Laura A. Reich, Lori A. Daiello, Sarah D. Berry, Adam M. D'Amico, Douglas P. Kiel, Daniel A. Harris, Kaleen N. Hayes, Charles E. Leonard, Yu-Chia (Sam) Hsu, Andrew R. Zullo
Background
Nursing home (NH) residents are at increased risk of drug–drug interactions (DDIs) due to multimorbidity and polypharmacy. While prior research suggests that many DDIs lead to adverse drug events in older adults, the extent of exposure to potentially clinically relevant DDIs among United States (US) NH residents is largely unknown.
Methods
In this cohort study, we calculated the prevalence and duration of exposure to 98 potential DDIs among US NH residents from 2018 to 2020. DDIs were sourced from three expert consensus publications, some of which defined similar interactions and overlapping drug combinations, allowing comparisons within and across lists. Data were drawn from Medicare claims linked to Minimum Data Set 3.0 clinical assessments. Eligible residents included Medicare Fee-for-Service beneficiaries aged ≥ 66 years living in NHs with observable Part D prescription drug data. DDI exposure was defined as ≥ 1 day of concurrent use of orally administered medications. Prevalence was calculated as the proportion of residents exposed to each DDI; duration was measured as the median number of days residents concurrently used the medications of interest.
Results
Among 485,251 NH residents, 61.6% experienced ≥ 1 potential DDI over 272,780 person-years. The 12 most prevalent DDIs involved central nervous system (CNS)-active drugs, anticholinergics, antihypertensives, opioids, and diuretics. Of these DDIs, concurrent use of acetylcholinesterase inhibitors and heart rate-reducing drugs had the longest median exposure duration (81 days; Q1–Q3, 24–235). The most prevalent DDI, concomitant use of ≥ 3 CNS-active drugs, was observed in 27.1% (95% CLs, 27.0%, 27.2%) of residents.
Conclusions
Nearly two-thirds of NH residents were exposed to medication combinations linked to potential DDIs, although the prevalence and duration of exposure associated with individual DDIs varied. Future research should determine which DDIs are most clinically significant and investigate barriers to reducing exposure duration in this high-risk population.
{"title":"Prevalence and Duration of Potential Drug–Drug Interactions Among US Nursing Home Residents, 2018–2020","authors":"Laura A. Reich, Lori A. Daiello, Sarah D. Berry, Adam M. D'Amico, Douglas P. Kiel, Daniel A. Harris, Kaleen N. Hayes, Charles E. Leonard, Yu-Chia (Sam) Hsu, Andrew R. Zullo","doi":"10.1111/jgs.70175","DOIUrl":"10.1111/jgs.70175","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Nursing home (NH) residents are at increased risk of drug–drug interactions (DDIs) due to multimorbidity and polypharmacy. While prior research suggests that many DDIs lead to adverse drug events in older adults, the extent of exposure to potentially clinically relevant DDIs among United States (US) NH residents is largely unknown.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this cohort study, we calculated the prevalence and duration of exposure to 98 potential DDIs among US NH residents from 2018 to 2020. DDIs were sourced from three expert consensus publications, some of which defined similar interactions and overlapping drug combinations, allowing comparisons within and across lists. Data were drawn from Medicare claims linked to Minimum Data Set 3.0 clinical assessments. Eligible residents included Medicare Fee-for-Service beneficiaries aged ≥ 66 years living in NHs with observable Part D prescription drug data. DDI exposure was defined as ≥ 1 day of concurrent use of orally administered medications. Prevalence was calculated as the proportion of residents exposed to each DDI; duration was measured as the median number of days residents concurrently used the medications of interest.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 485,251 NH residents, 61.6% experienced ≥ 1 potential DDI over 272,780 person-years. The 12 most prevalent DDIs involved central nervous system (CNS)-active drugs, anticholinergics, antihypertensives, opioids, and diuretics. Of these DDIs, concurrent use of acetylcholinesterase inhibitors and heart rate-reducing drugs had the longest median exposure duration (81 days; Q1–Q3, 24–235). The most prevalent DDI, concomitant use of ≥ 3 CNS-active drugs, was observed in 27.1% (95% CLs, 27.0%, 27.2%) of residents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Nearly two-thirds of NH residents were exposed to medication combinations linked to potential DDIs, although the prevalence and duration of exposure associated with individual DDIs varied. Future research should determine which DDIs are most clinically significant and investigate barriers to reducing exposure duration in this high-risk population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 12","pages":"3766-3777"},"PeriodicalIF":4.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748051/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310590","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}
Lan Luo, Anna L. Parks, Gahee Oh, Sarah D. Berry, Susan L. Mitchell, Dae Hyun Kim, Sachin J. Shah, Darae Ko
Patterns of oral anticoagulant use for atrial fibrillation following transition to long-term care.
