Journal of the American Geriatrics Society最新文献

{"title":"The Idea of Health.","authors":"Jeremiah A Barondess","doi":"10.1111/jgs.19514","DOIUrl":"https://doi.org/10.1111/jgs.19514","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236311","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":"Mapping the Final Journey: End-Of-Life Frailty Trajectories and Cause of Death.","authors":"Jianhong Xu, Jonathan Ka-Long Mak, Qian-Li Xue, Chenkai Wu","doi":"10.1111/jgs.19567","DOIUrl":"https://doi.org/10.1111/jgs.19567","url":null,"abstract":"<p><strong>Background: </strong>Frailty changes associated with aging have been well-documented in existing research. However, there is limited evidence on how frailty progresses during the end-of-life stage. We aimed to explore trajectories of frailty in the last year of life and explore how the distribution of these trajectories differs according to the conditions leading to death.</p><p><strong>Methods: </strong>Based on national death registries linkage data in the UK Biobank, 37,465 decedents were included in the analytic sample. Monthly frailty scores were obtained for 1 year prior to death using the Hospital Frailty Risk Score (HFRS; a cumulative deficit measure of frailty). Latent class trajectory models were used to estimate trajectories of frailty. We further analyzed the distribution of these frailty trajectories across different conditions leading to death. Multinomial logistic regression models were applied to examine the associations between predictors and frailty trajectories.</p><p><strong>Results: </strong>Among 37,465 decedents, 2895 (7.7%) died from neurodegenerative diseases. Three distinct frailty trajectories were identified among these decedents: rapidly progressive frailty (6.9%), moderate progression of frailty (21.1%), and advanced and stable frailty (72.0%). These patterns differed significantly from those observed in decedents with other causes of death, who exhibited persistently low frailty (24.7%), intermediate and progressive frailty (46.5%), and advanced and progressive frailty (28.8%). Compared to cancer decedents, individuals with neurodegenerative diseases had higher baseline frailty and a dominant trajectory of advanced and stable frailty. Older age, lower education, and greater chronic disease burden were associated with the advanced and progressive frailty trajectory.</p><p><strong>Conclusions: </strong>Frailty trajectories at the end of life varied by cause of death, with neurodegenerative disease decedents exhibiting more severe frailty. These findings underscored the need for early identification of frailty and tailored end-of-life care strategies, particularly for individuals with neurodegenerative diseases who often experienced prolonged and severe frailty.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236310","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":"Under Documentation of Anemia in Older Ambulatory Patients.","authors":"Min Woo Hwang, Hirra A Chaudhary, William B Ershler","doi":"10.1111/jgs.19503","DOIUrl":"https://doi.org/10.1111/jgs.19503","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236313","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":"Does Documenting a Dementia Diagnosis Improve Outcomes?","authors":"Jerry H Gurwitz","doi":"10.1111/jgs.19557","DOIUrl":"https://doi.org/10.1111/jgs.19557","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236309","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":"Transitional Care Management in Persons With Dementia After Heart Failure Hospitalization and Skilled Nursing Facility Care.","authors":"Thomas A Bayer, Hiren Varma, Peter A Hollmann, Pedro L Gozalo","doi":"10.1111/jgs.19563","DOIUrl":"https://doi.org/10.1111/jgs.19563","url":null,"abstract":"<p><strong>Background: </strong>Dementia complicates care transitions, such as discharge from heart failure hospitalization to a skilled nursing facility (SNF) and then to home. Transitional care management (TCM), a bundled service that includes telephone communication within 2 business days and an office visit within 14 days, potentially addresses this problem.</p><p><strong>Methods: </strong>We analyzed trends in TCM among Medicare beneficiaries with dementia hospitalized for heart failure in 2013-2017, comparing hospital-home discharges to hospital-SNF-home discharges. We then used a retrospective cohort study to estimate the risk-adjusted association of TCM with successful discharge home.