Search Our Scientific Publications & Authors

J Am Geriatr Soc 2019 Feb 19. Epub 2019 Feb 19.

Department of Neurobiology, Neurology and Geriatrics, Xuanwu Hospital of Capital Medical University, Beijing Institute of Geriatrics, Beijing, China.

Objectives: We sought to assess associations of postural tremor with gait and balance impairments among community-dwelling older people in both cross-sectional and longitudinal analyses.

Design: A prospective cohort study.

Setting: Communities in Beijing, China. Read More

J Am Geriatr Soc 2019 Feb 14. Epub 2019 Feb 14.

Department of Medicine, University of California, San Francisco, San Francisco, California.

Loneliness and social isolation are strongly associated with several adverse health outcomes in older persons including death and functional impairments. The strength of these associations has been compared with smoking. Accordingly, loneliness and isolation have significant public health implications. Read More

J Am Geriatr Soc 2019 Feb 13. Epub 2019 Feb 13.

NHMRC Cognitive Decline Partnership Centre, Kolling Institute of Medical Research, Northern Clinical School, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia.

Background/objectives: Use of harmful and/or unnecessary medications in older adults is common. Understanding older adult and caregiver attitudes toward deprescribing will contribute to medication optimization in practice. The aims of this study were to capture the attitudes and beliefs of older adults and caregivers toward deprescribing and determine what participant characteristics and/or attitudes (if any) predicted reported willingness to have a medication deprescribed. Read More

J Am Geriatr Soc 2019 Feb 12. Epub 2019 Feb 12.

Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.

As originally defined, the term "prescribing cascade" describes a sequence of events that begins when an adverse drug event (ADE) occurs, is misinterpreted as a new medical condition, and a subsequent drug is then inadvertently prescribed to treat the new condition. We refine the definition to encompass both recognized and unrecognized ADEs because they can both contribute to problematic prescribing practices. In addition, we discuss that although prescribing cascades are most commonly viewed as problematic, they may be appropriate and therapeutically beneficial in certain clinical situations. Read More

J Am Geriatr Soc 2019 Feb 12. Epub 2019 Feb 12.

College of Pharmacy, Purdue University, School of Medicine, Indiana University, Indianapolis, Indiana.

Background: The exponential increase in the number of medications associated with clinically important prolongation of the heart rate-corrected QT interval (QTc) places older adults at increased risk of arrhythmias including life-threatening torsade de pointes (TdP) and sudden death. Risk factors, other than age older than 65 years and female sex, include multiple concurrent drugs that prolong QTc and a variety of underlying predisposing conditions. Although electronic medical records and pharmacy dispensing systems can alert clinicians to the risk of QTc-prolonging therapy, more than 95% of safety alerts are overridden, and many systems have deactivated QTc drug interaction alerts. Read More

J Am Geriatr Soc 2019 Feb 12. Epub 2019 Feb 12.

Department of Surgery, University of California, Los Angeles, Los Angeles, California.

Background: The American College of Surgeons Coalition for Quality in Geriatric Surgery is a multidisciplinary stakeholder group that aims to systematically improve the surgical care of older adults by establishing a verifiable quality improvement program with standards based on best evidence. Prior work confirmed the validity of a preliminary set of 308 standards to improve the quality of geriatric surgery, but concerns exist as to whether the standards are feasible for hospitals to implement.

Objective: Our aim was to utilize data gained from a multi-institutional survey and interview to improve the scalability and generalizability of a geriatric quality improvement program. Read More

J Am Geriatr Soc 2019 Feb 8. Epub 2019 Feb 8.

Cognitive Neurology Unit, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Objectives: To examine the association between performance on subtests of the Mini-Mental State Examination (MMSE) and driving competence in people with cognitive impairment (CI) as well as those with no cognitive impairment (NCI).

Design: Retrospective observational study.

Setting: Participants referred for a DriveWise evaluation at Beth Israel Deaconess Medical Center in Boston, Massachusetts, were included in the study. Read More

J Am Geriatr Soc 2019 Feb 8. Epub 2019 Feb 8.

Palliative Care, Charleston, South Carolina.

J Am Geriatr Soc 2019 Feb 8. Epub 2019 Feb 8.

Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York.