心房颤动转入长期护理后口服抗凝剂的使用模式。
{"title":"Patterns of Oral Anticoagulant Use in Atrial Fibrillation Following Transition to Long-Term Care","authors":"Lan Luo, Anna L. Parks, Gahee Oh, Sarah D. Berry, Susan L. Mitchell, Dae Hyun Kim, Sachin J. Shah, Darae Ko","doi":"10.1111/jgs.70169","DOIUrl":"10.1111/jgs.70169","url":null,"abstract":"<p>Patterns of oral anticoagulant use for atrial fibrillation following transition to long-term care.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure>\u0000 </p>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"74 1","pages":"265-268"},"PeriodicalIF":4.5,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310585","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}
Emily K. Short, Phuong Y. Duong, Jennifer Tjia, Matthew Alcusky, Mary Lynn McPherson, Jon P. Furuno
Background
Little is known regarding antithrombotic prescribing in U.S. hospice patients. We quantified the prevalence and predictors of receiving an antithrombotic prescription on hospice admission.
Methods
This was a cross-sectional study using electronic health record data from adult (age ≥ 18 years) decedents of a large, for-profit hospice chain who died between January 1, 2017, and December 31, 2019. Our primary outcome was having a prescription for antithrombotic (anticoagulant or antiplatelet) therapy on hospice admission. We used multivariable logistic regression to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).
Results
Among 54,643 hospice decedents, the mean age was 79.7 (standard deviation (SD) 13.2) years, 44.6% were male, and 57.0% were White. The median hospice length of stay was 9 (interquartile range 3–40) days, and 18,531 patients (33.9%) had a Palliative Performance Scale (PPS) score of 30%. Overall, 11,360 patients (20.8%) had at least one antithrombotic prescription on hospice admission. The most frequently prescribed antithrombotic classes were antiplatelets (15.7%) and direct oral anticoagulants (3.7%). Patients with PPS scores of 20%–30% (adjusted OR (aOR) 9.38, 95% CI 8.03–10.95), 40%–50% (aOR 15.69, 95% CI 13.38–18.40), and 60%–100% (aOR 15.67, 95% CI 12.41–19.79) were significantly more likely to receive an antithrombotic prescription compared to patients with a PPS score < 20%. Additionally, patients receiving care in an assisted living facility (aOR 4.34, 95% CI 3.86–4.87), nursing home (aOR 4.02, 95% CI 3.62–4.47), or at home (aOR 4.08, 95% CI 3.74–4.45) were more likely to receive an antithrombotic prescription compared to patients receiving care in an inpatient hospice setting.
Conclusions
Antithrombotic therapy was prevalent on hospice admission and most associated with better patient prognosis and non-inpatient hospice care locations. More research is needed to optimize antithrombotic prescribing in hospice care.
背景：关于美国临终关怀病人的抗血栓处方知之甚少。我们量化了临终关怀入院时接受抗血栓处方的患病率和预测因素。方法：这是一项横断面研究，使用了2017年1月1日至2019年12月31日期间死亡的大型营利性临终关怀连锁机构成年（年龄≥18岁）死者的电子健康记录数据。我们的主要结局是在临终关怀入院时获得抗血栓（抗凝或抗血小板）治疗的处方。我们使用多变量逻辑回归计算校正优势比（aORs）和95%置信区间（CIs）。结果：54,643名临终关怀死者中，平均年龄为79.7（标准差13.2）岁，男性占44.6%，白人占57.0%。安宁疗护住院时间中位数为9天（四分位数间距为3-40），18531名患者（33.9%）的安宁疗护表现量表（PPS）得分为30%。总体而言，11,360名患者（20.8%）在临终关怀入院时至少有一种抗血栓处方。最常用的抗血栓药物是抗血小板（15.7%）和直接口服抗凝剂（3.7%）。与PPS评分的患者相比，PPS评分为20%-30%（调整后OR (aOR) 9.38, 95% CI 8.03-10.95）、40%-50% （aOR 15.69, 95% CI 13.38-18.40）和60%-100% （aOR 15.67, 95% CI 12.41-19.79）的患者接受抗栓处方的可能性显著高于PPS评分的患者。结论：抗栓治疗在临终关怀住院患者中普遍存在，且与更好的患者预后和非住院临终关怀地点相关。需要更多的研究来优化临终关怀中的抗血栓处方。
{"title":"Prevalence and Factors Associated With Receiving a Prescription for Antithrombotic Therapy on Hospice Admission","authors":"Emily K. Short, Phuong Y. Duong, Jennifer Tjia, Matthew Alcusky, Mary Lynn McPherson, Jon P. Furuno","doi":"10.1111/jgs.70170","DOIUrl":"10.1111/jgs.70170","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Little is known regarding antithrombotic prescribing in U.S. hospice patients. We quantified the prevalence and predictors of receiving an antithrombotic prescription on hospice admission.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a cross-sectional study using electronic health record data from adult (age ≥ 18 years) decedents of a large, for-profit hospice chain who died between January 1, 2017, and December 31, 2019. Our primary outcome was having a prescription for antithrombotic (anticoagulant or antiplatelet) therapy on hospice admission. We used multivariable logistic regression to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CIs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 54,643 hospice decedents, the mean age was 79.7 (standard deviation (SD) 13.2) years, 44.6% were male, and 57.0% were White. The median hospice length of stay was 9 (interquartile range 3–40) days, and 18,531 patients (33.9%) had a Palliative Performance Scale (PPS) score of 30%. Overall, 11,360 patients (20.8%) had at least one antithrombotic prescription on hospice admission. The most frequently prescribed antithrombotic classes were antiplatelets (15.7%) and direct oral anticoagulants (3.7%). Patients with PPS scores of 20%–30% (adjusted OR (aOR) 9.38, 95% CI 8.03–10.95), 40%–50% (aOR 15.69, 95% CI 13.38–18.40), and 60%–100% (aOR 15.67, 95% CI 12.41–19.79) were significantly more likely to receive an antithrombotic prescription compared to patients with a PPS score < 20%. Additionally, patients receiving care in an assisted living facility (aOR 4.34, 95% CI 3.86–4.87), nursing home (aOR 4.02, 95% CI 3.62–4.47), or at home (aOR 4.08, 95% CI 3.74–4.45) were more likely to receive an antithrombotic prescription compared to patients receiving care in an inpatient hospice setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Antithrombotic therapy was prevalent on hospice admission and most associated with better patient prognosis and non-inpatient hospice care locations. More research is needed to optimize antithrombotic prescribing in hospice care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 12","pages":"3789-3797"},"PeriodicalIF":4.