Pub Date : 2024-11-01Epub Date: 2023-06-19DOI: 10.1111/jgs.18484
Rachel Shapin
{"title":"Reflections on Lonely, Single and Over 50? China has a Game Show for That.","authors":"Rachel Shapin","doi":"10.1111/jgs.18484","DOIUrl":"10.1111/jgs.18484","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9717325","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}
<p>It is once again with great pleasure that we introduce the research work to be presented at the 2024 Chinese Congress on Gerontology and Health Industry (CCGI), which is published in abstract form in this issue of the Journal of the American Geriatrics Society (JAGS). The 2024 CCGI conference is the continuation of the annual national geriatrics and gerontology conference co-organized and co-sponsored by a number of major Chinese professional healthcare organizations including the Chinese Medical Association (CMA) Geriatrics Branch and China Health Promotion Foundation. This year's CCGI conference will be held on November 1–3. 2024 in the city of Haikou, China's island province Hainan. We have 115 quality abstracts to be included in this issue.</p><p>While COVID-19 pandemic is largely behind us, its impact on world economy and scientific conferences continues to be palpable. The current economic downturn and overseas regional conflicts create additional challenges. Despite these difficulties, the 2024 CCGI conference will be held in person and the research work to be presented at the conference is as robust as that presented at previous years' CCGI conferences. Similar to the previous 11 years, the work to be presented at this year's CCGI conference encompasses many important areas of geriatrics and gerontology, from basic aging research to geriatric syndromes; from clinical observation and large epidemiological studies to clinical trials; and from biological investigations to social and behavioral research. Unique to this year, it emphasizes palliative care, cardiovascular aging and diseases, systems approach for senior health, as well as socioeconomic determinants of aging care. It also includes a broad range of studies of basic and translational aging research, such as investigation into chronic cytomegalovirus (CMV) infection as a potential contributing factor to immunosenescence and age-related chronic inflammation, longitudinal cohort studies, mechanistic studies in animal models, and other types of studies including clinical trials for the prevention and treatment of common geriatric syndromes and age-related diseases. Moreover, almost 20% of the abstracts are submitted by researchers from other countries and regions including the United States, European countries (Germany, UK), South Korea, Macao, etc., demonstrating a robust international representation. The work described here will be presented in the form of oral presentation or poster at the conference. The conference will have similar number of symposia with individual symposium on translational aging research, common geriatric syndromes, prevention, rehabilitation, nutrition, geriatric nursing, traditional Chinese medicine, community geriatrics care, and long-term care, and so on. Publication of such exemplary work in geriatrics and gerontology in this supplement issue of JAGS will further enhance scientific and scholarly exchanges between colleagues in China and geriatrics and g
{"title":"Introduction for the 2024 Chinese Congress on Gerontology and Health Industry (CCGI) Abstracts","authors":"Sean X. Leng MD, PhD, Xiao-Ying Li MD","doi":"10.1111/jgs.19221","DOIUrl":"10.1111/jgs.19221","url":null,"abstract":"<p>It is once again with great pleasure that we introduce the research work to be presented at the 2024 Chinese Congress on Gerontology and Health Industry (CCGI), which is published in abstract form in this issue of the Journal of the American Geriatrics Society (JAGS). The 2024 CCGI conference is the continuation of the annual national geriatrics and gerontology conference co-organized and co-sponsored by a number of major Chinese professional healthcare organizations including the Chinese Medical Association (CMA) Geriatrics Branch and China Health Promotion Foundation. This year's CCGI conference will be held on November 1–3. 2024 in the city of Haikou, China's island province Hainan. We have 115 quality abstracts to be included in this issue.