Platypnea-Orthodeoxia Syndrome Masked by Delirium in an 85-Year-Old Woman
On February 3, 2016, an 85-year-old woman was brought to the emergency department (ED) because of mental confusion and intolerance of the sitting position, which had begun suddenly 2 days before. She had been wheelchair-bound for the past 9 years after a stroke that had left her with mild left-sided hemiparesis but without cognitive impairment. According to her medical records at the ED, she was initially found hypoxemic (SO2  = 75% in room air) and disoriented. She was diagnosed with pneumonia, and because there was major improvement regarding her oxygenation after hydration (SO2 = 94% in room air), she was disc...
Source: Journal of the American Medical Directors Association - November 28, 2017 Category: Health Management Authors: Leonardo A.R. Brito, Fernanda B. Fukushima, Rodrigo Bazan, Danieliso R. Fusco, Edison I.O. Vidal Tags: Letter to the Editor Source Type: research

JAMDA's New Editors-in-Chief Present a Vision for the Journal of Post-Acute and Long-Term Care Medicine
During JAMDA's first 15  years of publication, it was the Journal of the American Medical Directors Association. In 2014, JAMDA was renamed the Journal of Post-Acute and Long-Term Care Medicine, better reflecting the breadth of the long-term care spectrum and the involvement of nurse practitioners, physician assistants, a nd other members of the interdisciplinary care team.1 As the new editors-in-chief of JAMDA, we heartily endorse this evolution to a broader perspective of post-acute and long-term care (PA/LTC) medicine. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 28, 2017 Category: Health Management Authors: Sheryl Zimmerman, Philip D. Sloane Tags: Editorial Source Type: research

Redefining Cut-Points for High Symptom Burden of the Global Initiative for Chronic Obstructive Lung Disease Classification in 18,577 Patients With Chronic Obstructive Pulmonary Disease
Patients with chronic obstructive pulmonary disease (COPD) can be classified into groups A/C or B/D based on symptom intensity. Different threshold values for symptom questionnaires can result in misclassification and, in turn, different treatment recommendations. The primary aim was to find the best fitting cut-points for Global initiative for chronic Obstructive Lung Disease (GOLD) symptom measures, with an modified Medical Research Council dyspnea grade of 2 or higher as point of reference. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 21, 2017 Category: Health Management Authors: Dionne E. Smid, Frits M.E. Franssen, Maria Gonik, Marc Miravitlles, Ciro Casanova, Borja G. Cosio, Pilar de Lucas-Ramos, Jose M. Marin, Cristina Martinez, Isabel Mir, Joan B. Soriano, Juan P. de Torres, Alvar Agusti, Nart B. Atalay, Julia Billington, Afro Tags: JAMDA Online Source Type: research

Snoezelen Therapy as an Intervention to Reduce Agitation in Nursing Home Patients With Dementia: A Pilot Study
Nonpharmacologic interventions have been shown to be relatively effective in reducing agitation and improving the quality of life of patients with dementia.1,2 Programs/interventions that have been employed in many long-term care facilities include aromatherapy,3 art therapy,2 exercise therapy,4 –6 music therapy,2 pet therapy, and more.1 Exercise programs in particular have been shown in some studies to be effective in reducing agitation among patients with dementia.4,6,7 One emerging intervention that is not well established or validated, however, is snoezelen therapy. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 21, 2017 Category: Health Management Authors: Scott D. Berkheimer, Chen Qian, Theodore K. Malmstrom Tags: Letter to the Editor Source Type: research

A Decade of JAMDA
“The afternoon knows what the morning never suspected”∼Robert Frost (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 21, 2017 Category: Health Management Authors: John E. Morley Tags: Editorial Source Type: research

Determining the Physician-to-Patient Ratio in Post-Acute/Long-Term Care Using an Economic Model
There has been significant interest in providing both quality of care and fiscally responsible care with the advent of value-based medicine. Practitioners generally need more time to provide the excellence in care that will equate to improved quality and patient outcomes. Salaried and traditional fee-for-service –based care both depend on adequate revenues being generated. The pressure to produce income means seeing more patients per day, whereas the goal of quality of care will tend to produce fewer visits per day. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 21, 2017 Category: Health Management Authors: Charles Crecelius Tags: Letter to the Editor Source Type: research

