Journal of the American Medical Directors Association最新文献

{"title":"Interventions to Reduce Loneliness among Community-dwelling Older Adults: A Network Meta-analysis and Systematic Review","authors":"Yinghui Sun MD ,&nbsp;Haiyou Huang BM ,&nbsp;Guangyun Cai MD ,&nbsp;Jing Gu PhD ,&nbsp;Gordon K.L. Leung MD ,&nbsp;Yanxiao Gao PhD ,&nbsp;Samuel Y.S. Wong PhD ,&nbsp;Eliza L.Y. Wong PhD ,&nbsp;Winnie W.S. Mak PhD ,&nbsp;Timothy Kwok PhD ,&nbsp;Phoenix K.H. Mo PhD","doi":"10.1016/j.jamda.2024.105441","DOIUrl":"10.1016/j.jamda.2024.105441","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the effectiveness of interventions in reducing loneliness among community-dwelling older adults.</div></div><div><h3>Design</h3><div>A network meta-analysis (NMA) and systematic review.</div></div><div><h3>Setting and Participants</h3><div>Interventional studies were included if they contained original quantitative data on interventions to reduce loneliness among community-dwelling older adults. Qualitative studies were included if they contained views on loneliness coping strategies or intervention evaluation.</div></div><div><h3>Methods</h3><div>Six English databases and 3 Chinese databases were searched for studies published before August 2023. We extracted mean and standard deviation for the NMA to examine the overall effectiveness and efficacy of different interventions on loneliness. Thematic analysis was used to derive perspectives on coping strategies to mitigate loneliness.</div></div><div><h3>Results</h3><div>Forty-six quantitative studies with 6049 participants and 40 qualitative studies with 1095 participants were included in the analysis. The pooled effect size was large and significant [standardized mean difference (SMD), −0.95; 95% CI, −1.32 to −0.58; <em>P</em> &lt; .001], indicating a strong effect of interventions in reducing loneliness. Subgroup analyses revealed significant differences in effect sizes by study region and health risk. Results of the NMA suggested interventions seem to be most effective when having psychosocial interventions as the content, a combination of individual and group as the delivery mode, and a mixture of face-to-face and online methods as the contact mode. Findings of the qualitative synthesis revealed 2 main dimensions of activities for reducing loneliness, including delivery modes (individual or group or combination) and settings (indoor or outdoor or combination). Strategies for coping with loneliness at the social, cognitive, and behavioral levels were also identified.</div></div><div><h3>Conclusions and Implications</h3><div>The present study identified the most effective components of loneliness interventions in reducing loneliness among older adults. Findings offer important insights for practice and policy-making on potential strategies that can be used to reduce loneliness among community-dwelling older adults.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 3","pages":"Article 105441"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971543","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":"Shared Decision-Making on Tobacco Smoking by Older Adults Living in Residential Care Facilities: Care Professionals’ Perspectives","authors":"Lisette de Graaf MSc ,&nbsp;Tineke Roelofs PhD ,&nbsp;Meriam Janssen PhD ,&nbsp;Sascha Bolt PhD ,&nbsp;Katrien Luijkx PhD","doi":"10.1016/j.jamda.2024.105466","DOIUrl":"10.1016/j.jamda.2024.105466","url":null,"abstract":"<div><h3>Objectives</h3><div>Older adults with physical or cognitive disabilities may need to move to residential care facilities (RCFs). Some older adults smoke tobacco and become dependent on their care professionals to continue smoking. Care professionals need to balance an individual resident’s quality of life and well-being with the health and safety of all residents and staff. Shared decision-making (SDM) could support care professionals in these dilemmas. This study assesses multiple factors that could affect care professionals’ behavior and degree of SDM regarding residents’ tobacco use.</div></div><div><h3>Design</h3><div>We conducted quantitative cross-sectional research.</div></div><div><h3>Setting and Participants</h3><div>We included care professionals working in psychogeriatric and somatic units in Dutch RCFs.</div></div><div><h3>Methods</h3><div>Data were collected with an online or hard copy survey and analyzed with <em>t</em>-tests and regression analyses using SPSS.