Journal of the American Medical Directors Association最新文献

英文中文

A New Look at Diabetes Through the Revised 2024 Diabetes Clinical Practice Guideline 通过修订后的 2024 年糖尿病临床实践指南重新审视糖尿病。

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY

Journal of the American Medical Directors Association

Pub Date : 2024-11-01 DOI: 10.1016/j.jamda.2024.105325

Barbara Resnick PhD, CRNP

引用次数: 0

General Information 一般信息

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY

Journal of the American Medical Directors Association

Pub Date : 2024-11-01 DOI: 10.1016/S1525-8610(24)00793-X

引用次数: 0

Directions & Connections 路线与连接

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY

Journal of the American Medical Directors Association

Pub Date : 2024-11-01 DOI: 10.1016/S1525-8610(24)00794-1

引用次数: 0

Letter to the Editor in Response to “Meta-Analysis of Fall Risk in Older Adults with Alzheimer's Disease” 致编辑的信，回应 "老年痴呆症患者跌倒风险的 Meta 分析"。

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY

Journal of the American Medical Directors Association

Pub Date : 2024-11-01 DOI: 10.1016/j.jamda.2024.105221

Sheryl Zimmerman PhD, Glen L. Xiong MD, CMD, George Netscher MS

引用次数: 0

Corrigendum to ‘Deprescribing Interventions for Older Patients: A Systematic Review and Meta-Analysis’ [Journal of the American Medical Directors Association 24 (2023)1718-1725] 针对老年患者的去处方化干预措施：系统回顾和元分析》[《美国医务主任协会杂志》24 (2023)1718-1725] 更正。

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY

Journal of the American Medical Directors Association

Pub Date : 2024-11-01 DOI: 10.1016/j.jamda.2024.105305

Dan Zhou MS , Zhaoyan Chen PhD , Fangyuan Tian PhD

引用次数: 0

ORIENT Diet: A Potential Neuroprotective Dietary Pattern for Chinese Stroke High-Risk Population ORIENT 饮食：中国脑卒中高危人群的潜在神经保护膳食模式。

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY

Journal of the American Medical Directors Association

Pub Date : 2024-10-30 DOI: 10.1016/j.jamda.2024.105331

Luowei Chen PhD , Wansi Zhong MD , Hui Chen PhD , Ying Zhou PhD , Wang Ran MD , Yaode He MD , Tingxia Zhang MD , Xiao Zhu MD , Xin Xu PhD , Changzheng Yuan ScD, MSc, BM , Min Lou MD, PhD

Objectives

Given the particularity of Asian cultures and dietary habits, there is a need to establish a neuroprotective dietary pattern specially for the Asian stroke high-risk population, to prevent cognitive impairment.

Design

A systematic review and cross-sectional study.

Setting and Participants

Chinese stroke high-risk population from the CIRCLE (NCT03542734) study.

Methods

The Oriental Intervention for Enhanced Neurocognitive healTh (ORIENT) diet was developed by replacing the western foods in the Mediterranean-DASH diet Intervention for Neurodegenerative Delay (MIND) diet with appropriate Asian alternatives, and refining the recommended intake frequency based on a systematic review, which examined Asian studies in the cognition-diet field. Cognitive impairment was defined as a global cognitive score ≥1 SD below the sample mean, based on the National Institute of Neurological Disorders and Stroke and Canadian Stroke Network vascular cognitive impairment battery.

Results

A total of 568 participants were finally included, with 325 men (57.2%) and a mean age of 60.5 ± 7.3 years. Participants in the highest tertile of ORIENT score had 60.5% lower odds of cognitive impairment than those in the lowest tertile (odds ratio = 0.395, 95% CI = 0.165-0.944, P = .044) when adjusted for demographic variables, lifestyle factors, and health status. Multiple linear regression analysis showed that each 1-point increase in ORIENT score was associated with 0.048 higher global cognitive score, 0.281 higher Mini-Mental State Examination score, and 0.344 higher Montreal Cognitive Assessment score.

Conclusions and Implications

High adherence to ORIENT diet was associated with lower odds of cognitive impairment, providing a potential neuroprotective dietary pattern for Chinese stroke high-risk population.

