A Systematic Review of Nursing Home Palliative Care Interventions: Characteristics and Outcomes
Despite recommendations to integrate palliative care into nursing home care, little is known about the most effective ways to meet this goal. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - January 12, 2020 Category: Health Management Authors: Joan G. Carpenter, Karissa Lam, Ashley Z. Ritter, Mary Ersek Tags: Review Article Source Type: research

Association Between Bisphosphonates and Hospitalized Clostridioides difficile Infection Among Frail Older Adults
Clostridioides difficile infection is a major source of morbidity and mortality among frail older adults, especially those in nursing homes (NHs). Safety reports have signaled that bisphosphonate use may be a contributing cause. We therefore evaluated the risk of C difficile hospitalization associated with oral bisphosphonate use in the NH. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - January 12, 2020 Category: Health Management Authors: Kevin W. McConeghy, Andrew R. Zullo, Christine W. Lary, Tingting Zhang, Yoojin Lee, Lori. Daiello, Douglas P. Kiel, Sarah Berry Tags: Original Study - Brief Report Source Type: research

Impact of Overweight and Obesity on Functional and Clinical Outcomes of Early Parkinson's Disease
To determine whether being overweight or obese contributes to disease progression and functional status in Parkinson's disease (PD). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - January 12, 2020 Category: Health Management Authors: Ryul Kim, Jin-Sun Jun Tags: Original Study - Brief Report Source Type: research

Safety and Effectiveness of Direct Oral Anticoagulants vs Warfarin in People With Atrial Fibrillation and Dementia
To determine risks of embolic events, bleeding, and mortality with direct oral anticoagulants (DOACs) vs warfarin in people with atrial fibrillation (AF) and dementia. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - January 12, 2020 Category: Health Management Authors: Laura Fanning, Wallis C.Y. Lau, Pajaree Mongkhon, Kenneth K.C. Man, J. Simon Bell, Jenni Ilom äki, Pēteris Dārziņš, Kui Kai Lau, Li Wei, Ian C.K. Wong Tags: Original Study Source Type: research

Effectiveness of a Diet and Resistance Exercise Intervention on Muscle Health in Older Adults: ProMuscle in Practice
Clinical studies show that resistance exercise and a protein-rich diet can counteract the age-related decline of muscle mass, strength, and physical performance. The aim of the ProMuscle in Practice study was to test effectiveness of a resistance exercise and dietary protein intervention for older adults implemented in a real-life setting. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - January 12, 2020 Category: Health Management Authors: Ellen J.I. van Dongen, Annemien Haveman-Nies, Esm ée L. Doets, Berber G. Dorhout, Lisette C.P.G.M. de Groot Tags: Original Study Source Type: research

Associations Between Somatic Multimorbidity Patterns and Depression in a Longitudinal Cohort of Middle-Aged and Older Chinese
Depressive symptoms are commonly seen among patients with multiple chronic somatic conditions, or somatic multimorbidity (SMM); however, little is known about the relationships between depressive symptoms and different SMM combinations. Our study aimed to delineate the patterns of SMM and their longitudinal associations with depressive symptoms among a nationally representative sample of middle-aged and older Chinese adults. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - January 12, 2020 Category: Health Management Authors: Shan-Shan Yao, Gui-Ying Cao, Ling Han, Zi-Ting Huang, Zi-Shuo Chen, He-Xuan Su, Yonghua Hu, Beibei Xu Tags: Original Study Source Type: research

Landscape of Sarcopenia Research (1989 ‒2018): A Bibliometric Analysis
Despite the approximately 30-year history of sarcopenia research,1 a detailed quantitative analysis of the existing research has not been undertaken to elucidate the body of evidence on sarcopenia. To depict the sarcopenia research landscape, we performed a bibliometric analysis of the published literature on sarcopenia. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - January 12, 2020 Category: Health Management Authors: Ming Yang, Lingling Tan, Weimin Li Tags: Letter to the Editor Source Type: research

