Ambulatory Care –Sensitive Conditions Associated With Potentially Avoidable Hospital Admissions
Hospitalized nursing home residents have more chronic conditions, higher levels of care needs, and more unplanned admissions compared to non –nursing home residents.1,2 Unplanned admissions are admissions at out-of-hours care—thus, in the evening and night hours, and on weekends and holidays. However, evidence suggests that some of these unplanned admissions are potentially avoidable.3,4 (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 6, 2019 Category: Health Management Authors: Sarah Berger, Joachim Szecsenyi, Gunter Laux, R üdiger Leutgeb Tags: Research Letter Source Type: research

Effects of a Multicomponent Frailty Prevention Program in Prefrail Community-Dwelling Older Persons: A Randomized Controlled Trial
To examine the effects of a multicomponent frailty prevention program in community-dwelling older persons with prefrailty. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 5, 2019 Category: Health Management Authors: Ruby Yu, Cecilia Tong, Florence Ho, Jean Woo Tags: Original Study Source Type: research

The Longitudinal Associations of Handgrip Strength and Cognitive Function in Aging Americans
Factors that are responsible for age-related neurologic deterioration of noncognitive and cognitive processes may have a shared cause. We sought to examine the temporal, directional associations of handgrip strength and cognitive function in a national sample of aging Americans. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 5, 2019 Category: Health Management Authors: Ryan McGrath, Brenda M. Vincent, Kyle J. Hackney, Sheria G. Robinson-Lane, Brian Downer, Brian C. Clark Tags: Original Study Source Type: research

Diagnostic Accuracy of the SLU AMSAD Scale for Depression in Older Adults Without Dementia
To evaluate the diagnostic accuracy of a short depression screening tool, the Saint Louis University (SLU) AMSAD depression scale, relative to the Geriatric Depression Scale –15 (GDS-15) and Montgomery-Asberg Depression Rating Scale (MADRS), and in relation to the Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (DSM-5) criteria for major depressive disorder, in cognitively intact older adults. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 4, 2019 Category: Health Management Authors: Rita Khoury, Binu Chakkamparambil, John Chibnall, Jayashree Rajamanickam, Aneel Kumar, George T. Grossberg Tags: Original Study Source Type: research

State Variability in Assisted Living Residents ’ End-of-Life Care Trajectories
The objective of this study is to describe assisted living residents ’ end-of-life care trajectories and how they vary by state. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 4, 2019 Category: Health Management Authors: Kali S. Thomas, Emmanuelle Belanger, Wenhan Zhang, Paula Carder Tags: Original Study - Brief Report Source Type: research

Evolution of the Nursing Home Industry in States With Different Certificate of Need Policies
One of the earliest efforts to curb needless health care spending in the United States was certificate-of-need (CON) programs, which limit and manage the expansion of different health care institutions. CON programs mainly targeted nursing homes and home health industry that provide long-term care that is predominantly financed by states through Medicaid program. A large set of empirical studies documented that CON laws have been unsuccessful in limiting growth of hospital,1,2 nursing home,3,4 and home health5,6 spending. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 4, 2019 Category: Health Management Authors: Nasim B. Ferdows, Momotazur Rahman Tags: Research Letter Source Type: research

Links Between Physical Frailty and Regional Gray Matter Volumes in Older Adults: A Voxel-Based Morphometry Study
The relationship between physical frailty and regional gray matter volume in the brain was investigated among community-dwelling older Japanese people. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 31, 2019 Category: Health Management Authors: Yukiko Nishita, Akinori Nakamura, Takashi Kato, Rei Otsuka, Kaori Iwata, Chikako Tange, Fujiko Ando, Kengo Ito, Hiroshi Shimokata, Hidenori Arai Tags: Original Study Source Type: research

Assistance With Eating and Drinking Only When Requested Can Prevent Living With Advanced Dementia
Alzheimer's disease and other progressive neurodegenerative dementias are growing as the population ages. Managing dementia is challenging from economic, societal, and ethical perspectives. One significant ethical issue concerns people who want to avoid living with advanced dementia. Current strategies (suicide and traditional advance directives) are suboptimal or inadequate. Stopping eating and  drinking by advance directive (SED by AD) is a better potential solution. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 31, 2019 Category: Health Management Authors: Ladislav Volicer, Thaddeus Mason Pope, Karl E. Steinberg Tags: Care Decisions at the End of Life Source Type: research

