Journal of the American Geriatrics Society最新文献

{"title":"Post-Stroke Atrial Fibrillation Detection With Insertable Cardiac Monitors in Patients With Dementia and Frailty.","authors":"Peter T Evans, Xiecheng Chen, Sachin Shah, Dae Hyun Kim, Darae Ko","doi":"10.1111/jgs.70180","DOIUrl":"https://doi.org/10.1111/jgs.70180","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357420","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":"Willingness to Participate in Deprescribing Trials: A Survey of Older Adults in Two Countries.","authors":"Sarah E Vordenberg, Noelia Dulo, Alexander Chaitoff, Kirsten Ingwersen, Kristie Rebecca Weir","doi":"10.1111/jgs.70186","DOIUrl":"https://doi.org/10.1111/jgs.70186","url":null,"abstract":"<p><strong>Background: </strong>This study investigates the willingness of older adults to participate in a hypothetical deprescribing clinical trial.</p><p><strong>Methods: </strong>We conducted an online survey of adults aged 65+ years in Australia and the United States. Participants rated their willingness to enroll in a deprescribing trial, responding to the statement, \"Research is conducted to assess the safety and effectiveness of stopping medicines. Imagine your doctor made you aware of a research trial aiming to help people stop one or more of their medicines. To what extent would you be willing to enroll in the study?\" on a 6-point Likert scale with \"Not at all willing (1)\" and \"Extremely willing (6)\" as the scale anchors. Participants provided a brief free-text explanation. We dichotomized the outcome variable as willing (scores 4-6) and unwilling (scores 1-3) to enroll and conducted descriptive analyses, chi-square tests, and univariate and multivariate logistic regression models. Free-text responses were analyzed using content analysis, with descriptive statistics summarizing themes.</p><p><strong>Results: </strong>There were 2334 participants in the quantitative analysis and 2237 participants in the content analysis. Most were willing (n = 1705, 73%) rather than unwilling (n = 629, 27%) to enroll in a deprescribing trial (p < 0.001, 95% CI 0.712, 0.748). Over one-half of participants (n = 1252, 56%) expressed the \"positive about deprescribing trials\" domain, with Australian participants more likely to do so (AU 666 [60%] vs. US 586 [52%], p < 0.001). Participants (n = 1047, 47%) frequently reported at least one theme of the \"concerns and hesitations\" domain (n = 669, 30%) with US participants more frequently expressing negative views (US 273 [24%] vs. AU 211 [19%], p = 0.002) and reporting the \"mistrust\" theme (US 74 [7%] vs. AU 35 [3%], p < 0.001).</p><p><strong>Conclusions: </strong>Older adults showed a willingness to engage in deprescribing trials, though concerns may affect enrollment. Clear communication of risks and benefits could support recruitment.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145357361","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":"Association of Inpatient Prescribing of First-Generation Antihistamines With Delirium in Older Adults: A Cross-Sectional Study.","authors":"Alanna C Bridgman, Mohammad Arshad Imrit, Surain B Roberts, Mina Tadrous, Nathan M Stall, Michael Fralick, Jennifer Watt, Amol A Verma, Fahad Razak, Aaron M Drucker","doi":"10.1111/jgs.70121","DOIUrl":"https://doi.org/10.1111/jgs.70121","url":null,"abstract":"<p><strong>Background: </strong>Small studies have reported associations between first-generation antihistamines and delirium. It is unclear whether first-generation antihistamines cause clinically important delirium among older adult inpatients.</p><p><strong>Objective: </strong>To estimate the association between inpatient physician prescribing of first-generation antihistamines and delirium among older general medicine inpatients.</p><p><strong>Methods: </strong>Cross-sectional study using the GEMINI database of inpatient admissions between April 1, 2015, and March 31, 2022, across 17 hospitals in Ontario, Canada, among people aged 65 years and older. The main exposure was the proportion of attending physicians' admissions by quartile that included a first-generation antihistamine prescription. The primary outcome was inpatient delirium identified using a machine learning tool. We estimated the association between attending physicians' first-generation antihistamine prescribing rate and individual inpatients' risk of delirium using multivariable mixed-effects logistic regression.</p><p><strong>Results: </strong>Among 328,140 inpatient admissions to 755 physicians, 11,507 (3.5%) admissions included a first-generation antihistamine prescription. Physicians in the lowest quartile prescribed a first-generation antihistamine during 2.1% of admissions compared to 5.4% of physicians in the highest quartile. Delirium occurred in 32.3% of admissions to the lowest-prescribing quartile and 36.6% of the highest-prescribing quartile of physicians. In adjusted analyses, every 1% absolute increase in first-generation antihistamine prescribing was associated with 8% increased odds of delirium (aOR: 1.08, 95% CI: 1.05-1.10). Patients admitted to physicians in the highest quartile had 41% increased odds of delirium compared to the lowest quartile (aOR: 1.41, 95% CI: 1.28-1.56).