Orthostatic Drop in Diastolic but Not Systolic Blood Pressure Is Associated With Fear of Falling in Older Fallers
Orthostatic hypotension (OH) is very common in older persons and associated with several adverse outcomes,1 such as cardiovascular morbidity and mortality.2,3 Because OH can cause symptoms of dizziness and instability, it can also lead to falls and bone fractures,4 which consequently can contribute to physical impairment and decreased quality of life. It is estimated that up to 10% of falls occur secondary to abnormal blood pressure responses such as OH.4 However, it is not completely clear whether older fallers with OH differ from older fallers without OH in terms of their physical performance and fear of falling. (Source...
Source: Journal of the American Medical Directors Association - January 12, 2020 Category: Health Management Authors: Lisanne Tap, Nicole D.A. Boy é, Klaas A. Hartholt, Nathalie van der Velde, Tischa J.M. van der Cammen, Francesco U.S. Mattace-Raso Tags: Research Letter Source Type: research

Morbidity Measures Predicting Mortality in Inpatients: A Systematic Review
The objective of this systematic review was to compare the capacity of morbidity measures in predicting mortality among inpatients admitted to internal medicine, geriatric, or all hospital wards. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - January 12, 2020 Category: Health Management Authors: Cheng Hwee Soh, Syed Wajih Ul Hassan, Julian Sacre, Andrea B. Maier Tags: Review Article Source Type: research

Association Between Acetylcholinesterase Inhibitors and Osteoporotic Fractures in Older Persons With Alzheimer's Disease
To identify the association between the use of acetylcholinesterase inhibitors (AChEIs) and risk of osteoporotic fractures in older persons with Alzheimer's disease (AD). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - January 12, 2020 Category: Health Management Authors: Dae Yeon Won, Seong Jun Byun, Jin Sook Jeong, Ju-Young Shin Tags: Original Study Source Type: research

The Role of C-Reactive Protein in the Pain and Cognition Relationship
Chronic pain is frequently reported by older adults and is associated with systemic inflammation.1 Cross-sectional and longitudinal studies show that chronic pain —especially severe pain—is associated with worse cognitive function in older adults.2,3 A weak association between elevated levels of peripheral C-reactive protein (CRP) and cognitive decline has been shown in the general population.4 Animal studies suggest that inflammation is one of the mechan isms through which pain influences cognitive impairment. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - January 12, 2020 Category: Health Management Authors: Guusje van der Leeuw, Karen L. Siedlecki, Annette H. Blankenstein, Henri ëtte E. van der Horst, Joe Verghese Tags: Research Letter Source Type: research

Changes in US Nursing Home Infection Prevention and Control Programs From 2014 to 2018
Burgeoning rates of antibiotic resistance have resulted in a shift in national focus to improve infection prevention and control programs in US nursing homes (NHs). We sought to evaluate the changes in nursing home infection prevention and control programs over time. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 28, 2019 Category: Health Management Authors: Mansi Agarwal, Andrew W. Dick, Mark Sorbero, Lona Mody, Patricia W. Stone Tags: Original Study Source Type: research

Diagnosis, Treatment, and Prevention of Urinary Tract Infections in Post-Acute and Long-Term Care Settings: A Consensus Statement From AMDA's Infection Advisory Subcommittee
The diagnosis and management of urinary tract infections (UTIs) among residents of post-acute and long-term care (PALTC) settings remains challenging. Nonspecific symptoms, complex medical conditions, insufficient awareness of diagnostic criteria, and unnecessary urine studies all contribute to the inappropriate diagnosis and treatment of UTIs in PALTC residents. In 2017, the Infection Advisory Subcommittee at AMDA —The Society for Post-Acute and Long-Term Care Medicine convened a workgroup comprised of experts in geriatrics and infectious diseases to review recent literature regarding UTIs in the PALTC population. (...
Source: Journal of the American Medical Directors Association - December 28, 2019 Category: Health Management Authors: Muhammad S. Ashraf, Swati Gaur, Oluma Y. Bushen, Teena Chopra, Philip Chung, Kalin Clifford, Elizabeth Hames, Cees M.P.M. Hertogh, Amar Krishna, Dheeraj Mahajan, David R. Mehr, Vycki Nalls, Theresa Ann Rowe, Steven J. Schweon, Philip D. Sloane, Kavita K. Tags: Special Article Source Type: research

