Effectiveness of a Hospital-at-Home Integrated Care Program as Alternative Resource for Medical Crises Care in Older Adults With Complex Chronic Conditions
To compare clinical outcomes in older patients with acute medical crises attended by a geriatrician-led home hospitalization unit (HHU) vs an inpatient intermediate-care geriatric unit (ICGU) in a post-acute care setting. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 1, 2018 Category: Health Management Authors: Miquel À. Mas, Sebastià J. Santaeugènia, Francisco J. Tarazona-Santabalbina, Sara Gámez, Marco Inzitari Tags: Original Study Source Type: research

Quality Indicators of Primary Care Provider Engagement in Nursing Home Care
The initiative described here aims to identify quality indicators (QIs) germane to the international practice of primary care providers (PCP) in post-acute and long-term care in order to demonstrate the added value of medical providers in nursing homes (NHs). A 7-member international team identified and adapted existing QIs to the AMDA competencies for medical providers. QI sources included the ACOVE 3 Quality Indicators (2007), NH Quality Indicators (2004), NH Residential Care Quality Indicators (2002), and AGS Choosing Wisely (2014). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 1, 2018 Category: Health Management Authors: Allison Moser Mays, Debra Saliba, Sid Feldman, Martin Smalbrugge, Cees M.P.M. Hertogh, Tina L. Booker, Kisa A. Fulbright, Simone A. Hendriks, Paul R. Katz Tags: Special Article Source Type: research

Quality Clinical Care in Nursing Facilities
Despite improvements in selected nursing facility (NF) quality measures such as reduction in antipsychotic use; local, state, and national initiatives; and regulatory incentives, the quality of clinical care delivered in this setting remains inconsistent. Herein, recommendations for overcoming barriers to achieving consistent, high-quality clinical outcomes in long-term (LTC) and post-acute care are provided to address inadequate workforce, suboptimal culture and interprofessional teamwork, insufficiently evidence-based processes of care, and poor adoption and fidelity of technology and integrated clinical decision support...
Source: Journal of the American Medical Directors Association - October 1, 2018 Category: Health Management Authors: Barbara J. Zarowitz, Barbara Resnick, Joseph G. Ouslander Tags: Special Article Source Type: research

The Never-Ending Quest for Quality in Post-acute and Long-term Care: A Cup Half-Empty, or Half-Full?
The bad news/good news is that improving quality will forever be a concern of clinicians, researchers, policy makers, and others who have a stake in post-acute and long-term care. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 1, 2018 Category: Health Management Authors: Sheryl Zimmerman, Philip D. Sloane Tags: Editorial Source Type: research

Editorial Board
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 1, 2018 Category: Health Management Source Type: research

Table of Contents
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 1, 2018 Category: Health Management Source Type: research

General Information
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 1, 2018 Category: Health Management Source Type: research

Directions & Connections
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 1, 2018 Category: Health Management Source Type: research

Rehabilitation Therapy for Nursing Home Residents at the End-of-Life
Ultrahigh therapy use has increased in SNFs without concomitant increases in residents' characteristics. It has been suggested that this trend may also have influenced the provision of high-intensity rehabilitation therapies to residents who are at the end of life (EOL). Motivated by lack of evidence, we examined therapy use and intensity among long-stay EOL residents. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 1, 2018 Category: Health Management Authors: Helena Temkin-Greener, Tiffany Lee, Thomas Caprio, Shubing Cai Tags: Original Study Source Type: research

The Change in Nursing Home Residents' Preferences Over Time
Nursing home (NH) residents' preferences for everyday living are the foundation for delivering individualized person-centered care. Yet, work has not examined what the most and least important preferences of nursing home residents are and if those preferences change over time. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 1, 2018 Category: Health Management Authors: Katherine M. Abbott, Allison R. Heid, Morton Kleban, Michael J. Rovine, Kimberly Van Haitsma Tags: Original Study Source Type: research

Long-term Impact of Hip Fracture on the Use of Healthcare Resources: a Population-Based Study
To assess the impact of hip fracture (HF) on health care expenditures and resource use. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 1, 2018 Category: Health Management Authors: Jose M. Cancio, Emili Vela, Sebasti à Santaeugènia, Montse Clèries, Marco Inzitari, Domingo Ruiz Tags: Original Study Source Type: research