</div></div><div><h3>Results</h3><div>Care professionals’ positive attitudes toward residents’ tobacco use are significantly associated with a lower degree of SDM concerning this use and enabling residents to smoke more often. The degree of SDM regarding residents’ tobacco use is significantly positively associated with limiting residents’ tobacco use and the degree of person-centered care (PCC). Care professionals working in somatic units report a significantly higher degree of SDM regarding residents’ tobacco use compared with those working in psychogeriatric units.</div></div><div><h3>Conclusions and Implications</h3><div>Residents’ wish to smoke tobacco is a complex matter within RCFs. Care professionals’ attitudes cause inconsistencies in their behavior and the degree of SDM. Moreover, care professionals tend to use SDM more often when they need to limit residents’ use and cannot fulfill residents’ unhealthy habits, such as smoking tobacco. SDM could support care professionals to deal with dilemmas regarding residents’ tobacco use by including residents in decisions, regardless of the outcome. However, multiple factors affect care professionals’ behavior and the degree of SDM. Especially, their attitudes need to be addressed. SDM is further complicated by national acts and organizational policies.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 3","pages":"Article 105466"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143007530","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":"Urinary Catheterization Management in Older Adults with Hip Fracture: A Systematic Review","authors":"Stefano Cacciatore MD ,&nbsp;Maria Cristina Ferrara MD ,&nbsp;Maria Serena Iuorio MD ,&nbsp;Linda Dall’Olio MD ,&nbsp;Federico Bellelli MD ,&nbsp;Daniele Elmi MD ,&nbsp;Leonardo Bencivenga MD, PhD ,&nbsp;Caterina Trevisan MD, PhD ,&nbsp;Emanuele Marzetti MD, PhD ,&nbsp;Chukwuma Okoye MD, PhD","doi":"10.1016/j.jamda.2024.105410","DOIUrl":"10.1016/j.jamda.2024.105410","url":null,"abstract":"<div><h3>Objectives</h3><div>Urinary catheterization is a common procedure in the perioperative management of patients with hip fracture. However, decisions on its insertion or removal are often variable. This systematic review aimed to synthesize current evidence on urinary catheterization management in older patients with hip fracture by thoroughly reviewing the implementation of structured programs.</div></div><div><h3>Design</h3><div>Systematic review.</div></div><div><h3>Setting and Participants</h3><div>Older adults hospitalized for hip fracture.</div></div><div><h3>Methods</h3><div>Studies published until April 1, 2023, were retrieved from MEDLINE (PubMed interface), SCOPUS (Elsevier interface), and Cochrane Central Register of Controlled Trials (EBSCO interface). Observational and interventional studies investigating the use of urinary catheterization in older adults with hip fracture were included and corresponding data on structured programs and associated results were extracted. The quality assessment of the studies was performed using the Critical Appraisal Skills Programme tool.</div></div><div><h3>Results</h3><div>Of the 674 articles identified through the literature search, 16 studies were included. The mean ages in the 16 studies ranged from 67 to 86 years. Studies on the implementation of structured programs were few and heterogeneous. These studies identified 24 to 48 hours as the appropriate duration of postoperative catheterization; intermittent catheterization was associated with a lower incidence of complications.</div></div><div><h3>Conclusions and Implications</h3><div>Our review revealed a lack of standardized perioperative urinary catheterization management in older patients with hip fracture and uncovered the need for a tailored approach, which is crucial to improving the quality of care and outcomes in these patients.