Utilization of Antibiotics in Long-Term Care Facilities in British Columbia, Canada
The objective of this study was to understand the extent of antibiotic use in the population of residents in British Columbia's (BC) LTCFs from 2007 to  2014. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 21, 2017 Category: Health Management Authors: Fawziah Marra, Mark McCabe, Prateek Sharma, Bin Zhao, Christopher Mill, Victor Leung, Mei Chong, David M. Patrick Tags: JAMDA Online Source Type: research

Associations of Clinically Relevant Levels of Depressive Symptoms and Antidepressant Use With Mortality in African American Health
We examined the association of underuse of antidepressants in African American individuals with increased mortality. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 21, 2017 Category: Health Management Authors: Li Cao, Daphne Lew, Theodore K. Malmstrom, Douglas K. Miller Tags: Original Study Source Type: research

Examining the Effects of Age on Health Outcomes of Chronic Obstructive Pulmonary Disease: Results From the Genetic Epidemiology of Chronic Obstructive Pulmonary Disease Study and Evaluation of Chronic Obstructive Pulmonary Disease Longitudinally to Identify Predictive Surrogate Endpoints Cohorts
The prevalence of chronic obstructive pulmonary disease (COPD) and its associated comorbidities increase with age. However, little is understood about differences in the disease in patients over 65  years of age compared with younger patients. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 21, 2017 Category: Health Management Authors: Amit D. Parulekar, Carlos Martinez, Chu-Lin Tsai, Nicholas Locantore, Mustafa Atik, Abebaw M. Yohannes, Christina C. Kao, Hassan Al-Azzawi, Ali Mohsin, Robert A. Wise, Marilyn G. Foreman, Dawn L. Demeo, Elizabeth A. Regan, Barry J. Make, Aladin M. Boriek, Tags: Original Study Source Type: research

Response to the Letter to the Editor by Simon D. Smith “Recall Tests Can Be Effective to Detect Mild Cognitive Impairment: A Response to Tsoi and Colleagues”
In the response letter to our recent article, Smith1 and his colleagues  made a constructive suggestion to remind the users of cognitive tests in the aging population. Elderly people may have different levels of physical constrains, such as progressive deterioration of auditory acuity, that may affect the performance of cognitive screening tests, especially for both th e Mini-Mental State Examination (MMSE)2 and Montreal Cognitive Assessment (MoCA),3 which require verbal interchange between health professionals and the elderly participants. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 21, 2017 Category: Health Management Authors: Joyce Y.C. Chan, Samuel Y.S. Wong, Kelvin K.F. Tsoi Tags: Letter to the Editor Source Type: research

Overview of Two Different Nursing Home Health Systems: Examples From France and the United States
Many countries face the pressure of a rapidly growing aging population. Thus, due to this increase, the number of dependent older adults is projected to rise from 350 million in 2010 to 488 million in 2030 and 614 million in 2050.1 In the United States, slightly more than 5% of the population 65  years or older occupies nursing homes and approximately 4.2% are there at any given time. The rate of nursing home use increases with age from 1.4% of the young-old (younger than 85) to 24.5% of the oldest-old (85 or older). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 21, 2017 Category: Health Management Authors: Bertrand Foug ère, Julie K. Gammack Tags: Editorial Source Type: research

Editorial Board
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 21, 2017 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 21, 2017 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 21, 2017 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 21, 2017 Category: Health Management Source Type: research

Resident Vignettes for Assessing Care Quality in Nursing Homes
Validated process measures that correlate with patient outcomes are needed for research and quality improvement. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 21, 2017 Category: Health Management Authors: Cathleen S. Col ón-Emeric, Kirsten N. Corazzini, Eleanor S. McConnell, Wei Pan, Mark P. Toles, Rasheeda Hall, Melissa Batchelor-Murphy, Tracey L. Yap, Amber L. Anderson, Andrew Burd, Sathya Amarasekara, Ruth A. Anderson Tags: Original Study Source Type: research