Role of Geriatric Syndromes in the Management of Atrial Fibrillation in Older Adults: A Narrative Review
Atrial fibrillation (AF) is common in older adults and associated with increased risk of cardiovascular events including thromboembolism. However, less is known about its association with noncardiovascular events, especially geriatric syndromes and conditions such as dementia, depression, impaired physical function, polypharmacy, falls, and poor quality of life. This review aims to help healthcare professionals integrate the special needs of older adults into their management of AF. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - September 27, 2018 Category: Health Management Authors: Kannayiram Alagiakrishnan, Maciej Banach, Darren Mah, Ali Ahmed, Wilbert S. Aronow Tags: Review Article Source Type: research

The Course of Geriatric Syndromes in Acutely Hospitalized Older Adults: The Hospital-ADL Study
To establish the prevalence and course of geriatric syndromes from hospital admission up to 3  months postdischarge and to determine the probability to retain geriatric syndromes over the period from discharge until 3 months postdischarge, once they are present at admission. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - September 27, 2018 Category: Health Management Authors: Rosanne van Seben, Lucienne A. Reichardt, Jesse J. Aarden, Marike van der Schaaf, Martin van der Esch, Raoul H.H. Engelbert, Jos W.R. Twisk, Jos A. Bosch, Bianca M. Buurman, Hospital-ADL Study Group Tags: Original Study Source Type: research

Twelve-Month Incidence of Depressive Symptoms in Suburb-Dwelling Chinese Older Adults: Role of Sarcopenia
The objective of this study was to examine the incidence of new onset depressive symptoms and associated factors over a 1-year period in an older Chinese suburban population. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - September 26, 2018 Category: Health Management Authors: Xiaoyu Chen, Junhui Guo, Peipei Han, Liyuan Fu, Liye Jia, Hairui Yu, Xing Yu, Lin Hou, Lu Wang, Wen Zhang, Kaijun Niu, Qi Guo Tags: Original Study Source Type: research

Validity of the Mini-Nutritional Assessment Scale for Evaluating Frailty Status in Older Adults
Comprehensive Geriatric Assessment (CGA) may not be performed in clinical practice as it takes too much time and requires special training. The Mini-Nutritional Assessment (MNA) is widely used to assess nutritional status in older adults. We aimed to determine whether or not the MNA can estimate frailty status defined by the Fried criteria. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - September 24, 2018 Category: Health Management Authors: Pinar Soysal, Ahmet Turan Isik, Ferhat Arik, Ugur Kalan, Abdullah Eyvaz, Nicola Veronese Tags: Original Study Source Type: research

Predictors of Cholinesterase Discontinuation during the First Year after Nursing Home Admission
We examined patterns of ChEI use during nursing home (NH) transition and the factors associated with discontinuation following admission. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - September 24, 2018 Category: Health Management Authors: Laura C. Maclagan, Susan E. Bronskill, Jun Guan, Michael A. Campitelli, Nathan Herrmann, Kate L. Lapane, David B. Hogan, Joseph E. Amuah, Dallas P. Seitz, Sudeep S. Gill, Colleen J. Maxwell Tags: Original Study Source Type: research

Dysphagia in Nursing Home Residents: Management and Outcomes
To define the prevalence of dysphagia and its associated factors and to investigate the influence of dysphagia and nutritional therapies performed in dysphagic subjects on clinical outcomes, including nutritional status, pressure ulcers, hospitalization, and mortality. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - September 21, 2018 Category: Health Management Authors: Nikolina Jukic Peladic, Paolo Orlandoni, Giuseppina Dell'Aquila, Barbara Carrieri, Paolo Eusebi, Francesco Landi, Stefano Volpato, Giovanni Zuliani, Fabrizia Lattanzio, Antonio Cherubini Tags: Original Study Source Type: research

Exploring Antipsychotic Prescribing Behaviors for Nursing Home Residents With Dementia: A Qualitative Study
This study explored the determinants of appropriate, evidence-based antipsychotic prescribing behaviors for nursing home residents with dementia, with a view to informing future quality improvement efforts and behavior change interventions. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - September 18, 2018 Category: Health Management Authors: Kieran A. Walsh, Carol Sinnott, Aoife Fleming, Jenny Mc Sharry, Stephen Byrne, John Browne, Suzanne Timmons Tags: Original Study Source Type: research

Signs of Dehydration in Nursing Home Residents
Although dehydration can affect mental and physical health, there is no clear, consistent, and reproducible diagnostic tool for this condition in older people. We applied multiple methods to detect dehydration with the aim of assessing the value of using urine analysis for this purpose. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - September 15, 2018 Category: Health Management Authors: Peter Johnson, Robert G. Hahn Tags: Original Study Source Type: research