</p><p><strong>Conclusions: </strong>Older adults admitted to physicians who prescribe first-generation antihistamines more commonly were more likely to experience delirium in the hospital.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350794","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":"Aligning Innovation With Care: Continuous Glucose Monitoring in Skilled Nursing Facilities.","authors":"Hyungsoek Daniel Oh, Thaer Idrees, Theodore M Johnson","doi":"10.1111/jgs.70168","DOIUrl":"https://doi.org/10.1111/jgs.70168","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350831","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":"Characterization of National Institute on Aging-Funded Clinical Trials for Alzheimer's Disease.","authors":"Kavya M Shah, Bhav Jain, Abhinav Komanduri, Sravya Kuchibhotla, Urvish Jain, Rishi M Shah, Kevin A Schulman","doi":"10.1111/jgs.70185","DOIUrl":"https://doi.org/10.1111/jgs.70185","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350756","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-Generational Hospital Scene: Analysis of a Painting.","authors":"Esther-Lee Marcus, Shapir Rosenberg","doi":"10.1111/jgs.70178","DOIUrl":"https://doi.org/10.1111/jgs.70178","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145350810","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":"Effectiveness of Exercise in Older Adults Discharged From the ER After Minor Injuries: The CEDeComS Stepped-Wedge Trial.","authors":"Marie-Josée Sirois, Joannie Blais, Mylène Aubertin-Leheudre, Pierre-Hugues Carmichael, Laurence Fruteau de Laclos, Audrey Desjardins, Raoul Daoust, Debra Eagles, Jacques Lee, Jeffrey J Perry, Nancy M Salbach, Marcel Émond","doi":"10.1111/jgs.70166","DOIUrl":"https://doi.org/10.1111/jgs.70166","url":null,"abstract":"<p><strong>Background: </strong>Older adults consulting Emergency Departments (EDs) for minor injuries are at risk for new functional impairments in the 6 months following their injuries.</p><p><strong>Objective: </strong>To compare the effects of exercise programs versus usual ED practices on functional status and physical performance at 3-6 months in at-risk older adults with minor injuries.</p><p><strong>Design and settings: </strong>Stepped-wedge randomized trial in six Canadian EDs from 2017 to 2020. Participants aged ≥ 65 years were screened for low, moderate, or high risk of functional decline and assessed three times: baseline at ED, 3 and 6 months.</p><p><strong>Intervention and measures: </strong>Multicomponent (flexibility, balance, strengthening, aerobic) and risk-level adapted exercise programs targeting moderate- and high-risk patients, 3×/week for 12 weeks, at home or in community groups.</p><p><strong>Control: </strong>Usual ED care.</p><p><strong>Measures: </strong>Functional decline was defined as a 2/28-point loss from baseline on the Older Americans Resources and Services (OARS) scale. Basic physical performance (leg strength, balance, walking speed) was measured using the Short Physical Performance Battery (SPPB) test. Generalized linear mixed log-binomial regressions were used to examine the effects of the intervention on outcomes compared to usual ED care, stratified by risk level.</p><p><strong>Results: </strong>The intervention and control phases included 277 and 205 moderate-risk individuals, and 249 and 128 high-risk individuals, respectively. Among moderate-risk individuals, functional loss in intervention participants at 3 months was half that of controls: 12% [95% CI: 8%-17%] vs. 25% [95% CI: 18%-34%], RR: 0.48 [0.26, 0.90].</p><p><strong>Conclusion: </strong>12-week multicomponent exercises implemented early after minor injuries are associated with lower proportions of functional decline at 3 months in moderate-risk seniors and may help those at high risk recover some physical performance.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov, ID Cedecoms NCT03991598.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145338376","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":"Association Between Herpes Zoster and Risk of Incident Fragility Fractures in US Veterans: A Matched Cohort Study.","authors":"Calif A A Yousuf, Julie A Womack, Roger J Bedimo, Christopher T Rentsch, Charlotte Warren-Gash","doi":"10.1111/jgs.70174","DOIUrl":"https://doi.org/10.1111/jgs.70174","url":null,"abstract":"<p><strong>Background: </strong>Herpes zoster (HZ) and fragility fractures typically affect older adults and present major burdens to healthcare systems. While HZ is associated with an increased risk of neurological, ocular, skin, and visceral complications, it is unclear whether it affects long-term bone health. Therefore, we aimed to compare the risk of fragility fractures in Veterans with HZ relative to matched Veterans without HZ in the United States.