Journal of the American Medical Directors Association最新文献

{"title":"Clinician Perspectives on Supporting Advance Care Planning in Long-Term Care Homes","authors":"George A. Heckman MD, MSc, Anooshah Nasim BSc, Heather Keller PhD, Patrick Quail MD, Clare Ramsey MD, Veronique Boscart RN, PhD, Allan Garland MD","doi":"10.1016/j.jamda.2024.105303","DOIUrl":"10.1016/j.jamda.2024.105303","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 12","pages":"Article 105303"},"PeriodicalIF":4.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468547","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":"Associations of Regular Internet Usage with All-Cause and Cause-Specific Mortality: A Prospective Cohort Study","authors":"Cheng-Shen Qiu MD ,&nbsp;Xu-Lian Tang MD ,&nbsp;Hong-Min Li MD ,&nbsp;Dan-Qing Liao MD ,&nbsp;Han-Qing Chen MD ,&nbsp;Li-Ying Du MD ,&nbsp;Hong-Xuan Huang MD ,&nbsp;Shu-Min Lai MD ,&nbsp;Peng Ran PhD ,&nbsp;Zhi-Yuan Xiong MD ,&nbsp;Yan-Qiu Ou PhD ,&nbsp;Hao-Jian Dong PhD ,&nbsp;Zhi-Hao Li PhD","doi":"10.1016/j.jamda.2024.105301","DOIUrl":"10.1016/j.jamda.2024.105301","url":null,"abstract":"<div><h3>Objectives</h3><div>The impact of internet usage on mortality is not widely known. This study intended to investigate the associations between regular internet usage and the risks of all-cause and cause-specific mortality, while also ascertaining potential factors that may modify these correlations.</div></div><div><h3>Design</h3><div>A community-based prospective cohort study.</div></div><div><h3>Setting and Participants</h3><div>The study included 21,481 individuals [mean (SD) age, 64.1 (11.0) years] from the Health and Retirement Study, with data collected between 2006 and 2020.</div></div><div><h3>Methods</h3><div>The Cox proportional hazards regression model was used to evaluate the associations between regular internet usage and the risks of all-cause and cause-specific mortality, adjusting for demographic factors, lifestyle behaviors, and other potential confounding factors. Moreover, we explored the association between daily hours of internet usage and the risk of outcomes.</div></div><div><h3>Results</h3><div>Regular internet usage was significantly associated with a lower risk of all-cause mortality (hazard ratio, 0.78; 95% CI, 0.74-0.83) and cardiovascular mortality (hazard ratio, 0.72; 95% CI, 0.64-0.82). No significant interaction effects were observed for age, sex, regular exercise, or current alcohol consumption (all <em>P</em> interactions &gt; .05). Additionally, estimations for daily hours of usage indicated a U-shaped relationship with all-cause mortality. Adults who used 2.1 to 4 hours per day had the lowest risk; however, not all estimations showed their significance on account of the limited sample size.</div></div><div><h3>Conclusions and Implications</h3><div>Regular internet usage was associated with a lower risk of all-cause and cardiovascular mortality, which may prompt consideration of the beneficial impact of internet usage on lifespan.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 12","pages":"Article 105301"},"PeriodicalIF":4.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468545","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":"Clinical Practice Guideline for Diabetes Management in the Post-Acute and Long-Term Care Setting","authors":"H. Edward Davidson PharmD, MPH ,&nbsp;Sakshi Jain MD ,&nbsp;Carolyn Kazdan NHA, BCPA ,&nbsp;Barbara Resnick PhD, CRNP, FAAN, FAANP ,&nbsp;Tiziano Scarabelli MD, PhD, FACP, FAHA, FACC ,&nbsp;Naushira Pandya MD, CMD","doi":"10.1016/j.jamda.2024.105342","DOIUrl":"10.1016/j.jamda.2024.105342","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 11","pages":"Article 105342"},"PeriodicalIF":4.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468571","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":"Clinical Decision Support Systems Highlight Medication Risks for Hospitalized Older Patients","authors":"Pamela Euzebio BScPharm,,&nbsp;Patricia Carvalho Baruel Okumura BScPharm,&nbsp;Fábio de Cerqueira Lario MD, PhD,&nbsp;Christian Valle Morinaga MD, PhD,&nbsp;Pedro Kallas Curiati MD, PhD","doi":"10.1016/j.jamda.2024.105302","DOIUrl":"10.1016/j.jamda.2024.105302","url":null,"abstract":"","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 12","pages":"Article 105302"},"PeriodicalIF":4.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468546","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 Place of Death among Individuals with Huntington's Disease in the United States","authors":"Amy C. Ogilvie PhD ,&nbsp;Connie S. Cole PhD, DNP ,&nbsp;Benzi M. Kluger MD ,&nbsp;Hillary D. Lum MD, PhD","doi":"10.1016/j.jamda.2024.105304","DOIUrl":"10.1016/j.jamda.2024.105304","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe trends and identify factors associated with place of death among individuals with Huntington's disease (HD).