Journal of the American Medical Directors Association最新文献

{"title":"Association between Mortality and Time Spent Out of Bed in Older-Adult Nursing Home Residents","authors":"Shoji Kinoshita MD, PhD ,&nbsp;Akio Shimizu RD, PhD ,&nbsp;Naoki Yamada MD, PhD ,&nbsp;Ryo Momosaki MD, PhD, MPH ,&nbsp;Hidetaka Wakabayashi MD, PhD ,&nbsp;Kotomi Sakai SLHT, PhD, MPH ,&nbsp;Haruka Tohara DDS, PhD ,&nbsp;Ryosuke Yanagida DDS ,&nbsp;Tokiko Isowa RN, PHN, PhD ,&nbsp;Kenta Ushida RPT, MMSc ,&nbsp;Masahiro Abo MD, PhD","doi":"10.1016/j.jamda.2024.105458","DOIUrl":"10.1016/j.jamda.2024.105458","url":null,"abstract":"<div><h3>Objectives</h3><div>For older adults, spending time out of bed is important for preventing functional decline, but its relationship to mortality is not clear. In this study, we aimed to investigate the association between mortality and time spent out of bed in Japanese older-adult nursing home residents.</div></div><div><h3>Design</h3><div>We conducted a cohort study using data from the Long-term Care Information System for Evidence database.</div></div><div><h3>Setting and Participants</h3><div>We used data collected between April 2022 and March 2024 from older-adult nursing home residents who required assistance with the activities of daily living.</div></div><div><h3>Methods</h3><div>We compared outcome data between residents who spent 6 or more hours per day out of bed (group L) and those who spent less than 6 hours per day out of bed (group S). The outcome was all-cause mortality. Data were analyzed using Kaplan-Meier curves and Cox regression models.</div></div><div><h3>Results</h3><div>Data from 185 older-adult nursing home residents (median age: 89 years; 141 women) were analyzed. Group L included 144 residents (77.8% of all participants). Of the 185 participants, 40 died during the observation period. Mortality in group L was significantly lower than in group S (16.7% vs 39.0%, <em>P</em> = .002). Kaplan-Meier curve analysis after the log-rank test revealed a significantly higher mortality in group S than group L. Univariate and multivariate Cox regression analyses with robust (Huber-White) standard errors identified the factor of time spent out of bed (≥6 h) as a significant and independent risk factor for mortality.</div></div><div><h3>Conclusion and Implications</h3><div>More time spent out of bed is associated with lower mortality in older-adult nursing home residents who require assistance with the activities of daily living.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 3","pages":"Article 105458"},"PeriodicalIF":4.2,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142978935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of COVID-19 Diagnosis Codes for Identification of SARS-CoV-2 Infections in a Nursing Home Cohort, 2022–2023","authors":"Arshiya Patel MPH ,&nbsp;Amanda B. Payne PhD, MPH ,&nbsp;Dustin W. Currie PhD, MPH ,&nbsp;Thomas Franceschini MBA ,&nbsp;Amber Gensheimer MSN, RN ,&nbsp;Joseph D. Lutgring MD ,&nbsp;Sujan C. Reddy MD, MSc ,&nbsp;Kelly M. Hatfield DrPH, MSPH","doi":"10.1016/j.jamda.2024.105440","DOIUrl":"10.1016/j.jamda.2024.105440","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the utility of electronic health record (EHR) diagnosis codes for monitoring SARS-CoV-2 infections among nursing home residents.</div></div><div><h3>Design</h3><div>A retrospective cohort study design was used to analyze data collected from nursing homes operating under the tradename Signature Healthcare between January 2022 and June 2023.</div></div><div><h3>Setting and Participants</h3><div>Data from 31,136 nursing home residents across 76 facilities in Kentucky, Tennessee, Indiana, Ohio, North Carolina, Georgia, Alabama, and Virginia were included.</div></div><div><h3>Methods</h3><div>Resident demographics, diagnosis codes associated with clinical diagnoses (including COVID-19), and SARS-CoV-2 testing information were collected from the EHR and supplemental testing data sources. We described the rates of infection and the clinical characteristics of residents with incident-positive SARS-CoV-2 tests and new-onset COVID-19 diagnoses. Positive predictive values (PPVs) of COVID-19 diagnosis codes were calculated for residents stratified by whether a resident was continuously present in a facility for ±3 days from the diagnosis onset date listed in EHRs, using positive SARS-CoV-2 tests to confirm infection.