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310516","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}
Mélanie Le Berre, Fanny Leblanc, Mathieu Hotton, Samira Amil, Manon Cody, Louise Bertrand, André Côté, Émilie Dionne, Marie-Pierre Gagnon, Marie-Soleil Hardy, Maxime Sasseville, Maude Laberge
<p>Transitioning into a long-term care facility (LTCF) can be challenging [<span>1</span>], and is associated with risks, such as behavioral symptoms of dementia, delirium, or adverse drug events [<span>2, 3</span>]. In response, transitional care initiatives have emerged [<span>4</span>]. In Quebec, LTCFs were redefined as “living environments” rather than healthcare institutions in 2003 [<span>5</span>], promoting person-centered, humanized care that adapts to residents' needs. A 2022 policy further supported personalized care through recognition of residents' life stories [<span>6</span>]. One of the tools developed to implement this policy is the Life Story questionnaire [<span>7</span>], that collects information on residents' habits, relationships, and life events (Supporting Information: Text S1).</p><p>Despite growing use, little is known about how these tools are implemented in rural contexts. Rural regions like Côte-Nord face unique challenges, including workforce shortages and geographic isolation [<span>8</span>]. This study described older residents' and caregivers' perceptions regarding the Life Story questionnaire during transitions to LTCFs in Côte-Nord.</p><p>Fourteen participants (11 residents, 3 caregivers) were interviewed between fall 2023 and winter 2024. Most residents were women (<i>n</i> = 10/11), with a mean age of 88 years (Table 1). Three main themes emerged from the interviews: (1) completing the Life Story questionnaire, (2) integrating it into care, and (3) perceived benefits and limitations (Table 2).</p><p>Residents and caregivers generally viewed the Life Story questionnaire as beneficial in fostering person-centered care and wellbeing. However, inconsistent use limited its impact.</p><p>Staffing limitations could explain these inconsistencies, as collecting life stories and applying preferences can be time-intensive and require staff availability [<span>10</span>]. Simplified formats, such as one-page summaries, have been suggested to improve usability [<span>10</span>].</p><p>Study limitations include partial coverage of the Côte-Nord region. Limited caregiver availability led to interviews primarily with residents, restricting perspectives. Recall bias among some residents, due to delays between admission and interview, may have reduced the completeness and accuracy of recollections.</p><p>Given the importance of person-centered care for resident well-being, further research is needed on strategies to support consistent use of the Life Story questionnaire. Exploring healthcare providers' perspectives could reveal organizational and resource-related factors influencing implementation and inform optimization of care practices.</p><p>Study concept and design: Maude Laberge, Manon Cody, and Mathieu Hotton; Acquisition of data: Maude Laberge, Fanny Leblanc; Analysis and interpretation of data: Maude Laberge, Fanny Leblanc, Manon Cody; Writing – Original Draft Preparation: Mélanie Le Berre, Fanny Leblanc, and Maude
{"title":"Perceptions of Older Adults and Caregivers on the Life Story Questionnaire in the Transition to Long-Term Care in Côte-Nord Region","authors":"Mélanie Le Berre, Fanny Leblanc, Mathieu Hotton, Samira Amil, Manon Cody, Louise Bertrand, André Côté, Émilie Dionne, Marie-Pierre Gagnon, Marie-Soleil Hardy, Maxime Sasseville, Maude Laberge","doi":"10.1111/jgs.70120","DOIUrl":"10.1111/jgs.70120","url":null,"abstract":"<p>Transitioning into a long-term care facility (LTCF) can be challenging [<span>1</span>], and is associated with risks, such as behavioral symptoms of dementia, delirium, or adverse drug events [<span>2, 3</span>]. In response, transitional care initiatives have emerged [<span>4</span>]. In Quebec, LTCFs were redefined as “living environments” rather than healthcare institutions in 2003 [<span>5</span>], promoting person-centered, humanized care that adapts to residents' needs. A 2022 policy further supported personalized care through recognition of residents' life stories [<span>6</span>]. One of the tools developed to implement this policy is the Life Story questionnaire [<span>7</span>], that collects information on residents' habits, relationships, and life events (Supporting Information: Text S1).