Agile Implementation
Within this issue of JAMDA, there are multiple articles that describe barriers and facilitators to implementing and scaling evidence-based interventions in nursing homes (NHs). Together, these authors highlight many of the challenges that are universal to the implementation phase of the “Discovery-to-Delivery” translational cycle, as well as several that are unique to the NH setting. Mills and colleagues elicited feedback from NH staff regarding perceived barriers and facilitators for implementing evidence-based strategies to improve interactions between staff and residents; re spondents indicated that in addit...
Source: Journal of the American Medical Directors Association - June 25, 2019 Category: Health Management Authors: Craig Solid, Arif Nazir, Malaz Boustani Tags: Editorial Source Type: research

Where Have All the Experienced Clinicians Gone? How the Literature on Care of Older Persons Fails to Adequately Inform Clinical Decision Making
From our vantage point as journal editors, it's clear that we're in an era where systematic reviews and meta-analyses are the favored form of literature critique and synthesis. Of the last 50 review articles submitted to JAMDA, 38 had titles that included “systematic review,” “meta-analysis,” or both terms. This preponderance is not surprising, given that systematic reviews are prized as high quality evidence.1,2 Furthermore, much of the academic literature is written by trainees who are expected to conduct research and publish their findings , and a characteristic of the systematic review is that i...
Source: Journal of the American Medical Directors Association - June 25, 2019 Category: Health Management Authors: Philip D. Sloane, Sheryl Zimmerman Tags: Editorial Source Type: research

Editorial Board
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - June 25, 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 - June 25, 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 - June 25, 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 - June 25, 2019 Category: Health Management Source Type: research

Profiling the Characteristics of People Who Are Comatose in Long-term and Complex Continuing Care Settings
To describe the sociodemographic, clinical, and treatment characteristics of people who are comatose in Canadian complex continuing care (CCC) and long-term care (LTC) settings, and to make recommendations to promote comprehensive care planning for this population. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - June 20, 2019 Category: Health Management Authors: Caitlin McArthur, Margaret Saari, Melissa Northwood, Linda Sheiban Taucar, Veronique M. Boscart Tags: Original Study - Brief Report Source Type: research

Sarcopenia in Acute Care Patients: Protocol for the European Collaboration of Geriatric Surveys: Sarcopenia 9+ EAMA Project
Sarcopenia is a disease characterized by a progressive loss of skeletal muscle mass and strength and is related to physical impairment, disability, worse clinical outcomes, and mortality in all health care settings.1 An important fact is that it is also reversible, with tailored exercise and nutritional support.1,2 Sarcopenia prevalence varies widely depending on the criteria, measurement methods, and cut-off points used for its assessment1,2; to date, few studies addressed the issue of sarcopenia in hospitalized older patients, rendering it an under-recognized clinical entity. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - June 20, 2019 Category: Health Management Authors: Dolores Sanchez-Rodriguez, Suzy Hope, Karolina Piotrowicz, Florence Benoit, Joanna Czesak, Dhayana Dallmeier, Genia Decker, Anette Hansen H øjmann, Dana Hrnciarikova, Ester Marco, Delky Meza, Murielle Surquin, Miguel Toscano-Rico, Hana Vankova, Davide L. Tags: Research Letter Source Type: research

Development and Validation of the Nursing Home Care-related Quality of Life Scale
We developed an instrument to assess nursing home residents' quality of life (QOL), with a focus on QOL-related factors modifiable through nursing home care, within the South Korean context; then, we tested its validity and reliability. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - June 20, 2019 Category: Health Management Authors: Eunhee Cho, Kyongeun Lee, Deulle Min, Soo Jung Chang, Jeongah Kim, Hyejin Kim Tags: Original Study Source Type: research