Background: Hospital at home (HaH) is a model of care that provides acute-level services in the home. HaH has been shown to improve quality and patient satisfaction, and reduce iatrogenesis and costs. Uptake of HaH in the United States has been limited, and little research exists on how to implement it successfully. Read More

J Am Geriatr Soc 2019 Feb 6. Epub 2019 Feb 6.

Department of Geriatrics, Yale New Haven Hospital, New Haven, Connecticut.

Inability to climb stairs safely can lead older adults to miss desired medical appointments. To facilitate adequate access to routine medical care for older adults, affordable transportation assistance up and down stairs should be available. Read More

J Am Geriatr Soc 2019 Feb 6. Epub 2019 Feb 6.

Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Background/objectives: Obstructive sleep apnea (OSA) has been linked to an increased risk for Alzheimer's disease (AD), but little prospective evidence exists on the effects of OSA treatment in preclinical AD. The objective was to determine if continuous positive airway pressure (CPAP) treatment adherence, controlling for baseline differences, predicts cognitive and everyday function after 1 year in older adults with mild cognitive impairment (MCI) and to determine effect sizes for a larger trial.

Design: Quasi-experimental pilot clinical trial with CPAP adherence defined as CPAP use 4 hours or more per night over 1 year. Read More

J Am Geriatr Soc 2019 Feb 5. Epub 2019 Feb 5.

The Irish Longitudinal Study on Ageing Trinity College Dublin, Dublin, Ireland.

Background/objectives: There is growing interest in the association between gait disturbance and depression in later life. The aim of this study is to clarify the longitudinal relationship between specific gait parameters and incident depression within a population-representative sample of older people.

Design: Longitudinal analysis of spatiotemporal gait parameters at baseline (wave 1) and incident depression at 2 and 4 years (waves 2/3). Read More

J Am Geriatr Soc 2019 Feb 5. Epub 2019 Feb 5.

Center for Systems Medicine, Guangxi Key Laboratory of Excellence, Guilin Medical University, Guilin, China.

J Am Geriatr Soc 2019 Feb 4. Epub 2019 Feb 4.

Department of Medical Surgical Nursing, Nursing School, University of São Paulo, São Paulo, Brazil.

Objectives: To investigate the differences in life expectancy with and without cognitive impairment (CI) by educational levels and sex in Brazil.

Design: Longitudinal observational study.

Setting: The sample was drawn from three waves (2000, 2006, and 2010) of the Health, Well-Being, and Aging Study (Saúde, bem-estar e envelhecimento; SABE) collected in São Paulo, Brazil. Read More

J Am Geriatr Soc 2019 Feb 1. Epub 2019 Feb 1.

Department of Geriatrics and Aging Research, University Hospital Zurich and University of Zurich, Switzerland.

Objectives: To test the effect of monthly high-dose vitamin D supplementation on mental health in pre-frail older adults.

Design: Ancillary study of a 1-year double-blind randomized clinical trial conducted in Zurich, Switzerland.

Setting And Participants: A total of 200 community-dwelling adults 70 years and older with a prior fall event in the last year. Read More

J Am Geriatr Soc 2019 Feb 1. Epub 2019 Feb 1.

Univ. Bordeaux, Bordeaux Population Health Research Center, team Psychoepidemiology of aging and chronic diseases, UMR 1219, F-33000 Bordeaux, France.

J Am Geriatr Soc 2019 Feb 1. Epub 2019 Feb 1.

VA Center for Health Equity Research and Promotion (CHERP), Corporal Crescenz VA Medical Center, Philadelphia, Pennsylvania.

Background/objective: Older adults frequently receive post-acute care (PAC) after hospital discharge, but little is known about how perceived costs influence PAC choices. This research study sought to understand how clinicians, patients, and their caregivers evaluate the cost of skilled nursing facility (SNF) care in their decisions about whether to utilize SNFs after hospital discharge.

Design: Guided by principles of social constructivist theory, we conducted a qualitative interpretative study using semistructured interviews with clinicians, patients, and caregivers. Read More

J Am Geriatr Soc 2019 Feb 1. Epub 2019 Feb 1.

Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida.

J Am Geriatr Soc 2019 Feb 1. Epub 2019 Feb 1.

Center for the Study of Aging and Human Development, Duke University, Durham, NC.

J Am Geriatr Soc 2019 Feb 1. Epub 2019 Feb 1.

Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.

Objective: To determine the prevalence of retinal microvascular signs and associations between retinal signs and cognitive status.