</div></div><div><h3>Design</h3><div>Retrospective cohort of deceased individuals with HD from the Centers for Disease Control and Prevention's National Center for Health Statistics.</div></div><div><h3>Setting and Participants</h3><div>A total of 13,350 individuals with HD who died in the United States between 2009 and 2019.</div></div><div><h3>Methods</h3><div>We analyzed place of death, categorized as long-term care (LTC) facility, home, hospital, hospice facility, and other locations. Trends in the places of death from 2009 to 2019 were assessed using linear regression models. Multivariate logistic regression models were used to identify sociodemographic factors associated with place of death.</div></div><div><h3>Results</h3><div>From 2009 to 2019, the greatest proportion of deaths occurred in LTC facilities (48.4%). There was a significantly decreasing trend in the proportion of deaths occurring in LTC facilities (53.5%–43.9%, <em>P</em> &lt; .001). A greater proportion of deaths in rural areas occurred in LTC facilities compared with all other locations (<em>P</em> &lt; .001 for all comparisons). In the multivariate model, aged younger than 44 years, Black race, Hispanic ethnicity, some college education or greater, and being married were associated with significantly lower odds of dying in a LTC facility compared with home.</div></div><div><h3>Conclusions and Implications</h3><div>Despite a decreasing trend, LTC facilities remain a cornerstone of support for individuals with HD, particularly in rural areas. These results suggest multiple avenues for research to improve accessibility and quality of care for individuals with late stages of HD. Future studies are needed to further understand the impact of rurality and lack of support in the home on the accessibility and quality of LTC and hospice care for individuals with HD. These results may also help inform interventions focused on training and staff education within LTC and hospice facilities to better manage HD progression and symptoms.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"26 1","pages":"Article 105304"},"PeriodicalIF":4.2,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468550","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":"Navigating Dilemmas on Advance Euthanasia Directives of Patients with Advanced Dementia","authors":"Djura O. Coers MD ,&nbsp;Eefje M. Sizoo MD, PhD ,&nbsp;Maryam Bloemen MD ,&nbsp;Marike E. de Boer PhD ,&nbsp;Agnes van der Heide PhD ,&nbsp;Cees M.P.M. Hertogh MD, PhD ,&nbsp;Carlo J.W. Leget PhD ,&nbsp;Trynke Hoekstra PhD ,&nbsp;Martin Smalbrugge MD, PhD","doi":"10.1016/j.jamda.2024.105300","DOIUrl":"10.1016/j.jamda.2024.105300","url":null,"abstract":"<div><h3>Objectives</h3><div>This study revisited the complexities faced by physicians in meeting due care criteria for euthanasia in patients with advanced dementia in The Netherlands. Despite increasing cases and legal provisions for advance euthanasia directives (AEDs), physicians encounter challenges with ethical issues, including patient communication and assessing unbearable suffering in patients who lack decisional capacity. This study examines the perspectives of elderly care physicians (ECPs), support and consultation on euthanasia in The Netherlands (SCEN) physicians, and euthanasia expertise center (EEC) physicians.</div></div><div><h3>Design</h3><div>A multimethod descriptive study using a questionnaire with both closed and open-ended questions.</div></div><div><h3>Setting and Participants</h3><div>This study explores the complexities faced by physicians in handling AED-based euthanasia requests of patients with advanced dementia.</div></div><div><h3>Methods</h3><div>Baseline characteristics of physician subgroups were analyzed descriptively, and subgroup variations were assessed using univariate regression. Qualitative data underwent thematic content analysis.