</div></div><div><h3>Results</h3><div>A total of 4876 incident-positive SARS-CoV-2 tests and 6346 new-onset COVID-19 diagnoses were recorded during the study period. Weekly rates of new-onset diagnoses were significantly higher than positive test rates, although trends followed similar trajectories. Among residents continuously present in the nursing home ±3 days from the diagnosis onset date, the PPV of COVID-19 diagnosis codes was high (3395 of 3685 = 92%; 95% CI, 91%–93%). The PPV among this group significantly varied by study quarter (<em>P</em> &lt; .001). The PPV was substantially lower for 2661 diagnoses among residents not continuously present in the nursing home (24%; 95% CI, 22%–26%).</div></div><div><h3>Conclusions and Implications</h3><div>This study demonstrates the utility of diagnosis codes for assessment of COVID-19 epidemiology and trends when testing data are unavailable for residents during their stay in a nursing home. Future research should explore strategies to evaluate the utility of diagnosis codes at admission and discharge to nursing homes to enhance surveillance efforts.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 3","pages":"Article 105440"},"PeriodicalIF":4.2,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142950701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-Stay Nursing Home Residents with Dementia: Telemedicine Mental Health Use during the COVID-19 Pandemic","authors":"Qiuyuan Qin MS ,&nbsp;Helena Temkin-Greener PhD ,&nbsp;Adam Simning PhD ,&nbsp;Reza Yousefi-Nooraie PhD ,&nbsp;Shubing Cai PhD","doi":"10.1016/j.jamda.2024.105438","DOIUrl":"10.1016/j.jamda.2024.105438","url":null,"abstract":"<div><h3>Objective</h3><div>To examine racial and ethnic differences in telemedicine mental health (tele-MH) use among nursing home (NH) long-stay residents with Alzheimer’s disease and related dementias (ADRD) during the pandemic.</div></div><div><h3>Design</h3><div>Observational study.</div></div><div><h3>Setting and Participants</h3><div>The 2020–2021 Minimum Data Set 3.0, Medicare datasets, and Nursing Home Compare data were linked. A total of 259,467 NH long-stay residents with ADRD and 14,159 NHs were included.</div></div><div><h3>Methods</h3><div>The outcome variable was the percentage of NH ADRD long-stayers who used tele-MH in 2021. The main independent variables were NH racial and ethnic compositions (ie, percentages of Black and Hispanic residents) and individual race and ethnicity. We conducted a set of logistic regression models with NH random effect. We first included only individual characteristics and then added NH characteristics.</div></div><div><h3>Results</h3><div>Approximately 7% and 35% of the study cohort had tele-MH use and MH use in 2021, respectively. In our study cohort, 13.7% were Black, 6.6% were Hispanic, and 79.7% were white residents. The mean age was 83.4. After adjusting for NH characteristics, we found residents in NHs with a high proportion of Hispanic residents were more likely to use tele-MH both compared with those in NHs with a low proportion [odds ratio (OR), 1.867; 95% CI, 1.566–2.226], whereas residents in NHs with a high proportion of Black residents were less likely to use tele-MH both compared with those in NHs with a low proportion (OR, 0.843; 95% CI, 0.928–0.997).</div></div><div><h3>Conclusions and Implications</h3><div>Telemedicine may offer an opportunity for NHs with a higher proportion of Hispanic residents to better address their needs for MH services. However, NHs with a higher proportion of Black residents may face challenges in telemedicine adoption. Future studies are needed to better understand factors that could impact tele-MH use in NHs and reasons that lead to racial and ethnic differences.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 3","pages":"Article 105438"},"PeriodicalIF":4.2,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental and Clinical Factors Concerning Gastrointestinal Bleeding: An Umbrella Review of Meta-Analyses.","authors":"Keqian Yi, Yu Ma, Pengcheng Zhang, Haiyu He, Yueying Lin, Dali Sun","doi":"10.1016/j.jamda.2024.105412","DOIUrl":"https://doi.org/10.1016/j.jamda.2024.105412","url":null,"abstract":"<p><strong>Objectives: </strong>Gastrointestinal bleeding, an emergency and critical disease, is affected by multiple factors. This study aims to systematically summarize and appraise various factors associated with gastrointestinal bleeding.</p><p><strong>Design: </strong>Umbrella review.