</p><p><strong>Methods: </strong>We used routinely collected data from the Veterans Aging Cohort Study (VACS-National) from 01/01/2008 to 31/12/2023. Veterans with incident HZ diagnoses aged 40+ were matched on age, sex, race, ethnicity, site of care, and calendar time with up to five Veterans without HZ. The association between HZ and subsequent fragility fractures (defined as hip/femoral, shoulder/upper arm, vertebral, and wrist/forearm fractures) overall and by site was assessed using a Cox model stratified by matched set adjusting for sociodemographic, lifestyle, and clinical confounders. Age, frailty, and receipt of antivirals (AVT) within 7 days of exposure were investigated as potential effect modifiers for the relationship.</p><p><strong>Results: </strong>We included 229,992 Veterans with HZ matched to 1,134,519 Veterans without HZ. Both groups were comparable in median age (67.8 vs. 67.7 years), percentage males (93.5% vs. 93.7%), and median follow-up time (5.9 vs. 5.4 years). Veterans with HZ had a 15% higher risk of incident fragility fracture (aHR = 1.15, 95% CI: 1.13, 1.18) compared to Veterans without HZ. The increased risk was observed for each fracture site. There was evidence of interaction by age, frailty, and receipt of AVT, as older, frailer, and AVT-treated Veterans had a higher risk of fragility fracture.</p><p><strong>Conclusions: </strong>Veterans with HZ were at a higher risk of fragility fractures relative to Veterans without HZ, highlighting the need for improved fracture prevention among those diagnosed with HZ. Further research in non-Veteran and female populations will improve generalizability.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310546","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":"Reply to: The Unseen Burden: Undiagnosed Hypoglycemia and the Need for CGM in Long-Term Geriatric Care.","authors":"Marzan A Khan, Medha N Munshi, Christine Slyne, Nina R Joyce, Andrew R Zullo","doi":"10.1111/jgs.70147","DOIUrl":"https://doi.org/10.1111/jgs.70147","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310575","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":"Prevalence and Duration of Potential Drug-Drug Interactions Among US Nursing Home Residents, 2018-2020.","authors":"Laura A Reich, Lori A Daiello, Sarah D Berry, Adam M D'Amico, Douglas P Kiel, Daniel A Harris, Kaleen N Hayes, Charles E Leonard, Yu-Chia Sam Hsu, Andrew R Zullo","doi":"10.1111/jgs.70175","DOIUrl":"https://doi.org/10.1111/jgs.70175","url":null,"abstract":"<p><strong>Background: </strong>Nursing home (NH) residents are at increased risk of drug-drug interactions (DDIs) due to multimorbidity and polypharmacy. While prior research suggests that many DDIs lead to adverse drug events in older adults, the extent of exposure to potentially clinically relevant DDIs among United States (US) NH residents is largely unknown.</p><p><strong>Methods: </strong>In this cohort study, we calculated the prevalence and duration of exposure to 98 potential DDIs among US NH residents from 2018 to 2020. DDIs were sourced from three expert consensus publications, some of which defined similar interactions and overlapping drug combinations, allowing comparisons within and across lists. Data were drawn from Medicare claims linked to Minimum Data Set 3.0 clinical assessments. Eligible residents included Medicare Fee-for-Service beneficiaries aged ≥ 66 years living in NHs with observable Part D prescription drug data. DDI exposure was defined as ≥ 1 day of concurrent use of orally administered medications. Prevalence was calculated as the proportion of residents exposed to each DDI; duration was measured as the median number of days residents concurrently used the medications of interest.</p><p><strong>Results: </strong>Among 485,251 NH residents, 61.6% experienced ≥ 1 potential DDI over 272,780 person-years. The 12 most prevalent DDIs involved central nervous system (CNS)-active drugs, anticholinergics, antihypertensives, opioids, and diuretics. Of these DDIs, concurrent use of acetylcholinesterase inhibitors and heart rate-reducing drugs had the longest median exposure duration (81 days; Q1-Q3, 24-235). The most prevalent DDI, concomitant use of ≥ 3 CNS-active drugs, was observed in 27.1% (95% CLs, 27.0%, 27.2%) of residents.</p><p><strong>Conclusions: </strong>Nearly two-thirds of NH residents were exposed to medication combinations linked to potential DDIs, although the prevalence and duration of exposure associated with individual DDIs varied. Future research should determine which DDIs are most clinically significant and investigate barriers to reducing exposure duration in this high-risk population.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":4.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310590","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}