</div></div><div><h3>Results</h3><div>With a 13.8% response rate, the study included 290 participants: 108 ECPs, 188 SCEN physicians, and 53 EEC physicians. Some had combined roles: ECP and SCEN physicians (n = 29), ECP and EEC physician (n = 1), SCEN physicians and EEC physicians (n = 17), and ECP, SCEN physicians, and EEC physicians (n = 6). ECPs received most AED-based euthanasia requests but only 7 EEC physicians and 1 SCEN physician performed euthanasia. All subgroups stressed the importance of patient communication. ECPs found euthanasia ethically justifiable only when communication was possible, highlighting the need to understand current euthanasia wishes and verify unbearable suffering. Effective communication was deemed crucial for confirming request relevance, identifying obstacles, involving patients, fostering trust, and alleviating fears. Physicians generally agreed that unbearable suffering could be assessed through patient expressions, observations, and family input.</div></div><div><h3>Conclusions and Implications</h3><div>Despite receiving AED-based euthanasia requests, few physicians proceeded. Subgroup analysis showed varying views, with ECPs emphasizing communication and EEC physicians focusing on determining unbearable suffering. All subgroups highlighted the importance of current patient expressions and involvement in the decision-making process.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 12","pages":"Article 105300"},"PeriodicalIF":4.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468553","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":"The Effect of Sleep Duration and Excessive Daytime Sleepiness on All-Cause Dementia: A Longitudinal Analysis from the Hunter Community Study","authors":"Kay Khaing MMed,&nbsp;Xenia Dolja-Gore PhD,&nbsp;Balakrishnan R. Nair MD,&nbsp;Julie Byles PhD,&nbsp;John Attia PhD","doi":"10.1016/j.jamda.2024.105299","DOIUrl":"10.1016/j.jamda.2024.105299","url":null,"abstract":"<div><h3>Objectives</h3><div>It has been proposed that abnormal sleep duration and excessive daytime sleepiness might be risk factors for dementia. This study assessed the interaction between sleep duration and excessive daytime sleepiness, and the effect of sleep duration in the presence or absence of excessive daytime sleepiness on dementia risk in community-dwelling older adults.</div></div><div><h3>Design</h3><div>A longitudinal study.</div></div><div><h3>Setting and Participants</h3><div>Data from 2187 community-dwelling participants with mean age 70 years from the Hunter Community Study were included in this study.</div></div><div><h3>Methods</h3><div>Participants were classified as participants with long sleep duration (slept &gt;8 hours per night), recommended sleep duration (7–8 hours) as per the National Sleep Foundation, or short sleep duration (slept &lt;7 hours per night). The Berlin Questionnaire was used to identify excessive daytime sleepiness. Dementia was defined as per International Classification of Diseases, 10^th Revision codes. To calculate all-cause dementia risk, the Fine-Gray sub-distribution hazard model was computed with death as a competing risk.</div></div><div><h3>Results</h3><div>Over a mean follow-up of 6 years, 64 participants developed dementia and 154 deaths were identified. The average onset of dementia was 5.4 years. Long sleep duration was associated with increased dementia risk only in the presence of excessive daytime sleepiness (adjusted hazard ratio, 2.86; 95% confidence interval 1.03–7.91). A statistically significant interaction was found between excessive daytime sleepiness and sleep duration for all-cause dementia.</div></div><div><h3>Conclusions and Implications</h3><div>Long sleep duration with excessive daytime sleepiness was associated with increased risk of all-cause dementia. This suggests the importance of promoting awareness of healthy sleep and the possible role of nurturing good quantity and quality sleep in reducing the risk of dementia.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 12","pages":"Article 105299"},"PeriodicalIF":4.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468570","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":"Depressive Signs and Daily Life of Residents When Relocating from a Regular to an Innovative Nursing Home","authors":"Mara Brouwers MSc ,&nbsp;Bram de Boer PhD ,&nbsp;Wim G. Groen PhD ,&nbsp;Andrea Gabrio PhD ,&nbsp;Hilde Verbeek PhD","doi":"10.1016/j.jamda.2024.105298","DOIUrl":"10.1016/j.jamda.2024.105298","url":null,"abstract":"<div><h3>Objectives</h3><div>In this study, we examine how residents are affected by moving from a regular nursing home into an innovative living arrangement. In the past decade, a culture change has taken place, leading to rapid developments of innovative living arrangements that aim to change the physical, social, and organizational environment to better suit the needs of older adults needing 24-hour care. This has inevitably led to more group relocations in long-term care. Insight into the change in residents when relocating is lacking.