Quick and Simple FRAIL Scale Predicts Incident Activities of Daily Living (ADL) and Instrumental ADL (IADL) Disabilities: A Systematic Review and Meta-analysis
To quantitatively examine frailty defined by FRAIL scale as a predictor of incident disability risks by conducting a systematic review and meta-analysis. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - September 8, 2018 Category: Health Management Authors: Gotaro Kojima Tags: Review Article Source Type: research

Agitation and Aggression Are 2 Different Syndromes in Persons With Dementia
Behavioral and psychological symptoms of dementia are very common, and a recent study found that they occur in up to 90% of people living in residential care facilities.1 These symptoms are often more disturbing than cognitive impairment and are associated with increased healthcare use, earlier institutionalization,2 excess morbidity and mortality, and greater caregiver distress and depression.3 Development of strategies for the effective management of this problem is hindered by confusing terminology. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - September 6, 2018 Category: Health Management Authors: Ladislav Volicer, Elizabeth Galik Tags: Editorial Source Type: research

Who Should Deliver Primary Care in Long-term Care Facilities to Optimize Resident Outcomes? A Systematic Review
The objective of this review is to investigate how the health outcomes of older adults in LTCFs vary according to which professional group(s) provides first-line medical care. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 30, 2018 Category: Health Management Authors: Robert Oliver Barker, Dawn Craig, Gemma Spiers, Patience Kunonga, Barbara Hanratty Tags: Review Article Source Type: research

Who Should Deliver Primary Care in Nursing Homes to Optimize Resident Outcomes? A Systematic Review
The objective of this review is to investigate how the health outcomes of older adults in LTCFs vary according to which professional group(s) provides first-line medical care. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 30, 2018 Category: Health Management Authors: Robert Oliver Barker, Dawn Craig, Gemma Spiers, Patience Kunonga, Barbara Hanratty Tags: Review Article Source Type: research

Development and Validation of the Perceptions, Attitudes, and Challenges of Physicians Towards Deprescribing (PACPD-12) Questionnaire
An ideal holistic health care model, where an apt, cost-effective and well-timed medicine is available and the patient is fittingly counseled on his or her medications, is still a fantasy to most of the common people in a developing country. Factors like inappropriate medication use, polypharmacy, intentional and nonintentional nonadherence to medications, high drug costs, present barriers to ideal patient care.1 –4 The complex process of deprescribing is gaining merit as one of the tools that can reduce the incidence of the previously mentioned issues. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 30, 2018 Category: Health Management Authors: Doorva Bhuvanendra Bhat, Ganesan Rajalekshmi Saraswathy, Kumari Sweta Tags: Research Letter Source Type: research

Association Between Potentially Inappropriate Medications and Frailty in the Early Old Age: A Longitudinal Study in the GAZEL Cohort
This study aimed to assess the role of inappropriate prescribing on changes in frailty status over 3  years of follow-up. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 29, 2018 Category: Health Management Authors: P. Martinot, B. Landr é, M. Zins, M. Goldberg, J. Ankri, M. Herr Tags: Original Studies Source Type: research

Opioid Prescribing Behavior in Long-Term Geriatric Care in the Netherlands
Pain is a highly prevalent problem in older adults and dying patients. Opioids are the main analgesic for moderate to severe pain in these patients. Different properties of various opioids can make them more or less suitable for this specific population. We therefore aim to explore opioid prescribing behavior in a group of physicians specialized in long-term geriatric care and to identify factors that are taken into account when selecting a specific opioid for treatment of pain in older patients and patients in the dying phase. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 28, 2018 Category: Health Management Authors: Mark J.M. Martens, Daisy J.A. Janssen, Jos M.G.A. Schols, Marieke H.J. van den Beuken-van Everdingen Tags: Original Study Source Type: research

The Sustainable Development Agenda Needs to Include Long-term Care
The rapid ageing of populations around the world and the associated shift in the burden of disease from infectious to chronic conditions are creating complex challenges for national governments. Addressing the needs of these older populations in a sustainable and equitable way, will be a fundamental pillar of socioeconomic development in the 21st Century.The World Health Organization (WHO) Global strategy and action plan on ageing and health, which was adopted by all the Organization ’s 194 Member states in 2016, provides a clear framework for global action. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 25, 2018 Category: Health Management Authors: Anne Margriet Pot, Andrew M. Briggs, John R. Beard Tags: Long-Term Care in the Developing World Source Type: research