An Even Distribution of Protein Intake Daily Promotes Protein Adequacy but Does Not Influence Nutritional Status in Institutionalized Elderly
Although it has been established that sufficient protein is required to maintain good nutritional status and support healthy aging, it is not clear if the pattern of protein consumption may also influence nutritional status, especially in institutionalized elderly who are at risk of malnutrition. Therefore, we aim to determine the association between protein intake distribution and nutritional status in institutionalized elderly people. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 21, 2017 Category: Health Management Authors: Michael Tieland, Janne Beelen, Anna C.M. Laan, Shirley Poon, Lisette C.P.G.M. de Groot, Ego Seeman, Xiaofang Wang, Sandra Iuliano Tags: Original Study Source Type: research

Successful Ageing in Nonagenarians: Bio-psychosocial Factors Determining Successful Ageing in Long-Lived Older Adults
In their seminal paper, Rowe and Kahn defined successful aging as having 3 main components: limited disease and disease-related disability, high cognitive and physical functional capacity, and active engagement with life.1 Nonagenarians represent a unique and relevant catchment group to conduct research on successful aging.2 Much of the prevailing literature focuses mainly on longevity per se rather than attributes that promote healthy aging and well-being in a group that has attained exceptional longevity. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 21, 2017 Category: Health Management Authors: Mei Sian Chong, Cai Ning Tan, Suzanne Yew, Jun Pei Lim, Wee Shiong Lim, Ping Kong Lieu Tags: Letter to the Editor Source Type: research

Resident Vignettes for Assessing Care Quality in Nursing Homes
Validated process measures that correlate with patient outcomes are needed for research and quality improvement. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 21, 2017 Category: Health Management Authors: Cathleen S. Col ón-Emeric, Kirsten N. Corazzini, Eleanor S. McConnell, Wei Pan, Mark P. Toles, Rasheeda Hall, Melissa Batchelor-Murphy, Tracey L. Yap, Amber L. Anderson, Andrew Burd, Sathya Amarasekara, Ruth A. Anderson Tags: Original Study Source Type: research

Effects of Combined Physical and Cognitive Exercises on Cognition and Mobility in Patients With Mild Cognitive Impairment: A  Randomized Clinical Trial
Although participation in physical and cognitive activities is encouraged to reduce the risk of dementia, the preventive efficacy of these activities for patients with mild cognitive impairment is unestablished. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 16, 2017 Category: Health Management Authors: Hiroyuki Shimada, Hyuma Makizako, Takehiko Doi, Hyuntae Park, Kota Tsutsumimoto, Joe Verghese, Takao Suzuki Tags: Original Study Source Type: research

Hospice Care for Patients With Dementia in the United States: A Longitudinal Cohort Study
Patients with dementia form an increasing proportion of those entering hospice care. Little is known about the types of hospices serving patients with dementia and the patterns of hospice use, including timing of hospice disenrollment between patients with and without dementia. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 16, 2017 Category: Health Management Authors: Aline De Vleminck, R. Sean Morrison, Diane E. Meier, Melissa D. Aldridge Tags: Original Study Source Type: research

Effects of Combined Physical and Cognitive Exercises on Cognition and Mobility in Patients With Mild Cognitive Impairment: A  Randomized Clinical Trial
Although participation in physical and cognitive activities is encouraged to reduce the risk of dementia, the preventive efficacy of these activities for patients with mild cognitive impairment is unestablished. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 16, 2017 Category: Health Management Authors: Hiroyuki Shimada, Hyuma Makizako, Takehiko Doi, Hyuntae Park, Kota Tsutsumimoto, Joe Verghese, Takao Suzuki Tags: Original Study Source Type: research