A Review of Nonantibiotic Agents to Prevent Urinary Tract Infections in Older Women
This article provides a comprehensive literature review on nonantibiotic agents used for the prevention of urinary tract infections (UTIs) in women ≥45 years of age. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - June 18, 2019 Category: Health Management Authors: Christian M. Gill, Maria-Stephanie A. Hughes, Kerry L. LaPlante Tags: Review Article Source Type: research

Lap Time Variability From a 400-m Walk Is Associated With Future Mild Cognitive Impairment and Alzheimer's Disease
To determine whether the trajectory of preclinical lap time variability from a 400-m walk differentiates participants with future mild cognitive impairment (MCI)/Alzheimer's disease (AD) from matched controls. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - June 18, 2019 Category: Health Management Authors: Qu Tian, Susan M. Resnick, Stephanie A. Studenski, Luigi Ferrucci Tags: Original Study Source Type: research

Identifying Patient Readmissions: Are Our Data Sources Misleading?
The accuracy of data is vital to identifying hospitalization outcomes for clinical trials. Patient attrition and recall bias affects the validity of patient-reported outcomes, and the growing prevalence of Medicare Advantage (MA) could mean Fee-for-Service (FFS) claims are less reliable for ascertaining hospital utilization. Statewide health information exchanges (HIEs) may be a more complete data source but have not been frequently used for research. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - June 18, 2019 Category: Health Management Authors: Andrea E. Daddato, Blythe Dollar, Hillary D. Lum, Robert E. Burke, Rebecca S. Boxer Tags: Original Study - Brief Report Source Type: research

Two-Year Weight Loss but Not Body Mass Index Predicts Mortality and Disability in an Older Japanese Community-Dwelling Population
Previous studies in older populations have shown a cardioprotective effect for obesity, an observation known as the obesity paradox. However, whether a decrease or increase in body weight over a certain period affects disability and mortality in older adults remains unknown. Hence, we examined whether the percent body weight change can predict the risk of mortality and disability in older Japanese adults. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - June 18, 2019 Category: Health Management Authors: Marcio M. Nishida, Mika Okura, Mihoko Ogita, Tomoki Aoyama, Tadao Tsuboyama, Hidenori Arai Tags: Original Study Source Type: research

Managing Paratonia in Persons With Dementia: Short-term Effects of Supporting Cushions and Harmonic Techniques
In this study, the short-term effect of harmonic techniques (HT) and supporting cushions (SC) on paratonia was explored. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - June 18, 2019 Category: Health Management Authors: Bieke Van Deun, Nele Van Den Noortgate, Anke Van Bladel, Koen De Weerdt, Dirk Cambier Tags: Original Study Source Type: research

Motoric Cognitive Risk Syndrome and Risk for Falls, Their Recurrence, and Postfall Fractures: Results From a Prospective Observational Population-Based Cohort Study
Motoric cognitive risk syndrome (MCR) is a predementia stage associated with increased risk for falls. There are conflicting results regarding its association with recurrent falls and no information about its association with postfall fractures. The aim of the study was to examine the association of MCR and its components [ie, slow walking speed and subjective cognitive complaint (SCC)] with the occurrence of falls, their recurrence, and postfall fractures in older community-dwelling adults. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - June 11, 2019 Category: Health Management Authors: Olivier Beauchet, Harmehr Sekhon, Anne-Marie Schott, Yves Rolland, Susan Muir-Hunter, Maureen Markle-Reid, Helene Gagne, Gilles Allali Tags: Original Study Source Type: research

Preoperative Sleep Questionnaires Identify Medical Emergency Team Activation in Older Adults
Patients with obstructive sleep apnea (OSA) have increased postoperative complications that are important for patient safety and healthcare utilization. Questionnaires help identify patients at risk for OSA; however, among older adults who preoperatively self-administered OSA questionnaires, the frequency of postoperative Medical Emergency Team Activation (META), rapid response, code blue, code stroke, is unknown. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - June 11, 2019 Category: Health Management Authors: Andrew M. Namen, Daniel J. Forest, Zeeshan N. Ahmad, Arjun B. Chatterjee, Amit K. Saha, Sandhya Kumar, Angela F. Edwards, Jill A. Ohar, Nicholas Kassis, Alexander O. Sy, Stephen P. Peters, Edward F. Haponik Tags: Original Study - Brief Report Source Type: research