</p><p>While COVID-19 pandemic is largely behind us, its impact on world economy and scientific conferences continues to be palpable. The current economic downturn and overseas regional conflicts create additional challenges. Despite these difficulties, the 2024 CCGI conference will be held in person and the research work to be presented at the conference is as robust as that presented at previous years' CCGI conferences. Similar to the previous 11 years, the work to be presented at this year's CCGI conference encompasses many important areas of geriatrics and gerontology, from basic aging research to geriatric syndromes; from clinical observation and large epidemiological studies to clinical trials; and from biological investigations to social and behavioral research. Unique to this year, it emphasizes palliative care, cardiovascular aging and diseases, systems approach for senior health, as well as socioeconomic determinants of aging care. It also includes a broad range of studies of basic and translational aging research, such as investigation into chronic cytomegalovirus (CMV) infection as a potential contributing factor to immunosenescence and age-related chronic inflammation, longitudinal cohort studies, mechanistic studies in animal models, and other types of studies including clinical trials for the prevention and treatment of common geriatric syndromes and age-related diseases. Moreover, almost 20% of the abstracts are submitted by researchers from other countries and regions including the United States, European countries (Germany, UK), South Korea, Macao, etc., demonstrating a robust international representation. The work described here will be presented in the form of oral presentation or poster at the conference. The conference will have similar number of symposia with individual symposium on translational aging research, common geriatric syndromes, prevention, rehabilitation, nutrition, geriatric nursing, traditional Chinese medicine, community geriatrics care, and long-term care, and so on. Publication of such exemplary work in geriatrics and gerontology in this supplement issue of JAGS will further enhance scientific and scholarly exchanges between colleagues in China and geriatrics and g","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19221","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549854","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":"Abstracts for JGS Chinese Supplement","authors":"","doi":"10.1111/jgs.19222","DOIUrl":"10.1111/jgs.19222","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.19222","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549855","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}
Rachel O'Conor PhD, MPH, Andrea M. Russell PhD, Allison Pack PhD, MPH, Dianne Oladejo BA, Sarah Filec MPH, Emily Rogalski PhD, Darby Morhardt PhD, Lee A. Lindquist MD, MPH, MBA, Michael S. Wolf PhD, MPH
Cover caption: Summary of Medication Management Responsibilities by Severity of Cognitive Impairment. For full details, see “Managing medications among individuals with mild cognitive impairment and dementia: Patient-caregiver perspectives” on page 3011.
{"title":"Cover","authors":"Rachel O'Conor PhD, MPH, Andrea M. Russell PhD, Allison Pack PhD, MPH, Dianne Oladejo BA, Sarah Filec MPH, Emily Rogalski PhD, Darby Morhardt PhD, Lee A. Lindquist MD, MPH, MBA, Michael S. Wolf PhD, MPH","doi":"10.1111/jgs.17872","DOIUrl":"https://doi.org/10.1111/jgs.17872","url":null,"abstract":"<p><b>Cover caption</b>: Summary of Medication Management Responsibilities by Severity of Cognitive Impairment. For full details, see “Managing medications among individuals with mild cognitive impairment and dementia: Patient-caregiver perspectives” on page 3011.\u0000\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":4.3,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.17872","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142429507","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}
BACKGROUNDThe incidence and prevalence of dementia, and thus dementia-related behavioral and psychological symptoms, are increasing significantly. Currently, there are limited safe and efficacious options for treating these symptoms. Dexmedetomidine has been used for agitation related to delirium and showed significant benefit in prior studies. This raises the question whether dexmedetomidine could also provide a safe and effective treatment for BPSD, including agitation related to dementia.METHODSOur team searched PubMed, Cochrane Database, and Ovid with the terms dexmedetomidine and dementia. Only studies published in English language journals, or with official English language translations, and human studies were included. All reports of dexmedetomidine for dementia were included regardless of study type.RESULTSNo completed studies on dexmedetomidine for agitation in dementia were identified. The TRANQUILITY study is in progress, although results are yet to be published.CONCLUSIONDexmedetomidine has shown benefit for hospital delirium and for agitation in schizophrenia and bipolar disorder. However, there are no completed studies published on dexmedetomidine for agitation in dementia. Controlled studies with larger sample sizes are needed to assess the efficacy, safety, and the best route of administration for this drug in managing BPSD including agitation.