Hospice Care for Patients With Dementia in the United States: A Longitudinal Cohort Study
Patients with dementia form an increasing proportion of those entering hospice care. Little is known about the types of hospices serving patients with dementia and the patterns of hospice use, including timing of hospice disenrollment between patients with and without dementia. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 16, 2017 Category: Health Management Authors: Aline De Vleminck, R. Sean Morrison, Diane E. Meier, Melissa D. Aldridge Tags: Original Study Source Type: research

An Easy Assessment of Frailty at Baseline Independently Predicts Prognosis in Very Elderly Patients With Acute Coronary Syndromes
Information about the impact of frailty in patients with acute coronary syndromes (ACS) is scarce. No study has assessed the prognostic impact of frailty as measured by the FRAIL scale in very elderly patients with ACS. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 16, 2017 Category: Health Management Authors: Oriol Alegre, Francesc Formiga, Ram ón López-Palop, Francisco Marín, María T. Vidán, Manuel Martínez-Sellés, Antoni Carol, Alessandro Sionis, Pablo Díez-Villanueva, Jaime Aboal, Anna Palau-Vendrel, Héctor Bueno, Angel Perez Rivera, Juan Sanchís, Tags: Original Study Source Type: research

Efficacy and Safety of Citalopram Compared With Atypical Antipsychotics on Agitation in Nursing Home Residents With Alzheimer Dementia
We are delighted to know that our article has captured the attention of readers. Regarding the findings of our previous study, Professor Naharci points out that unrecognized delirium could have had a relevant confounding effect and that the differential role of specific antidementia drugs should have been analyzed in detail. Delirium is a common geriatric syndrome with the highest incidence in acutely ill hospitalized older patients.1 Professor Naharci cited a retrospective study by Dosa et  al2 reporting a very high occurrence of either full-spectrum or subsyndromal delirium among long-stay residents. (Source: Journa...
Source: Journal of the American Medical Directors Association - November 16, 2017 Category: Health Management Authors: Giovanni Viscogliosi, Iulia Maria Chiriac, Evaristo Ettorre Tags: Letter to the Editor Source Type: research

Frailty in Hospitalized Older Adults: Comparing Different Frailty Measures in Predicting Short- and Long-term Patient Outcomes
Data for the assessment of frailty in acutely ill hospitalized older adults remains limited. Using the Frailty Index (FI) as “gold standard,” we compared (1) the diagnostic performance of 3 frailty measures (FRAIL, Clinical Frailty Scale [CFS], and Tilburg Frailty Indicator [TFI]) in identifying frailty, and (2) their ability to predict negative outcomes at 12 months after enrollment. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 15, 2017 Category: Health Management Authors: Edward Chong, Esther Ho, Jewel Baldevarona-Llego, Mark Chan, Lynn Wu, Laura Tay, Yew Yoong Ding, Wee Shiong Lim Tags: Original Study Source Type: research

Could delirium and anti-dementia drugs effect the treatment of agitated nursing home residents with Alzheimer dementia?
In a recent issue of Journal of the American Medical Directors Association, Viscogliosi et  al have achieved important results in testing safer and more effective alternatives in the treatment of agitation in nursing home residents with Alzheimer dementia (AD).1 There is insufficient data on the comparison of citalopram with antipsychotics in this regard, indicating that this study could make important contributions for beneficial treatment options in agitation improvement in AD patients. Besides, the authors may not have considered a few factors that could affect the results in the adjusted analysis. (Source: Journal...
Source: Journal of the American Medical Directors Association - November 15, 2017 Category: Health Management Authors: Mehmet Ilkin Naharci Tags: Letter to the Editor Source Type: research

Frailty in Hospitalized Older Adults: Comparing Different Frailty Measures in Predicting Short- and Long-term Patient Outcomes
Data for the assessment of frailty in acutely ill hospitalized older adults remains limited. Using the Frailty Index (FI) as “gold standard,” we compared (1) the diagnostic performance of 3 frailty measures (FRAIL, Clinical Frailty Scale [CFS], and Tilburg Frailty Indicator [TFI]) in identifying frailty, and (2) their ability to predict negative outcomes at 12 months after enrollment. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 15, 2017 Category: Health Management Authors: Edward Chong, Esther Ho, Jewel Baldevarona-Llego, Mark Chan, Lynn Wu, Laura Tay, Yew Yoong Ding, Wee Shiong Lim Tags: Original Study Source Type: research