</p><p>Despite growing use, little is known about how these tools are implemented in rural contexts. Rural regions like Côte-Nord face unique challenges, including workforce shortages and geographic isolation [<span>8</span>]. This study described older residents' and caregivers' perceptions regarding the Life Story questionnaire during transitions to LTCFs in Côte-Nord.</p><p>Fourteen participants (11 residents, 3 caregivers) were interviewed between fall 2023 and winter 2024. Most residents were women (<i>n</i> = 10/11), with a mean age of 88 years (Table 1). Three main themes emerged from the interviews: (1) completing the Life Story questionnaire, (2) integrating it into care, and (3) perceived benefits and limitations (Table 2).</p><p>Residents and caregivers generally viewed the Life Story questionnaire as beneficial in fostering person-centered care and wellbeing. However, inconsistent use limited its impact.</p><p>Staffing limitations could explain these inconsistencies, as collecting life stories and applying preferences can be time-intensive and require staff availability [<span>10</span>]. Simplified formats, such as one-page summaries, have been suggested to improve usability [<span>10</span>].</p><p>Study limitations include partial coverage of the Côte-Nord region. Limited caregiver availability led to interviews primarily with residents, restricting perspectives. Recall bias among some residents, due to delays between admission and interview, may have reduced the completeness and accuracy of recollections.</p><p>Given the importance of person-centered care for resident well-being, further research is needed on strategies to support consistent use of the Life Story questionnaire. Exploring healthcare providers' perspectives could reveal organizational and resource-related factors influencing implementation and inform optimization of care practices.</p><p>Study concept and design: Maude Laberge, Manon Cody, and Mathieu Hotton; Acquisition of data: Maude Laberge, Fanny Leblanc; Analysis and interpretation of data: Maude Laberge, Fanny Leblanc, Manon Cody; Writing – Original Draft Preparation: Mélanie Le Berre, Fanny Leblanc, and Maude ","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 12","pages":"3907-3910"},"PeriodicalIF":4.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12748025/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305090","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}
David M. Levine, Linda V. DeCherrie, Annabel Steiner, Gabrielle Schiller, Albert Siu, Bruce Leff
{"title":"Role and Expectations of Family Caregivers in Hospital at Home in the US and Canada","authors":"David M. Levine, Linda V. DeCherrie, Annabel Steiner, Gabrielle Schiller, Albert Siu, Bruce Leff","doi":"10.1111/jgs.70167","DOIUrl":"10.1111/jgs.70167","url":null,"abstract":"","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"74 1","pages":"262-264"},"PeriodicalIF":4.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145305132","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}
Thomas A. Bayer, Malisa Barber, Christopher Halladay, Mazhgan Rowneki, Heather Davila, Michelle Mengeling, Scotte Hartronft, James L. Rudolph, Kaleen N. Hayes
Background
The Age-Friendly Health System movement has been building teams and systems to implement the assessment of the “4Ms” (What Matters, Medications, Mobility, and Mentation). Although each of the 4Ms is an evidence-based practice, the reporting of outcomes for people who receive the assessment of all 4Ms has been limited.
Methods
This retrospective matched cohort study included Veterans admitted to six VA medical centers implementing inpatient assessment of the 4Ms from January 2022 to December 2024. Using electronic health records, we identified a cohort of Veterans admitted to inpatient wards and with documented assessment of the 4Ms. Propensity score matching was used to select a matched cohort without complete 4M assessments. The matching algorithm required matching on facility, admission quarter, and year in addition to a propensity score based on covariates including demographics and comorbidities. We selected the AFHS outcomes of 30-day readmission, emergency department use, and mortality. We used Kaplan–Meier methods to estimate cumulative incidence of outcomes and Cox proportional hazard models to estimate hazard ratios.
Results
The propensity matching analysis resulted in 2420 Veterans with 4Ms care and 4688 matched Veterans without (mean age 79 years, 97% male). The matched groups were well balanced. AFHS care with the 4Ms was associated with reduced hazard for readmission (HR 0.67, 95% CI 0.62–0.73) and statistically similar hazard for ED visits in 30 days (HR 0.95, 95% CI 0.82–1.13) and mortality (HR 1.02, 95% CI 0.86–1.21). Results were similar when restricting to those with dementia and excluding those with any of the 4Ms assessments in the control group.
Conclusions
In this retrospective cohort study, AFHS care including assessment of the 4Ms was associated with reduced readmission without changes in emergency department visits or mortality. The results support the effort of implementing AFHS evidence-based practices into inpatient care sites.