</p><p><strong>Setting and participants: </strong>Meta-analyses that evaluated environmental and clinical factors concerning gastrointestinal bleeding.</p><p><strong>Methods: </strong>We conducted a systematic search to identify eligible meta-analyses. For each included study, the risk estimates, heterogeneity estimates, small-study effects, excess significance tests, and publication biases were recalculated and appraised. Furthermore, we considered the methodologic quality and classified the evidence.</p><p><strong>Results: </strong>In this study, 51 beneficial and 44 harmful associations were found. This study found that preemptive transjugular intrahepatic portosystemic shunt was the most reliable treatment to reduce gastroesophageal variceal bleeding and mortality risk, followed by antibiotics. For gastroduodenal ulcer bleeding, Yunnan Baiyao and proton pump inhibitors (PPIs) were relatively dependable treatment drugs, and the comparatively reliable prophylactic drugs comprised PPIs and H₂-receptor antagonists. Patients with hemodynamic instability and larger ulcers had a higher risk of rebleeding. Both weekend admissions and the combination of selective serotonin reuptake inhibitors and nonsteroidal anti-inflammatory drugs were high-risk factors for upper gastrointestinal bleeding and mortality. We also found that tranexamic acid was a credible drug for overall gastrointestinal bleeding. Meanwhile, aspirin, warfarin, diabetes, and renal failure were all high-risk factors.</p><p><strong>Conclusions and implications: </strong>Altogether, many factors can substantially influence gastrointestinal bleeding. Therefore, in daily life and clinical practice, we should not only remain cautious in prescribing and taking some drugs but also pay attention to the management of lifestyle and underlying diseases. If necessary, protective drugs should be properly supplemented.</p>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":" ","pages":"105412"},"PeriodicalIF":4.2,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Nursing Home Changes in Antipsychotic Use on Outcomes among Residents with Dementia","authors":"Andrew R. Zullo PharmD, PhD ,&nbsp;Melissa R. Riester PharmD ,&nbsp;Hiren Varma MS ,&nbsp;Lori A. Daiello PharmD, ScM ,&nbsp;Lauren B. Gerlach DO, MS ,&nbsp;Antoinette B. Coe PharmD, PhD ,&nbsp;Kali S. Thomas PhD ,&nbsp;Richa Joshi MS, MBA ,&nbsp;Tingting Zhang MD, PhD ,&nbsp;Theresa I. Shireman PhD ,&nbsp;Julie P.W. Bynum MD, MPH","doi":"10.1016/j.jamda.2024.105439","DOIUrl":"10.1016/j.jamda.2024.105439","url":null,"abstract":"<div><h3>Objectives</h3><div>Little information exists on whether nationwide efforts to reduce antipsychotic use among nursing home (NH) residents with Alzheimer's disease and related dementias improved mortality and hospitalization outcomes for residents. Our objective was to examine the effect of NH decreases in antipsychotic use on outcomes for residents with Alzheimer's disease and related dementias.</div></div><div><h3>Design</h3><div>Observational nationwide study that emulated a series of cluster randomized trials.</div></div><div><h3>Setting and Participants</h3><div>Long-stay NH residents with Alzheimer's disease and related dementias in US NHs.</div></div><div><h3>Methods</h3><div>The study used data from Medicare claims to emulate cluster randomized trials in which NHs were assigned to either decrease or maintain/increase antipsychotic use. Outcome ascertainment for the first trial began on April 1, 2012 (ie, following the announcement of the National Partnership to Improve Dementia Care in NHs). The last day of follow-up was December 31, 2017. Outcomes measured included 12-month all-cause mortality, all-cause hospitalization, and hospitalization for stroke, myocardial infarction, fracture, and psychiatric conditions. Use of other psychotropic medications was also evaluated. Inverse-probability-of-treatment-weighted pooled Poisson regression models estimated covariate-adjusted risk ratios (RRs).</div></div><div><h3>Results</h3><div>The adjusted risks of death (RR, 1.01; 95% CLs, 1.00, 1.01), all-cause hospitalization (RR, 1.00; 95% CLs, 1.00, 1.01), and hospitalization for specific causes were similar between resident-trials in NHs that decreased vs maintained/increased antipsychotic use. Use of antidepressants, anxiolytic/sedative-hypnotics, anticonvulsant/mood stabilizers, and antidementia medications was slightly higher among resident-trials in NHs that decreased antipsychotic use.