{"title":"Dexmedetomidine for agitation in dementia: Current data and future direction.","authors":"Kayla S Murphy,Julia C Golden,Rajesh R Tampi","doi":"10.1111/jgs.19196","DOIUrl":"https://doi.org/10.1111/jgs.19196","url":null,"abstract":"BACKGROUNDThe incidence and prevalence of dementia, and thus dementia-related behavioral and psychological symptoms, are increasing significantly. Currently, there are limited safe and efficacious options for treating these symptoms. Dexmedetomidine has been used for agitation related to delirium and showed significant benefit in prior studies. This raises the question whether dexmedetomidine could also provide a safe and effective treatment for BPSD, including agitation related to dementia.METHODSOur team searched PubMed, Cochrane Database, and Ovid with the terms dexmedetomidine and dementia. Only studies published in English language journals, or with official English language translations, and human studies were included. All reports of dexmedetomidine for dementia were included regardless of study type.RESULTSNo completed studies on dexmedetomidine for agitation in dementia were identified. The TRANQUILITY study is in progress, although results are yet to be published.CONCLUSIONDexmedetomidine has shown benefit for hospital delirium and for agitation in schizophrenia and bipolar disorder. However, there are no completed studies published on dexmedetomidine for agitation in dementia. Controlled studies with larger sample sizes are needed to assess the efficacy, safety, and the best route of administration for this drug in managing BPSD including agitation.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251927","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}
Xin Li, Yichen Jin, Stefania Bandinelli, Luigi Ferrucci, Toshiko Tanaka, Sameera A. Talegawkar
BackgroundDementia poses considerable challenges to healthy aging. Prevention and management of dementia are essential given the lack of effective treatments for this condition.MethodsA secondary data analysis was conducted using data from 928 InCHIANTI study participants (55% female) aged 65 years and older without dementia at baseline. Cardiovascular health (CVH) was assessed by the “Life's Essential 8” (LE8) metric that included health behaviors (diet, physical activity, smoking status, sleep duration) and health factors (body mass index, blood lipid, blood glucose, blood pressure). This new LE8 metric scores from 0 to 100, with categorization including “low LE8” (0–49), indicating low CVH, “moderate LE8 (50‐79)”, indicating moderate CVH, and “high LE8 (80‐100)”, indicating high CVH. Dementia was ascertained by a combination of neuropsychological testing and clinical assessment at each follow‐up visit. Cox proportional hazards models were used to examine associations between CVH at baseline and risk of incident dementia after a median follow‐up of 14 years.ResultsBetter CVH (moderate/high LE8 vs. low LE8) was inversely associated with the risk of incident dementia (hazard ratio [HR]: 0.61, 95% confidence interval [CI]: 0.46–0.83, p = 0.001). Compared with health factors, higher scores of the health behaviors (per 1 standard deviation [SD]), specifically weekly moderate‐to‐vigorous physical activity time (per 1 SD), were significantly associated with a lower risk of incident dementia (health behaviors: HR:0.84, CI:0.73–0.96, p = 0.01; physical activity: HR: 0.62, CI: 0.53–0.72, p < 0.001).ConclusionWhile longitudinal studies with repeated measures of CVH are needed to confirm these findings, improving CVH, measured by the LE8 metric, may be a promising dementia prevention strategy.