Could delirium and anti-dementia drugs effect on the treatment of agitated nursing home residents with Alzheimer dementia?
In a recent issue of Journal of the American Medical Directors Association, Viscogliosi et  al have achieved important results in testing safer and more effective alternatives in the treatment of agitation in nursing home residents with Alzheimer dementia (AD).1 There is insufficient data on the comparison of citalopram with antipsychotics in this regard, indicating that this study could make important contributions for beneficial treatment options in agitation improvement in AD patients. Besides, the authors may not have considered a few factors that could affect the results in the adjusted analysis. (Source: Journal...
Source: Journal of the American Medical Directors Association - November 15, 2017 Category: Health Management Authors: Mehmet Ilkin Naharci Tags: Letter to the Editor Source Type: research

Nursing Staff Distress Associated With Neuropsychiatric Symptoms in Young-Onset Dementia and Late-Onset Dementia
The aims of this study were (1) to investigate the relationship between different neuropsychiatric symptoms (NPS) and the level of distress experienced by nurses caring for residents with young-onset dementia (YOD) and (2) to compare these findings with those for nurses caring for residents with late-onset dementia (LOD). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 14, 2017 Category: Health Management Authors: Jeannette C.L. van Duinen-van den IJssel, Ans J.M.J. Mulders, Martin Smalbrugge, Sandra A. Zwijsen, Britt Appelhof, Sytse U. Zuidema, Marjolein E. de Vugt, Frans R.J. Verhey, Christian Bakker, Raymond T.C.M. Koopmans Tags: Original Study Source Type: research

Delivering Person-Centered Care: Important Preferences for Recipients of Long-term Services and Supports
Although assessing individual consumer preferences are an important first step in providing person-centered care, the purpose of this study was to identify the top 10 shared preferences that are important to a majority of consumers receiving long-term services and supports. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 14, 2017 Category: Health Management Authors: Katherine M. Abbott, Rachel Klumpp, Kendall A. Leser, Jane K. Straker, Gerald C. Gannod, Kimberly Van Haitsma Tags: Original Study Source Type: research

Joint Trajectories of Cognition and Frailty and Associated Burden of Patient-Reported Outcomes
To evaluate joint trajectories of cognition and frailty and their association with the cumulative burden of patient-reported outcomes, including hospitalization, nursing home admission, and disability. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 14, 2017 Category: Health Management Authors: Zuyun Liu, Ling Han, Evelyne A. Gahbauer, Heather G. Allore, Thomas M. Gill Tags: Original Study Source Type: research

The Pathophysiology of Frailty: Why Sex Is So Important
Although a decade has passed since the elegant theory of “inflammaging” was proposed,1 the precise pathophysiological pathways that lead to frailty, as opposed to “healthy” aging, remain elusive. Elevated inflammatory markers have been associated with frailty in cross-sectional studies of older adults.2 A leading hypothesis is that persistent low- grade inflammation causes frailty via catabolic effects of proinflammatory cytokines on muscle.3 The inflammatory milieu is also thought to influence the progression of age-related diseases, which in turn contribute to the development of frailty. (Source: ...
Source: Journal of the American Medical Directors Association - November 10, 2017 Category: Health Management Authors: Emily H. Gordon, Ruth E. Hubbard Tags: Editorial Source Type: research