背景：老年人友好型卫生系统运动一直在建立团队和系统来实施“4Ms”（重要的是什么，药物，流动性和心理状态）的评估。虽然每一个4m都是基于证据的实践，但对接受所有4m评估的人的结果报告是有限的。方法：这项回顾性匹配队列研究纳入了从2022年1月到2024年12月在6个VA医疗中心对4Ms进行住院评估的退伍军人。使用电子健康记录，我们确定了一组住院病房的退伍军人，并记录了4Ms的评估。倾向评分匹配用于选择匹配的队列，没有完整的4M评估。匹配算法需要匹配设施、入院季度和年份，以及基于人口统计学和合并症等协变量的倾向评分。我们选择了30天再入院、急诊科使用和死亡率的AFHS结果。我们使用Kaplan-Meier方法估计结果的累积发生率，使用Cox比例风险模型估计风险比。结果：倾向匹配分析结果显示，有4Ms护理的退伍军人2420人，没有4Ms护理的退伍军人4688人（平均年龄79岁，97%为男性）。配对组的平衡很好。AFHS护理与4Ms的再入院风险降低相关（HR 0.67, 95% CI 0.62-0.73）， 30天急诊科就诊风险（HR 0.95, 95% CI 0.82-1.13）和死亡率相似（HR 1.02, 95% CI 0.86-1.21）。当限制痴呆患者并排除对照组中具有4Ms评估中的任何一种的患者时，结果相似。结论：在这项回顾性队列研究中，包括4Ms评估在内的AFHS护理与减少再入院有关，而急诊就诊或死亡率没有变化。结果支持在住院护理场所实施AFHS循证实践的努力。
{"title":"Post-Hospitalization Outcomes for Veterans Receiving Age-Friendly Health Systems 4M Care","authors":"Thomas A. Bayer, Malisa Barber, Christopher Halladay, Mazhgan Rowneki, Heather Davila, Michelle Mengeling, Scotte Hartronft, James L. Rudolph, Kaleen N. Hayes","doi":"10.1111/jgs.70156","DOIUrl":"10.1111/jgs.70156","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The Age-Friendly Health System movement has been building teams and systems to implement the assessment of the “4Ms” (What Matters, Medications, Mobility, and Mentation). Although each of the 4Ms is an evidence-based practice, the reporting of outcomes for people who receive the assessment of all 4Ms has been limited.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective matched cohort study included Veterans admitted to six VA medical centers implementing inpatient assessment of the 4Ms from January 2022 to December 2024. Using electronic health records, we identified a cohort of Veterans admitted to inpatient wards and with documented assessment of the 4Ms. Propensity score matching was used to select a matched cohort without complete 4M assessments. The matching algorithm required matching on facility, admission quarter, and year in addition to a propensity score based on covariates including demographics and comorbidities. We selected the AFHS outcomes of 30-day readmission, emergency department use, and mortality. We used Kaplan–Meier methods to estimate cumulative incidence of outcomes and Cox proportional hazard models to estimate hazard ratios.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The propensity matching analysis resulted in 2420 Veterans with 4Ms care and 4688 matched Veterans without (mean age 79 years, 97% male). The matched groups were well balanced. AFHS care with the 4Ms was associated with reduced hazard for readmission (HR 0.67, 95% CI 0.62–0.73) and statistically similar hazard for ED visits in 30 days (HR 0.95, 95% CI 0.82–1.13) and mortality (HR 1.02, 95% CI 0.86–1.21). Results were similar when restricting to those with dementia and excluding those with any of the 4Ms assessments in the control group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In this retrospective cohort study, AFHS care including assessment of the 4Ms was associated with reduced readmission without changes in emergency department visits or mortality. The results support the effort of implementing AFHS evidence-based practices into inpatient care sites.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"74 1","pages":"220-226"},"PeriodicalIF":4.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310521","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}
Mara Rosenberg, Irena Cenzer, Kenneth Covinsky, Alexander K. Smith, Ashwin A. Kotwal
Background
Social engagement is crucial for well-being, yet caregivers often face restrictions due to care responsibilities. The caregiver-specific consequences of these restrictions are underexplored.
Methods
We used cross-sectional data from the National Study of Caregiving (2021), a nationally representative study of 1619 unpaid caregivers of adults aged 65 years and older. Caregivers reported if care responsibilities kept them from participating in four social activities (visiting friends/family, attending religious services, going out for enjoyment, and attending group activities). Caregiver burden (emotional, physical, and/or financial) was self-reported. “Any” burden was defined as reporting at least one of the three types of burden. We performed survey-weighted, multivariable logistic regression to determine the adjusted probability of caregiver burden based on social activity participation.
Results
Caregivers were on average 62.5 (SD 22) years old, 65% female, 53% children of the care recipient, and 73% White. 43% reported at least one form of caregiving burden: 35% emotional, 17% physical, and 9% financial. Caregivers had higher adjusted probabilities of “any” caregiving burden (p < 0.001) if they were kept from going out (88% vs. 62%), visiting family/friends (86% vs. 55%), or engaging in group activities (88% vs. 61%). For missed religious activities, caregivers primarily reported higher burden if they rated the missed activities as “important” versus “unimportant” (Any burden: 85% vs. 57%; Emotional burden: 74% vs. 45%; Physical burden: 65% vs. 29%, p < 0.05). Importance was not significant for other activities. There was a step-wise association between the number of missed activities and any reported burden (0 activities missed: 54%, 1 activity: 77%, 2+ activities: 91%, p < 0.01).
Conclusions
Restriction from social activities was associated with higher caregiver burden, with the impact of missing religious activities influenced by its importance to the caregiver. These findings emphasize the need for tailored interventions to help caregivers maintain social engagement despite care responsibilities.