Nursing Home –Associated Pneumonia, Part I: Diagnosis
Pneumonia is 1 of the 3 most common infections identified in nursing home residents and is associated with the highest mortality of any infection in this setting. In regard to pneumonia in the nursing home setting, practitioners are focused primarily on identifying residents with this infection and choosing a treatment regimen. In this article, the diagnosis of this infection is addressed. Based on published studies and clinical experience, “bedside criteria” for the diagnosis of nursing home–associated pneumonia (NHAP) are proposed that are based primarily on objective respiratory signs and symptoms that...
Source: Journal of the American Medical Directors Association - June 6, 2019 Category: Health Management Authors: Joseph M. Mylotte Tags: Special Article Source Type: research

Use of the Frailty Index in Older Persons With Chronic Kidney Disease
Chronic kidney disease (CKD) affects more than one-third of people aged 65 and older.1 At the same time, a large proportion of persons referred to nephrologists because of their renal disease may be considered as “geriatric” patients. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - June 5, 2019 Category: Health Management Authors: Carlotta Vezza, Simone Vettoretti, Lara Caldiroli, Luigi Bergamaschini, Piergiorgio Messa, Matteo Cesari Tags: Research Letter Source Type: research

Derivation and Validation of a Model to Predict 30-Day Readmission in Surgical Patients Discharged to Skilled Nursing Facility
To identify factors associated with 30-day all-cause readmission rates in surgical patients discharged to skilled nursing facilities (SNFs), and derive and validate a risk score. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - June 5, 2019 Category: Health Management Authors: Luke D. Kim, Elizabeth R. Pfoh, Bo Hu, Lei Kou, Lisa M. Knowlton, Kristan Staudenmayer, Michael B. Rothberg Tags: Original Study Source Type: research

Bilateral Anterior Thigh Thickness: A New Diagnostic Tool for the Identification of Low Muscle Mass?
To develop an ultrasonographic scanning protocol that included an assessment of muscle size [the proposed Bilateral Anterior Thigh Thickness (BATT)] and quality (echogenicity) to support the diagnosis of sarcopenia in a clinical setting. To determine the relationship of BATT and ultrasound echogenicity with physical function parameters of sarcopenia and test the reliability of ultrasound echogenicity measurements. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - June 1, 2019 Category: Health Management Authors: Daisy V. Wilson, Hannah Moorey, Howard Stringer, Ilfita Sahbudin, Andrew Filer, Janet M. Lord, Elizabeth Sapey Tags: Original Study Source Type: research

Energy Expenditure of Nursing Home Residents and Participation in Exercise Classes: An Analysis of the SENIOR Cohort
This study aimed to compare the WEE generated by physical activity of nursing home residents involved in group exercise classes to the WEE of residents who do not take part in such classes. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 31, 2019 Category: Health Management Authors: Alexia Charles, Fanny Buckinx, Alexandre Mouton, Jean-Yves Reginster, Jean Petermans, Bastien Gruslin, Olivier Bruy ère Tags: Research Letter Source Type: research

Sarcopenia and Chronic Musculoskeletal Pain in 729 Community-Dwelling Chinese Older Adults With Multimorbidity
Multimorbidity, sarcopenia, and chronic musculoskeletal pain (CMSP) are common in the older adult population. Each is associated with adverse health outcomes, such as functional decline, frailty, loss of independence, reduced well-being and health-related quality of life, hospitalization, and mortality.1 –3 The simultaneous presence of all 3 conditions among older individuals may have important prognostic and health care use implications. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 31, 2019 Category: Health Management Authors: Regina Wing Shan Sit, Dexing Zhang, Bo Wang, Carmen Wong, Benjamin Hon Kei Yip, Jean Woo, Samuel Yeung Shan Wong Tags: Research Letter Source Type: research