Frailty and Clinical Outcomes in Advanced Heart Failure Patients Undergoing Left Ventricular Assist Device Implantation: A Systematic Review and Meta-analysis
Frailty has been identified as a risk factor for adverse clinical outcomes after cardiac intervention or surgery. However, whether it increases the risk of adverse outcomes in patients undergoing left ventricular assist device (LVAD) therapy has been controversial. Therefore, we conducted a systematic review and meta-analysis of the frailty measures and clinical outcomes of length of stay and mortality in this setting. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 9, 2017 Category: Health Management Authors: Gary Tse, Mengqi Gong, Sunny Hei Wong, William K.K. Wu, George Bazoukis, Konstantinos Lampropoulos, Wing Tak Wong, Yunlong Xia, Martin C.S. Wong, Tong Liu, Jean Woo, International Health Informatics Study (IHIS) Network Tags: Original Study Source Type: research

Renin-Angiotensin System Blockers and Statins Are Associated With Lower In-Hospital Mortality in Very Elderly Hypertensives
Cardiovascular diseases are mainly related to hypertension and dyslipidemia and increase with aging because of the larger time span for these risk factors to damage arterial blood vessels. The impact of cardiovascular drug therapy on outcomes in the very elderly hospitalized is still not well established. The aim of our study was to evaluate the associations between cardiovascular therapy and in-hospital mortality in very elderly hypertensives. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 8, 2017 Category: Health Management Authors: Francesco Spannella, Federico Giulietti, Paolo Balietti, Guido Cocci, Laura Landi, Francesca Elena Lombardi, Elisabetta Borioni, Beatrice Bernardi, Giulia Rosettani, Valentina Bordoni, Riccardo Sarzani Tags: Original Study Source Type: research

Age, Sex, and Dose Effects of Nonbenzodiazepine Hypnotics on Hip Fracture in Nursing Home Residents
The Food and Drug Administration recommends a reduced dose of nonbenzodiazepine hypnotics in women, yet little is known about the age-, sex-, and dose-specific effects of these drugs on risk of hip fracture, especially among nursing home (NH) residents. We estimated the age-, sex-, and dose-specific effects of nonbenzodiazepine hypnotics on the rate of hip fracture among NH residents. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 7, 2017 Category: Health Management Authors: David D. Dore, Andrew R. Zullo, Vincent Mor, Yoojin Lee, Sarah D. Berry Tags: Original Study Source Type: research

Management of Dyspnea and Anxiety in Chronic Obstructive Pulmonary Disease: A Critical Review
Anxiety and dyspnea, 2 major symptoms in patients with chronic obstructive pulmonary disease (COPD), are associated with high morbidity and mortality. Thus, critically evaluating and synthesizing the existing literature employing pulmonary rehabilitation (PR) and other behavioral therapies in the treatment of anxiety and dyspnea in patients with COPD may help clinicians determine the most efficacious potential treatments. We aim to examine the efficacy of PR and behavioral therapy [eg, cognitive behavioral therapy (CBT) and counseling] and other adjunct modalities used in patients with COPD. (Source: Journal of the America...
Source: Journal of the American Medical Directors Association - November 3, 2017 Category: Health Management Authors: Abebaw Mengistu Yohannes, Maira Junkes-Cunha, Jacky Smith, Jorgen Vestbo Tags: Review Article Source Type: research

Is Fear of Falling Associated With Decline in Global Cognitive Functioning in Older Adults: Findings From the Irish Longitudinal Study on Ageing
Fear of falling (FoF) is present in 20% to 85% of older adults and may be an early marker of decline in global cognitive functioning (GCF). We tested the hypothesis that FoF is associated with lower levels of GCF (cross-sectional) and greater decline in GCF (prospective) in adults aged 50 and older. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 3, 2017 Category: Health Management Authors: Geeske Peeters, Siobhan Leahy, Sean Kennelly, Rose Anne Kenny Tags: Original Study Source Type: research

Determining the Optimum Physician-to-Resident Ratio in the Nursing Home
Nursing home (NH) practice has changed dramatically over the past decade. Shorter lengths of stay, higher patient acuity, pay for performance, and bundled payment are but a few of the trends impacting the delivery of medical care in the NH. Recognizing these changes, as well as the unique skill set necessary for optimal practice in the NH, AMDA has defined 26 core competencies for NH attending physicians. An accompanying online curriculum sets forth expectations for NH medical providers as it relates to the provision of high-quality, evidence-based NH care. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 3, 2017 Category: Health Management Authors: Paul R. Katz, Laurel A. Pfeil, Jonathan Evans, Mary Evans, Heather Sobel Tags: Letter to the Editor Source Type: research