Moving From Recommendations to Impact in Post-acute and Long-term Care Research
Articles published in JAMDA aim to inform practice and policy in post-acute and long-term care. Three of the articles in the November 2019 issue serve as a good illustration of the promise of research in that regard, and how that promise can be augmented. The intent of this editorial is to encourage researchers to take the next step toward impact in their work by more fully and thoughtfully presenting this next step as part of their recommendations. In the paragraphs below, we summarize 3 articles in the current issue, providing examples of how each of a retrospective cohort study, prospective observational study, and clus...
Source: Journal of the American Medical Directors Association - October 31, 2019 Category: Health Management Authors: Sheryl Zimmerman, Meera Tandan Tags: Editorial Source Type: research

Delirium Superimposed Upon Dementia
Like the ouroboros, the snake eating another snake which is, in turn, eating the first snake, and also sometimes portrayed as a single snake eating its own tail, so delirium and dementia feed off each other. Delirium leads to dementia and dementia leads to delirium, in a downward spiral of worsening cognitive and physical function, such that it is, at times, hard to separate them and, as the 2 snakes swallow each other, they become one. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 31, 2019 Category: Health Management Authors: Gideon A. Caplan Tags: Editorial Source Type: research

Editorial Board
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 31, 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 - October 31, 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 - October 31, 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 - October 31, 2019 Category: Health Management Source Type: research

Predictive Accuracy of Frailty Tools for Adverse Outcomes in a Cohort of Adults 80  Years and Older: A Decision Curve Analysis
To compare the predictive performance of 3 frailty identification tools for mortality, hospitalization, and functional decline in adults aged ≥80 years using risk reclassification statistics and decision curve analysis. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 30, 2019 Category: Health Management Authors: Eralda Hegend örfer, Bert Vaes, Gijs Van Pottelbergh, Catharina Matheï, Jan Verbakel, Jean-Marie Degryse Tags: Original Study Source Type: research

The Minimum Data Set Agitated and Reactive Behavior Scale: Measuring Behaviors in Nursing Home Residents With Dementia
Interventions aimed at managing agitated and aggressive behaviors in dementia without the use of antipsychotics are currently being tested in nursing homes (NHs). Researchers and clinicians require a measure that can capture the severity of residents ’ behaviors. We test the internal consistency and construct validity of the Agitated and Reactive Behavior Scale (ARBS), a measure created using data from mandatory NH assessments. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 30, 2019 Category: Health Management Authors: Ellen McCreedy, Jessica A. Ogarek, Kali S. Thomas, Vincent Mor Tags: Original Study - Brief Report Source Type: research

Quality Indicators as Predictors of Future Inspection Performance in Ontario Nursing Homes
In this study, we aimed to examine whether quality indicators could predict future inspection performance in LTC homes across Ontario, Canada. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 28, 2019 Category: Health Management Authors: Pouria Mashouri, Babak Taati, Hannah Quirt, Andrea Iaboni Tags: Original Study Source Type: research

A Multicenter Study to Identify Clinician Barriers to Participating in Goals of Care Discussions in Long-term Care
Long-term care (LTC) is an important setting for goals of care (GoC) discussions. Understanding clinician barriers to GoC discussions could identify opportunities for LTC-specific interventions to improve quantity and quality of GoC discussions in the context of serious illness. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 27, 2019 Category: Health Management Authors: Henry Y.H. Siu, Dawn Elston, Neha Arora, Amie Vahrmeyer, Sharon Kaasalainen, Paula Chidwick, Michelle Howard, Daren K. Heyland Tags: Original Study Source Type: research

Outcome Priorities for Older Persons With Sarcopenia
To evaluate patients ’ preferences for sarcopenia outcomes. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 27, 2019 Category: Health Management Authors: Mickael Hiligsmann, Charlotte Beaudart, Olivier Bruy ère, Emmanuel Biver, Jürgen Bauer, Alfonso J. Cruz-Jentoft, Antonella Gesmundo, Sabine Goisser, Francesco Landi, Médéa Locquet, Stefania Maggi, Rene Rizzoli, Yves Rolland, Nieves Vaquero, Cyrus Coop Tags: Original Study - Brief Report Source Type: research