Response to Resolution A19 Regarding “Stopping Eating and Drinking by Advance Directives”
In March 2019, the Society for Post-Acute and Long-Term Care Medicine's (AMDA's) House of Delegates adopted Resolution A19 as policy, which AMDA's Ethics Committee had proposed.1 We appreciate their effort to address a difficult issue. But we disagree both with their categorical rejection of “Stopping Eating and Drinking by Advanced Directives” (SED by AD) and with their categorical insistence that feeding must continue for all advanced dementia patients until their behavior manifests refusal or distress. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 31, 2019 Category: Health Management Authors: Ladislav Volicer, Thaddeus Mason Pope, Karl E. Steinberg, Stanley A. Terman Tags: Letter to the Editor Source Type: research

Antidepressant and Risk of Dementia: Confounding by Indication
The meta-analysis by Chan et  al1 highlighted the uncertain role of antidepressants in dementia prevention, which is pertinent considering that depression has been identified as a potentially modifiable risk factor of dementia in a recent Lancet Commission.2 By pooling the risk estimates from 4 longitudinal studies, Chan et a l suggested that antidepressant use may be associated with a higher risk of dementia among patients with depression, and that future research is needed to investigate the benefit-risk ratio of antidepressant use in at-risk patients. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 31, 2019 Category: Health Management Authors: Tau Ming Liew Tags: Letter to the Editor Source Type: research

Oldest Old With Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Noninvasive Ventilation: 2 Planets Approaching
We read with great interest the article of Spannella et  al1 on the predictors of in-hospital mortality and need for post-acute care in acute exacerbation of chronic obstructive pulmonary disease (COPD) in the oldest adults. Furthermore, in our opinion, there are some uncertainties to clarify. The hospitalized oldest old patients represent a very compli cated planet for the presence of frailty, the long-term cognitive impairment, the incidence of delirium, the malnutrition, the comorbidities, the problematic decision-making process, the disability, the life expectancy evaluation, the polypharmacy, and the possible nec...
Source: Journal of the American Medical Directors Association - May 31, 2019 Category: Health Management Authors: Nicola Vargas, Antonio M. Esquinas Tags: Letter to the Editor Source Type: research

Response to: “Oldest Old With Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Noninvasive Ventilation: 2 Planets Approaching”
We are thankful for the interest in our work and for the stimulating comments on our study.1 We agree with the authors regarding the complex clinical conditions of the hospitalized oldest old, and our study population, with a mean age of 87  years, stressed out this aspect. High comorbidity, according to the Geriatric Index of Comorbidity (GIC), and functional impairment were found in almost three-quarters of patients, and almost half of them had a cognitive decline. The aim of our study was to investigate the most relevant predictors of in-hospital mortality and need for post-acute care among a wide range of clinical...
Source: Journal of the American Medical Directors Association - May 31, 2019 Category: Health Management Authors: Francesco Spannella, Federico Giulietti, Piero Giordano, Riccardo Sarzani Tags: Letter to the Editor Source Type: research

Response to the Letter to the Editor “Antidepressant and Risk of Dementia: Confounding by Indication”
The response letter to our recent article raises the concern that the severity of depression may affect the risk of dementia, so confounding by indication may also be a potential limitation of this study. Therefore, we would like to further explain this point with more evidence from the existing literature. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 31, 2019 Category: Health Management Authors: Joyce Y.C. Chan, Kelvin K.F. Tsoi Tags: Letter to the Editor Source Type: research