Exercise Deficiency Diseases of Ageing: The Primacy of Exercise and Muscle Strengthening as First-Line Therapeutic Agents to Combat Frailty
In the management of older patients, frailty has emerged as one of the most relevant clinical syndromes that will exponentially increase with population ageing. The United Nations project that between 2015 and 2030, the number of people in the world older than 60  years will grow by 56%, from 901 million to 1.4 billion, with the fastest increases among those older than 80 years.1 This has major implications for clinical management and health care delivery, and also contributes to increased health care spending in the United States, United Kingdom, and glob ally. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 25, 2018 Category: Health Management Authors: Norman R. Lazarus, Mikel Izquierdo, Irene J. Higginson, Stephen D.R. Harridge Tags: Editorial Source Type: research

Pathophysiology of Oropharyngeal Dysphagia Assessed by Videofluoroscopy in Patients with Dementia Taking Antipsychotics
The objective of this study was to assess the pathophysiology of oropharyngeal dysphagia (OD) in patients with dementia, specifically in those taking antipsychotics (APs). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 25, 2018 Category: Health Management Authors: Marta Miarons, Pere Clav é, Robin Wijngaard, Omar Ortega, Viridiana Arreola, Weslania Nascimento, Laia Rofes Tags: JAMDA Online Source Type: research

Long-term Care for Older Adults in Africa: Whither Now?
The global population of older persons aged 60  years and older increased from 382 million (8.6%) in 1980 to 962 million (12.7%) in 2017. It is expected to double by 2050 to nearly 2.1 billion (21.3%). Two-thirds of the world's older persons live in the developing regions like Africa, where their numbers are growing faster than in the developed regions. By 2050, it is estimated that 8 in 10 of the world's older persons will be living in the developing regions. Africa is projected to increase its population of older persons by 229% between 2017 and 2050. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 25, 2018 Category: Health Management Authors: Akye Essuman, F. Akosua Agyemang, C. Charles Mate-Kole Tags: Long-Term Care in the Developing World Source Type: research

Addressing the “Tsunami” of Long-Term Care Needs in Latin America: Is Preparation Feasible?
The special article by Pot et  al from the World Health Organization (WHO) in this issue of JAMDA raises important issues about the future needs for long-term care (LTC) in the developing world.1 Unfortunately, it is difficult to think of a national LTC strategy in Nicaragua and no doubt in many other Latin American countries a s well, because it is more urgent to strengthen primary health care in ways that are innovative and attractive to the population. In addition, LTC policy is far from being implemented as recommended by WHO because our attention—for better or worse—prioritizes diseases rather than pe...
Source: Journal of the American Medical Directors Association - August 25, 2018 Category: Health Management Authors: Milton L ópez Norori Tags: Long-Term Care in the Developing World Source Type: research

Uncomplicated Cystitis in Nursing Home Residents: A Practical Guide to Diagnosis and Management
Suspected urinary tract infections (UTIs) are the most commonly encountered and treated infections in nursing homes.1,2 The incidence of symptomatic UTI approaches 2.5 cases per 1000 resident-days,3 and approximately one-third of antibiotics administered in nursing homes are attributable to UTI.4 Nevertheless, most antibiotic prescriptions for suspected UTI in nursing homes are inappropriate,5 resulting in high risks of antibiotic-associated harms, including an 8-fold greater odds of Clostridium difficile infection when compared to unexposed residents. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 25, 2018 Category: Health Management Authors: Rupak Datta, Manisha Juthani-Mehta Tags: Editorial Source Type: research

Dysphagia in Frail Older Persons: Making the Most of Current Knowledge
Dysphagia and related problems with oral intake must certainly be numbered among the important geriatric syndromes.1 They, like other geriatric syndromes, become increasingly common as people age, are especially prevalent in aging-related conditions such as stroke and Alzheimer's disease, and are usually multifactorial.2 In developing evidence-based approaches to such common aging problems, the scientific community goes through a sequence of investigative steps. We begin by identifying and defining the problem. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 25, 2018 Category: Health Management Authors: Nicole Rogus-Pulia, Rainer Wirth, Philip D. Sloane Tags: Editorial Source Type: research

Editorial Board
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 25, 2018 Category: Health Management Source Type: research

Table of Contents
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 25, 2018 Category: Health Management Source Type: research

General Information
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 25, 2018 Category: Health Management Source Type: research

Directions & Connections
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 25, 2018 Category: Health Management Source Type: research