{"title":"When Missing Out Matters: Associations Between Social Activity Restriction and Caregiver Burden","authors":"Mara Rosenberg, Irena Cenzer, Kenneth Covinsky, Alexander K. Smith, Ashwin A. Kotwal","doi":"10.1111/jgs.70173","DOIUrl":"10.1111/jgs.70173","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Social engagement is crucial for well-being, yet caregivers often face restrictions due to care responsibilities. The caregiver-specific consequences of these restrictions are underexplored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used cross-sectional data from the National Study of Caregiving (2021), a nationally representative study of 1619 unpaid caregivers of adults aged 65 years and older. Caregivers reported if care responsibilities kept them from participating in four social activities (visiting friends/family, attending religious services, going out for enjoyment, and attending group activities). Caregiver burden (emotional, physical, and/or financial) was self-reported. “Any” burden was defined as reporting at least one of the three types of burden. We performed survey-weighted, multivariable logistic regression to determine the adjusted probability of caregiver burden based on social activity participation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Caregivers were on average 62.5 (SD 22) years old, 65% female, 53% children of the care recipient, and 73% White. 43% reported at least one form of caregiving burden: 35% emotional, 17% physical, and 9% financial. Caregivers had higher adjusted probabilities of “any” caregiving burden (<i>p</i> < 0.001) if they were kept from going out (88% vs. 62%), visiting family/friends (86% vs. 55%), or engaging in group activities (88% vs. 61%). For missed religious activities, caregivers primarily reported higher burden if they rated the missed activities as “important” versus “unimportant” (Any burden: 85% vs. 57%; Emotional burden: 74% vs. 45%; Physical burden: 65% vs. 29%, <i>p</i> < 0.05). Importance was not significant for other activities. There was a step-wise association between the number of missed activities and any reported burden (0 activities missed: 54%, 1 activity: 77%, 2+ activities: 91%, <i>p</i> < 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Restriction from social activities was associated with higher caregiver burden, with the impact of missing religious activities influenced by its importance to the caregiver. These findings emphasize the need for tailored interventions to help caregivers maintain social engagement despite care responsibilities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"74 1","pages":"56-63"},"PeriodicalIF":4.5,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145310559","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}
Sean M. Mortenson, Josephine M. McCartney, Joy X. Moy, Geralyn M. Palmer, Jaime H. Goldberg, Demetrius B. Solomon, Madison Polley, Neera Grover, Margaret L. Schwarze, Toby C. Campbell, Jane L. Holl, Sarah L. Esmond, Jacqueline M. Kruser
Background
For older adults with critical illness, decisions about life-sustaining therapies can be challenging. A time-limited trial (TLT) is a collaborative care plan endorsed by experts in palliative and critical care to help navigate these challenges. TLTs entail trying life-sustaining therapy for a defined duration. Response to treatment then informs whether to continue recovery-directed care or shift focus exclusively to comfort. TLTs require collaboration among clinicians, patients, and/or surrogate decision makers, yet there is little practical guidance on how to accomplish this. Thus, we sought to design a collaborative TLT planning tool and characterize its valued characteristics.
Methods
In this qualitative study framed by human-centered Design Thinking, we conducted a series of semi-structured interviews (n = 25) and focus groups (n = 5) with 28 participants who were (1) older adults (age ≥ 65) with serious illness, (2) adults of any age with surrogate decision-making experience for an older adult, and/or (3) intensive care unit (ICU) physicians. We purposively sampled across a Midwestern state to achieve diverse representation and used the Rigorous and Accelerated Data Reduction (RADaR) technique for qualitative analysis.
Results
We used participants' input to design the ICU Care Plan, a paper-based tool consisting of a fillable template. The tool is designed to guide a collaborative TLT planning conversation among clinicians, patients, and surrogates and then serve as a visual summary of the care plan. Participants endorsed the tool as (1) creating a unified frame of reference for a complex process; (2) promoting transparency; and (3) setting and managing expectations. The tool exemplifies participants' design priorities of simplicity and flexibility.
Conclusions
We used a human-centered design process to develop a tool for in-the-moment TLT planning that is endorsed by older adults, surrogates, and ICU physicians. Low technology, intentionally simple interventions are a promising approach to promote patient- and family-centered collaboration.
