Journal of the American Geriatrics Society最新文献

{"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}

{"title":"Facilitators of and Barriers to Deprescribing Diabetes Medications in Older Adults: A Qualitative Study.","authors":"Aimee N Pickering, Sam Richardson, Shari Rogal, Carolyn T Thorpe, Jennifer Brach, Thomas R Radomski","doi":"10.1111/jgs.19550","DOIUrl":"https://doi.org/10.1111/jgs.19550","url":null,"abstract":"<p><strong>Background: </strong>Over half of older adults with diabetes remain on overly intensive or inappropriate medication regimens to treat diabetes and related complications, leading to adverse drug events, polypharmacy, and increased risk of hospitalization and death. This study aimed to identify facilitators and barriers to deprescribing diabetes medications in this population.</p><p><strong>Methods: </strong>We conducted 15 semi-structured interviews with adults aged 65 and older with diabetes who were on at least one high-risk hypoglycemic medication (e.g., sulfonylurea) or potentially inappropriate medication to treat diabetes-related peripheral neuropathy (e.g., tricyclic antidepressant) and 10 family caregivers of older adults meeting inclusion criteria. Interviews explored participants' general perspectives on diabetes medications, as well as barriers to and facilitators of following a prescriber's recommendation to deprescribe a diabetes medication. Interviews were audio recorded and transcribed verbatim. Two members of the research team developed a codebook, coded the transcripts, and reconciled any discrepancies. We then conducted a thematic analysis to identify key themes.</p><p><strong>Results: </strong>We identified various factors influencing the views of patients and caregivers, which we categorized into four groups: patient-, prescriber-, medication-, and process-related facilitators and barriers. Patient-related facilitators included understanding of prescriber rationale and preference to minimize medications, while barriers included fear of negative consequences. Prescriber-related facilitators included trust, perceived investment in care, perceived expertise, and collaboration with other prescribers. Medication-related barriers included perceived benefit and a lack of side effects impacting quality of life. Lastly, process-related facilitators included a gradual reduction of medications, a detailed follow-up plan, and the option to restart the medication if necessary.</p><p><strong>Conclusion: </strong>We identified key facilitators and barriers that influence patients' and caregivers' willingness to have diabetes medications deprescribed. Our findings will inform the development of targeted strategies to support deprescribing diabetes medications in older adults.</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":"144228005","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":"Behind Bars and Beyond Reach: Systemic Barriers to Preventive and Palliative Healthcare for Justice-Involved Older Adults.","authors":"Kriti Prasad, Ricardo Cruz, Ryan Chippendale","doi":"10.1111/jgs.19560","DOIUrl":"https://doi.org/10.1111/jgs.19560","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210590","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":"Oral Health, Xerogenic Medications, and Frailty in Acutely Ill Older Adults.","authors":"Ingrid Beate Ringstad, Rita Romskaug, Leonor Roa Santervas, Katrine Gahre Fjeld, Lene Hystad Hove, Eva Skovlund, Torgeir Bruun Wyller, Janicke Liaaen Jensen","doi":"10.1111/jgs.19564","DOIUrl":"https://doi.org/10.1111/jgs.19564","url":null,"abstract":"<p><strong>Background: </strong>Oral health is an essential part of overall health and well-being in older adults and may be influenced by medications and frailty. This study aimed to describe the prevalence of xerostomia and hyposalivation and examine their associations with xerogenic medications and frailty in acutely ill older adults.</p><p><strong>Methods: </strong>This cross-sectional study included patients aged ≥ 70 years admitted to the Municipal In-Patient Acute Care unit in Oslo, Norway. General xerostomia was defined as a score ≥ 3 on the General Xerostomia Question (GXQ). Specific xerostomia was measured with the Summated Xerostomia Inventory (SXI). Objective dry mouth measures included unstimulated whole saliva (UWS) secretion rate and the Clinical Oral Dryness Score (CODS), with hyposalivation defined as UWS ≤ 0.1 mL/min. Examination of dentition included numbers of missing teeth and posterior occluding pairs of teeth. Medication data included total drug burden and number of xerogenic medications. Frailty was assessed using the Clinical Frailty Scale (CFS). Associations were analyzed using logistic regression models.</p><p><strong>Results: </strong>Among 382 patients (mean age 84 years, 72% women), general xerostomia was present in 30% and hyposalivation in 56%. Mean number (SD) of xerogenic medications was 3.7 (±2.2). The number of xerogenic medications used was significantly associated with general xerostomia in both unadjusted (OR: 1.17, 95% CI: 1.05-1.29) and adjusted models (OR: 1.13, 95% CI: 1.01-1.26). Median UWS declined numerically with increasing number of xerogenic medications. Higher CFS scores were associated with increased subjective xerostomia scores (GXQ and SXI), elevated CODS, more missing teeth, and reduced occlusion, but not with general xerostomia or hyposalivation when predefined cut-off values were applied.</p><p><strong>Conclusion: </strong>Xerostomia and hyposalivation were common among acutely ill older adults. General xerostomia was associated with xerogenic medication use and frailty. Our findings highlight the need to incorporate oral health assessments into routine geriatric care and emphasize the importance of interdisciplinary collaborations.