Design: Cross-sectional analysis of visit 5 (2011-2013) of the Atherosclerosis Risk in Communities (ARIC) cohort. Data analysis took place November 30, 2017, to May 1, 2018. Read More

J Am Geriatr Soc 2019 Jan 31. Epub 2019 Jan 31.

Department of Medicine, Division of General Internal Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Background/objectives: The treatment of type 2 diabetes in older adults requires special considerations including avoidance of hypoglycemia, yet variation in diabetes treatment with aging is not well understood. In this study, we compared nationally representative diabetes treatment patterns and trends between older adults (≥65 y) and younger adults (30-64 y).

Design: Repeated cross-sectional physician surveys from 2006 to 2015. Read More

J Am Geriatr Soc 2019 Jan 31. Epub 2019 Jan 31.

Division of General Internal Medicine and Geriatrics, Oregon Health & Science University, Portland, Oregon.

J Am Geriatr Soc 2019 Jan 30. Epub 2019 Jan 30.

School of Dentistry, University of Detroit Mercy, Detroit, Michigan.

Objectives: To examine changes in tooth loss and untreated tooth decay among older low-income and higher-income US adults and whether disparities have persisted.

Design: Sequential cross-sectional study using nationally representative data.

Setting: The 1999 to 2004 and 2011 to 2016 National Health and Nutrition Examination Survey. Read More

J Am Geriatr Soc 2019 Jan 30. Epub 2019 Jan 30.

Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontario, Canada.

Background And Objectives: Polypharmacy, defined as the use of five or more medications, has been repeatedly linked to fall incidence, and recently it was cross-sectionally associated with gait disturbances. Our objectives were to evaluate cross-sectional and longitudinal associations between polypharmacy and gait performance in a well-established clinic-based cohort study. We also assessed whether gait impairments could mediate associations between number of medications and fall incidence. Read More

J Am Geriatr Soc 2019 Jan 30. Epub 2019 Jan 30.

NYU Winthrop Hospital, Mineola, New York.

Background: Limited information is available on the influence of vitamin D on falls in older high-functioning black American women. Endocrine Society guidelines propose serum 25(OH)D levels over 30 ng/mL.

Objective: To determine if maintenance of serum 25(OH)D above 30 ng/mL protects against falls. Read More

J Am Geriatr Soc 2019 Jan 30. Epub 2019 Jan 30.

James P. Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, New York.

Objective: To evaluate the efficacy and toxicity of immune checkpoint inhibitors (ICIs) in older patients with advanced non-small cell lung cancer (NSCLC) seen in routine clinical practice.

Design: Retrospective study.

Setting: Single academic institution and its affiliated centers. Read More

J Am Geriatr Soc 2019 Jan 30. Epub 2019 Jan 30.

Department of Internal Medicine, Division of Geriatric Medicine Ankara, Hacettepe University, Faculty of Medicine, Ankara, Turkey.

J Am Geriatr Soc 2019 Jan 30. Epub 2019 Jan 30.

VA Connecticut Healthcare System, Clinical Epidemiology Research Center and Geriatrics & Extended Care, West Haven, Connecticut.

Older adults are prescribed a growing number of medications. Polypharmacy, commonly considered the receipt of five or more medications, is associated with a range of adverse outcomes. There is a debate about the reason(s) why. Read More

J Am Geriatr Soc 2019 Jan 30. Epub 2019 Jan 30.

Department of Epidemiology and Biostatistics, The University of Arizona, Tucson, Arizona.

J Am Geriatr Soc 2019 Jan 29. Epub 2019 Jan 29.

Mercy Health Saint Mary's, Grand Rapids, Michigan.

J Am Geriatr Soc 2019 Jan 29. Epub 2019 Jan 29.

Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas.

Background/objectives: Peripheral neuropathy is a common diabetes complication that can increase fall risk. Regarding fall risk, the impact of pain management using tricyclic antidepressants (TCAs) or γ-aminobutyric acid (GABA) analogs is unclear because these medications can also cause falls. This study investigates the impact of these drugs on fall and fracture risk in older diabetic peripheral neuropathy (DPN) patients. Read More

J Am Geriatr Soc 2019 Jan 29. Epub 2019 Jan 29.

ARC Centre of Excellence in Population Ageing Research (CEPAR), The Australian National University, Canberra, Australian Capital Territory, Australia.

Objectives: To examine whether older adults aged 85+, with different health and functional capacities, cluster in different ways and to demonstrate whether individuals within particular clusters report differential mortality risk.