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105410"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829164","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":"Mitigating Deconditioning in Nursing Homes: A Feasibility and Acceptability Study of the PUSH Tool (Promoting the Autonomy through Exercise in Nursing Home)","authors":"Fanny Buckinx PhD,&nbsp;Valentine Libin MSc,&nbsp;Eva Peyrusqué PhD,&nbsp;Mylène Aubertin-Leheudre PhD,&nbsp;Olivier Bruyère PhD","doi":"10.1016/j.jamda.2024.105381","DOIUrl":"10.1016/j.jamda.2024.105381","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105381"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792048","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":"Financial Conflicts of Interest among Geriatrics Journal Editors in the United States","authors":"Anju Murayama,&nbsp;Yuji Yamada MD,&nbsp;Elizabeth S. Tarras MD,&nbsp;David-Dan Nguyen MD, MPH,&nbsp;Deborah C. Marshall MD, MAS","doi":"10.1016/j.jamda.2024.105426","DOIUrl":"10.1016/j.jamda.2024.105426","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105426"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907215","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":"Association between Potentially Inappropriate Medication and Mortality Risk in Older Adults: A Systematic Review and Meta-Analysis","authors":"Yue Zhou MSN,&nbsp;YuFan Pan MSN,&nbsp;Yi Xiao MSN,&nbsp;YuJian Sun MSN,&nbsp;Yu Dai MSN,&nbsp;YuFeng Yu MD","doi":"10.1016/j.jamda.2024.105394","DOIUrl":"10.1016/j.jamda.2024.105394","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to comprehensively assess the association between potentially inappropriate medication (PIM) and mortality risk in older adults through systematic review and meta-analysis.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Setting and Participants</h3><div>Adults aged 60 years and older with PIM use.</div></div><div><h3>Methods</h3><div>A systematic search was conducted in PubMed, Web of Science, Cochrane Library, Embase, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and China National Knowledge Infrastructure (CNKI) databases up to July 23, 2024. Studies assessing the association between PIM and the risk of death in older adults with sufficient data for meta-analysis were included. Effect sizes were combined using a random-effects model, and heterogeneity was systematically explored.</div></div><div><h3>Results</h3><div>A total of 44 studies involving 2,191,651 older adults were included. The overall PIM incidence was 45.7% (95% CI, 34.5%-57.0%). Meta-analysis revealed a combined odds ratio (OR) of 1.28 (95% CI, 1.20–1.36) for the association between PIM and increased risk of death. In addition, antipsychotics were associated with a higher risk of death (OR, 2.19; 95% CI, 1.75–2.73), as were anticholinergics (OR, 1.52; 95% CI, 1.23–1.88). Subgroup analyses indicated the association between PIM and death risk was particularly significant in Asia and Oceania, with a weaker association in North America and Europe. The strongest associations were found in individuals aged 70 years and older. The Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP) criteria had stronger associations than other diagnostic criteria for PIM.</div></div><div><h3>Conclusions and Implications</h3><div>This study confirms a significant association between PIM and mortality risk in older adults, highlighting the need for rational medication use. Clinicians should carefully assess medications in treatment plans. Future research should enhance assessment tools and investigate the impact of PIM on health outcomes to improve medication management.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105394"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801315","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":"Association Between Home-Base Primary Care and Postdischarge Outcomes Among Older Adults in Korea","authors":"Hyun Ji Lee MA ,&nbsp;Ae Jung Yoo PhD ,&nbsp;Hyo Jung Bang PhD ,&nbsp;Hyun-Kyung Park PhD ,&nbsp;Jae Woo Choi PhD","doi":"10.1016/j.jamda.2024.105415","DOIUrl":"10.1016/j.jamda.2024.105415","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the association between home-based primary care (HBPC) and postdischarge outcomes in Korean older adults.</div></div><div><h3>Design</h3><div>HBPC was a service that provided medical care by visiting the homes of older adults with limited mobility. In this study, data from the National Health Insurance Service (NHIS) were used, and groups with and without HBPC services were matched 1:1 through propensity score matching. Cox proportional hazards model and linear regression analysis were performed to compare the HBPC group with the control group.</div></div><div><h3>Setting and Participants</h3><div>Overall, 1580 older adults in Korea who used HBPC services after discharge from hospital and 1580 propensity score–matched older adults who did not use HBPC services were included.