Recommendations for Mandatory Influenza Vaccinations for Health Care Personnel From AMDA's Infection Advisory Subcommittee
Preventing influenza infections is a national health priority, particularly among geriatric and adults with frailty who reside in post-acute and long-term care (PALTC) settings. Older adults account for more than 70% of deaths from influenza, a reflection of decreased vaccine effectiveness in that age group. Annually vaccinating health care personnel (HCP) working with these patients against influenza is critical to reducing influenza morbidity and mortality among patients. PALTC HCP have the lowest influenza vaccination rate when compared to HCP in other settings. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 28, 2019 Category: Health Management Authors: Elizabeth Frentzel, Robin L.P. Jump, Laurie Archbald-Pannone, David A. Nace, Steven J. Schweon, Swati Gaur, Fatima Naqvi, Naushira Pandya, William Mercer, Infection Advisory Subcommittee of AMDA, The Society for Post-Acute and Long-Term Care Medicine Tags: Special Article Source Type: research

Reducing Fluoroquinolone Use and Clostridioides difficile Infections in Community Nursing Homes Through Hospital –Nursing Home Collaboration
We describe a collaborative model to reduce Clostridioides difficile infections (CDIs) in NHs through optimization of antibiotic use including a reduction in high-risk antibiotics such as fluoroquinolones. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 28, 2019 Category: Health Management Authors: Christina B. Felsen, Elizabeth S. Dodds Ashley, Grant R. Barney, Dallas L. Nelson, Joseph A. Nicholas, Hongmei Yang, Marie E. Aydelotte, Alexander Karlic, Nirmala C. Nicholas, Kim K. Petrone, Rena D. Pine, Scott L. Schabel, Annette Medina-Walpole, Ghinwa Tags: Original Study Source Type: research

Are Antibiograms Ready for Prime Time in the Nursing Home?
In 2017, the Centers for Medicare& Medicaid Services (CMS) initiated a requirement that nursing homes have an antibiotic stewardship program.1 As part of this requirement, nursing homes must track antibiotic use as well as monitor and communicate trends in antibiotic resistance. One tool specifically mentioned in the regulatory guidance that can aid in tracking antibiotic resistance is the antibiogram.2 As part of the Agency for Healthcare Research and Quality (AHRQ) –funded Improving Outcomes of Urinary Tract Infection Management in Long-Term Care (IOU) project (R18-HS023779), one-on-one coaching calls were cond...
Source: Journal of the American Medical Directors Association - December 28, 2019 Category: Health Management Authors: David A. Nace, Scott K. Fridkin Tags: Editorial Source Type: research

Prioritizing Prevention to Combat Multidrug Resistance in Nursing Homes: A Call to Action
Multidrug-resistant organisms (MDROs) do not discriminate —they spread in all health care settings. From our unique vantage point at the Centers for Disease Control and Prevention (CDC), we are witnessing the emergence of novel MDROs across the country, which are causing life-threatening infections, with limited to no available treatments.1 Public health efforts to detect and contain these pathogens have revealed the significant role nursing homes, especially those caring for a medically complex, higher-acuity resident population, are playing in the regional spread of these dangerous pathogens. (Source: Journal of th...
Source: Journal of the American Medical Directors Association - December 28, 2019 Category: Health Management Authors: Kara M. Jacobs Slifka, Sarah Kabbani, Nimalie D. Stone Tags: Editorial Source Type: research

Progress and Challenges in the Management of Nursing Home Infections
Infections are one of the leading causes of death and hospitalization for residents in post-acute and long-term care settings. With the aging population, increasing complexity of care and the growing threat of antibiotic resistance, infection prevention and antibiotic stewardship have been receiving even greater emphasis worldwide. This issue of JAMDA –The Journal of Post-Acute and Long-Term Care Medicine is entirely devoted to infections in these settings and was spearheaded by JAMDA's editors in collaboration with the US Centers for Disease Control and Prevention. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 28, 2019 Category: Health Management Authors: Philip D. Sloane, Sheryl Zimmerman, David A. Nace Tags: Editorial Source Type: research

