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

Athletic “Oldest-Old”: Alive and Kicking
On October 13, 2018, an 86-year-old Japanese man named Hiromu Inada, finished the Ironman Triathlon World Championship (Hawaii) in 16  hours 54 minutes. The Ironman triathlon is the paradigm of grueling endurance races, with its 2.4-mile swim, 112-mile cycle, and 26.2-mile marathon all rolled into 1 event held under extreme heat, humidity, and wind conditions. And yet this is just 1 of the many feats accomplished worldwide by th e so-called oldest-old (those aged ≥85 years) in both endurance and more “power”-oriented sports (Figure 1). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 17, 2019 Category: Health Management Authors: Pedro L. Valenzuela, Adri án Castillo García, Javier S. Morales, Alejandro Santos-Lozano, Alejandro Lucia Tags: Editorial Source Type: research

Nonpharmacologic Management of Orthostatic Hypotension in Older People: A Systematic Review. The SENATOR ONTOP Series
Nonpharmacologic therapies are often recommended as a first-line treatment for orthostatic hypotension (OH). However, the true effect of nonpharmacologic therapy remains unclear, particularly in the older population. We undertook a systematic review evaluating the efficacy of nonpharmacologic interventions in older people with OH to provide evidence-based recommendations. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 17, 2019 Category: Health Management Authors: Selvarani Subbarayan, Phyo K. Myint, Kathryn R. Martin, Iosief Abraha, Sirjana Devkota, Denis O'Mahony, Alfonso J. Cruz-Jentoft, Antonio Cherubini, Roy L. Soiza Tags: Review Article Source Type: research

Treatment of Hypertension in People With Dementia: A Multicenter Prospective Observational Cohort Study
To describe the treatment of hypertension in people with dementia and collate evidence on adverse health events whilst on treatment. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 17, 2019 Category: Health Management Authors: Tomas J. Welsh, Adam L. Gordon, John R.F. Gladman Tags: Original Study Source Type: research

Outbreak of Human Metapneumovirus in a Nursing Home: A Clinical Perspective
To describe a human metapneumovirus (hMPV) outbreak occurring in a nursing home for older adults and to identify the risk factors associated with the clinical infection. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 14, 2019 Category: Health Management Authors: Damien Seynaeve, Brigitte Augusseau-Rivi ère, Pascal Couturier, Christine Morel-Baccard, Caroline Landelle, Jean-Luc Bosson, Gaëtan Gavazzi, Marie-Reine Mallaret Tags: Original Study Source Type: research

Skilled Nursing Facility Utilization Management in a Risk-Sharing Environment in the Community
Post-acute care (PAC) has been one of the fastest-growing segments of Medicare spending in the past 2  decades.1 More than 40% of all Medicare fee-for-service beneficiaries who were discharged from hospitals received PAC.2 Skilled nursing facility (SNF) care expenses rose from $12 billion in 2001 to $29 billion in 2013 at an average of 7.6% annual growth.3 Furthermore, PAC utilization determines ho spitals' per-beneficiary cost of care. High per-beneficiary cost hospitals spend approximately $2200 more than low-cost hospitals annually, with PAC being a large driver for the difference. (Source: Journal of the American ...
Source: Journal of the American Medical Directors Association - May 9, 2019 Category: Health Management Authors: Ziad Alfarah, Mark Walker, Robin Hynds, Derek Bourgoine, Pracha P. Eamranond Tags: Letter to the Editor Source Type: research

Experiences of Ambulatory Care for Frail, Older People and Their Carers During Acute Illness: A Qualitative, Ethnographic Study
Increased age is associated with increased emergency department attendance and emergency hospital admissions,1 but there is evidence that the acute hospital environment is unsuited to older people with frailty.2 –5 There are policy imperatives to increase the acute care delivered outside traditional hospital settings.6 For some patients, acute care can be delivered on an ambulatory basis,7 but the impact on them is uncertain. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 9, 2019 Category: Health Management Authors: Margaret Glogowska, Helen Cramer, Sarah Pendlebury, Sarah Purdy, Daniel Lasserson Tags: Research Letter Source Type: research