</div></div><div><h3>Methods</h3><div>For 30-day readmission, hospitalizations, and admission to long-term care hospitals or facilities after discharge, this study used a Cox proportional hazards regression model. And linear regression analysis was performed considering that the dependent variable was a continuous variable to examine the average total medical costs after discharge from acute hospital.</div></div><div><h3>Results</h3><div>Older adults who used HBPC services exhibited a lower risk of readmission for the same disease (risk reduction of 0.66, 95% CI 0.50, 0.87) and hospitalization (risk reduction of 0.58, 95% CI 0.46, 0.73) compared with those who did not use HBPC services. The annual average total medical cost was $4764 lower for older adults who used HBPC services than for those who did not (95% CI –6469.49, −3057.52). There was no significant difference in the risk of admission to long-term care hospitals or facilities.</div></div><div><h3>Conclusions and Implications</h3><div>HBPC services had a positive effect on reducing 30-day readmission due to the same disease, hospitalization, and annual average total medical costs among older adults after discharge.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105415"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846945","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":"Influence of the COVID-19 Pandemic on Influenza and SARS-CoV-2 Vaccination Willingness Among Dutch Nursing Home Health Care Workers","authors":"Lisa M. Kolodziej MD ,&nbsp;Kelly C. Paap MSc ,&nbsp;Laura W. van Buul PhD ,&nbsp;Sacha D. Kuil MD, PhD ,&nbsp;Cees M.P.M. Hertogh MD, PhD ,&nbsp;Menno D. de Jong MD, PhD","doi":"10.1016/j.jamda.2024.105420","DOIUrl":"10.1016/j.jamda.2024.105420","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the influenza and COVID-19 vaccination status among Dutch nursing home (NH) health care workers (HCWs), factors associated with vaccination including the influence of the pandemic, and the facilitators and barriers to vaccination willingness.</div></div><div><h3>Design</h3><div>An explanatory sequential mixed methods study.</div></div><div><h3>Setting and Participants</h3><div>HCWs providing direct care to residents in Dutch NHs.</div></div><div><h3>Methods</h3><div>An online questionnaire (September 2022) assessed vaccination status, barriers to vaccination, and the influence of the pandemic on influenza vaccination willingness. Facilitators and barriers to vaccination willingness were identified in 10 semistructured interviews and 1 focus group (February and September 2023).</div></div><div><h3>Results</h3><div>A total of 298 HCWs completed the questionnaire (87.5% women, 43.5% aged &gt; 50 years). Nearly all HCWs (94.0%) received the primary COVID-19 vaccination(s). Influenza vaccination coverage was 41.7% prepandemic, 56.4% in 2021-2022, and 54.7% of the HCWs intended to receive an influenza vaccination in 2022-2023. Perceived urgency was identified as an important reason for the increased influenza vaccination coverage during the pandemic and for the difference between COVID-19 and influenza vaccination willingness. We identified knowledge gaps and (dis-)beliefs regarding vaccine efficacy, the role of preventive measures, and the role of the own immune system. Facilitators to vaccination willingness included addressing practical issues (eg, flexible scheduling, on-site vaccine provision).</div></div><div><h3>Conclusions and Implications</h3><div>The influence of the pandemic on influenza vaccination willingness among Dutch NH HCWs appears to be temporary, underscoring the importance of addressing practical barriers to vaccine access. Concerns about the added value of vaccinations relative to trust in one's immune system or health and other preventive measures should be addressed in strategies aimed at optimizing vaccination uptake. To achieve this, a foundation of trust must first be created by neutral and factual communication and education.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105420"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872416","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":"Nursing Home Staffing Levels and Resident Health Outcomes: Is the Role of the Physical Therapist Undervalued?","authors":"Abubakar Sadiq Bouda Abdulai PhD, MA, MSc","doi":"10.1016/j.jamda.2024.105422","DOIUrl":"10.1016/j.jamda.2024.105422","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the relationship between nursing home staffing levels and excess outpatient emergency department (ED) visits by residents.</div></div><div><h3>Study Design</h3><div>A retrospective analysis of nursing home facility–level data.