Editorial Board
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 28, 2019 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 - December 28, 2019 Category: Health Management Source Type: research

General Information
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 28, 2019 Category: Health Management Source Type: research

Directions & Connections
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 28, 2019 Category: Health Management Source Type: research

Community-Dwelling Older Women: The Association Between Living Alone and Use of a Home Nursing Service
To investigate the use of home nursing by community-dwelling older women to determine the nature of services required by those living alone. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 26, 2019 Category: Health Management Authors: Angela Joe, Marissa Dickins, Joanne Enticott, Rajna Ogrin, Judy Lowthian Tags: Original Study Source Type: research

Impact of Stiffer Arteries on the Response to Antihypertensive Treatment: A Longitudinal Study of the SardiNIA Cohort
Carotid-femoral pulse wave velocity (PWV), an index of arterial stiffness and a proxy of arterial aging, has been reported to be an independent determinant of cardiovascular health. Whether the effects of antihypertensive treatment vary in the presence of accelerated arterial aging (stiffer artery, ie, PWV>10  m/s) has not been established. We tested this hypothesis in a longitudinal study in a large community-dwelling population. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 25, 2019 Category: Health Management Authors: Edward G. Lakatta, Danilo AlunniFegatelli, Christopher H. Morrell, Edoardo Fiorillo, Marco Orru, Alessandro Delitala, Michele Marongiu, David Schlessinger, Francesco Cucca, Angelo Scuteri Tags: Original Study Source Type: research

Tibetan Medicated Bathing Therapy for Patients With Post-stroke Limb Spasticity: A Randomized Controlled Clinical Trial
To determine the short- (4  weeks) and long-term (6 month) effectiveness of Tibetan medicated bathing therapy in patients with post-stroke limb spasticity. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 23, 2019 Category: Health Management Authors: Meng Wang, Shouguo Liu, Zhihang Peng, Yi Zhu, Xiaodong Feng, Yihuang Gu, Jianhua Sun, Qiang Tang, Hongxia Chen, Xiaolin Huang, Jun Hu, Wei Chen, Jie Xiang, ChunXiao Wan, Gangqi Fan, Jianhu Lu, Wenguang Xia, Lihua Wang, Steven Y. Cheng, Xiao Lu, Jianan L Tags: Original Study Source Type: research

Association Between Home Health Services and Facility Admission in Older Adults With and Without Alzheimer's Disease
To evaluate the association between home health (HH) services, including skilled nursing (SN), physical therapy (PT), occupational therapy, social work (SW), and homemaking aide assistance with the hazard of unplanned facility admissions among Medicare patients with and without Alzheimer's disease and related dementias (ADRD). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 22, 2019 Category: Health Management Authors: Jinjiao Wang, Thomas V. Caprio, Adam Simning, Jingjing Shang, Yeates Conwell, Fang Yu, Yue Li Tags: Original Study Source Type: research

Residential Greenness and Frailty Among Older Adults: A  Longitudinal Cohort in China
Frailty is an accumulation of deficits characterized by reduced resilience to stressors and increased vulnerability to adverse outcomes. There is evolving evidence on the health benefits of residential greenness, but little is known about its impact on frailty. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 19, 2019 Category: Health Management Authors: Anna Zhu, Lijing Yan, Chenkai Wu, John S. Ji Tags: Original Study Source Type: research

Development and Validation of the Norfolk Quality of Life Fatigue Tool (QOL-F): A New Measure of Perception of Fatigue
To design a questionnaire to evaluate and distinguish between cognitive and physical aspects of fatigue in different age groups of “nondiseased” people and guide appropriate prevention and interventions for the impact of frailty occurring in normative aging. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 18, 2019 Category: Health Management Authors: Etta J. Vinik, Aaron I. Vinik, Serina A. Neumann, Rajan Lamichhane, Steven Morrison, Sheri R. Colberg, Ying-Chuen Lai, James Paulson, Richard Handel, Carolina Casellini, Kim Hodges, Joshua Edwards, Henri K. Parson Tags: Original Study Source Type: research