Experienced Quality of Post-Acute and Long-Term Care From the Care Recipient's Perspective –A Conceptual Framework
This article aims to conceptualize experienced quality of post-acute and long-term care for older people as perceived by care recipients. An iterative literature review and consultations with stakeholders led to the development of the INDividually Experienced QUAlity of Long-term care (INDEXQUAL) framework. INDEXQUAL presents the process of an individual care experience consisting of a pre (expectations), during (experiences), and post (assessment) phase. Expectations are formed prior to an experience by personal needs, past experiences, and word-of-mouth. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 9, 2019 Category: Health Management Authors: Katya Y.J. Sion, Roy Haex, Hilde Verbeek, Sandra M.G. Zwakhalen, Gaby Odekerken-Schr öder, Jos M.G.A. Schols, Jan P.H. Hamers Tags: Special Article Source Type: research

Long-Term Mortality and Prognostic Factors in Aspiration Pneumonia
Aspiration pneumonia is a leading cause of death among older patients; however, little is known about the long-term mortality in aspiration pneumonia. The purpose of this study was to evaluate long-term mortality and its associated factors in patients with aspiration pneumonia. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 9, 2019 Category: Health Management Authors: Hee-Young Yoon, Sung Shine Shim, Soo Jung Kim, Jin Hwa Lee, Jung Hyun Chang, Su Hwan Lee, Yon Ju Ryu Tags: Original Study Source Type: research

Effects of the FIT-HIP Intervention for Fear of Falling After Hip Fracture: A Cluster-Randomized Controlled Trial in Geriatric Rehabilitation
Fear of falling (FoF) is common after hip fracture and can impede functional recovery because of activity restriction. The Fear of falling InTervention in HIP fracture geriatric rehabilitation (FIT-HIP intervention) was designed to target FoF and consequently to improve mobility. The aim of this study was to evaluate the effect of the FIT-HIP intervention in patients with FoF in geriatric rehabilitation (GR) after hip fracture. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 8, 2019 Category: Health Management Authors: Maaike N. Scheffers-Barnhoorn, Monica van Eijk, Jolanda C.M. van Haastregt, Jos M.G.A. Schols, Romke van Balen, Nan van Geloven, Gertrudis I.J.M. Kempen, Wilco P. Achterberg Tags: Original Study Source Type: research

Relation Between Genetic Factors and Frailty in Older Adults
Frailty is a geriatric syndrome that identifies individuals at higher risk of disability, institutionalization, and death. We previously reported that frailty is related to oxidative stress and cognitive impairment-related biomarkers. The aim of this study was to determine whether frailty is associated with genetic variants. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 8, 2019 Category: Health Management Authors: Marta Ingl és, Cristina Mas-Bargues, Lucia Gimeno-Mallench, Raquel Cruz-Guerrero, Francisco J. García-García, Juan Gambini, Consuelo Borrás, Leocadio Rodríguez-Mañas, Jose Viña Tags: Original Study Source Type: research

Prevalence and Impact of Functional and Psychosocial Problems in Hospitalized Adults: A Prospective Cohort Study
Underpinning standards for delivering comprehensive care in hospital is the need to identify issues contributing to patient complexity and risk of harm. The study aimed to investigate the prevalence of functional and psychosocial problems in hospitalized adults, to compare prevalence rates across age groups, and to assess their impact on discharge outcomes. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 8, 2019 Category: Health Management Authors: Nancye M. Peel, Yvonne C. Hornby-Turner, Amanda Henderson, Ruth E. Hubbard, Leonard C. Gray Tags: Original Study Source Type: research

Dietary Protein Intake and Falls in Older People: Longitudinal Analyses From the Osteoarthritis Initiative
Literature regarding dietary protein intake and risk of falls is limited to a few studies with relatively small sample sizes and short follow-ups, which have reported contrasting findings. Thus, we investigated whether dietary protein intake is associated with risk of falls in a large cohort of North American adults. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 8, 2019 Category: Health Management Authors: Nicola Veronese, Pinar Soysal, Brendon Stubbs, Stefania Maggi, Sarah E. Jackson, Jacopo Demurtas, Stefano Celotto, Ai Koyanagi, Francesco Bolzetta, Lee Smith Tags: Original Study Source Type: research