{"title":"The ICU Care Plan: Human-Centered Design of a Tool to Support Time-Limited Trials for Older Adults With Critical Illness","authors":"Sean M. Mortenson, Josephine M. McCartney, Joy X. Moy, Geralyn M. Palmer, Jaime H. Goldberg, Demetrius B. Solomon, Madison Polley, Neera Grover, Margaret L. Schwarze, Toby C. Campbell, Jane L. Holl, Sarah L. Esmond, Jacqueline M. Kruser","doi":"10.1111/jgs.70155","DOIUrl":"10.1111/jgs.70155","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>For older adults with critical illness, decisions about life-sustaining therapies can be challenging. A time-limited trial (TLT) is a collaborative care plan endorsed by experts in palliative and critical care to help navigate these challenges. TLTs entail trying life-sustaining therapy for a defined duration. Response to treatment then informs whether to continue recovery-directed care or shift focus exclusively to comfort. TLTs require collaboration among clinicians, patients, and/or surrogate decision makers, yet there is little practical guidance on how to accomplish this. Thus, we sought to design a collaborative TLT planning tool and characterize its valued characteristics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this qualitative study framed by human-centered Design Thinking, we conducted a series of semi-structured interviews (<i>n</i> = 25) and focus groups (<i>n</i> = 5) with 28 participants who were (1) older adults (age ≥ 65) with serious illness, (2) adults of any age with surrogate decision-making experience for an older adult, and/or (3) intensive care unit (ICU) physicians. We purposively sampled across a Midwestern state to achieve diverse representation and used the Rigorous and Accelerated Data Reduction (RADaR) technique for qualitative analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We used participants' input to design the <i>ICU Care Plan</i>, a paper-based tool consisting of a fillable template. The tool is designed to guide a collaborative TLT planning conversation among clinicians, patients, and surrogates and then serve as a visual summary of the care plan. Participants endorsed the tool as (1) creating a unified frame of reference for a complex process; (2) promoting transparency; and (3) setting and managing expectations. The tool exemplifies participants' design priorities of simplicity and flexibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We used a human-centered design process to develop a tool for in-the-moment TLT planning that is endorsed by older adults, surrogates, and ICU physicians. Low technology, intentionally simple interventions are a promising approach to promote patient- and family-centered collaboration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 12","pages":"3747-3756"},"PeriodicalIF":4.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12650797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145282347","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}
Joshua D. Niznik, Lena K. Makaroun, Florentia E. Sileanu, Nicole Beyer, Xinhua Zhao, Kelvin Tran, Keri L. Rodriguez, Laura C. Hanson, Thomas R. Radomski, Loren J. Schleiden, Alexa Ehlert, Carolyn T. Thorpe
Background
Documentation of patient goals and preferences within medical records has the potential to align medication use with goals of care (GoC) and individualize medication appropriateness criteria. We characterized patient and surrogate-expressed GoC for older Veterans living with dementia and explored concordance with medication use during VA Community Living Center (CLC) (i.e., nursing home) stays.
Methods
We conducted a cross-sectional analysis using the VA Residential History File, Minimum Data Set, Corporate Data Warehouse, and Medicare claims for Veterans with dementia admitted to VA CLCs from 4/2021 to 12/2021 for > 7 days. We extracted free text responses for “Veteran goals in own words” from a standardized GoC note. Two coders classified GoC topics using iterative coding. We examined bar code medication administration data for aspirin, benzodiazepines, opioids and antidementia medications within the 7 days following admission. We determined a schema for potential goal-concordant medication use (e.g., opioids for GoC focused on comfort) and assessed concordance of medication use with GoC topics.
Results
Among 1000 VA CLC residents with dementia and GoC documented, 46.4% of responses were reported by the Veteran versus a surrogate. Common topics included comfort (44.6%), life-sustaining treatments (31.8%), function (13.7%), care setting/transitions (12.9%), and life prolongation (11.2%). Medications were seldom discussed. Opioid and benzodiazepine use was classified as goal-concordant for 56.7% and 72.2% of patients who used them. Aspirin and antidementia medication use was more commonly classified as goal-discordant (54.7% and 38.7%, respectively).
Conclusions
Goals elicited via an open-ended question provided only indirect information relevant to medication use, but in many cases could be used to refine judgments of appropriateness. Integration of patient goals into formal criteria evaluating medication appropriateness is a logical next step for medication optimization research. Future research should explore the utility of questions specific to medications in GoC conversations for individuals with dementia.
{"title":"Exploring Goal-Concordant Medication Use Among VA Community Living Center Residents With Dementia","authors":"Joshua D. Niznik, Lena K. Makaroun, Florentia E. Sileanu, Nicole Beyer, Xinhua Zhao, Kelvin Tran, Keri L. Rodriguez, Laura C. Hanson, Thomas R. Radomski, Loren J. Schleiden, Alexa Ehlert, Carolyn T. Thorpe","doi":"10.1111/jgs.70158","DOIUrl":"10.1111/jgs.70158","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Documentation of patient goals and preferences within medical records has the potential to align medication use with goals of care (GoC) and individualize medication appropriateness criteria. We characterized patient and surrogate-expressed GoC for older Veterans living with dementia and explored concordance with medication use during VA Community Living Center (CLC) (i.e., nursing home) stays.