Development of a Frailty Phenotype Questionnaire for Use in Screening Community-Dwelling Older Adults
The purpose of this study was to develop a screening questionnaire for frailty based on the Fried frailty phenotype (FFP) in community-dwelling older adults. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 27, 2019 Category: Health Management Authors: Sunyoung Kim, Miji Kim, Hee-Won Jung, Chang Won Won Tags: Original Study Source Type: research

Deprescribing as a Clinical Improvement Focus
This study was conducted to determine the deprescribing success rate and relate it to drug classes and clinical settings, and to identify factors that influence the deprescribing process. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 27, 2019 Category: Health Management Authors: Thiruvinvamalai S. Dharmarajan, Hanbyul Choi, Nadia Hossain, Uthpala Munasinghe, Fehmida Lakhi, Dennisdhilak Lourdusamy, Somechukwu Onuoha, Padmavathi Murakonda, Anna Skokowska-Lebelt, Madhusudhana Kanagala, Robin O. Russell Tags: Original Study Source Type: research

Handgrip Strength References for Middle-Age and Older Chinese Individuals
Handgrip strength (HGS) is an important indicator of cardiovascular disease (CVD) and all-cause mortality, and it is a simple, inexpensive method for assessing the risk of death in a number of countries and populations, particularly among older people who develop major illnesses.1 Height is a reflection of the bone structure, and bone mass also has demonstrated implications for muscular and strength performance.2 The handgrip strength index (HGSI) is an effective and convenient parameter for predicting the functional nutritional status and muscular health of patients with Crohn disease, and it could be a potential marker o...
Source: Journal of the American Medical Directors Association - October 27, 2019 Category: Health Management Authors: Guimin Huang, Lijun Wu Tags: Letter to the Editor Source Type: research

Screening Accuracy of SARC-F Combined With Calf Circumference for  Sarcopenia in Older Adults: A Diagnostic Meta-Analysis
Sarcopenia is one of the major health problems among older adults. It is defined as a progressive, systemic decrease in muscle mass and muscle strength, and or a decline in physiological muscle function associated with aging.1 Population screening to detect sarcopenia before the occurrence of physical disability is of great significance as there are no obvious symptoms of early sarcopenia.2 (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 27, 2019 Category: Health Management Authors: Yihan Mo, Xin Dong, Xiu-hua Wang Tags: Research Letter Source Type: research

The Prevalence and Persistence of Dizziness in Older European Home Care Recipients: A Prospective Cohort Study
The objective of this study was to investigate the prevalence and persistence of dizziness in HC recipients. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 27, 2019 Category: Health Management Authors: Hanneke Stam, Vincent A. van Vugt, Jos W.R. Twisk, Harriet Finne-Soveri, Vjenka Garms-Homolov á, Anja Declercq, Pálmi V. Jónsson, Graziano Onder, Henriëtte G. van der Roest, Hein van Hout, Otto R. Maarsingh Tags: Original Study Source Type: research

Engaging Physician Leaders for Higher Value
Case Example: Daisy Villa is a 3-star-rated skilled nursing facility (SNF) that is at the verge of losing its place in a local Accountable Care Organization (ACO) network as a result of high hospitalization rates of its short-stay patients. Through their quality assurance processes, the facility leadership conclude that lack of timely admission visits and medication reconciliation by physicians is a key contributory factor. When they approach the medical director to get help on the matter, she proclaims that poor outcomes are a result of “undue focus on profits rather than quality.” Disagreeing with the claim a...
Source: Journal of the American Medical Directors Association - October 27, 2019 Category: Health Management Authors: Arif Nazir, Victoria Walker, Richard A. Feifer Tags: Editorial Source Type: research