</p><p><strong>Results: </strong>TCM occurred in 45 (2.3%) of 1990 eligible hospital-SNF-home discharges in year 2013, increasing to 205 (9.8%) of 2095 eligible in year 2017. In a cohort of 11,376 hospital-SNF-home transitions, the relative risk (95% CI) of successful community discharge was 1.24 (1.11-1.40) with TCM compared with no office visit within 14 days of discharge or TCM.</p><p><strong>Conclusions: </strong>Persons with dementia transitioning from heart failure hospitalization to SNF to home receive TCM less frequently than persons discharged directly home from the hospital. Nonetheless, TCM is associated with successful discharge in this vulnerable group of patients.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144236312","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 Large Health System Quality Improvement Intervention Providing Training and Tools to Improve Detection of Cognitive Impairment in Primary Care.","authors":"Barak Gaster, Monica Zigman Suchsland, Joshua M Liao, Sarah McKiddy, Annette L Fitzpatrick, Basia Belza, Amy P Hsu, Jaqueline Raetz","doi":"10.1111/jgs.19565","DOIUrl":"https://doi.org/10.1111/jgs.19565","url":null,"abstract":"<p><strong>Background: </strong>Primary care providers (PCPs) are at the forefront of evaluating cognitive concerns and detecting Alzheimer's disease and related dementias (ADRD), but they generally lack the training and tools to do so.</p><p><strong>Methods: </strong>We performed a 2-year pragmatic intervention across a large health system of 14 community-based primary care clinics (94 PCPs). The intervention consisted of an education series integrated with workup tools in the exam room to assist PCPs in evaluating cognition. Electronic health record (EHR) data was extracted for 9 months before and 9 months after the intervention. Outcome measures were the number of cognitive assessments that PCPs recorded as discrete results in the EHR and the number of patients who PCPs newly diagnosed with an ADRD-related diagnosis.</p><p><strong>Results: </strong>Comparing EHR data from the 9 months before the intervention to the 9 months after the intervention, the number of cognitive assessments documented in the EHR increased from 2.8 per month to 19.8 per month (p < 0.001), and the number of new ADRD-related diagnoses made by PCPs increased from 6.2 per month to 14.6 per month (p = 0.012).</p><p><strong>Conclusions: </strong>An intervention integrating tools for PCPs to use in the exam room, together with concise continuing education, increased the number of cognitive evaluations and the number of ADRD-related diagnoses in a large primary care health system. Such interventions are essential for building age-friendly ambulatory health systems and connecting patients to improved and innovative models of ADRD care.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228089","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: Comment on \"Accelerating the Pace of Elder Justice Policy to Meet the Needs of a Growing Aging Population\".","authors":"Kristin E Lees Haggerty, Gary Epstein-Lubow","doi":"10.1111/jgs.19523","DOIUrl":"https://doi.org/10.1111/jgs.19523","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228007","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":"An Initiative to Address Health Disparities: Calls, Advocacy, and Resources for OldEr Adults (CARE).","authors":"Morgan M Nakatani, Victoria Lue, Nicole J Schindler, Sandro Pinheiro de Oliveira, Liza Genao","doi":"10.1111/jgs.19558","DOIUrl":"https://doi.org/10.1111/jgs.19558","url":null,"abstract":"<p><p>Goals and components of the Calls, Advocacy, and Resources for OldEr Adults program.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228090","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":"Readiness and Barriers to Participate in Alzheimer's and Dementia Research Among Older Adults.","authors":"Oshadi Jayakody, Helena M Blumen, Morgan Grabanski, Mirnova Ceïde, Claudene George","doi":"10.1111/jgs.19568","DOIUrl":"https://doi.org/10.1111/jgs.19568","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228006","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":"Comment on: Accelerating the Pace of Elder Justice Policy to Meet the Needs of a Growing Aging Population.","authors":"Pi-Ju Liu","doi":"10.1111/jgs.19524","DOIUrl":"https://doi.org/10.1111/jgs.19524","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144228091","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}