Reducing Avoidable Facility Transfers (RAFT): Outcomes of a Team Model to Minimize Unwarranted Emergency Care at Skilled Nursing Facilities
We describe a provider-focused care model to reduce unwarranted or unwanted acute health care utilization. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 6, 2019 Category: Health Management Authors: Daniel S. Stadler, Brant J. Oliver, Jennifer G. Raymond, George F. Routzhan, Ellen A. Flaherty, James E. Stahl, John A. Batsis, Stephen J. Bartels Tags: Original Study Source Type: research

Reducing the Tension Between Patient Safety and Trainee Autonomy
Maintaining quality of care and improving patient safety is a constant challenge in out-of-hospital settings like nursing homes1 and general practices,2 and can be even more challenging when care is provided by trainees during residency training. On one hand, trainees need sufficient supervision because they are more prone to making mistakes3; on the other hand, trainees need opportunities for working autonomously, to prepare them for unsupervised practice.4 Supervision means balancing these interests. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 4, 2019 Category: Health Management Authors: Nelleke Noeverman-Poel, Martine C. de Bruijne, Nynke van Dijk, Cees M.P.M. Hertogh, Martin Smalbrugge, Esther Helmich Tags: Research Letter Source Type: research

Determinants of Post-acute Care Costs in Acutely Hospitalized Older Adults: The Hospital-ADL Study
After hospitalization, many older adults need post-acute care, including rehabilitation or home care. However, post-acute care expenses can be as high as the costs for the initial hospitalization. Detailed information on monthly post-acute health care expenditures and the characteristics of patients that make up for a large share of these expenditures is scarce. We aimed to calculate costs in acutely hospitalized older patients and identify patient characteristics that are associated with high post-acute care costs. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 2, 2019 Category: Health Management Authors: Marthe E. Ribbink, Rosanne van Seben, Lucienne A. Reichardt, Jesse J. Aarden, Marike van der Schaaf, Martin van der Esch, Raoul H.H. Engelbert, Jos W.R. Twisk, Jos. A. Bosch, Janet L. MacNeil Vroomen, Bianca M. Buurman, Hospital-ADL study group Tags: Original Study Source Type: research

Priority Setting in Improving Hospital Care for Older Patients Using Clinical Decision Support
Despite rising attention and successful interventions, the quality of hospital care for older people remains suboptimal in some areas.1 Health care professionals need to adopt a specific approach for older patients that takes into account the patients' vulnerability to adverse events, as well as individual preferences.1,2 Geriatric knowledge needed for this adoption is described in guidelines. However, implementation into daily practice is complex. Clinical Decision Support Systems (CDSSs) can support implementation of guidelines and improve quality of care. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 2, 2019 Category: Health Management Authors: Birgit A. Damoiseaux-Volman, Stephanie Medlock, Kim J. Ploegmakers, Fatma Karapinar- Çarkit, C.T. Paul Krediet, Sophia E. de Rooij, A. Margot Lagaay, Mike J.L. Peters, Joanna E. Klopotowska, Rob J. van Marum, Oscar J. de Vries, Johannes A. Romijn, Nathal Tags: Research Letter Source Type: research

Preparing Long-Term Care Staff to Meet the Needs of Aging Persons With Serious Mental Illness
Individuals with serious mental illness (SMI; schizophrenia spectrum disorders and affective psychoses) are increasingly aging into older adulthood and are overrepresented in residential long-term care settings. The present study aimed to examine the preparedness of staff in these settings to care for individuals with SMI. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 2, 2019 Category: Health Management Authors: Anjana Muralidharan, Whitney L. Mills, Denise R. Evans, Daryl Fujii, Victor Molinari Tags: Special Article Source Type: research

Response to the Comment on “Decreased Basal Metabolic Rate Can Be an Objective Marker for Sarcopenia and Frailty in Older Males”
In this study, we showed that a lower basal metabolic rate (BMR) was associated with a higher prevalence of sarcopenia and frailty and that BMR/BSA (body surface area) might be an indicator fo r screening the 2 geriatric syndromes in older males. The multiple linear regression analysis was used to predict BMR parameters after adjustment for age, hypertension, and diabetes as independent variables, but comprehensive geriatric assessment (CGA) parameters were not used simultaneously for the analysis as the author mentioned. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - May 2, 2019 Category: Health Management Authors: Pinar Soysal, Esra Ates Bulut, Idil Yavuz, Ahmet Turan Isik Tags: Letter to the Editor Source Type: research