目的：鉴于亚洲文化和饮食习惯的特殊性，有必要专门为亚洲中风高危人群建立神经保护性饮食模式，以预防认知障碍：鉴于亚洲文化和饮食习惯的特殊性，有必要专门为亚洲中风高危人群建立神经保护性饮食模式，以预防认知障碍：设计：系统回顾和横断面研究：环境和参与者：CIRCLE（NCT03542734）研究中的中国中风高危人群：方法：根据对认知-饮食领域的亚洲研究进行的系统回顾，将地中海-DASH饮食干预神经退行性延迟（MIND）饮食中的西方食物替换为适当的亚洲食物，并改进推荐的摄入频率，从而开发出东方干预增强神经认知愈合（ORIENT）饮食。根据美国国立神经疾病与中风研究所和加拿大中风网络的血管认知障碍电池，认知障碍的定义是总体认知得分低于样本平均值≥1 SD：最终共纳入 568 名参与者，其中男性 325 人（57.2%），平均年龄为 60.5 ± 7.3 岁。在对人口统计学变量、生活方式因素和健康状况进行调整后，ORIENT得分最高三等分的参与者发生认知障碍的几率比最低三等分的参与者低60.5%（几率比=0.395，95% CI=0.165-0.944，P=0.044）。多元线性回归分析显示，ORIENT得分每增加1分，全局认知得分就会增加0.048分，迷你精神状态检查得分增加0.281分，蒙特利尔认知评估得分增加0.344分：结论与启示：ORIENT饮食的高依从性与认知障碍发生几率的降低相关，为中国脑卒中高危人群提供了一种潜在的神经保护饮食模式。

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引用次数: 0

Association between Time Since Smoking Cessation and Frailty Trajectory among Community-Dwelling Older People: English Longitudinal Study of Ageing 社区老年人戒烟时间与虚弱轨迹之间的关系：英国老龄化纵向研究

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY

Journal of the American Medical Directors Association

Pub Date : 2024-10-30 DOI: 10.1016/j.jamda.2024.105328

Gotaro Kojima PhD , Yu Taniguchi PhD , Reijiro Aoyama PhD , Tomohiko Urano MD, PhD

Objectives

To examine the associations of smoking cessation with the subsequent frailty status trajectory using data from a nationally representative sample of community-dwelling older adults living in England.

Design

A prospective panel study.

Setting and Participants

A total of 2600 community-dwelling older adults aged 60 or older in England who used to smoke.

Methods

The past smokers were divided into 5 groups based on years since smoking cessation: 0–10, 11–20, 21–30, 31–40, and 41+ years. The Frailty Index (FI) was constructed using 60 deficits and repeatedly calculated every 2 years over 16 years. Trajectories of FI according to years since smoking cessation were estimated by a mixed-effects model.

Results

A mixed-effects model adjusted for age, sex, education, wealth, and alcohol use showed that FI increased over time in all groups and that longer duration since smoking cessation was significantly associated with lower FI (more fit). Those who quit 41 years earlier or more had the lowest frailty trajectory, however, there was still a gap between them and never smokers.

Conclusions and Implications

The current study showed that past smokers with a longer duration of quitting smoking had a significantly lower degree of frailty at baseline and over time. These findings highlight beneficial effects of smoking cessation on frailty even in middle or old age and could be used in public health education to promote the importance of quitting smoking.

目的利用具有全国代表性的英格兰社区老年人样本数据，研究戒烟与随后的虚弱状态轨迹之间的关系：设计：前瞻性小组研究：环境和参与者：英国60岁及以上居住在社区的老年人，共2600人，他们曾经吸烟：根据戒烟年限将过去吸烟者分为 5 组：0-10岁、11-20岁、21-30岁、31-40岁和41岁以上。虚弱指数（FI）由 60 项缺陷构成，在 16 年中每两年重复计算一次。通过混合效应模型估算了根据戒烟年限计算的 FI 轨迹：混合效应模型对年龄、性别、教育程度、财富和酗酒情况进行了调整，结果表明，随着时间的推移，所有群体的FI都在增加，戒烟时间越长，FI越低。戒烟时间在 41 年或更早的人的虚弱程度轨迹最低，但他们与从不吸烟者之间仍有差距：目前的研究表明，戒烟时间较长的既往吸烟者在基线时和随着时间的推移，其虚弱程度明显较低。这些发现凸显了戒烟对中老年虚弱的有益影响，可用于公共健康教育，宣传戒烟的重要性。

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引用次数: 0

Reducing the Inappropriate Use of Antipsychotics in Long-Term Care: Strategies for Success 减少长期护理中抗精神病药物的不当使用：成功策略》。

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY

Journal of the American Medical Directors Association

Pub Date : 2024-10-28 DOI: 10.1016/j.jamda.2024.105327

Ahmed Vanker MD , Lara de Waal MBA , Natasha Milijasevic PhD , Matthew Morgan MD

The inappropriate use of antipsychotic medications in older adults can reduce the quality of life and increase the risk of adverse drug interactions. To address this concern, a quality improvement study was implemented across 34 long-term care (LTC) homes in Ontario, Canada. The study aimed to reduce inappropriate antipsychotic use by implementing evidence-based deprescribing practices. The study resulted in a 40.6% reduction in inappropriate antipsychotic use. The results of this study can inform quality improvement approaches for reducing the inappropriate use of antipsychotics in LTC and beyond.