Optimizing Practices, Use, Care and Services –Antipsychotics (OPUS-AP) in Long-term Care Centers in Québec, Canada: A Strategy for Best Practices
Antipsychotic medications are often used for the first-line management of behavioral and psychological symptoms of dementia (BPSD) contrary to guideline recommendations. The Optimizing Practices, Use, Care and Services –Antipsychotics (OPUS-AP) strategy aims to improve the well-being of long-term care (LTC) residents with major neurocognitive disorder (MNCD) by implementing a resident-centered approach, nonpharmacologic interventions, and antipsychotic deprescribing in inappropriate indications. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 24, 2019 Category: Health Management Authors: Benoit Cossette, Marie-Andr ée Bruneau, Yves Couturier, Suzanne Gilbert, Diane Boyer, Jacques Ricard, Tanya McDonald, Karine Labarre, Véronique Déry, Marcel Arcand, Claudie Rodrigue, Andrée-Anne Rhéaume, Sylvie Moreault, Catherine Allard, Maude-Émil Tags: Original Study Source Type: research

The Joint Occurrence of Osteoporosis and Sarcopenia (Osteosarcopenia): Definitions and Characteristics
We sought to examine the associations of osteosarcopenia with physical performance, balance, and falls and fractures in community-dwelling older adults. Additionally, we aimed to determine which clinical outcomes are associated with specific components of osteosarcopenia. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 24, 2019 Category: Health Management Authors: Walter Sep úlveda-Loyola, Steven Phu, Ebrahim Bani Hassan, Sharon L. Brennan-Olsen, Jesse Zanker, Sara Vogrin, Romy Conzade, Ben Kirk, Ahmed Al Saedi, Vanessa Probst, Gustavo Duque Tags: Original Study Source Type: research

Trajectories of Long-Term Residential Care Needs Among Older Australian Women: A Cohort Study Using Linked Data
Older women are more likely than men to enter residential aged care (RAC) and generally stay longer. We aimed to identify and examine their trajectories of care needs over time in RAC across 3 fundamental care needs domains, including activities of daily living (ADL), behavior, and complex health care. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 23, 2019 Category: Health Management Authors: Md Mijanur Rahman, Julie E. Byles Tags: Original Study Source Type: research

Patient's Engagement in the Identification of Critical Outcomes in Sarcopenia
The identification of relevant clinical outcomes of sarcopenia could be helpful for health professionals to improve sarcopenia management and for designing valid and useful clinical trials and outcome studies. Through observational studies, a flow of outcomes associated with sarcopenia has already been identified.1 –4 However, to ensure that the outcomes measured reflect those that matter most to patients, incorporation of the patients' perspective in clinical research is also critical.5,6 Qualitative interviews with experts and patients are a wise way to generate original outcomes not usually observed in st udies de...
Source: Journal of the American Medical Directors Association - October 23, 2019 Category: Health Management Authors: Charlotte Beaudart, Olivier Bruy ère, Alfonso J. Cruz-Jentoft, María Nieves Vaquero-Pinto, Médéa Locquet, Jürgen Bauer, Cyrus Cooper, Yves Rolland, Charlotte Dupuy, Francesco Landi, Jean-Yves Reginster, Stefania Maggi, René Rizzoli, Mickaël Hiligsm Tags: Research Letter Source Type: research

Pain Assessment for Older Persons in Nursing Home Care: An Evidence-Based Practice Guideline
Up to 80% of nursing home residents are affected by pain. Pain assessment aims to determine pain intensity, quality, and course of pain to underpin diagnostic decision making. In the nursing home population, pain assessment is frequently compromised by cognitive impairment. Characteristics of the nursing home setting, such as resident's age, staff skill mix, and overall aims of the care provided, also need to be taken into account. Therefore, an interdisciplinary evidence-based clinical practice guideline for pain assessment in the nursing home setting was developed. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 22, 2019 Category: Health Management Authors: Erika Sirsch, Albert Lukas, Corinna Drebenstedt, Irmela Gnass, Marjan Laekeman, Kirsten Kopke, Thomas Fischer, Guideline workgroup (Schmerzassessment bei älteren Menschen in der vollstationären Altenhilfe, AWMF Registry 145-001) Tags: Special Article Source Type: research