</div></div><div><h3>Conclusions and Implications</h3><div>Decreases in NH antipsychotic use do not appear to improve resident outcomes. Intensive initiatives focused predominantly on achieving a decrease in antipsychotic use may not be effective at improving mortality and hospitalization outcomes for residents with Alzheimer's disease and related dementias. These findings suggest the need for better strategies that incorporate safe and effective nonpharmacological or pharmacological alternatives for managing neuropsychiatric symptoms of dementia.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 3","pages":"Article 105439"},"PeriodicalIF":4.2,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142909837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Sources and Experiences of Joy in Caregiving: Insights From Formal Caregivers in Long-Term Care","authors":"Lillian Hung RN, PhD ,&nbsp;Nathan A. Boucher DrPH, PA, MPA, MS ,&nbsp;Lily Haopu Ren PhD ,&nbsp;Karen Lok Yi Wong RSW, MA, MSW ,&nbsp;Joey Oi Yee Wong PhD ,&nbsp;Yong Zhao MD ,&nbsp;Tiffany Wu MSc","doi":"10.1016/j.jamda.2024.105437","DOIUrl":"10.1016/j.jamda.2024.105437","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore and understand the sources and experiences of joy in caregiving among formal caregivers in Canadian long-term care (LTC).</div></div><div><h3>Design</h3><div>A qualitative study with interpretative descriptive design.</div></div><div><h3>Setting and Participants</h3><div>The participants consisted of 20 formal caregivers from a large public LTC home in British Columbia, Canada, focusing on those with at least 6 months of direct caregiving experience.</div></div><div><h3>Methods</h3><div>Convenience sampling was conducted to recruit participants. Data were collected through 3 focus groups, with discussions moderated by the primary investigator, and were audio recorded and transcribed. Reflexive thematic analysis was used to identify themes, combining inductive and deductive strategies. To enhance rigor and trustworthiness, the research team engaged in reflective practices, leveraging diverse expertise, and ensuring a rich description of the study context. The study received ethical approval, and participant confidentiality was maintained through pseudonyms.</div></div><div><h3>Results</h3><div>Three interconnected themes of joy in caregiving were identified: (1) Joy in caregiving is a relational and dynamic process that evolves over time and coexists with other emotions, such as sadness and grief. (2) Joy is driven by an attitude shaped by the environment, stemming from an internal attitude, and contributing to a deeper sense of fulfillment despite challenges. (3) Joy in caregiving builds personal team resilience that reduces burnout, fostering compassion and creating a supportive atmosphere through gratitude and shared experiences, benefiting caregivers and residents.</div></div><div><h3>Conclusions and Implications</h3><div>This study highlights the relational and evolving nature of joy in caregiving, the influence of internal attitudes and supportive environments, and the impact of joy on resilience and burnout. The findings contribute to characterizing how joy functions within caregiving contexts—specifically for LTC workers—and its broader implications for caregiver well-being and team dynamics.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 3","pages":"Article 105437"},"PeriodicalIF":4.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Frail Older Adults with High Anticholinergic Burden are at Risk of Orthostatic Hypotension","authors":"Mehmet Ilkin Naharci PhD","doi":"10.1016/j.jamda.2024.105436","DOIUrl":"10.1016/j.jamda.2024.105436","url":null,"abstract":"<div><h3>Objectives</h3><div>Frailty has been shown to be linked with orthostatic hypotension (OH) in older adults, but the role of anticholinergic drugs in this relationship never has been explored. The purpose of this was to examine the relationship between anticholinergic burden (ACB) and OH in frail older adults living in the community and to examine whether this association differs according to polypharmacy.</div></div><div><h3>Design</h3><div>A cross-sectional study.</div></div><div><h3>Setting and Participants</h3><div>Frail community-dwelling individuals aged ≥65 years admitted to the geriatric outpatient clinic (n = 399).