A Higher Proportion of Home Care Recipients Experience Nonhip Fractures Than Long-Term Care Residents
Fractures pose a significant burden to the health, quality of life, and mortality of older adults residing in long-term care (LTC)1,2 or receiving home care (HC) services.3 The costs associated with fractures in Canada are $274 million and $1.03 billion in HC and LTC, respectively.4 (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 18, 2019 Category: Health Management Authors: Caitlin McArthur, George Ioannidis, Micaela Jantzi, Loretta Hillier, Jonathan D. Adachi, Lora Giangregorio, John Hirdes, Alexandra Papaioannou Tags: Research Letter Source Type: research

Effectiveness of Powerful Tools for Caregivers on Caregiver Burden and on Care Recipient Behavioral and Psychological Symptoms of Dementia: A Randomized Controlled Trial
The aim of this study was to evaluate the effectiveness of a psychoeducational intervention, Powerful Tools for Caregivers (PTC), for family caregivers of individuals with dementia. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 18, 2019 Category: Health Management Authors: Antonio Terracciano, Ashley Artese, Jenie Yeh, LaVon Edgerton, Lisa Granville, Damaris Aschwanden, Martina Luchetti, Robert L. Glueckauf, Yannick Stephan, Angelina R. Sutin, Paul Katz Tags: Original Study Source Type: research

Erratum
The Authors wish to make a correction to their article published in JAMDA (https://www.jamda.com/article/S1525-8610(19)30188-4/pdf). “Sociodemographic Factors and Characteristics of Caregivers as Determinants of Skilled Nursing Facility Admissions When Modeled Jointly With Functional Limitations” (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 18, 2019 Category: Health Management Tags: Erratum Source Type: research

Sepsis Survivors Transitioned to Home Health Care: Characteristics and Early Readmission Risk Factors
To profile the characteristics of growing numbers of sepsis survivors receiving home healthcare (HHC) by type of sepsis before, during, and after a sepsis hospitalization and identify characteristics significantly associated with 7-day readmission. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 15, 2019 Category: Health Management Authors: Kathryn H. Bowles, Christopher M. Murtaugh, Lizeyka Jordan, Yolanda Barr ón, Mark E. Mikkelsen, Christina R. Whitehouse, Jo-Ana D. Chase, Miriam Ryvicker, Penny Hollander Feldman Tags: Original Study Source Type: research

The Association of Oral Bisphosphonate Use With Mortality Risk Following a Major Osteoporotic Fracture in the United Kingdom: Population-Based Cohort Study
Bisphosphonates (BPs) might have extra benefits in reducing mortality because of their anti-atherosclerotic effects, but studies reported conflicting results. We investigated the association between oral BP use and mortality risk following a major osteoporotic fracture (MOF) in the United Kingdom. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 11, 2019 Category: Health Management Authors: Shahab Abtahi, Andrea M. Burden, Piet Geusens, Joop P. van den Bergh, Tjeerd van Staa, Frank de Vries Tags: Original Study Source Type: research

Measurement of Dynamical Resilience Indicators Improves the Prediction of Recovery Following Hospitalization in Older Adults
This study aimed to investigate if dynamical resilience indicators based on repeated physical and mental measurements in acutely hospitalized geriatric patients have added value over single baseline measurements in predicting favorable recovery. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 9, 2019 Category: Health Management Authors: Sanne M.W. Gijzel, Jerrald Rector, Fokke B. van Meulen, Rolinka Schim van der Loeff, Ingrid A. van de Leemput, Marten Scheffer, Marcel G.M. Olde Rikkert, Ren é J.F. Melis Tags: Original Study Source Type: research

Epidemiology of Antibiotic Use for Urinary Tract Infection in Nursing Home Residents
Describe antibiotic use for urinary tract infection (UTI) among a large cohort of US nursing home residents. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 6, 2019 Category: Health Management Authors: Nicola D. Thompson, Austin Penna, Taniece R. Eure, Wendy M. Bamberg, Grant Barney, Devra Barter, Paula Clogher, Malini B. DeSilva, Ghinwa Dumyati, Erin Epson, Linda Frank, Deborah Godine, Lourdes Irizarry, Marion A. Kainer, Linda Li, Ruth Lynfield, J.P. M Tags: Original Study Source Type: research

