help ensure more consistent, value-aligned care for residents with serious illness.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016963","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":"Caregiving Network Characteristics and Mental Health Care Utilization by Older Adults.","authors":"Mary F Wyman, Josephine Jacobs, Lily Stalter, Manasa Venkatesh, Ranak B Trivedi, Amy L Byers","doi":"10.1111/jgs.70082","DOIUrl":"https://doi.org/10.1111/jgs.70082","url":null,"abstract":"<p><strong>Background: </strong>Rates of mental health service use are low among older adults. This study examined associations between mental health care utilization and caregiving network characteristics, including caregiving network size, caregiving intensity, the presence of formal helpers, and primary caregiver characteristics.</p><p><strong>Methods: </strong>Using a sample of 692 respondents in the health and retirement study (HRS) with linkage to veterans affairs healthcare records (mean age = 78.7, SD = 8.08; 97.1% male), logistic regression models tested caregiving network characteristics as predictors of mental health care utilization, adjusting for demographics and health conditions. Moderation effects of cognitive status (Langa-Weir HRS Classification) and depressive symptoms (CESD-8 Scale) were explored.</p><p><strong>Results: </strong>Mean network size was 1.6 helpers (SD 1.0), with 77.6% of networks comprising only family caregivers and 41.7% of care recipients reporting high-intensity caregiving. Primary caregiver was most often a spouse (61.1%) and female (89.4%, n = 49 (7.1%) missing data). In multivariable models, primary caregiver female gender was associated with a three-fold increase in likelihood of mental health service utilization (OR = 3.95, 95% CI 1.72-9.05), while other caregiving network characteristics were not associated. Having a primary caregiver who was female was most strongly associated with service utilization for care recipients with less severe depressive symptoms or impaired cognition.</p><p><strong>Conclusions: </strong>Caregiver characteristics, particularly gender, may be important factors in facilitating greater mental health care use for older veterans. Targeted education and support may improve caregivers' effectiveness as a resource to help reduce age-related disparities in mental health access. This study contributes to the growing body of research examining the impact of caregivers on healthcare outcomes of older adults.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994891","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":"Communication Surrounding Treatment Preferences for Older Adults With Dementia During Emergency Medical Services Response.","authors":"Lauren R Pollack, Danae G Dotolo, Anna L Condella, Whitney A Kiker, Jamie T Nomitch, Elizabeth Dzeng, Nicholas J Johnson, Thomas D Rea, May J Reed, Michael R Sayre, Erin K Kross","doi":"10.1111/jgs.70078","DOIUrl":"https://doi.org/10.1111/jgs.70078","url":null,"abstract":"<p><strong>Background: </strong>Emergency Medical Services (EMS) providers, capable of rapidly delivering life-prolonging interventions, are often first to respond to acute health concerns for older adults in the United States. Prior work has shown a preference among many people with dementia for comfort-focused care near end-of-life. People with dementia frequently use EMS; however, little is known about communication surrounding treatment preferences during EMS response for this group.</p><p><strong>Methods: </strong>We conducted a qualitative content analysis of EMS incident reports for older adults with dementia transported to two urban academic hospitals (2011-2021). We identified eligible patients in the hospital electronic health record applying the following criteria: age ≥ 65, diagnosis code indicating dementia, assessment by EMS, hospitalization between 2011 and 2021, and National Early Warning Score ≥ 7 indicating critical illness. We characterized the frequency and content of documented patient treatment preferences in EMS incident reports and identified barriers and facilitators to communication about treatment preferences or goal-concordant care.</p><p><strong>Results: </strong>We reviewed incident reports for 171 patients with a median age of 82 (IQR 12) years. About half (51%) of the patients were residing in nursing homes. A minority (23%) of the patients were described as able to communicate needs, and only 24% had a family member or friend present at the time of EMS assessment. Treatment preferences were mentioned in 27% of the reports. EMS providers documented barriers to communication or delivery of goal-concordant care in nursing home settings that included difficulty obtaining information from professional caregivers, receiving secondhand information, and variable role expectations. Goal-concordant care was facilitated in these settings when EMS providers spoke directly with patients' family members by telephone.</p><p><strong>Conclusions: </strong>EMS providers treating critically ill older adults with dementia face challenges that may hinder their ability to elicit treatment preferences, in particular when responding to calls from professional caregivers. Direct communication with surrogate decision-makers may facilitate goal-concordant care.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994944","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":"The National Dementia Workforce Study: The Plan for Organization Sample Frames and Data Collection.","authors":"James Wagner, Laura M Wagner, Sheryl Zimmerman, Johanna van Tyen Silbersack Hickey, Kate Stewart, Sandi Nelson, Ji Qi, Raphael Nishimura, Piotr Dworak, Margaret Hudson, Jennifer Kelley, Heidi Guyer, Amy R Pettit, Donovan T Maust, Joanne Spetz","doi":"10.1111/jgs.70036","DOIUrl":"10.1111/jgs.70036","url":null,"abstract":"<p><p>The National Dementia Workforce Study was designed to improve our understanding of the individuals and systems who care for people with dementia, but designing and implementing such a study is challenging due to the large number of patient care organizations, clinical and direct care roles, and locations in which care is provided. Specifically, developing a probability sample of organizations and staff caring for people with dementia is a complex and difficult process. While there are national sampling frames available for federally certified nursing homes (i.e., via data from the Center for Medicare and Medicaid Services), there are no national sampling frames for assisted living communities or home care agencies. The latter frames must be developed through querying state-level regulatory agencies and through other, supplemental strategies such as working with professional organizations, large employers, and organizations that provide services (e.g., payroll services) to this sector. Further, since there are no national sampling frames that allow for direct sampling of staff working in any of these types of organizations, we opted for a two-stage design. In the first stage, organizations are identified, sampled, recruited to participate in an organizational-level survey, and asked to provide a roster of eligible staff. In the second stage, individual staff members are recruited for a staff-level survey. We describe the plan for sampling and recruitment procedures to be used in each stage and discuss limitations, including implications for coverage of the target population. Data collected through these surveys will be available to the research community.