Coexistence of Chronic Musculoskeletal Pain and Depressive Symptoms and Their Combined and Individual Effects on Onset of Disability in Older Adults: A Cohort Study
Coexistence of chronic musculoskeletal pain and depressive symptoms is common, and their combined effect on adverse events warrants investigation. The purpose of this study was to investigate the individual and combined effect of chronic musculoskeletal pain and depressive symptoms on the onset of disability, which is a crucial outcome in older adults. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 31, 2019 Category: Health Management Authors: Shunsuke Murata, Rei Ono, Junichi Omata, Tatsuya Endo, Koji Otani Tags: Original Study Source Type: research

Gender Differences in Trajectories of Lower Extremity Function in Older Adults: Findings From the International Mobility in Aging Study
We examined the  lower extremity function trajectories of older men and women over 4 years and baseline predictors of these trajectories. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 31, 2019 Category: Health Management Authors: Tamer Ahmed, Simon D. French, Emmanuelle Belanger, Ricardo Oliveira Guerra, Maria Victoria Zunzunegui, Mohammad Auais Tags: Original Study Source Type: research

Dementia Caf és as a Community Resource for Persons With Early-Stage Cognitive Disorders: A Nationwide Survey in Japan
The objective of the present study was to examine effective ways to manage dementia cafés through an overview of dementia cafés in Japan and an analysis of the factors related to their effective ness on attendees. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 31, 2019 Category: Health Management Authors: Hajime Takechi, Tomoyuki Yabuki, Masahiko Takahashi, Hisao Osada, Shinji Kato Tags: Original Study Source Type: research

Adherence to “No Transfer to Hospital” Advance Directives Among Nursing Home Residents
This study aims to estimate the prevalence of, and adherence to, “no transfer to hospital” ADs in LTC, and to explore the circumstances leading to transfers against previously expressed directives. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 27, 2019 Category: Health Management Authors: Leah Nemiroff, Emily Gard Marshall, Jan L. Jensen, Barry Clarke, Melissa K. Andrew Tags: Original Study Source Type: research

End-of-Life Decision Making for People Who Died of Dementia: A Mortality Follow-Back Study Comparing 1998, 2007, and 2013 in Flanders, Belgium
Declining cognitive abilities in people with dementia (PwD) complicate communication and decision making,1 particularly at end of life. These circumstances lead to insecurity among physicians about end-of-life decisions (ELDs) and preferences of PwD. ELDs entail a range of medical decisions with potential life-shortening effects that can be categorized into 3 types: (1) withholding or withdrawing potentially life-prolonging treatment; (2) alleviating pain or symptoms pharmaceutically, in large enough doses to hasten death as a potential side effect; and (3) administration, prescription, or supply of drugs to end life at th...
Source: Journal of the American Medical Directors Association - May 27, 2019 Category: Health Management Authors: Annelien E. Wendrich-van Dael, Lara Pivodic, Joachim Cohen, Luc Deliens, Lieve Van den Block, Kenneth Chambaere Tags: Research Letter Source Type: research

Dementia Care Across a Tertiary Care Health System: What Exists Now and What Needs to Change
This study explored the process of care for persons living with dementia (PLWDs) in various care settings across a tertiary care system and considers challenges and opportunities for change. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 27, 2019 Category: Health Management Authors: Amanda Leggett, Cathleen Connell, Leslie Dubin, Ruth Dunkle, Kenneth M. Langa, Donovan T. Maust, J. Scott Roberts, Beth Spencer, Helen C. Kales Tags: Original Study Source Type: research

Erratum
The Authors wish to make a correction to their article published in JAMDA (https://doi.org/10.1016/j.jamda.2017.11.002) “A Randomized Controlled Study Comparing a DPP4 Inhibitor (Linagliptin) and Basal Insulin (Glargine) in Patients with Type 2 Diabetes in Long-Term Care and Skilled Nursing Facilities: Linagliptin-LTC Trial”. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 27, 2019 Category: Health Management Source Type: research