Reducing Hospital Readmissions Through a Skilled Nursing Facility Discharge Intervention: A Pragmatic Trial
To determine if implementation of Project Re-Engineered Discharge (RED), designed for hospitals but adapted for skilled nursing facilities (SNFs), reduces hospital readmissions after SNF discharge to the community in residents admitted to the SNF following an index hospitalization. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - December 4, 2019 Category: Health Management Authors: Rebekah L. Gardner, Kimberly Pelland, Rouba Youssef, Blake Morphis, Kathleen Calandra, Lara Hollands, Stefan Gravenstein Tags: Original Study Source Type: research

Respiratory Practices in the Long-term Care Setting: A Human Factors –Based Risk Analysis
To systematically assess safety risks pertaining to tracheostomy care in the long-term care (LTC) setting using a human factors engineering approach. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 29, 2019 Category: Health Management Authors: Morgan J. Katz, Patience M. Osei, Arjun Vignesh, Andrea Montalvo, Ifeoluwa Oresanwo, Ayse P. Gurses Tags: Original Study Source Type: research

Combining Procalcitonin and Rapid Multiplex Respiratory Virus Testing for Antibiotic Stewardship in Older Adult Patients With Severe Acute Respiratory Infection
Virus infection is underevaluated in older adults with severe acute respiratory infections (SARIs). We aimed to evaluate the clinical impact of combining point-of-care molecular viral test and serum procalcitonin (PCT) level for antibiotic stewardship in the emergency department (ED). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 28, 2019 Category: Health Management Authors: Chien-Chang Lee, Julia Chia-Yu Chang, Xiao-Wei Mao, Wan-Ting Hsu, Shey-Ying Chen, Yee-Chun Chen, Chorng-Kuang How Tags: Original Study Source Type: research

Antibiotic Stewardship in European Nursing Homes: Experiences From the Netherlands, Norway, Poland, and Sweden
Antibiotics are among the most widely prescribed drugs in long-term care facilities, which highlights the importance of antibiotic stewardship (ABS) in this setting. In this article, we describe the experiences with ABS in nursing homes (NHs) from the perspective of 4 European countries: the Netherlands, Norway, Poland, and Sweden. In these countries, a large variety of initiatives to develop and implement ABS in NHs have been introduced in recent years. Among these initiatives are national antibiotic prescribing surveillance systems, NH-specific prescribing guidelines, and national networks of healthcare institutions that...
Source: Journal of the American Medical Directors Association - November 28, 2019 Category: Health Management Authors: Laura W. Van Buul, Annelie A. Monnier, P är-Daniel Sundvall, Peter Ulleryd, Maciek Godycki-Cwirko, Anna Kowalczyk, Morten Lindbaek, Cees M.P.M. Hertogh Tags: Special Article Source Type: research

Effectiveness of Intervention Based on End-effector Gait Trainer in Older Patients With Stroke: A Systematic Review
The objective of the article is to analyze the effects of the end-effector technology for gait rehabilitation on acute, subacute, and chronic stroke in order to verify the efficacy of the treatment in older people, based on evidence from randomized controlled trials, and thus increase the clinical knowledge for future applications in the hospital setting. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 27, 2019 Category: Health Management Authors: Elvira Maranesi, Giovanni Renato Riccardi, Valentina Di Donna, Mirko Di Rosa, Paolo Fabbietti, Riccardo Luzi, Luigi Pranno, Fabrizia Lattanzio, Roberta Bevilacqua Tags: Review Article Source Type: research

Weakness May Have a Causal Association With Early Mortality in Older Americans: A Matched Cohort Analysis
Quantifying the association between muscle weakness and mortality with carefully matched cohorts will help to better establish the impact of weakness on premature death. We used a matched cohort analysis in a national sample of older Americans to determine if those who were weak had a higher risk for mortality compared with control groups with incrementally higher strength capacities. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 26, 2019 Category: Health Management Authors: Ryan McGrath, Brenda M. Vincent, Mark D. Peterson, Donald A. Jurivich, Lindsey J. Dahl, Kyle J. Hackney, Brian C. Clark Tags: Original Study Source Type: research