Residential Respite Care Use Is Associated With Fewer Overall Days in Residential Aged Care
To examine the use of residential respite care and determine associations between respite care and total days spent in residential care (respite days plus long-term care days). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 22, 2019 Category: Health Management Authors: Stephanie L. Harrison, Catherine Lang, Craig Whitehead, Maria Crotty, Megan Corlis, Steve Wesselingh, Maria C.Inacio Tags: Original Study Source Type: research

Uncertain Association Between Benzodiazepine Use and the Risk of Dementia: A Cohort Study
To examine the association between benzodiazepine use and the risk of dementia. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 21, 2019 Category: Health Management Authors: Yeon-Hee Baek, Hyesung Lee, Woo Jung Kim, Jee-Eun Chung, Nicole Pratt, Lisa Kalisch Ellett, Ju-Young Shin Tags: Original Study Source Type: research

Combined Impact of Traditional and Nontraditional Healthy Behaviors on Frailty and Disability: A Prospective Cohort Study of Older Adults
To assess the short- and long-term association of 6 healthy behaviors (not smoking, vigorous to moderate physical activity, healthy diet, adequate sleeping duration, not being sedentary, and daily social interaction) with incident frailty and disability. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 18, 2019 Category: Health Management Authors: Ra úl Francisco Pérez-Tasigchana, Helena Sandoval-Insausti, Carolina Donat-Vargas, Jose Ramón Banegas, Fernando Rodríguez-Artalejo, Pilar Guallar-Castillon Tags: Original Study Source Type: research

Evaluation of Viruses Associated With Acute Respiratory Infections in Long-Term Care Facilities Using a Novel Method: Wisconsin, 2016 ‒2019
We report on findings of a surveillance feasibility substudy from a larger prospective trial of introducing rapid influenza diagnostic testing (RIDT) at 10 Wisconsin LTCFs. Any resident with symptoms consistent with ARI had a nasal swab specimen collected for RIDT by staff. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 18, 2019 Category: Health Management Authors: Mary M. Checovich, Shari Barlow, Peter Shult, Erik Reisdorf, Jonathan L. Temte Tags: Special Article Source Type: research

Reducing Loneliness and Depression: The Power of Peer Mentoring in Long-term Care
Moving into a long-term care home can be accompanied by negative psychosocial effects. Loneliness and depression are common,1 and residents complain about superficial social connections in these settings.2 Despite a desire among residents for more purposeful activities, recreational programming provided overall tends toward entertainment and distraction, rather than opportunities for meaningful contributions or connections.3 (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 16, 2019 Category: Health Management Authors: Kristine A. Theurer, Robyn I. Stone, Melinda J. Suto, Virpi Timonen, Susan G. Brown, W. Ben Mortenson Tags: Research Letter Source Type: research

Identifying Key Risk Factors for Dizziness Handicap in Middle-Aged and Older People
More than 10% of people aged 50  years and older report dizziness. Despite available treatments, dizziness remains unresolved for many people due in part to suboptimal assessment. We aimed to identify factors associated with dizziness handicap in middle-aged and older people to identify targets for intervention to address this de bilitating problem. A secondary aim was to determine whether factors associated with dizziness differed between middle-aged ( (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 16, 2019 Category: Health Management Authors: Jasmine C. Menant, Daniela Meinrath, Daina L. Sturnieks, Cameron Hicks, Joanne Lo, Mayna Ratanapongleka, Jessica Turner, Americo A. Migliaccio, Kim Delbaere, Nickolai Titov, Jacqueline C.T. Close, Stephen R. Lord Tags: Original Study Source Type: research

A Method to the Madness: Using Technology to Enhance Team-Based Care Coordination
In this age of innovation, data generated in 2  days is as much as all data generated in human history before 2003!1 An explosion of startups aiming to improve senior care is resulting in a flurry of new ideas and products. How does one make the best use of all the technology, and is technology the path to best outcomes?2 Let's go back to the f uture (June 2021) to make some sense out of this tech onslaught. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 15, 2019 Category: Health Management Authors: Arif Nazir Tags: Letter to the Editor Source Type: research