{"title":"Cardiovascular health, measured using Life's Essential 8, is associated with reduced dementia risk among older men and women","authors":"Xin Li, Yichen Jin, Stefania Bandinelli, Luigi Ferrucci, Toshiko Tanaka, Sameera A. Talegawkar","doi":"10.1111/jgs.19194","DOIUrl":"https://doi.org/10.1111/jgs.19194","url":null,"abstract":"BackgroundDementia poses considerable challenges to healthy aging. Prevention and management of dementia are essential given the lack of effective treatments for this condition.MethodsA secondary data analysis was conducted using data from 928 InCHIANTI study participants (55% female) aged 65 years and older without dementia at baseline. Cardiovascular health (CVH) was assessed by the “Life's Essential 8” (LE8) metric that included health behaviors (diet, physical activity, smoking status, sleep duration) and health factors (body mass index, blood lipid, blood glucose, blood pressure). This new LE8 metric scores from 0 to 100, with categorization including “low LE8” (0–49), indicating low CVH, “moderate LE8 (50‐79)”, indicating moderate CVH, and “high LE8 (80‐100)”, indicating high CVH. Dementia was ascertained by a combination of neuropsychological testing and clinical assessment at each follow‐up visit. Cox proportional hazards models were used to examine associations between CVH at baseline and risk of incident dementia after a median follow‐up of 14 years.ResultsBetter CVH (moderate/high LE8 vs. low LE8) was inversely associated with the risk of incident dementia (hazard ratio [HR]: 0.61, 95% confidence interval [CI]: 0.46–0.83, <jats:italic>p</jats:italic> = 0.001). Compared with health factors, higher scores of the health behaviors (per 1 standard deviation [SD]), specifically weekly moderate‐to‐vigorous physical activity time (per 1 SD), were significantly associated with a lower risk of incident dementia (health behaviors: HR:0.84, CI:0.73–0.96, <jats:italic>p</jats:italic> = 0.01; physical activity: HR: 0.62, CI: 0.53–0.72, <jats:italic>p</jats:italic> < 0.001).ConclusionWhile longitudinal studies with repeated measures of CVH are needed to confirm these findings, improving CVH, measured by the LE8 metric, may be a promising dementia prevention strategy.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251625","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}
Jennifer Perloff, Alex Hoyt, Meera Srinivasan, Michelle Alvarez, Sam Sobul, Monica O'Reilly‐Jacob
BackgroundAs the US population ages, there is an increasing demand for home‐based primary care (HBPC) by those with Alzheimer's/dementia, multiple chronic conditions, severe physical limitations, or those facing end‐of life. Nurse practitioners (NPs) are increasingly providing HBPC, yet little is known about their quality of care in this unique setting.MethodsThis observational study uses Medicare claims data from 2018 to assess the quality of care for high‐intensity HBPC users (5 or more visits/year) based on provider type (NP‐only, physician (MD)‐only, or both NP and MDs). We employ 12 quality measures from 3 care domains: access and prevention, acute care utilization, and end‐of‐life. Analysis includes bivariate comparisons and logistic regression models that adjust for demographic, clinical, and geographic characteristics.ResultsAmong the 574,567 beneficiaries with 5 or more HBPC visits, 37% saw an NP, 37% saw a MD, and 27% saw both NPs and MDs. In multivariate models, those receiving HBPC from an NP or both NP‐MD are significantly more likely to receive a flu shot than the MD‐only group, but less likely to access preventive care. NP‐only care is associated with more acute care hospitalizations, avoidable ED visits, and fall‐related injuries, but significantly fewer avoidable admissions. For end‐of‐life care, those with NP‐only or both NP‐MD care are significantly more likely to have an advanced directive, be in hospice in the last 3 days of life, and more likely to die in hospice. The NP group is also more likely to die in the next year.ConclusionsHBPC patients are complex, with both palliative and curative needs. NPs provide almost half of HBPC in the Medicare program, to patients who are possibly sicker than those treated by physicians, with similar quality to MDs.
{"title":"The quality of home‐based primary care delivered by nurse practitioners: A national Medicare claims analysis","authors":"Jennifer Perloff, Alex Hoyt, Meera Srinivasan, Michelle Alvarez, Sam Sobul, Monica O'Reilly‐Jacob","doi":"10.1111/jgs.19182","DOIUrl":"https://doi.org/10.1111/jgs.19182","url":null,"abstract":"BackgroundAs the US population ages, there is an increasing demand for home‐based primary care (HBPC) by those with Alzheimer's/dementia, multiple chronic conditions, severe physical limitations, or those facing end‐of life. Nurse practitioners (NPs) are increasingly providing HBPC, yet little is known about their quality