The Effect of a 2-Year Intervention Consisting of Diet, Physical Exercise, Cognitive Training, and Monitoring of Vascular Risk on Chronic Morbidity —the FINGER Randomized Controlled Trial
To verify whether a multidomain intervention lowers the risk of developing new chronic diseases in older adults. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 3, 2017 Category: Health Management Authors: Alessandra Marengoni, Debora Rizzuto, Laura Fratiglioni, Riitta Antikainen, Tiina Laatikainen, Jenni Lehtisalo, Markku Peltonen, Hilkka Soininen, Timo Strandberg, Jaakko Tuomilehto, Miia Kivipelto, Tiia Ngandu Tags: Original Study Source Type: research

Trajectories Over the First Year of Long-Term Care Nursing Home Residence
To describe the trajectories in the first year after individuals are admitted to long-term care nursing homes. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 3, 2017 Category: Health Management Authors: Shuang Li, Addie Middleton, Kenneth J. Ottenbacher, James S. Goodwin Tags: Original Study Source Type: research

Proposed POLST Replacement Creates More Problems than it Solves
We appreciate Drs Richard Stuart and Stephen Thielke ’s praise for the POLST (Physician Orders for Life-Sustaining Treatment) Paradigm and their effort to “upgrade” the POLST form in their editorial, “Standardizing Protection of Patients’ Rights from POLST to MOELI (Medical Orders for End-of-Life Intervention).”1 The primary goal of the PO LST Paradigm is to align patient preferences with the treatments provided through the use of a standardized medical order form. The National POLST Paradigm Task Force (NPPTF) maintains standards for POLST Paradigm programs that reflect the accumulated ...
Source: Journal of the American Medical Directors Association - November 3, 2017 Category: Health Management Authors: Susan E. Hickman, Alvin H. Moss, Karl E. Steinberg, Charles P. Sabatino, Amy Vandenbroucke Tags: Letter to the Editor Source Type: research

Recall Tests may be Effective to Detect Mild Cognitive Impairment: A Response to Tsoi and Colleagues
In their systematic review of recall tests to detect mild cognitive impairment, Tsoi and colleagues1 provide a comprehensive, scholarly, and helpful summary of the literature. They selected 108 studies with 23,564 participants and evaluated 9 cognitive tests to detect mild cognitive impairment. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - November 3, 2017 Category: Health Management Authors: Simon D. Smith, Patrick Henn, Colm O' Tuathaigh Tags: Letter to the Editor Source Type: research

Sleep Apnea: A Geriatric Syndrome
“Most of the time [President Taft] simply did not and could not function in alert fashion…Often when I was talking to him after a meal his head would fall over on his breast and he would be sound asleep for ten or fifteen minutes. He would waken and resume the conversation, only to repeat the pe rformance in the course of half an hour or so.”∼Senator James Watson1 (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 26, 2017 Category: Health Management Authors: John E. Morley, Angela Sanford, Raymond Bourey Tags: Editorial Source Type: research

Clinical Update on Nursing Home Medicine: 2017
This is the 11th annual Clinical Update from the AMDA meeting article. This year the topics covered are hypertension after the Systolic Blood Pressure Intervention Trial; chronic obstructive pulmonary disease risk factors, diagnosis and management including end-of-life planning, and the difficulties with exacerbations such as breathlessness; diagnosis and treatment of cognitive impairment and dementia; and wound care and pressure ulcer management. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 26, 2017 Category: Health Management Authors: Barbara J. Messinger-Rapport, Milta O. Little, John E. Morley, Julie K. Gammack Tags: Updates from the AMDA meeting Source Type: research

Editorial Board
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - October 26, 2017 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 26, 2017 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 26, 2017 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 26, 2017 Category: Health Management Source Type: research