Post-Acute Care for Older People Following Injury: A Randomized Controlled Trial
The study sought to determine whether older people, on discharge from hospital and on referral to a supported discharge team (SDT), will have: (1) reduced length of stay in hospital; (2) reduced risk of hospital readmission; and (3) reduced healthcare costs. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 15, 2019 Category: Health Management Authors: Matthew Parsons, John Parsons, Avinesh Pillai, Paul Rouse, Sean Mathieson, Rochelle Bregmen, Christine Smith, Tim Kenealy Tags: Original Study - Brief Report Source Type: research

Motoric Cognitive Risk Syndrome in a Chinese Older Adult Population: Prevalence and Associated Factors
China is expected to host almost half of the global dementia population by 2050.1 Such projections demand immediate preventive therapies to delay the progression of cognitive decline in the community. Motoric cognitive risk (MCR) syndrome characterized by subjective memory complaints and decreased gait speed (in older adults without dementia and mobility disability) has been shown to predict incident dementia, and hence is referred to as a predementia stage.2,3 MCR has been suggested to be an efficient tool for identifying high-risk individuals and thus could be a useful measure for preventive therapies or studies targetin...
Source: Journal of the American Medical Directors Association - October 13, 2019 Category: Health Management Authors: Jagadish K. Chhetri, Chao Han, Xiaojuan Dan, Lina Ma, Piu Chan Tags: Research Letter Source Type: research

Effects of Copayment in Long-term Care Insurance on Long-term Care and Medical Care Expenditure
This study aimed to clarify the difference in (1) long-term care (LTC) usage and expenditure and (2) medical care service usage and expenditure before and after the change in the copayment limit for qualifying individuals from 10% to 20%. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 13, 2019 Category: Health Management Authors: Huei-Ru Lin, Yuichi Imanaka Tags: Original Study Source Type: research

A Randomized Trial of Alerting to Hypocholesterolemia Results of the Low Indexes of Metabolism Intervention Trial-C (LIMIT-C)
The benefit of alerting clinical staff to drug-induced hypocholesterolemia in patients aged 75  years and older remains uncertain. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 11, 2019 Category: Health Management Authors: Nir Tsabar, Yan Press, Johanna Rotman, Bracha Klein, Yonatan Grossman, Maya Vainshtein-Tal, Sophia Eilat-Tsanani Tags: Original Study - Brief Report Source Type: research

Predictors of Incident Fear of Falling in Community-Dwelling Older Adults
Fear of falling (FoF) is common in older people and may lead to physical decline, disability, poor quality of life, and falls. Several risk factors for FoF have been identified in cross-sectional studies, but evidence on predictors of its incidence is scarce. We investigated the latter in community-dwelling older people undergoing a comprehensive geriatric assessment at baseline and after a 2-year follow-up. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 10, 2019 Category: Health Management Authors: Giulia Rivasi, Rose Anne Kenny, Andrea Ungar, Roman Romero-Ortuno Tags: Original Study Source Type: research

Safety of Subcutaneous Piperacillin/Tazobactam Administration Compared to Intravenous Administration: Propensity Score –Matched Cohort Study
Currently, the subcutaneous administration of antibiotics is considered to be an alternative route to intravenous administration because of its safety and effectiveness in treating bacterial infection,1 leading to its widespread use, especially for palliative purposes.2 Oral intolerance, poor venous access, refusal or contraindication of central venous access, and refusal or contraindication of intramuscular administration are common reasons for choosing subcutaneous administration of antibiotics. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 9, 2019 Category: Health Management Authors: Daiki Kobayashi, Misuzu Cho, Kyoko Yokota, Takuro Shimbo Tags: Research Letter Source Type: research

Lessons Learned From Implementation of the Indiana SMART Campaign to Reduce Nursing Home Polypharmacy
Polypharmacy among nursing home (NH) residents is prevalent, potentially hazardous, and can be reduced if prescribing guidelines and processes such as in-depth medication reviews are properly implemented.1 –4 Given the known hazards of NH polypharmacy, why does the problem persist? Several approaches have demonstrated success in reducing polypharmacy among NH residents, including multidisciplinary care conferences involving geriatric specialist physicians and pharmacists,1 targeting residents most a t risk of adverse drug events for supplemental pharmacist review,2 medication review followed by targeted deprescribing...
Source: Journal of the American Medical Directors Association - October 9, 2019 Category: Health Management Authors: Kathleen Abrahamson, Kathleen Unroe, Kristi Lieb, Tochukwu Iloabuchi, Robert Russell, Yun Cai, Arif Nazir Tags: Letter to the Editor Source Type: research