老年人不适当地使用抗精神病药物会降低生活质量，并增加药物不良相互作用的风险。针对这一问题，加拿大安大略省的 34 家长期护理（LTC）机构开展了一项质量改进研究。该研究旨在通过实施循证处方实践，减少抗精神病药物的不当使用。研究结果显示，抗精神病药物的不当使用减少了 40.6%。这项研究的结果可以为质量改进方法提供参考，从而减少长期护理机构及其他机构中抗精神病药物的不当使用。

引用次数: 0

The Impact of Enhanced Group Activity Kits (EGAKs) on Well-being of Persons With Dementia 强化小组活动套件对痴呆症患者福祉的影响。

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY

Journal of the American Medical Directors Association

Pub Date : 2024-10-28 DOI: 10.1016/j.jamda.2024.105329

Jiska Cohen-Mansfield PhD

Objectives

People living with dementia (PLwD) often feel lonely and bored. This study examined the impact of group activities on the well-being of this population when these activities were facilitated by enhanced group activity kits (EGAKs) and compared the impact of this intervention with (1) group activities not facilitated by EGAKs and (2) the absence of group activities.

Design

The study was conducted as a stepped-wedge clustered trial.

Setting and Participants

The study included 123 PLwD from 6 nursing care units and 4 senior day units for PLwD in the Tel Aviv and Jerusalem metropolitan areas of Israel.

Methods

The participants took part in group activities while their well-being was assessed using the Group Observational Measurement of Engagement (GOME) assessment tool, from which a Wellbeing Index was derived. Participants attended baseline group activities, during which a facility staff activity leader conducted activities without using EGAKs. Thereafter, the same activity leader and participants engaged in activities that used EGAKs. During the course of the study, 1 activity leader resigned, and her participants, who were no longer offered group activities, were assessed at the times during which their previous activities would have occurred.

Results

Significant improvement in well-being (P < .001) was found during group activities facilitated using EGAKs compared with group activities conducted by the same activity leaders not using EGAKs. Compared with baseline group activity sessions (without EGAKs), a no-activity state yielded a highly significant decrease in well-being (P < .001).

Conclusions and Implications

The results demonstrate the potential utility of EGAKs to improve the well-being of people living with dementia. This relatively inexpensive innovation can be made available on a large scale to nursing homes, assisted living facilities, and senior day centers. Future research should expand the range of content of EGAKs in order to serve PLwD of diverse cultural backgrounds.

目的：痴呆症患者（PLwD）常常感到孤独和无聊。本研究探讨了在增强型小组活动包（EGAKs）的协助下开展小组活动对这一人群幸福感的影响，并比较了这一干预措施与（1）无增强型小组活动包协助的小组活动和（2）不开展小组活动的影响：研究以阶梯式分组试验的形式进行：研究对象包括以色列特拉维夫和耶路撒冷市区 6 家护理机构和 4 家为 PLwD 设立的日间老年护理机构的 123 名 PLwD：参与者在参加小组活动的同时，使用 "小组参与观察测量"（GOME）评估工具对他们的幸福感进行评估，并从中得出幸福指数。参与者参加了基线小组活动，在此期间，设施员工活动负责人在不使用 EGAK 的情况下开展活动。之后，同一位活动负责人和参与者参加了使用 EGAK 的活动。在研究过程中，一名活动负责人辞职，她的参与者不再参加小组活动，我们在他们之前参加活动的时间对他们进行了评估：结果：与未使用 EGAKs 的同一位活动负责人开展的小组活动相比，使用 EGAKs 的小组活动显著提高了参与者的幸福感（P < .001）。与基线小组活动课程（未使用 EGAKs）相比，无活动状态下的幸福感出现了非常显著的下降（P < .001）：研究结果表明了 EGAKs 在改善痴呆症患者生活质量方面的潜在作用。养老院、生活辅助设施和老年人日间活动中心可以大规模使用这种相对廉价的创新方法。未来的研究应扩大 EGAK 的内容范围，以便为不同文化背景的痴呆症患者提供服务。