Body Composition, IGF1 Status, and Physical Functionality in Nonagenarians: Implications for Osteosarcopenia
Body composition alterations occur during aging. The purpose of the present analysis was to explore the functional consequences of the overlap of sarcopenia and osteoporosis, and the potential role of insulin-like growth factor 1 (IGF1) in their development in the oldest old. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 24, 2018 Category: Health Management Authors: Eleonora Poggiogalle, Katie E. Cherry, L. Joseph Su, Sangkyu Kim, Leann Myers, David A. Welsh, S. Michal Jazwinski, Eric Ravussin Tags: Original Study Source Type: research

The Impact of Frailty and Comorbidity on Institutionalization and Mortality in Persons With Dementia: A Prospective Cohort Study
The predictive value of frailty and comorbidity, in addition to more readily available information, is not widely studied. We determined the incremental predictive value of frailty and comorbidity for mortality and institutionalization across both short and long prediction periods in persons with dementia. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 22, 2018 Category: Health Management Authors: Miriam L. Haaksma, Debora Rizzuto, Inez H.G.B. Ramakers, Sara Garcia-Ptacek, Alessandra Marengoni, Wiesje M. van der Flier, Frans R.J. Verhey, Marcel G.M. Olde Rikkert, Ren é J.F. Melis Tags: Original Study Source Type: research

Response to the Letter to the Editor: Flaws Related to the Article Entitled “Frailty Predicts Incident Urinary Incontinence Among Hospitalized Older Adults”
We appreciate the interest in our article1 and the opportunity to discuss the issues raised. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 22, 2018 Category: Health Management Authors: Edward Chong, Mark Chan, Wee Shiong Lim, Yew Yoong Ding Tags: Letter to the Editor Source Type: research

Flaws Related to the Article Entitled “Frailty Predicts Incident Urinary Incontinence Among Hospitalized Older Adults”
We have read the article by Edward Chong et  al1 with great interest. In their article, the authors have studied to determine the utility of identifying frailty status in predicting incident urinary incontinence (UI) and to establish whether UI is an independent predictor of mortality within 12 months of an acute hospital admission among ol der adults. They report that underlying UI, irrespective of frailty status, independently increased the risk of mortality, even up to 12 months following hospitalization. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 22, 2018 Category: Health Management Authors: Tugba Erdogan, Gulistan Bahat Tags: Letter to the Editor Source Type: research

Utility of the Identification of Seniors at Risk Score to Predict In-Hospital Mortality in Older Patients With Heart Failure
Heart failure (HF) is a life-threatening medical condition that requires urgent evaluation and treatment.1 The decision to enter an intensive care unit is usually individual and based on risk models of the specific process.2 In clinical practice, this decision making can be extremely complex, especially for older patients with HF without dependence on the activities of established daily life or the existence of advanced guidelines limiting the therapeutic effort.3,4 Frailty is considered a dynamic state of vulnerability that if not detected and treated early can trigger adverse outcomes such as death, dependency, or instit...
Source: Journal of the American Medical Directors Association - August 22, 2018 Category: Health Management Authors: Alberto Dom ínguez-Rodríguez, Magali González-Colaço Harmand, Francisco Javier Martín-Sánchez, Nestor Baez-Ferrer, Víctor Gil, Òscar Miró, Pedro Abreu-González Tags: Research Letter Source Type: research

Advancing Research on Care Needs and Supportive Approaches for Persons With Dementia: Recommendations and Rationale
The first National Research Summit on Care, Services, and Supports for Persons with Dementia and Their Caregivers was held on October 16-17, 2017, at the National Institutes of Health. In this paper, participants from the Summit Session on Research on Care Needs and Supportive Approaches for Persons with Dementia summarize the state of the science, identify gaps in knowledge, and offer recommendations to improve science and practice in long-term care. Recommendations cover 4 areas focused on persons living with dementia: (1) symptoms (behavioral and psychological symptoms of dementia, function, cognition, and sleep); (2) d...
Source: Journal of the American Medical Directors Association - August 22, 2018 Category: Health Management Authors: Ann Kolanowski, Richard H. Fortinsky, Margaret Calkins, Davangere P. Devanand, Elizabeth Gould, Tamar Heller, Nancy A. Hodgson, Helen C. Kales, Jeffrey Kaye, Constantine Lyketsos, Barbara Resnick, Melanie Schicker, Sheryl Zimmerman Tags: Special Article Source Type: research