Design: Retrospective cohort study.

Setting: The Dynamic Analyses to Optimize Aging (DYNOPTA) project is a harmonization project of nine Australian longitudinal surveys of health and well-being in adults aged 50+ between 1991 and 2006. Read More

J Am Geriatr Soc 2019 Feb 29;67(2):218-222. Epub 2019 Jan 29.

National Institute on Aging, National Institutes of Health, Bethesda, Maryland.

In the United States, the population aged 65 and older is rapidly growing, and this group uses more healthcare resources and has unique healthcare needs that do not exist in younger populations. However, it was reported that older adults are excluded or underrepresented in clinical trials for several diseases. We examined phase III clinical trials funded by the National Institutes of Health found in www. Read More

J Am Geriatr Soc 2019 Feb 29;67(2):211-217. Epub 2019 Jan 29.

Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs, Durham, North Carolina.

After passage of the 21st Century Cures Act, the National Institutes of Health held a workshop in 2017 to consider expanding its inclusion policy to encompass individuals of all ages. American Geriatrics Society (AGS) leaders and members participated in the workshop and formal feedback period. AGS advocacy clearly impacted the resulting workshop report and Inclusion Across the Lifespan policy that eliminates upper-age limits for research participation unless risk justified and changes the language used to describe older adults and other vulnerable groups. Read More

J Am Geriatr Soc 2019 Jan 29. Epub 2019 Jan 29.

College of Nursing and College of Medicine, Pennsylvania State University, State College, Pennsylvania.

J Am Geriatr Soc 2019 Jan 29. Epub 2019 Jan 29.

University of Michigan, Ann Arbor, Michigan.

The American Geriatrics Society convened a conference in Bethesda, Maryland, to explore models and studies of aging. This was the second of three conferences, supported by a U13 grant from the National Institute on Aging, to aid recipients of Grants for Early Medical/Surgical Specialists Transition to Aging Research (GEMSSTAR) in integrating geriatrics into their specialties. Recognizing that aging is the largest risk factor for multiple chronic diseases and age-related loss of resilience, the conference organizers focused scientific sessions on how targeting age-related mechanisms can delay, prevent, or reverse geriatric syndromes, age-related chronic diseases, and loss of resilience. Read More

J Am Geriatr Soc 2019 Feb 29;67(2):342-346. Epub 2019 Jan 29.

Department of Veterans Affairs Medical Center, Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Decatur, Georgia.

Background/objectives: To address the underrepresentation of older adults in clinical research, the National Institutes of Health will require investigators to include individuals across the lifespan. As investigators from other fields endeavor to recruit participants who are more representative of the patient population, geriatricians may have the opportunity to influence a broad range of research studies in older adults. Our aims were to elicit challenges to inclusion of older adults in clinical research and to develop a preliminary framework for communicating these challenges to non-geriatrics-trained researchers. Read More

J Am Geriatr Soc 2019 Jan 29. Epub 2019 Jan 29.

Clinical Cardiovascular Research Laboratory for the Elderly, Allen Hospital of New York-Presbyterian, Columbia University Irving Medical Center, New York, New York.

Background: The need for mentorship in aging research among postdoctoral trainees and junior faculty across medical disciplines and subspecialties is increasing, yet senior personnel with expertise in aging are lacking to fulfill the traditional dyadic mentorship role. Facilitated peer mentorship is grounded in collaborative work among peers with the guidance of a senior mentor.

Methods And Results: We evaluated the Columbia University Mentor Peer Aging Research (CoMPAdRE) program, an interprofessional facilitated peer mentorship program for early stage investigators, using the Reach Effectiveness Adoption Implementation and Maintenance framework (RE-AIM). Read More

J Am Geriatr Soc 2019 Jan 29. Epub 2019 Jan 29.

American Geriatrics Society, New York, New York.

The American Geriatrics Society (AGS) Beers Criteria® (AGS Beers Criteria®) for Potentially Inappropriate Medication (PIM) Use in Older Adults are widely used by clinicians, educators, researchers, healthcare administrators, and regulators. Since 2011, the AGS has been the steward of the criteria and has produced updates on a 3-year cycle. The AGS Beers Criteria® is an explicit list of PIMs that are typically best avoided by older adults in most circumstances or under specific situations, such as in certain diseases or conditions. Read More

J Am Geriatr Soc 2019 Jan 29. Epub 2019 Jan 29.