Basal Metabolic Rate Parameters, Sarcopenia, and Frailty in Older Males
I read the recent article published in this journal by Soysal et  al1 with interest. The authors conducted a cross-sectional study to evaluate the association between the basal metabolic rate (BMR) with several adjustments, frailty, and sarcopenia in 305 older males. Several comprehensive geriatric assessment (CGA) parameters were also used for the analysis, and the predictive ability of BMR parameters was evaluated for detecting sarcopenia, frailty, and CGA status. The adjusted odds ratio (95% confidence interval) of subjects without sarcopenia for higher BMR per body surface area (BSA) was 6.60 (3.52-12.38). (Source...
Source: Journal of the American Medical Directors Association - May 2, 2019 Category: Health Management Authors: Tomoyuki Kawada Tags: Letter to the Editor Source Type: research

Sundown Syndrome in Older Persons: A Scoping Review
To map comprehensive investigations of the sundown syndrome (SS), highlighting its key definition and associated characteristics. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 28, 2019 Category: Health Management Authors: Alexandre C. Boronat, Ana Paula Ferreira-Maia, Yuan-Pang Wang Tags: Review Article Source Type: research

Repeated Cerebrospinal Fluid Removal Procedure in Older Patients With Idiopathic Normal Pressure Hydrocephalus Ineligible for Surgical Treatment?
I read with great interest the article by Rossi et  al in which they illustrate the positive responses obtained with repeated cerebrospinal fluid (CSF) tap procedures in patients with normal pressure hydrocephalus (NPH) who were ineligible for surgical intervention with shunting.1 In the Introduction section, the authors have commented on the rapid loss of the benefits gained with the surgical procedure in NPH patients because of the parallel progression of comorbid conditions.1,2 They have also stated that there are a substantial number of patients who are ineligible for shunting surgery because of their advanced age...
Source: Journal of the American Medical Directors Association - April 28, 2019 Category: Health Management Authors: Halil Onder Tags: Letter to the Editor Source Type: research

Hospital Readmission From Skilled Nursing Facilities (SNFs): Perspectives of Hospital and SNF Providers
Following an acute hospital stay, 1 in 4 Medicare patients is transferred to a skilled nursing facility (SNF).1 Meanwhile, 25% of these patients are readmitted to the hospital within 30  days.2 In addition to the increasing costs, repeated hospitalizations and multiple transitions of care put patients at risk for adverse health outcomes, including decline in physical function, medication errors, and delirium.3,4 (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 28, 2019 Category: Health Management Authors: Karl E. Minges, Meredith Campbell Britton, Bennett W. Clark, Gregory M. Ouellet, Beth Hodshon, Sarwat I. Chaudhry Tags: Research Letter Source Type: research

Preventable Hospitalizations Among Nursing Home Residents With Dementia and Behavioral Health Disorders
The objectives of this study were to (1) examine the risk of PAH among residents with ADRD only, BHD only, ADRD and BHD compared to residents with neither and (2) identify associations between individual- and facility-level factors and PAH in these subgroups. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 28, 2019 Category: Health Management Authors: Helena Temkin-Greener, Xi Cen, Michael J. Hasselberg, Yue Li Tags: Original Study Source Type: research

Impact of Glycemic Control on Daily Living Activities Over 1-Year Follow-up in Memory Clinic Patients With Diabetes
Ample evidence suggests that type 2 diabetes mellitus (DM) increases the risk of impairment of activities of daily living (ADL).1 Although the association between poor glycemic control and ADL decline has already been described,2 the impact of excessive glycemic control on ADL has not been elucidated. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 28, 2019 Category: Health Management Authors: Taiki Sugimoto, Rei Ono, Ai Kimura, Naoki Saji, Shumpei Niida, Kenji Toba, Takashi Sakurai Tags: Research Letter Source Type: research

No One Cares When Planes Don't Crash: The Message for Long-term Care
I was recently interviewed for an article on assisted living.i The reporter asked informed questions, and sent me the article after it went to press. Our follow-up e-mail interchange went something like this:Me: Thanks for sending the finished article. It's well-written and engaging, and points out that this is a challenging business where people's welfare is at stake. That said, we also need articles that talk about the many thousands of people who receive good care and have a better quality of life because of it. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 26, 2019 Category: Health Management Authors: Arif Nazir, Sheryl Zimmerman, Michele L. Meyer Tags: Editorial Source Type: research