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002359","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":"A Meta-Analysis of Sex-Based Differences in Health Service Use for Persons Living With Dementia Between 2018 and 2020 in Four Canadian Provinces.","authors":"María Alejandra Rodríguez-Duarte, Isabelle Marie Vedel, Deniz Cetin-Sahin, Ilhem Bousbiat, Claire Godard-Sebillotte, Nadia Sourial, Laura C Maclagan, Christina Diong, Susan E Bronskill, Dallas Seitz, Debra Morgan, Louis Rochette, Victoria Massamba, Jacqueline Quail, Geneviève Arsenault-Lapierre","doi":"10.1111/jgs.70066","DOIUrl":"https://doi.org/10.1111/jgs.70066","url":null,"abstract":"<p><strong>Background: </strong>Ensuring equitable healthcare services for persons with dementia is of utmost importance. Recent evidence points to sex-based differences in healthcare use in this population. However, available evidence is based on data from limited geographic regions and predates the COVID-19 pandemic, which is said to have further magnified disparities. This study aims to estimate sex-based differences in ambulatory and acute care service use in persons with dementia in four Canadian provinces between 2018 and 2020.</p><p><strong>Methods: </strong>A retrospective multicohort design was conducted using linked health administrative data from Quebec, Ontario, Alberta, and Saskatchewan. Three cohorts (2018, 2019, and 2020) of community-dwelling persons aged 65 and older with dementia were identified. Within each cohort, rates of sex-stratified outcomes were calculated (per 10,000 person-years). The outcomes were visits to family physicians, cognitive specialists, other specialists, all-cause emergency departments, and all-cause hospitalizations. Estimates of the incidence rate difference (IRD) between males and females within each cohort year for each outcome were pooled using random-effect meta-analysis.</p><p><strong>Results: </strong>The 2018, 2019, and 2020 cohorts included 97,811, 100,316, and 103,638 females, respectively. Similarly, 64,628, 67,013, and 69,839 males were included in the same respective cohorts. We found sex differences in ambulatory and acute care use in all three cohorts. Compared to females, males with dementia had higher rates of other specialists' visits, emergency department visits, and all-cause hospitalizations, with significant IRDs during the three cohort years.</p><p><strong>Conclusion: </strong>Consistent sex differences in healthcare use by persons with dementia were observed before and during the pandemic in four Canadian provinces, especially in acute care. This emphasizes the need to address sex-based differences in dementia care, ultimately working toward ensuring equitable and tailored healthcare services to enhance the quality of care and experiences for all persons with dementia.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994934","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":"Few Older Women Are Aware of Guidelines on When to Stop Breast Cancer Screening.","authors":"Nancy L Schoenborn, Qian-Li Xue, Sarah E Gollust, Rebekah H Nagler, Craig E Pollack, Cynthia M Boyd, Mara A Schonberg","doi":"10.1111/jgs.70080","DOIUrl":"10.1111/jgs.70080","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994886","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":"The National Dementia Workforce Study: Development of Questionnaires for Home Care, Assisted Living, and Nursing Home Settings.","authors":"Joanne Spetz, Laura M Wagner, Elizabeth M White, Susan A Chapman, Winston Chiong, Esther M Friedman, Lauren B Gerlach, Krista L Harrison, Lauren J Hunt, Soo-Jeong Lee, Ulrike Muench, Katherine Possin, Alissa Sideman, Johanna van Tyen Silbersack Hickey, Pongpat Putthinun, Jarmin Yeh, Sofia Sandoval, Amber Rose, Joanie Rothstein, Amy R Pettit, Donovan T Maust, Sheryl Zimmerman","doi":"10.1111/jgs.70048","DOIUrl":"10.1111/jgs.70048","url":null,"abstract":"<p><p>The growing aging population and rising prevalence of dementia are driving increased demand for long-term care services and supports in the United States. People with dementia require substantial support and care, often from direct care workers in private homes, assisted living communities, and nursing homes. Despite their crucial role, these workers receive highly variable training, particularly in dementia care, and face significant work-related challenges including stress, injury, and burnout. The National Dementia Workforce Study (NDWS), sponsored by the National Institute on Aging, was designed to include large-scale, nationally representative annual surveys of staff and administrators providing care to individuals with dementia in home care, assisted living, and nursing homes, and of community clinicians practicing across settings. NDWS will capture workforce demographics, training adequacy, job satisfaction, and their impact on dementia care quality. This report describes NDWS's rigorous process for questionnaire design for the initial wave of home care, assisted living, and nursing home surveys. Our survey development methods integrated literature reviews, validated questionnaire items, expert consultations, and cognitive interviews to ensure instrument reliability and validity. Resulting survey data will be available to researchers seeking to examine workforce conditions, training, and worker knowledge, and their impact on care for people with dementia. NDWS infrastructure will also allow researchers to link survey responses with administrative and medical claims data to examine how workforce dynamics and organizational factors are associated with outcomes for people with dementia over time, enabling insights into policies to improve dementia care training, workforce retention, and care delivery.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12407246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144984038","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}