Division of Geriatric and Palliative Medicine, Department of Internal Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan.

Through the National Institute on Aging's (NIA's) "Grants for Early Medical/Surgical Specialists" Transition to Aging Research (GEMSSTAR) U13 grant, the NIA and the American Geriatrics Society (AGS) developed three transdisciplinary research conferences with a focus on mentoring and leadership skills development. The NIA's GEMSSTAR program evolved from two earlier programs, the AGS' Dennis W. Jahnigen and the Association of Specialty Professors' T. Read More

J Am Geriatr Soc 2019 Jan 29. Epub 2019 Jan 29.

Harvard School of Dental Medicine, Department of Oral Health Policy and Epidemiology, Boston, Massachusetts.

Oral health (OH) has profound effects on the overall health of elderly people. While oral disease is prevalent in the geriatric population and access to care is a major issue, it is unclear the extent of OH training among US geriatric fellowship programs. A 19-item electronic survey was sent to all 148 accredited geriatric fellowship training programs via the Association of Directors of Geriatric Medicine. Read More

J Am Geriatr Soc 2019 Feb 29;67(2):203-204. Epub 2019 Jan 29.

University of Connecticut Health Center - UCONN Center on Aging, Farmington, Connecticut.

J Am Geriatr Soc 2019 Jan 28. Epub 2019 Jan 28.

ICES, Toronto, Ontario, Canada.

Objectives: To determine whether decreased communication ability among long-term care residents is associated with increased antibiotic exposure.

Design: Retrospective cohort study.

Setting: All long-term care homes in Ontario, Canada. Read More

J Am Geriatr Soc 2019 Jan 28. Epub 2019 Jan 28.

University of Massachusetts Medical School and the Meyers Primary Care Institute, Worcester, Massachusetts.

J Am Geriatr Soc 2019 Jan 28. Epub 2019 Jan 28.

University of Helsinki, Clinicum, and Helsinki University Hospital, Helsinki, Finland.

J Am Geriatr Soc 2019 Jan 27. Epub 2019 Jan 27.

Department of Emergency Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

Objectives: To describe the frequency and risk of return visit to the emergency department (ED) by older adults after prescription of any of four potentially inappropriate medication (PIM) classes included in the 2015 Beers Criteria commonly used for the relief of acute pain in the ED.

Design: Retrospective cohort study.

Setting: Large urban academic ED from January 1, 2013, to December 31, 2015. Read More

J Am Geriatr Soc 2019 Jan 25. Epub 2019 Jan 25.

Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana.

Background/objective: Delirium in the intensive care units (ICUs) is prevalent, with both delirium duration and delirium severity associated with adverse outcomes. We designed a pragmatic trial to test the efficacy of a pharmacological management of delirium (PMD) bundle in improving delirium/coma-free days and reducing delirium severity among ICU patients.

Design: A randomized pragmatic clinical trial. Read More

J Am Geriatr Soc 2019 Jan 24. Epub 2019 Jan 24.

Multicampus Program in Geriatric Medicine and Gerontology, David Geffen School Medicine, University of California, Los Angeles, California.

Background/objectives: Although Alzheimer disease and other dementias are life limiting, only a minority of these patients or their proxy decision makers participate in advance care planning. We describe end-of-life care preferences and acute care and hospice use in the last 6 months of life for persons enrolled in a comprehensive dementia care management program.

Design: Observational, retrospective cohort. Read More

J Am Geriatr Soc 2019 Jan 24. Epub 2019 Jan 24.

University of Washington and Dementia Care Research and Consulting, Palm Springs, California.

J Am Geriatr Soc 2019 Jan 23. Epub 2019 Jan 23.

University of Tennessee College of Pharmacy, Memphis, Knoxville and Nashville, Tennessee.

Background/objectives: Previous research indicates that eligibility criteria for medication therapy management (MTM) services in Medicare prescription drug (Part D) plans, defined under the Medicare Modernization Act (MMA), are associated with racial/ethnic disparities and ineffective in identifying individuals with medication utilization issues. Our study's objective was to determine the comparative effectiveness of MTM eligibility criteria under MMA and in the Affordable Care Act (ACA) in identifying patients with medication utilization issues across racial/ethnic groups.

Design: ACA and MMA MTM eligibility criteria were compared on proportions of eligible individuals among patients with medication utilization issues. Read More