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

Table of Contents
(Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 26, 2019 Category: Health Management Source Type: research

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

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

Importance of Social Support Within the Nursing Staff on Agitation in Residents With Dementia
Patient characteristics such as gender and severity of dementia are associated with neuropsychiatric symptoms (NPS) in dementia but insufficiently explain differences in the prevalence of NPS between dementia care units, thereby suggesting environmental influences.1 Physical environmental factors such as perception of privacy, temperature, and number of residents per unit, as well as psychosocial environmental factors such as higher perception of staffing levels, have been associated with NPS.2 –4 However, the associations between NPS and job characteristics of nurses, such as job demands, control, and social support...
Source: Journal of the American Medical Directors Association - April 16, 2019 Category: Health Management Authors: Eva Y.L. Tan, Marjolein E. de Vugt, Sebastian K öhler, Frans R.J. Verhey, Jos M.G.A. Schols Tags: Research Letter Source Type: research

Poor Social Network, Not Living Alone, Is Associated With Incidence of Adverse Health Outcomes in Older Adults
This study aimed to examine whether the interactive effects of living alone and poor social network contribute to adverse health outcomes. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 15, 2019 Category: Health Management Authors: Ryota Sakurai, Hisashi Kawai, Hiroyuki Suzuki, Hunkyung Kim, Yutaka Watanabe, Hirohiko Hirano, Kazushige Ihara, Shuichi Obuchi, Yoshinori Fujiwara Tags: Original Studies Source Type: research

Developing a Brief Neuropsychological Battery for Early Diagnosis of Cognitive Impairment
This study investigated whether a small subset of neuropsychological tests can be added on to MoCA to match its performance to that of the FNB in discriminating mild cognitive impairment and dementia (MCI/dementia) from normal cognition. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 13, 2019 Category: Health Management Authors: Tau Ming Liew Tags: Original Study-Brief Report Source Type: research

Research Priorities in Post-acute and Long-term Care: Results of a Stakeholder Needs Assessment
Conduct a needs assessment among post-acute and long-term care (PA-LTC) stakeholder groups to identify (1) research topics of highest priority and (2) perspectives on research, including concerns/barriers to conducting research in the PA-LTC setting. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 11, 2019 Category: Health Management Authors: Cynthia Drake, Heidi L. Wald, Leslie B. Eber, Joanna I. Trojanowski, Kathryn A. Nearing, Rebecca S. Boxer Tags: Brief Report Source Type: research

Quality of Life and Pain Medication Use in Persons With Advanced Dementia Living in Long-Term Care Facilities
In residents with dementia living in a long-term care facility (LTCF), un(der)treated pain may trigger behavioral disturbances, mood syndromes, and deterioration of physical functioning and self-maintenance. Because these factors can have considerable impact on the quality of life (QoL), this study aimed to (1) compare characteristics of persons with advanced dementia living in LTCFs with and without pain medication; (2) compare QoL in these persons with and without pain, stratified by type of pain medication use; and (3) explore associations between the use of paracetamol and QoL in persons with advanced dementia living i...
Source: Journal of the American Medical Directors Association - April 11, 2019 Category: Health Management Authors: Paulien H. van Dam, Monique A.A. Caljouw, Dagrun D. Sletteb ø, Wilco P. Achterberg, Bettina S. Husebo Tags: Original Study Source Type: research

A Prospective Cohort Study on the Effects of Geriatric Rehabilitation Following Acute Exacerbations of COPD
Older patients with chronic obstructive pulmonary disease (COPD), hospitalized for an acute exacerbation, often do not receive recommended post-acute pulmonary rehabilitation. This underuse might be related to the impaired clinical and functional status of these patients, who are more likely to present with frailty, comorbidities, and disability. Having developed and implemented a geriatric rehabilitation program for these patients (GR_COPD), the primary aim of this study was to investigate the effectiveness of this program. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 11, 2019 Category: Health Management Authors: El éonore F. van Dam van Isselt, Monica van Eijk, Nan van Geloven, Karin H. Groenewegen-Sipkema, Jan-Willem K. van den Berg, Cécile M.A. Nieuwenhuys, Niels H. Chavannes, Wilco P. Achterberg Tags: Original Study Source Type: research