The Research Agenda for Dementia in Post-acute and Long-term Care, 2020 (Part I)
The December 2019 issue of JAMDA includes 11 articles related to cognitive impairment, Alzheimer's disease, and other dementias —no surprise, given that 50 million people across the globe have dementia. In 10 years, this number will grow to 82 million, and by 2050 it will be 152 million, with much of the increase due to rising numbers in low- and middle-income countries.1 The United States accounts for 5.8 of the current 50 million, and with a new case being identified every 65 seconds, will account for 14 million by 2050. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 26, 2019 Category: Health Management Authors: Sheryl Zimmerman Tags: Dementia Care Research Source Type: research

Is Physical Frailty a Neuromuscular Condition?
Various mechanisms have been suggested for the age-associated concomitant decline of brain volume and musculoskeletal mass, strength, and function,1 most of which indicate that a decline in one tissue leads to decreased mutual feedback (chemical or electroneurologic). In other terms, a decline in neuronal stimulation of muscle could lead to disuse atrophy, whereas lack of sensory input from inactive muscles and proprioceptors may, in turn, lead to the atrophy of relevant brain centers.2 Several potential factors and mechanisms have also been suggested for such crosstalk. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 26, 2019 Category: Health Management Authors: Ebrahim Bani Hassan, Mahdi Imani, Gustavo Duque Tags: Editorial Source Type: research

Editorial Board
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 26, 2019 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 - November 26, 2019 Category: Health Management Source Type: research

General Information
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 26, 2019 Category: Health Management Source Type: research

Directions & Connections
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 26, 2019 Category: Health Management Source Type: research

FRAIL Scale also Predicts Long-Term Outcomes in Older Patients With Acute Coronary Syndromes
No previous studies have assessed the role of the FRAIL scale in predicting long-term outcomes in older patients with acute coronary syndromes (ACS). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 25, 2019 Category: Health Management Authors: Oriol Rodr íguez-Queraltó, Francesc Formiga, Ramón López-Palop, Francisco Marín, María T. Vidán, Manuel Martínez-Sellés, Pablo Díez-Villanueva, Juan Sanchís, Miguel Corbí, Jaime Aboal, Eva Bernal, Oriol Alegre, Lourdes Vicent, Albert Ariza-Sol Tags: Original Study - Brief Report Source Type: research

Optimizing Quality of Life With Cognitive Impairment: A Study of End-of-Life Care in Assisted Living
Assisted living (AL) is an expanding site of end-of-life (EOL) care in the United States. Understanding determinants of quality of life (QoL) for AL residents near EOL is vital to optimize care for  this growing population, most of whom have some degree of cognitive impairment (CI). This analysis aimed to identify factors associated with QoL in a diverse sample of AL residents with CI approaching EOL. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 25, 2019 Category: Health Management Authors: Laura Arneson, Alexis A. Bender, Maggi N. Robert, Molly M. Perkins Tags: Original Study - Brief Report Source Type: research

Comment on “Polypharmacy and Kidney Function in Community-Dwelling Adults Age 60 Years and Older: A Prospective Observational Study”
We read with interest the study by Rahel Ernst et  al in which they aimed to investigate whether there was a relationship between the total intake of drugs or nonsteroidal anti-inflammatory drugs (NSAIDs) and kidney function. The authors found that each additional medication taken cumulatively for 24 months decreased renal function and, in a high -risk subgroup, per NSAID taken cumulatively for 24 months, the renal function decreased by 1.21 mL/min/1.73 m2 estimated glomerular filtration rate.1 In the present study, the cumulative uptake of NSAIDs was found to be associated with a nearly 3-fold red...
Source: Journal of the American Medical Directors Association - November 25, 2019 Category: Health Management Authors: Pinar Soysal, Lee Smith, Ahmet Turan Isik Tags: Letter to the Editor Source Type: research