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引用次数: 0

Designing LTC Physical Work Environments to Support Worker Well-being: A Review and Recommendations 设计 LTC 物理工作环境以支持工作人员的福祉：回顾与建议》。

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY

Journal of the American Medical Directors Association

Pub Date : 2024-10-28 DOI: 10.1016/j.jamda.2024.105326

Cedra M. Goldman MPH , Traci R. Rider PhD , Gwenith G. Fisher PhD , Angela L. Loder PhD , Natalie V. Schwatka PhD , Mike V. Van Dyke PhD

Objectives

Well-designed, health-promoting physical work environments have the potential to reduce burnout and attrition for employees who work in long-term care (LTC) facilities. Unfortunately, there is limited existing guidance for LTC facility owners and operators related to specific health-promoting design strategies for LTC work environments. This narrative review aims to fill this knowledge gap.

Methods

Information was synthesized from healthy-building certification standards for health care and non–health care buildings, LTC design guidelines, academic studies, and expert commentaries. The review was conducted in 3 phases to (1) identify specific space types and design characteristics generally considered to be health-supportive, (2) gather existing research on the identified strategies to critically analyze their supportive value, and (3) communicate the findings to a broad audience of stakeholders.

Results

Five specific space types and 21 design characteristics were identified as both supportive of employee health and well-being, and relevant to LTC physical work environments.

Conclusions

When health care organizations construct new facilities or renovate existing facilities, using these health-promoting design strategies should be considered. Benefits of health-promoting physical work environments include better employee mental and physical health, less burnout, and less turnover. Reducing burnout and increasing employee retention is essential to mitigate the ongoing staffing crisis in the LTC industry.

目标：设计良好、促进健康的物质工作环境有可能减少长期护理（LTC）机构员工的倦怠和流失。遗憾的是，目前针对长期护理机构业主和经营者的有关长期护理机构工作环境的具体健康促进设计策略的指导非常有限。本综述旨在填补这一知识空白：方法：从医疗保健和非医疗保健建筑的健康建筑认证标准、长期护理中心设计指南、学术研究和专家评论中综合了相关信息。审查分三个阶段进行：（1）确定通常被认为有利于健康的特定空间类型和设计特点；（2）收集有关已确定策略的现有研究，以批判性地分析其支持价值；以及（3）将审查结果传达给广大利益相关者：结果：五种特定的空间类型和 21 种设计特征被确定为既能支持员工的健康和幸福，又与 LTC 物理工作环境相关：结论：医疗机构在建造新设施或翻新现有设施时，应考虑使用这些促进健康的设计策略。促进健康的物质工作环境的好处包括改善员工的身心健康、减少职业倦怠和人员流动。减少职业倦怠和提高员工留任率对于缓解长期护理行业持续的人员危机至关重要。

{"title":"Designing LTC Physical Work Environments to Support Worker Well-being: A Review and Recommendations","authors":"Cedra M. Goldman MPH , Traci R. Rider PhD , Gwenith G. Fisher PhD , Angela L. Loder PhD , Natalie V. Schwatka PhD , Mike V. Van Dyke PhD","doi":"10.1016/j.jamda.2024.105326","DOIUrl":"10.1016/j.jamda.2024.105326","url":null,"abstract":"<div><h3>Objectives</h3><div>Well-designed, health-promoting physical work environments have the potential to reduce burnout and attrition for employees who work in long-term care (LTC) facilities. Unfortunately, there is limited existing guidance for LTC facility owners and operators related to specific health-promoting design strategies for LTC work environments. This narrative review aims to fill this knowledge gap.</div></div><div><h3>Methods</h3><div>Information was synthesized from healthy-building certification standards for health care and non–health care buildings, LTC design guidelines, academic studies, and expert commentaries. The review was conducted in 3 phases to (1) identify specific space types and design characteristics generally considered to be health-supportive, (2) gather existing research on the identified strategies to critically analyze their supportive value, and (3) communicate the findings to a broad audience of stakeholders.</div></div><div><h3>Results</h3><div>Five specific space types and 21 design characteristics were identified as both supportive of employee health and well-being, and relevant to LTC physical work environments.</div></div><div><h3>Conclusions</h3><div>When health care organizations construct new facilities or renovate existing facilities, using these health-promoting design strategies should be considered. Benefits of health-promoting physical work environments include better employee mental and physical health, less burnout, and less turnover. Reducing burnout and increasing employee retention is essential to mitigate the ongoing staffing crisis in the LTC industry.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 1","pages":"Article 105326"},"PeriodicalIF":4.2,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558114","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}

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