</div></div><div><h3>Design</h3><div>An observational longitudinal study.</div></div><div><h3>Setting and Participants</h3><div>Four Dutch care organizations in which 5 relocations took place from a regular to an innovative living arrangement. Residents (N = 97) requiring 24-hour care who were relocated from a regular nursing home to an innovative living arrangement were included.</div></div><div><h3>Methods</h3><div>Data were collected 1 month before, 2 weeks after, and 6 months after relocating. Depressive signs and symptoms, cognitive functioning, and dependence in activities of daily living were measured using questionnaires. Furthermore, the daily lives of the residents were assessed using ecological momentary assessments.</div></div><div><h3>Results</h3><div>Overall, no long-term change in depressive signs and symptoms, cognitive functioning, and dependence in activities of daily living was found when relocating. Furthermore, the daily life of residents was not different 6 months after moving. Relocating was accompanied by a significant short-term increase in depressive signs and symptoms in 2 out of 4 locations (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions and Implications</h3><div>This study shows that relocating to an innovative living arrangement does not lead to long-term changes in residents. There are indications that there might be a short-term change in depressive signs and symptoms that could be prevented by considering the approach and context. More research is needed into the changes in the physical, social, and organizational environment that are necessary for a positive impact on the daily lives of residents.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 12","pages":"Article 105298"},"PeriodicalIF":4.2,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468549","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":"Effect of Simple Swallowing Training Program on Early Oropharyngeal Dysphagia in Community-Dwelling Older Adults: A Randomized Controlled Study","authors":"Hongji Zeng MMed ,&nbsp;Weijia Zhao MMed ,&nbsp;Rui Wang MMed ,&nbsp;Shufan Wei MMed ,&nbsp;Xin'ao Wang MMed ,&nbsp;Siyu Luo MMed ,&nbsp;Heping Li MD ,&nbsp;Liugen Wang MD ,&nbsp;Xi Zeng MD","doi":"10.1016/j.jamda.2024.105297","DOIUrl":"10.1016/j.jamda.2024.105297","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;Oropharyngeal dysphagia (OD) in community-dwelling older adults continues to be a challenge due to its insidious onset. This study developed a simple swallowing training program (SSTP) to address these issues and conducted a randomized controlled trial to explore its effect on swallowing function and quality of life.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Two-arm randomized controlled trial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting: and Participants&lt;/h3&gt;&lt;div&gt;A total of 248 community-dwelling older adults with OD from were included in 2024 and randomly divided into intervention and control groups.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;The SSTP was developed through expert consultation. A total of 248 community-dwelling older adults with OD were included in 2024 and randomly divided into intervention and control groups. The intervention group underwent the SSTP twice daily for 21 days, with weekends off, and the control group participants did light physical activities by themselves. The primary outcome was the Gugging Swallowing Screen (GUSS), and the secondary outcomes were the Eating Assessment Tool-10 (EAT-10), Swallowing Quality of Life questionnaire (SWAL-QoL), maximum tongue pressure, masticatory ability, bite force, and meal duration. Assessments were conducted on days 1 and 21, while meal duration was assessed every 3 days for lunch.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Twenty-seven participants withdrew halfway. There were no significant differences in baseline assessments (&lt;em&gt;P&lt;/em&gt; &gt; .05). There were significant between-group and interactive effects in the GUSS [(19.07 ± 1.38) vs (17.28 ± 2.17), F&lt;sub&gt;between-group&lt;/sub&gt; = 6.893, &lt;em&gt;P&lt;/em&gt;&lt;sub&gt;between-group&lt;/sub&gt; = .009, F&lt;sub&gt;interactive&lt;/sub&gt; = 59.504, &lt;em&gt;P&lt;/em&gt;&lt;sub&gt;interactive&lt;/sub&gt;&lt;.001], EAT-10 {[4.00 (3.00, 5.00)] vs [9.00 (7.00, 10.00)], z&lt;sub&gt;between-group&lt;/sub&gt; = −3.502, &lt;em&gt;P&lt;/em&gt;&lt;sub&gt;between-group&lt;/sub&gt;&lt;.001; z&lt;sub&gt;interactive&lt;/sub&gt; = −6.252, &lt;em&gt;P&lt;/em&gt;&lt;sub&gt;interactive&lt;/sub&gt;&lt;.001}, SWAL-QoL {[166.00 (163.00, 171.50)] vs [154.00 (150.00, 158.00)], z&lt;sub&gt;between-group&lt;/sub&gt; = 