of care in this unique setting.MethodsThis observational study uses Medicare claims data from 2018 to assess the quality of care for high‐intensity HBPC users (5 or more visits/year) based on provider type (NP‐only, physician (MD)‐only, or both NP and MDs). We employ 12 quality measures from 3 care domains: access and prevention, acute care utilization, and end‐of‐life. Analysis includes bivariate comparisons and logistic regression models that adjust for demographic, clinical, and geographic characteristics.ResultsAmong the 574,567 beneficiaries with 5 or more HBPC visits, 37% saw an NP, 37% saw a MD, and 27% saw both NPs and MDs. In multivariate models, those receiving HBPC from an NP or both NP‐MD are significantly more likely to receive a flu shot than the MD‐only group, but less likely to access preventive care. NP‐only care is associated with more acute care hospitalizations, avoidable ED visits, and fall‐related injuries, but significantly fewer avoidable admissions. For end‐of‐life care, those with NP‐only or both NP‐MD care are significantly more likely to have an advanced directive, be in hospice in the last 3 days of life, and more likely to die in hospice. The NP group is also more likely to die in the next year.ConclusionsHBPC patients are complex, with both palliative and curative needs. NPs provide almost half of HBPC in the Medicare program, to patients who are possibly sicker than those treated by physicians, with similar quality to MDs.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251626","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":"Home alone and high risk: Supporting medication management in older adults living alone with cognitive impairment","authors":"Peter M. Hoang, Nathan M. Stall, Paula A. Rochon","doi":"10.1111/jgs.19186","DOIUrl":"https://doi.org/10.1111/jgs.19186","url":null,"abstract":"See related article by <jats:ext-link xmlns:xlink=\"http://www.w3.org/1999/xlink\" xlink:href=\"https://doi.org/10.1111/jgs.19108\">Growdon et al</jats:ext-link>.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142252188","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}
Kerry M. Sheets, Allyson M. Kats, Howard A. Fink, Lisa Langsetmo, Kristine Yaffe, Kristine E. Ensrud
BackgroundLife‐space mobility captures the daily, enacted mobility of older adults. We determined cross‐sectional associations between life‐space mobility and cognitive impairment (CI) among community‐dwelling women in the 9th and 10th decades of life.MethodsA total of 1375 (mean age 88 years; 88% White) community‐dwelling women enrolled in a prospective cohort of older women. Life‐space score was calculated with range 0 (daily restriction to one's bedroom) to 120 (daily trips leaving town without assistance) and categorized (0–20, 21–40, 41–60, 61–80, 81–120). The primary outcome was adjudicated CI defined as mild cognitive impairment or dementia; scores on a 6‐test cognitive battery were secondary outcomes.ResultsCompared to women with life‐space scores of 81–120 and after adjustment for demographics and depressive symptoms, the odds of CI was 1.4‐fold (OR 1.36, 95% CI 0.91–2.03) higher for women with life‐space scores of 61–80, twofold (OR 1.98, 95% CI 1.33–2.94) higher for women with life‐space scores of 41–60, 2.6‐fold (OR 2.62, 95% CI 1.71–4.01) higher for women with life‐space scores of 21–40, and 2.7‐fold (OR 2.71, 95% CI 1.27–5.79) higher for women with life‐space scores of 0–20. The association of life‐space scores with adjudicated CI was primarily due to higher odds of dementia; the odds of dementia versus normal cognition was eightfold (OR 8.63, 95% CI 3.20–23.26) higher among women with life‐space scores of 0–20 compared to women with life‐space scores of 81–120. Lower life‐space scores were associated in a graded manner with lower mean scores on tests of delayed recall (California Verbal Learning Test‐II delayed recall) and language and executive function (phonemic fluency, category fluency, and Trails B). Life‐space score was not associated with scores on tests of attention and working memory (forward and backward digit span).ConclusionsLower life‐space mobility is associated in a graded manner with CI among community‐dwelling White women in the 9th and 10th decades of life.