A “Hospital-Day-1” Model to Predict the Risk of Discharge to a Skilled Nursing Facility
To derive and validate a model to predict a patient's probability of skilled nursing facility (SNF) discharge using data available from day 1 of hospitalization. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 25, 2019 Category: Health Management Authors: Andrew S. Oseran, Daniel E. Lage, Michael C. Jernigan, Joshua P. Metlay, Sachin J. Shah Tags: Original Study Source Type: research

A Crystal Ball to Aid Hospital Discharge Planning
As per Benjamin Franklin, “By failing to prepare, you are preparing to fail.” Who would have thought that words spoken more than 200 years ago would so aptly apply today to the situation when patients transition after hospitalization? Indeed, instead of properly preparing for a patient's discharge through comprehensive, timely discharge planning, hospitals often initiate these moves hastily, resulting in preventable adverse outcomes such as medication errors and unnecessary rehospitalizations. The failure of quality discharge planning becomes increasingly important as hospitals and nursing homes are held a...
Source: Journal of the American Medical Directors Association - May 25, 2019 Category: Health Management Authors: Richard G. Stefanacci, Philip D. Sloane, Sheryl Zimmerman Tags: Editorial Source Type: research

Physician Visits at the Nursing Home: Does More Mean Better Care?
The quality of care in the nursing home setting has attracted significant attention in recent years, especially when it comes to end-of-life care. In particular, there is a nexus between clinical burden, organizational context, and the quality of care in the nursing home.1 In broad terms, organizational context can be categorized into 2 domains: systemwide processes and human behavioral factors. The systemwide processes are often multi-pronged and complex, and it is often difficult, if not impossible, to attribute the benefits of any individual process within the system. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 25, 2019 Category: Health Management Authors: Roger Y. Wong, Paul R. Katz Tags: Editorial Source Type: research

Editorial Board
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 25, 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 - May 25, 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 - May 25, 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 - May 25, 2019 Category: Health Management Source Type: research

Sarcopenia According to the Revised European Consensus on Definition and Diagnosis (EWGSOP2) Criteria Predicts Hospitalizations and Long-Term Mortality in Rehabilitation Patients With Stable Chronic Obstructive Pulmonary Disease
Sarcopenia has been classically defined as the loss of skeletal muscle mass and function that occurs with advancing age. According to the original definition of the European Working Group of Sarcopenia in Older People (EWGSOP),1 diagnosis of sarcopenia required documentation of both low muscle mass and either low muscle strength or low performance. In the recently updated definition (EWGSOP-2), sarcopenia must be suspected in presence of low muscle strength and confirmed by documentation of reduced muscle mass. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 24, 2019 Category: Health Management Authors: Vanesa D ávalos-Yerovi, Ester Marco, Dolores Sánchez-Rodríguez, Anna Guillen-Solà, Xavier Duran, Eva M. Pascual, Josep M. Muniesa, Ferran Escalada, Esther Duarte Tags: Research Letter Source Type: research

Physical Exercise Improves Function in Acutely Hospitalized Older Patients: Secondary Analysis of a Randomized Clinical Trial
To evaluate the effects of an exercise intervention on physical function, maximal muscle strength, and muscle power in very old hospitalized patients. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 24, 2019 Category: Health Management Authors: Mikel L. S áez de Asteasu, Nicolás Martínez-Velilla, Fabricio Zambom-Ferraresi, Álvaro Casas-Herrero, Alejandro Lucía, Arkaitz Galbete, Mikel Izquierdo Tags: Original Study Source Type: research

Hypertension Management in the Very Old
In 2017, the American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for treatment of hypertension were published.1 Since then, much controversy continues to exist around whether and to what extent they should and should not be applied to older persons, including nursing home residents, with multiple comorbidities, frailty, and relatively short life expectancy. This has led to persistence of the philosophy among many physicians that the dangers of intensive blood pressure treatment in older persons outweigh the benefits in most, if not all, persons age 75  years and older. (Source: Journal of ...
Source: Journal of the American Medical Directors Association - May 24, 2019 Category: Health Management Authors: Wilbert S. Aronow Tags: Editorial Source Type: research