</div></div><div><h3>Methods</h3><div>Frailty status was defined by having ≥3 clinical features of the Fried Frailty Index. OH was a drop of ≥20 mm Hg in systolic blood pressure or a drop of ≥10 mm Hg in diastolic blood pressure 1 or 3 min after rising from a sitting position. ACB for each participant was categorized as none (ACB = 0), low (ACB = 1), or high (ACB ≥2). Multivariate logistic regression models were implemented to examine the association of ACB with OH.</div></div><div><h3>Results</h3><div>The mean age of the sample was 79.8 years and 59.9% were women; 59 (13.3%) participants had OH. Exposure to anticholinergics was present in 41.4% of the participants, polypharmacy in 48.1%, and potentially inappropriate drug use in 44.1%. Multivariate analysis yielded a statistically significant risk of high ACB-related OH in the fully adjusted model [OR: 4.14 (1.33–12.86), <em>P</em> = .014]. None of the interaction terms of ACB with polypharmacy were significant in any model.</div></div><div><h3>Conclusions and Implications</h3><div>In frail older people, because exposure to a high anticholinergic load may be associated with OH, special attention should be paid to anticholinergics in medical treatment to prevent a reduction in blood pressure upon standing.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 3","pages":"Article 105436"},"PeriodicalIF":4.2,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General Information","authors":"","doi":"10.1016/S1525-8610(24)00871-5","DOIUrl":"10.1016/S1525-8610(24)00871-5","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 1","pages":"Article 105449"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement Practice of Slow Gait Speed for Motoric Cognitive Risk Syndrome: A Systematic Review","authors":"Lina Wang PhD ,&nbsp;Liming Su MD ,&nbsp;Lulu Shi MD ,&nbsp;Dan Zhao PhD ,&nbsp;Chen Zhang BSMed ,&nbsp;Bei Wu PhD","doi":"10.1016/j.jamda.2024.105361","DOIUrl":"10.1016/j.jamda.2024.105361","url":null,"abstract":"<div><h3>Objectives</h3><div>Individuals with motoric cognitive risk (MCR) syndrome have a high dementia risk. However, a knowledge gap exists in the measurement procedure for slow gait speed, which is a crucial component of MCR diagnosis. The study aimed to systematically review slow gait speed measurement practices in MCR diagnosis to identify critical constructs in gait speed measurement procedure.</div></div><div><h3>Design</h3><div>Systematic review.</div></div><div><h3>Setting and Participants</h3><div>Included studies were conducted in clinical and community settings, involving participants with MCR receiving gait speed measurement.</div></div><div><h3>Methods</h3><div>A systematic search across PubMed, Medline, Embase, CINHAL (EBSCO), Web of Science, Cochrane Library, and ProQuest Dissertation from inception until January 2024 for articles with detailed MCR diagnosis. Study quality was evaluated with the Joanna Briggs Institute (JBI) Critical Appraisal Checklists and slow gait speed measurement methods were summarized through narrative synthesis.</div></div><div><h3>Results</h3><div>From 27,600 unique entries, 50 relevant studies with 55 cohorts were identified and included in the review. Slow gait speed measurement methods in existing MCR studies showed heterogeneity in measurement tools, start/end protocols and buffer distance, walking test distance, number of tests, calculation methods, and cutoff values. Commonly, manual stopwatches and 4-meter walking test distance with a 2-meter buffer at each end at a usual pace were used, averaging 2 tests for gait speed analysis, with the need for cohort-specific slow gait cutoff values.</div></div><div><h3>Conclusions and Implications</h3><div>The measurement practices of slow gait speed in MCR diagnosis were heterogeneous. A relatively comprehensive gait speed measurement procedure with 7 constructs was initially delineated in this study based on synthesis analysis, with the potential to improve diagnostic accuracy and consistency of MCR, although further validation is still needed.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 1","pages":"Article 105361"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142687358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Directions & Connections","authors":"","doi":"10.1016/S1525-8610(24)00872-7","DOIUrl":"10.1016/S1525-8610(24)00872-7","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 1","pages":"Article 105450"},"PeriodicalIF":4.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}