背景生活空间的流动性反映了老年人的日常活动能力。我们测定了社区居住的九十岁和十十岁女性的生活空间流动性与认知障碍（CI）之间的横断面关联。方法共有 1375 名（平均年龄 88 岁；88% 白人）社区居住的女性加入了老年女性前瞻性队列。生活空间得分的计算范围为 0（每天仅限于自己的卧室）至 120（每天出城旅行无需他人协助），并分为 0-20、21-40、41-60、61-80、81-120 分。结果与生活空间评分为 81-120 分的女性相比，在对人口统计学和抑郁症状进行调整后，生活空间评分为 81-120 分的女性患 CI 的几率是生活空间评分为 81-120 分女性的 1.4 倍（OR 1.36，95% CI 0.91-2.03）。生命空间分数为 61-80 分的女性的几率要高出 1.4 倍（OR 1.36，95% CI 0.91-2.03），生命空间分数为 41-60 分的女性的几率要高出 2 倍（OR 1.98，95% CI 1.33-2.94），生命空间分数为 21-40 分的女性的几率要高出 2.6 倍（OR 2.62，95% CI 1.71-4.01），生命空间分数为 0-20 分的女性的几率要高出 2.7 倍（OR 2.71，95% CI 1.27-5.79）。生命空间得分与判定的 CI 的关系主要是由于痴呆的几率更高；与生命空间得分 81-120 分的女性相比，生命空间得分 0-20 分的女性痴呆的几率是正常认知的 8 倍（OR 8.63，95% CI 3.20-23.26）。生命空间分数较低与延迟回忆测试（加利福尼亚言语学习测试-II延迟回忆）以及语言和执行功能测试（语音流畅性、类别流畅性和Trails B）的平均分数较低呈分级关系。结论在社区居住的白人妇女中，生命期第 9 和第 10 个十年的生命空间活动度较低与 CI 呈分级关系。
{"title":"Life‐space mobility and cognition in community‐dwelling late‐life women: A cross‐sectional analysis","authors":"Kerry M. Sheets, Allyson M. Kats, Howard A. Fink, Lisa Langsetmo, Kristine Yaffe, Kristine E. Ensrud","doi":"10.1111/jgs.19190","DOIUrl":"https://doi.org/10.1111/jgs.19190","url":null,"abstract":"BackgroundLife‐space mobility captures the daily, enacted mobility of older adults. We determined cross‐sectional associations between life‐space mobility and cognitive impairment (CI) among community‐dwelling women in the 9th and 10th decades of life.MethodsA total of 1375 (mean age 88 years; 88% White) community‐dwelling women enrolled in a prospective cohort of older women. Life‐space score was calculated with range 0 (daily restriction to one's bedroom) to 120 (daily trips leaving town without assistance) and categorized (0–20, 21–40, 41–60, 61–80, 81–120). The primary outcome was adjudicated CI defined as mild cognitive impairment or dementia; scores on a 6‐test cognitive battery were secondary outcomes.ResultsCompared to women with life‐space scores of 81–120 and after adjustment for demographics and depressive symptoms, the odds of CI was 1.4‐fold (OR 1.36, 95% CI 0.91–2.03) higher for women with life‐space scores of 61–80, twofold (OR 1.98, 95% CI 1.33–2.94) higher for women with life‐space scores of 41–60, 2.6‐fold (OR 2.62, 95% CI 1.71–4.01) higher for women with life‐space scores of 21–40, and 2.7‐fold (OR 2.71, 95% CI 1.27–5.79) higher for women with life‐space scores of 0–20. The association of life‐space scores with adjudicated CI was primarily due to higher odds of dementia; the odds of dementia versus normal cognition was eightfold (OR 8.63, 95% CI 3.20–23.26) higher among women with life‐space scores of 0–20 compared to women with life‐space scores of 81–120. Lower life‐space scores were associated in a graded manner with lower mean scores on tests of delayed recall (California Verbal Learning Test‐II delayed recall) and language and executive function (phonemic fluency, category fluency, and Trails B). Life‐space score was not associated with scores on tests of attention and working memory (forward and backward digit span).ConclusionsLower life‐space mobility is associated in a graded manner with CI among community‐dwelling White women in the 9th and 10th decades of life.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251627","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}
Daokun Sun, Romil R. Parikh, Wendy Wang, Anne Eaton, Pamela L. Lutsey, B. Gwen Windham, Riccardo M. Inciardi, Scott D. Solomon, Christie M. Ballantyne, Amil M. Shah, Lin Yee Chen
BackgroundFrailty is common in people with cardiovascular disease. Worse left atrial (LA) function is an independent risk factor for cardiovascular disease. However, whether worse LA function is associated with frailty is unclear.MethodsWe included 3292 older adults from the Atherosclerosis Risk in Communities study who were non‐frail at baseline (visit 5, 2011–2013) and had LA function (reservoir, conduit, and contractile strain) measured from two‐dimensional speckle‐tracking echocardiography. LA stiffness index was calculated as a ratio of E/e′ to LA reservoir strain. Frailty was defined using the validated Fried frailty phenotype. Incident frailty was assessed between 2016 and 2019 during two follow‐up visits. LA function was analyzed as quintiles. Multivariable logistic regression examined odds of incident frailty.ResultsMedian (interquartile range [IQR]) age was 74 (71–77) years, 58% were female, and 214 (7%) participants developed frailty during a median (IQR) follow‐up of 6.3 (5.6–6.8) years. After adjusting for baseline confounders and incident cardiovascular events during follow‐up, the odds of developing frailty was 2.42 (1.26–4.66) times greater among participants in the lowest (vs highest) quintile of LA reservoir strain and 2.41 (1.11–5.22) times greater among those in the highest (vs lowest) quintile of LA stiffness index. Worse LA function was significantly associated with the development of exhaustion, but not the other components of the Fried frailty phenotype.ConclusionsWorse LA function is associated with higher incidence of frailty and exhaustion component independent of LA size and left ventricular function. Future studies are needed to elucidate the underlying mechanisms that drive the observed association.