2.681, &lt;em&gt;P&lt;/em&gt;&lt;sub&gt;between-group&lt;/sub&gt; = .007; z&lt;sub&gt;interactive&lt;/sub&gt; = 5.475, &lt;em&gt;P&lt;/em&gt;&lt;sub&gt;interactive&lt;/sub&gt;&lt;.001}, maximum tongue pressure {[33.10 (26.48, 36.86)] vs [28.85 (19.21, 35.77)], z&lt;sub&gt;between-group&lt;/sub&gt; = 3.377, &lt;em&gt;P&lt;/em&gt;&lt;sub&gt;between-group&lt;/sub&gt; = .001; z&lt;sub&gt;interactive&lt;/sub&gt; = −6.208, &lt;em&gt;P&lt;/em&gt;&lt;sub&gt;interactive&lt;/sub&gt;&lt;.001}, masticatory ability {[176.92 (133.10, 212.91) vs [163.33 (116.66, 189.32)], z&lt;sub&gt;between-group&lt;/sub&gt; = 4.801, &lt;em&gt;P&lt;/em&gt;&lt;sub&gt;between-group&lt;/sub&gt;&lt;.001; z&lt;sub&gt;interactive&lt;/sub&gt; = 6.979, &lt;em&gt;P&lt;/em&gt;&lt;sub&gt;interactive&lt;/sub&gt;&lt;.001}. Between-group, time, and interactive effects were significant in the meal duration [(23.39 ± 4.32) vs (27.64 ± 5.63), F&lt;sub&gt;between-group&lt;/sub&gt; = 8.692, &lt;em&gt;P&lt;/em&gt;&lt;sub&gt;between-group&lt;/sub&gt; = .004, F&lt;sub&gt;time&lt;/sub&gt; = 138.683, &lt;em&gt;P&lt;/em&gt;&lt;sub&gt;time&lt;/sub&gt;&lt; 0.001, &lt;em&gt;P&lt;/em&gt;&lt;sub&gt;interactive&lt;/sub&gt; = 73.196, &lt;e","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 12","pages":"Article 105297"},"PeriodicalIF":4.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406550","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":"Effectiveness of Horticultural Therapy in Older Adults without Dementia: A Systematic Review and Meta-Analysis","authors":"Thuy Anh Giang MSc ,&nbsp;Jing Ying Cheng BSN (Hons), RN ,&nbsp;Hannah Yi Fang Kwok ,&nbsp;Gabriel Ming Shao Hay MBBS ,&nbsp;Jonathan Ern Juan Koh ,&nbsp;Faisal Johandi MMED ,&nbsp;Tau Ming Liew PhD ,&nbsp;Davynn Gim Hoon Tan PhD ,&nbsp;Philip Lin Kiat Yap MBBS ,&nbsp;Shiou Liang Wee PhD ,&nbsp;Ling Jie Cheng MPH, BSN(Hons), RN","doi":"10.1016/j.jamda.2024.105296","DOIUrl":"10.1016/j.jamda.2024.105296","url":null,"abstract":"<div><h3>Objectives</h3><div>Horticultural therapy (HT) has garnered growing interest because of its psychological and physical benefits. Previous reviews have demonstrated its therapeutic effects in older adults with cognitive impairment or mental illnesses. However, its impact on older adults without dementia has not been synthesized. This systematic review studied the effects of HT on the physical and psychosocial functions of older adults without dementia.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis.</div></div><div><h3>Settings and Participants</h3><div>Older adults without dementia ≥60 years of age.</div></div><div><h3>Methods</h3><div>Randomized controlled trials and quasi-experimental studies were systematically searched in 7 databases. The Cochrane Risk of Bias Tool version 2 and the Risk of Bias in Non-randomized Studies of Interventions tool were used to assess study quality. A random-effects meta-analysis with Hedges' <em>g</em> was conducted to estimate the effect size, and Cochran's <em>Q</em> test and <em>I</em>² were used to evaluate heterogeneity. The Grading of Recommendations Assessment, Development, and Evaluation approach was applied to determine the overall quality of evidence.</div></div><div><h3>Results</h3><div>Twenty-seven studies, including 11 randomized controlled trials and 16 quasi-experimental studies comprising 1629 older adults from 11 countries, were included. HT tended to improve psychosocial outcomes in older adults, particularly in terms of self-efficacy (<em>g</em> = 0.52; 95% CI, 0.26-0.79) and self-esteem (<em>g</em> = 0.52; 95% CI, 0.26-0.79). In terms of physical benefits, HT appeared to have a greater impact on aerobic endurance, with a large effect size (g = 0.84; 95% CI, 0.54-1.15), compared to agility, which showed a smaller effect size (g = 0.45; 95% CI, −0.90 to −0.01).</div></div><div><h3>Conclusions and Implications</h3><div>This review demonstrated that HT could provide psychosocial and physical benefits to older adults without dementia. These benefits include slight improvements in self-efficacy, self-esteem, aerobic endurance, and agility. However, the certainty of this evidence is very low due to the quasi-experimental design and potential bias in outcome measurements. Further research with well-designed clinical trials is necessary to confirm its effectiveness.</div></div>","PeriodicalId":17180,"journal":{"name":"Journal of the American Medical Directors Association","volume":"25 12","pages":"Article 105296"},"PeriodicalIF":4.2,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142406551","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}