</div></div><div><h3>Setting and Participants</h3><div>A total of 14,860 Medicare- and Medicaid-certified long-term care facilities in the United States.</div></div><div><h3>Methods</h3><div>Using publicly available data from the Centers for Medicare and Medicaid Services database for the period October 1, 2022, to September 30, 2023, we used linear regression analysis to assess the association between facility-level rates of excess outpatient emergency department (ED) visits by residents and staffing hours per resident per day for physical therapists, registered nurses, nurse aides, and licensed practical nurses, controlling for other facility characteristics.</div></div><div><h3>Results</h3><div>For long-stay residents, an increase in physical therapist (PT) hours per resident per day was negatively associated with excess ED utilization (−0.58 per 1000; 95% CI, −0.91 to −0.25; <em>P</em> &lt; .001). Similarly, registered nurse (RN) hours per resident per day were significantly associated with a decrease in excess ED utilization (−0.27 per 1000; 95% CI, −0.35 to −0.19; <em>P</em> &lt; .001).</div><div>For short-stay residents, although RN hours showed a significant negative association (−0.69%; 95% CI, −1.03 to −0.35; <em>P</em> &lt; .001), PT hours did not reach statistical significance (−0.88%; 95% CI, −2.36 to 0.60). Nurse aide and licensed practical nurse hours did not significantly correlate with excess visits for long- and short-stay residents.</div></div><div><h3>Conclusions and Implications</h3><div>The findings underscore the significance of an optimal combination of nursing home staff to reduce excess outpatient ED visits, particularly for long-stay residents. They point to the need for policy measures that promote balanced staffing levels across different roles to effectively minimize excess outpatient ED visits by residents.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105422"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872418","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":"Accuracy of Ultrasound Measurements of Muscle Thickness in Identifying Older Patients With Sarcopenia and Its Impact on Frailty: A Systematic Review and Meta-Analysis","authors":"Fengxue Yang MPH ,&nbsp;Linfang Zhu MSc ,&nbsp;Bing Cao MMed ,&nbsp;Li Zeng MMed ,&nbsp;Zhongqing Yuan MMed ,&nbsp;Yi Tian PhD, MD ,&nbsp;Yuanting Li MSN ,&nbsp;Xiaoshan Chen BSc","doi":"10.1016/j.jamda.2024.105419","DOIUrl":"10.1016/j.jamda.2024.105419","url":null,"abstract":"<div><h3>Objectives</h3><div>The aim of this systematic review was to assess the diagnostic test accuracy of muscle ultrasound for identifying older patients with sarcopenia and to investigate its association with frailty.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis of observational studies. Comprehensive searches were conducted in PubMed, MEDLINE, Cochrane Library, Scopus, and Embase through October 2024.</div></div><div><h3>Setting and Participants</h3><div>Clinical and community settings across 7 countries, with 2537 adults aged ≥65 years.</div></div><div><h3>Methods</h3><div>Two reviewers assessed study quality using QUADAS-2. Data on participant characteristics, ultrasound methods, and diagnostic outcomes were extracted. Pooled sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operating characteristic (SROC) curve were calculated with a random-effects model. Sensitivity analyses ensured robustness.</div></div><div><h3>Results</h3><div>Pooled sensitivity was 0.85 (95% CI, 0.78–0.93), specificity was 0.74 (95% CI, 0.65–0.81), DOR was 16.65 (95% CI, 4.90–96.67), and SROC-area under the curve was 0.87, indicating moderate to high diagnostic accuracy. Association with frailty yielded an odds ratio of 7.91 (95% CI, 6.15–10.17). Most studies received an \"unclear\" rating in several QUADAS-2 domains, especially in patient selection and reference standards, indicating limitations in study design that may impact the generalizability of results.</div></div><div><h3>Conclusions and Implications</h3><div>Ultrasound is a reliable, noninvasive, and cost-effective tool for diagnosing sarcopenia in older patients. Further research should standardize cutoffs and explore integration with other methods.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 2","pages":"Article 105419"},"PeriodicalIF":4.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854274","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}