背景心血管疾病患者普遍存在心力衰竭问题。左心房（LA）功能较差是心血管疾病的一个独立风险因素。方法我们纳入了社区动脉粥样硬化风险研究（Atherosclerosis Risk in Communities）中的 3292 名老年人，他们在基线（2011-2013 年第 5 次就诊）时并不虚弱，并通过二维斑点追踪超声心动图测量了 LA 功能（储血室、导管和收缩应变）。LA僵化指数按E/e′与LA储层应变的比值计算。虚弱的定义采用经过验证的弗里德虚弱表型。在2016年至2019年期间的两次随访中对发生的虚弱情况进行了评估。LA功能以五分位数进行分析。结果中位数（四分位数间距 [IQR]）年龄为 74（71-77）岁，58% 为女性，214（7%）名参与者在中位数（IQR）为 6.3（5.6-6.8）年的随访期间出现虚弱。在对基线混杂因素和随访期间发生的心血管事件进行调整后，LA储层应变最低（与最高）五分位数的参与者发生虚弱的几率是前者的2.42（1.26-4.66）倍，LA僵硬度指数最高（与最低）五分位数的参与者发生虚弱的几率是前者的2.41（1.11-5.22）倍。结论 LA功能较差与虚弱和衰竭的发生率较高有关，与LA大小和左心室功能无关。未来的研究还需要阐明导致这种关联的潜在机制。
{"title":"Association of left atrial function with frailty: The Atherosclerosis Risk in Communities (ARIC) study","authors":"Daokun Sun, Romil R. Parikh, Wendy Wang, Anne Eaton, Pamela L. Lutsey, B. Gwen Windham, Riccardo M. Inciardi, Scott D. Solomon, Christie M. Ballantyne, Amil M. Shah, Lin Yee Chen","doi":"10.1111/jgs.19187","DOIUrl":"https://doi.org/10.1111/jgs.19187","url":null,"abstract":"BackgroundFrailty is common in people with cardiovascular disease. Worse left atrial (LA) function is an independent risk factor for cardiovascular disease. However, whether worse LA function is associated with frailty is unclear.MethodsWe included 3292 older adults from the Atherosclerosis Risk in Communities study who were non‐frail at baseline (visit 5, 2011–2013) and had LA function (reservoir, conduit, and contractile strain) measured from two‐dimensional speckle‐tracking echocardiography. LA stiffness index was calculated as a ratio of E/e′ to LA reservoir strain. Frailty was defined using the validated Fried frailty phenotype. Incident frailty was assessed between 2016 and 2019 during two follow‐up visits. LA function was analyzed as quintiles. Multivariable logistic regression examined odds of incident frailty.ResultsMedian (interquartile range [IQR]) age was 74 (71–77) years, 58% were female, and 214 (7%) participants developed frailty during a median (IQR) follow‐up of 6.3 (5.6–6.8) years. After adjusting for baseline confounders and incident cardiovascular events during follow‐up, the odds of developing frailty was 2.42 (1.26–4.66) times greater among participants in the lowest (vs highest) quintile of LA reservoir strain and 2.41 (1.11–5.22) times greater among those in the highest (vs lowest) quintile of LA stiffness index. Worse LA function was significantly associated with the development of exhaustion, but not the other components of the Fried frailty phenotype.ConclusionsWorse LA function is associated with higher incidence of frailty and exhaustion component independent of LA size and left ventricular function. Future studies are needed to elucidate the underlying mechanisms that drive the observed association.","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":null,"pages":null},"PeriodicalIF":6.3,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251629","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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