Sleep Duration and the Risk of Dementia: A Systematic Review and Meta-analysis of Prospective Cohort Studies
Epidemiologic studies have reported inconsistent findings about the association between sleep duration and the risk of dementia. We aimed to clarify this association by method of meta-analysis. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 7, 2019 Category: Health Management Authors: Li Fan, Weihao Xu, Yulun Cai, Yixin Hu, Chenkai Wu Tags: Review Article Source Type: research

Cognitive Outcomes of Long-term Benzodiazepine and Related Drug (BDZR) Use in People Living With Mild to Moderate Alzheimer's Disease: Results From NILVAD
Benzodiazepines and related drugs (BDZRs) have been associated with an increased risk of Alzheimer's disease (AD) in later life. Despite this, it remains unclear whether ongoing BDZR use may further accelerate cognitive decline in those diagnosed with mild to moderate AD. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 7, 2019 Category: Health Management Authors: Adam H. Dyer, Claire Murphy, Brian Lawlor, Sean P. Kennelly, NILVAD Study Group Tags: Original Study Source Type: research

The Presence of a Geriatrician in a Nursing Home Could Prevent Hospitalization
In Switzerland, general practitioners mostly provide medical care in the nursing home (NH). They generally work in their own practice, which is not located in the NH. In case of an emergency, the NH resident is often transferred to the emergency room if the general practitioner is not available, although hospitalization is a risk factor for functional and cognitive decline.1 –3 (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 3, 2019 Category: Health Management Authors: Francois R. Herrmann, Dina Zekry, Reto W. Kressig, Christophe E. Graf Tags: Research Letter Source Type: research

Stopping Eating and Drinking by Advance Directives (SED by AD) in Assisted Living and Nursing Homes
The Ethics Subcommittee of AMDA –The Society for Post-Acute and Long-Term Care Medicine (“The Society”) presents arguments for and against Stopping Eating and Drinking by Advance Directives (SED by AD). SED by AD is a type of advance directive in which a proxy is instructed to stop offering food and fluids to a person when t hey reach a certain stage of dementia. Although most conversations regarding SED by AD focus on patient autonomy and the right to determine one's care, we propose that the ethical principle of justice—the obligation to treat all individuals equally regardless of race, gender, an...
Source: Journal of the American Medical Directors Association - October 2, 2019 Category: Health Management Authors: James L. Wright, Peter M. Jaggard, Timothy Holahan, Ethics Subcommittee of AMDA –The Society for Post-Acute and Long-Term Care Tags: Controversies in Care Source Type: research

Leisure Activities and All-Cause Mortality Among the Chinese Oldest-Old Population: A Prospective Community-Based Cohort Study
To investigate associations between leisure activities, examining each activity separately and in combination, and all-cause mortality among the Chinese oldest-old ( ≥80 years) population. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 2, 2019 Category: Health Management Authors: Zhi-Hao Li, Xi-Ru Zhang, Yue-Bin Lv, Dong Shen, Fu-Rong Li, Wen-Fang Zhong, Qing-Mei Huang, Xian-Bo Wu, Yi Zeng, Xiang Gao, Xiao-Ming Shi, Chen Mao Tags: Original Study Source Type: research

A Randomized Trial of Alerting to Low Glycated Hemoglobin Level in Older Adults: Results of the Low Indexes of Metabolism Intervention Trial B (LIMIT-B)
The benefit of alerting clinical staff to low plasma glycated hemoglobin (HbA1c) in patients aged 75  years and older who receive antidiabetic drugs remains uncertain. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 2, 2019 Category: Health Management Authors: Nir Tsabar, Yan Press, Johanna Rotman, Bracha Klein, Yonatan Grossman, Maya Vainshtein-Tal, Sophia Eilat-Tsanani Tags: Original Study - Brief Report Source Type: research