Visit-to-Visit Blood Pressure Variability and Progression of White Matter Hyperintensities Among Older People With Hypertension
Visit-to-visit blood pressure (BP) variability is a risk factor for cardiovascular disease and cognitive decline. Our aim was to assess the association between visit-to-visit BP variability and progression of white matter hyperintensities (WMH). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 24, 2019 Category: Health Management Authors: Tessa van Middelaar, Edo Richard, Eric P. Moll van Charante, Willem A. van Gool, Jan-Willem van Dalen Tags: Original Study - Brief Report Source Type: research

The Prevalence, Incidence, and Correlates of Fecal Incontinence Among Older People Residing in Care Homes: A Systematic Review
Older people resident in care homes often rely on staff for support relating to their activities of daily living, including intimate care such as continence care. Managing fecal incontinence can be challenging for both residents and care staff. We conducted this review to describe the prevalence, incidence, and correlates of fecal incontinence among care home residents. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 22, 2019 Category: Health Management Authors: Massirfufulay Kpehe Musa, Susan Saga, Lene Elisabeth Blekken, Ruth Harris, Claire Goodman, Christine Norton Tags: Review Article Source Type: research

Clinical Implications of Potentially Inappropriate Prescribing According to STOPP/START Version 2 Criteria in Older Polymorbid Patients Discharged From Geriatric and Internal Medicine Wards: A  Prospective Observational Multicenter Study
To evaluate whether STOPP/START v2 potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) are associated with 6-month mortality and unplanned hospitalization in hospital-discharged older patients. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 17, 2019 Category: Health Management Authors: Enrico Brunetti, Maria L. Aurucci, Edoardo Boietti, Maddalena Gibello, Matteo Sappa, Yolanda Falcone, Giorgetta Cappa, Mario Bo Tags: Original Study Source Type: research

Predicting Cognitive and Functional Trajectories in People With Late-Onset Dementia: 2 Population-Based Studies
Previous studies have shown large heterogeneity in the progression of dementia, both within and between patients. This heterogeneity offers an opportunity to limit the global and individual burden of dementia through the identification of factors associated with slow disease progression in dementia. We explored the heterogeneity in dementia progression to detect disease, patient, and social context factors related to slow progression. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 17, 2019 Category: Health Management Authors: Miriam L. Haaksma, Debora Rizzuto, Jeannie-Marie S. Leoutsakos, Alessandra Marengoni, Edwin C.K. Tan, Marcel G.M. Olde Rikkert, Laura Fratiglioni, Ren é J.F. Melis, Amaia Calderón-Larrañaga Tags: Original Studies Source Type: research

Impact of Cognitive, Functional, Behavioral Disorders, and Caregiver Burden on the Risk of Nursing Home Placement
To estimate the attributable fraction of nursing home placement associated with cognitive impairment, neuropsychiatric symptoms, behavioral disorders, functional limitations, and caregiver burden. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 17, 2019 Category: Health Management Authors: Marine Dufournet, Virginie Dauphinot, Claire Moutet, Mathieu Verdurand, Floriane Delphin-Combe, Pierre Krolak-Salmon, MEMORA group Tags: Original Study Source Type: research

Relationship Between Nutritional Status and Insomnia Severity in  Older Adults
Both insomnia and malnutrition are quite common and can cause similar negative consequences, such as falls, depression, and cognitive impairment in older adults, but there is no study investigating the relationship between the 2. The aims were to investigate relationships between insomnia/insomnia severity and Mini Nutritional Assessment (MNA) score and serum nutrient levels. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 17, 2019 Category: Health Management Authors: Pinar Soysal, Lee Smith, Ozge Dokuzlar, Ahmet Turan Isik Tags: Original Study Source Type: research