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144210591","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":"Balancing Independence and Adherence: A Team-Based Approach to Overcoming Barriers in Geriatric Cancer Care.","authors":"Thomas George, Jaime Rosenthal, Evgenia Granina, Meredith Halpin, Ryan Z Chippendale","doi":"10.1111/jgs.19562","DOIUrl":"https://doi.org/10.1111/jgs.19562","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217960","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":"Cocota's Story: Life Lessons in Aging, Resilience, and End-of-Life Agency From a Brazilian Matriarch.","authors":"Thiago J Avelino-Silva, Niousha Moini","doi":"10.1111/jgs.19566","DOIUrl":"https://doi.org/10.1111/jgs.19566","url":null,"abstract":"<p><p>Resilience is increasingly recognized as a central factor in how older adults adapt to life's inevitable changes, yet many clinicians remain unfamiliar with its practical applications in late life. Drawing on the true story of Cocota, a Brazilian matriarch who lived to be 100, this special article illustrates how resilience is neither a static trait nor limited to mere survival. Instead, it emerges over decades, shaped by early adversities and sustained through purposeful roles, strong social ties, and an enduring sense of autonomy. Although psychological, social, and spiritual resources are crucial, physiological resilience also plays an essential role, reflecting adaptive responses at organ, cellular, and molecular levels that help older adults recover from acute health stressors. In Cocota's case, a hip fracture in her 80s did not lead to permanent disability; rather, she reclaimed her daily routines, demonstrating the interplay between physical robustness and unwavering determination. Equally telling was her decision to \"stop eating and drinking\" near life's end, exemplifying resilience as a final expression of agency. We further explore how her experiences align with deeper forms of well-being, marked by purpose and prosocial behavior, and practical wisdom, including emotional regulation and sound moral judgment. By examining her life journey, clinicians and community partners can better appreciate how resilience spans physical, cognitive, psychosocial, and spiritual domains, ultimately guiding more integrated strategies to support older adults. The lessons learned have direct relevance for clinical interventions, community programs, and public health initiatives aimed at fostering autonomy and meaningful engagement in later life.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217961","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":"Factors Associated With Hospitalization for Hypoglycemia and Hyperglycemia Among Older People in Long-Term Care Facilities.","authors":"Yohanes A Wondimkun, Gillian E Caughey, Maria C Inacio, Tracy Air, Catherine Lang, Michelle Hogan, Janet K Sluggett","doi":"10.1111/jgs.19553","DOIUrl":"https://doi.org/10.1111/jgs.19553","url":null,"abstract":"<p><strong>Background: </strong>Individuals with diabetes newly entering long-term care facilities (LTCFs) encounter changes in care needs and facility and care process-related factors, which potentially impact diabetes treatment outcomes. This study examined the 12-month incidence of hospitalizations for hypoglycemia and hyperglycemia in residents with diabetes and factors associated with these hospitalizations following LTCF entry.</p><p><strong>Methods: </strong>This retrospective cohort study included residents aged ≥ 65 years with diabetes who entered a LTCF between 2015 and 2018 using data from the Registry of Senior Australians. Cumulative incidence of hospitalization for hypoglycemia or hyperglycemia in the 12 months following entry was evaluated. Factors associated with hypoglycemia or hyperglycemia hospitalizations were examined using a Fine-Gray model, accounting for the competing event of mortality. Subdistribution hazard ratios (sHRs) were reported.</p><p><strong>Results: </strong>Of the 55,734 individuals included (median age 84 years), 1.0% (95% confidence interval [CI]: 0.9-1.1) were hospitalized for hypoglycemia, and 0.5% (95% CI: 0.4-0.6) for hyperglycemia in the 12 months after LTCF entry. Factors associated with a higher rate of hospitalization for hypoglycemia included high (sHR: 2.59, 95% CI: 1.61-4.17) or medium (sHR: 2.61, 95% CI: 1.61-4.24) level of care needs, renal disease (sHR: 1.22, 95% CI: 1.01-1.49), prior hospitalization with hypoglycemia (sHR: 2.18, 95% CI: 1.77-2.67) or hyperglycemia (sHR: 1.61, 95% CI: 1.19-2.18), use of insulin (sHR: 6.15, 95% CI: 4.99-7.59), sulfonylureas (sHR: 1.41, 95% CI: 1.14-1.74), or angiotensin-converting enzyme inhibitors (sHR: 1.23, 95% CI: 1.02-1.47). Factors associated with a higher rate of hospitalization for hyperglycemia included preferred spoken language other than English (sHR: 1.40, 95% CI: 1.02-1.93), dementia (sHR: 1.39, 95% CI: 1.08-1.80), prior hospitalization with hyperglycemia (sHR: 3.88, 95% CI: 2.72-5.53) or hypoglycemia (sHR: 2.50, 95% CI: 1.83-3.41), use of insulin (sHR: 2.01, 95% CI: 1.51-2.69), or metformin (sHR: 1.42, 95% CI: 1.10-1.84).</p><p><strong>Conclusions: </strong>The risk of hospitalization for hypoglycemia or hyperglycemia may be reduced through diabetes care planning at LTCF entry informed by the identified risk factors for these complications.</p>","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217962","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 \"Motor Signs and Incident Dementia With Lewy Bodies in Older Adults With Mild Cognitive Impairment\".","authors":"Neziha Erken, Dilara Erdem, Mehmet Ilkin Naharci","doi":"10.1111/jgs.19541","DOIUrl":"https://doi.org/10.1111/jgs.19541","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201190","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: \"Motor Signs and Incident Dementia With Lewy Bodies in Older Adults With Mild Cognitive Impairment\".","authors":"Ioannis Liampas, Efthimios Dardiotis","doi":"10.1111/jgs.19543","DOIUrl":"https://doi.org/10.1111/jgs.19543","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144201191","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":"Unveiling Hidden Abuse of Older Adults: A Case Study on the Critical Role of Clinical Vigilance and Skin Examinations.","authors":"Yuka Shichijo, Thomas Fusillo, Fay Kahan, Sonica Bhatia, Yuji Yamada","doi":"10.1111/jgs.19561","DOIUrl":"https://doi.org/10.1111/jgs.19561","url":null,"abstract":"","PeriodicalId":94112,"journal":{"name":"Journal of the American Geriatrics Society","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188735","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}