Pain Management in the Last 6  Months of Life: Predictors of Opioid and Non-Opioid Use
When it comes to pain, nursing home care falls short. The experience of pain negatively impacts life quality and function, especially for residents with multiple chronic comorbidities. The proportion of residents with pain is high, with estimates ranging from 45%1 to 65%.2 Because the experience of pain is primarily subjective, clinicians rely on patients' self-report to direct pain management strategies. Yet, in a nursing home, many residents have dementia and are unable to communicate pain. It is not surprising that pain in the nursing home is both high and under-recognized. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 11, 2019 Category: Health Management Authors: Tammy L. Marshall, Joann P. Reinhardt Tags: Research Letter Source Type: research

Discontinuation of Antihypertensive Therapy and Dementia Incidence in the United Kingdom
Van Dalen et  al1 have reported that antihypertensive therapy withdrawal in older people living in communities may increase dementia risk. In their interesting and clinically relevant study, they investigated approximately 1500 patients, 5.5% of whom discontinued antihypertensive therapy during the study. Disco ntinuation of antihypertensive medication was associated with a 1.8-2.2 higher incidence of dementia (hazard ratio from 1.8 to 2.2 depending on the covariables included in the model). (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 11, 2019 Category: Health Management Authors: Karel Kostev, Jens Bohlken Tags: Letter to the Editor Source Type: research

Cross-Country Validation of the Association Between Oral Health and General Health in Community-Dwelling Older Adults
Oral health is known to be associated with general health, but longitudinal relationships between oral health and general health indicators have not yet been fully explored in international research. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 9, 2019 Category: Health Management Authors: Johanna de Almeida Mello, Trung Dung Tran, Stefanie Krausch-Hofmann, Brigette Meehan, Hein van Hout, Luke Turcotte, Henriette G. van der Roest, Vjenka Garms-Homolov á, Pálmi Jónsson, Graziano Onder, Harriet Finne-Soveri, Jan De Lepeleire, Dominique Dec Tags: Original Study Source Type: research

Multimorbidity and Health-Related Quality of Life in Old Age: Role of Functional Dependence and Depressive Symptoms
To examine the associations of multimorbidity patterns with health-related quality of life (HRQL) in rural-dwelling older adults in China, and to explore to what extent their associations were mediated by functional dependence and depressive symptoms. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 9, 2019 Category: Health Management Authors: Rui She, Zhongrui Yan, Hui Jiang, Davide L. Vetrano, Joseph T.F. Lau, Chengxuan Qiu Tags: Original Study Source Type: research

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The Authors wish to make a correction to their article published in JAMDA (https://doi.org/10.1016/j.jamda.2018.09.036) “Improving Nursing Home Residents' Oral Hygiene: Results of a Cluster Randomized Intervention Trial”. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 8, 2019 Category: Health Management Tags: Erratum Source Type: research

Do-Not-Resuscitate and Do-Not-Hospitalize Orders in Nursing Homes: Who Gets Them and Do They Make a Difference?
To describe the rate of do-not-resuscitate (DNR) and do-not-hospitalize (DNH) orders among residents newly admitted into long-term care homes. We also assessed the association between DNR and DNH orders with hospital admissions, deaths in hospital, and survival. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 8, 2019 Category: Health Management Authors: Peter Tanuseputro, Amy Hsu, Mathieu Chalifoux, Robert Talarico, Daniel Kobewka, Mary Scott, Kwadwo Kyeremanteng, Giulia Perri Tags: Original Study Source Type: research

Effect of Clinical Care Pathways on Quality of Life and Physical Function After Fragility Fracture: A Meta-analysis
To evaluate the effect of clinical care pathways (CCPs) on health-related quality of life (HRQoL) and physical function following fragility fracture and identify the specific characteristics of CCPs that are associated with improved outcomes. (Source: Journal of the American Medical Directors Association)
Source: Journal of the American Medical Directors Association - April 8, 2019 Category: Health Management Authors: Jason Talevski, Kerrie M. Sanders, Gustavo Duque, Catherine Connaughton, Alison Beauchamp, Darci Green, Lynne Millar, Sharon L. Brennan-Olsen Tags: Review Article Source Type: research