Increasing Antimicrobial Resistance in Long-Term Care Facility Patients With Bacteremia: A 5  Year's Surveillance
Older patients residing in institutions, who are predisposed to frequent hospitalizations, invasive procedures, and repeated antibiotic use, are at higher risk for bacterial infections. The most common infection in a long-term care facility (LTCF) is an urinary tract infection (UTI) mainly caused by multidrug-resistant (MDR) gram-negative rods (GNR).1 –6 Our objectives were to characterize antimicrobials susceptibility patterns of LTCF residents hospitalized with bacteremia acquired at LTCF and examine the adequacy of empiric antibiotic treatment and outcome. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 16, 2018 Category: Health Management Authors: Moty Almog, Anna Yanovskay, Hana Edelstein, Naama Schwartz, Raul Colodner, Bibiana Chazan Tags: Letter to the Editor Source Type: research

Decreased Basal Metabolic Rate Can Be an Objective Marker for Sarcopenia and Frailty in Older Males
The aim of this study is to demonstrate the ability of the basal metabolic rate (BMR) to detect frailty and sarcopenia in older males. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 16, 2018 Category: Health Management Authors: Pinar Soysal, Esra Ates Bulut, Idil Yavuz, Ahmet Turan Isik Tags: Original Study Source Type: research

Evaluation of Nursing Facility Resident Safety During Implementation of the INTERACT Quality Improvement Program
Medicare incentivizes the reduction of hospitalizations of nursing facility (NF) residents. The effects of these incentives on resident safety have not been examined. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 11, 2018 Category: Health Management Authors: Ruth M. Tappen, David Newman, Peter Huckfeldt, Zhiyou Yang, Gabriella Engstrom, David G. Wolf, Jill Shutes, Carolina Rojido, Joseph G. Ouslander Tags: Original Study Source Type: research

One Week of Hospitalization Following Elective Hip Surgery Induces Substantial Muscle Atrophy in Older Patients
Short successive periods of skeletal muscle disuse have been suggested to substantially contribute to the observed loss of skeletal muscle mass over the life span. Hospitalization of older individuals due to acute illness, injury, or major surgery generally results in a mean hospital stay of 5 to 7  days, during which the level of physical activity is strongly reduced. We hypothesized that hospitalization following elective total hip arthroplasty is accompanied by substantial leg muscle atrophy in older men and women. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 11, 2018 Category: Health Management Authors: Imre W.K. Kouw, Bart B.L. Groen, Joey S.J. Smeets, Irene Fleur Kramer, Janneau M.X. van Kranenburg, Rach él Nilwik, Jan A.P. Geurts, René H.M. ten Broeke, Martijn Poeze, Luc J.C. van Loon, Lex B. Verdijk Tags: Original Study Source Type: research

Deprescribing Medications for Chronic Diseases Management in Primary Care Settings: A Systematic Review of Randomized Controlled Trials
Perform a systematic review to evaluate the outcome of deprescription compared with standard care. The focus was on chronic medical and mental health conditions managed in primary care. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 11, 2018 Category: Health Management Authors: Hannah Dills, Kruti Shah, Barbara Messinger-Rapport, Kevin Bradford, Quratulain Syed Tags: Review Article Source Type: research

An Analysis of Falls and Those who Fall in a Chronic Care Facility
Falls in hospitals lead to adverse patient outcomes and prevention of falls is of upmost importance. Little is known about fall and injury rates in chronic care facilities, which are similar to skilled nursing facilities in the United States. Current fall risk tools in this setting are not well studied. Enhancing the understanding of how patient characteristics relate to fall circumstances is also needed. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 11, 2018 Category: Health Management Authors: Chris A. McGibbon, Jeremy T. Slayter, Linda Yetman, Alexander McCollum, Rose McCloskey, Sharron G. Gionet, Heather Oakley, Pamela Jarrett Tags: Original Study Source Type: research

Energy and Protein Intake of Alzheimer's Disease Patients Compared to Cognitively Normal Controls: Systematic Review
Protein and energy malnutrition and unintended weight loss are frequently reported in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Possible underlying mechanisms include increased energy expenditure, altered uptake of nutrients, a reduced nutritional intake, or a combination of these 3. We aimed at systematically reviewing the literature to examine potential differences in energy and protein intake in patients with MCI and AD compared to controls as a possible mechanism for unintended weight loss. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - August 9, 2018 Category: Health Management Authors: Astrid S. Doorduijn, Ondine van de Rest, Wiesje M. van der Flier, Marjolein Visser, Marian A.E. de van der Schueren Tags: Review Article Source Type: research