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a cross-sectional analysis using the VA Residential History File, Minimum Data Set, Corporate Data Warehouse, and Medicare claims for Veterans with dementia admitted to VA CLCs from 4/2021 to 12/2021 for > 7 days. We extracted free text responses for “Veteran goals in own words” from a standardized GoC note. Two coders classified GoC topics using iterative coding. We examined bar code medication administration data for aspirin, benzodiazepines, opioids and antidementia medications within the 7 days following admission. We determined a schema for potential goal-concordant medication use (e.g., opioids for GoC focused on comfort) and assessed concordance of medication use with GoC topics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 1000 VA CLC residents with dementia and GoC documented, 46.4% of responses were reported by the Veteran versus a surrogate. Common topics included comfort (44.6%), life-sustaining treatments (31.8%), function (13.7%), care setting/transitions (12.9%), and life prolongation (11.2%). Medications were seldom discussed. Opioid and benzodiazepine use was classified as goal-concordant for 56.7% and 72.2% of patients who used them. Aspirin and antidementia medication use was more commonly classified as goal-discordant (54.7% and 38.7%, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Goals elicited via an open-ended question provided only indirect information relevant to medication use, but in many cases could be used to refine judgments of appropriateness. Integration of patient goals into formal criteria evaluating medication appropriateness is a logical next step for medication optimization research. Future research should explore the utility of questions specific to medications in GoC conversations for individuals with dementia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"73 12","pages":"3738-3746"},"PeriodicalIF":4.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://agsjournals.onlinelibrary.wiley.com/doi/epdf/10.1111/jgs.70158","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254204","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}
<p>Hypertension is a leading risk factor for morbidity in older adults, yet its prevalence and clinical characteristics in centenarians remain understudied. Analyses of data from China have shown that hypertension prevalence increases with age and is higher in men [<span>1</span>]. Specifically, in the Chinese Hypertension Survey, hypertension prevalence increased from 4.0% in the 18–24 years group to 60.2% in the ≥ 75 years group. A limitation of these findings is the grouping of all individuals aged 75 years and above, which limits insight into centenarians who often differ physiologically from their younger older-aged counterparts. Many centenarians maintain functional independence and have fewer chronic conditions, suggesting a distinct and healthier aging phenotype [<span>2</span>]. As such, it remains unclear whether known patterns of hypertension persist into extreme old age. Additionally, when all age groups were combined, analysis from the Chinese Hypertension Survey identified a difference in hypertension prevalence between men and women (24.5% vs. 21.9%). However, as data from all age groups were pooled, it is unclear whether a sex difference in hypertension prevalence exists specifically among centenarians. Therefore, we investigated the prevalence of hypertension among centenarians using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a large-scale examination of older adults across 23 provinces in China.</p><p>The CLHLS includes adults aged 65 + years. For this study, data collected from the sample of centenarians (<i>n</i> = 2877) from the 8th wave (2017–2018) were analyzed. All CLHLS participants or their authorized representatives signed informed consent. Ethical approval was granted by the Ethics Committee of Peking University. Hypertension was defined as: (a) systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg; (b) self-reported hospital diagnosis of hypertension; and/or (c) the use of antihypertensive medicine. Blood pressure was measured by trained staff using a mercury sphygmomanometer on the right arm at heart level [<span>3</span>]. After a 5-min rest, two readings were taken, and their average was recorded. Hypertension prevalence was calculated and presented with the 95% confidence interval (95% CI). In the primary analysis, an overall prevalence was calculated for both sexes combined. Secondary analysis included sex-stratified overall prevalence and prevalence according to the different diagnostic criteria.</p><p>Women (<i>n</i> = 2169) and men (<i>n</i> = 708) had an average age of 102.2 ± 2.6 and 101.8 ± 2.2 years, respectively. For women, the average systolic and diastolic blood pressure was 138.5 ± 23.9 mmHg and 76.8 ± 9.3 mmHg, respectively. For men, the average systolic and diastolic blood pressure was 134.8 ± 20.5 mmHg and 75.6 ± 8.8 mmHg, respectively. The overall prevalence of hypertension among the sample was 53.7% (95% CI = 51.9%, 55.5%). For females and males, the ov
{"title":"Hypertension Prevalence Among Centenarians: Data From the Chinese Longitudinal Healthy Longevity Survey","authors":"Jozo Grgic, Vanessa Kristina Wazny, Christine Cheung","doi":"10.1111/jgs.70139","DOIUrl":"10.1111/jgs.70139","url":null,"abstract":"<p>Hypertension is a leading risk factor for morbidity in older adults, yet its prevalence and clinical characteristics in centenarians remain understudied. Analyses of data from China have shown that hypertension prevalence increases with age and is higher in men [<span>1</span>]. Specifically, in the Chinese Hypertension Survey, hypertension prevalence increased from 4.0% in the 18–24 years group to 60.2% in the ≥ 75 years group. A limitation of these findings is the grouping of all individuals aged 75 years and above, which limits insight into centenarians who often differ physiologically from their younger older-aged counterparts. Many centenarians maintain functional independence and have fewer chronic conditions, suggesting a distinct and healthier aging phenotype [<span>2</span>]. As such, it remains unclear whether known patterns of hypertension persist into extreme old age. Additionally, when all age groups were combined, analysis from the Chinese Hypertension Survey identified a difference in hypertension prevalence between men and women (24.5% vs. 21.9%). However, as data from all age groups were pooled, it is unclear whether a sex difference in hypertension prevalence exists specifically among centenarians. Therefore, we investigated the prevalence of hypertension among centenarians using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), a large-scale examination of older adults across 23 provinces in China.</p><p>The CLHLS includes adults aged 65 + years. For this study, data collected from the sample of centenarians (<i>n</i> = 2877) from the 8th wave (2017–2018) were analyzed. All CLHLS participants or their authorized representatives signed informed consent. Ethical approval was granted by the Ethics Committee of Peking University. Hypertension was defined as: (a) systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg; (b) self-reported hospital diagnosis of hypertension; and/or (c) the use of antihypertensive medicine. Blood pressure was measured by trained staff using a mercury sphygmomanometer on the right arm at heart level [<span>3</span>]. After a 5-min rest, two readings were taken, and their average was recorded. Hypertension prevalence was calculated and presented with the 95% confidence interval (95% CI). In the primary analysis, an overall prevalence was calculated for both sexes combined. Secondary analysis included sex-stratified overall prevalence and prevalence according to the different diagnostic criteria.</p><p>Women (<i>n</i> = 2169) and men (<i>n</i> = 708) had an average age of 102.2 ± 2.6 and 101.8 ± 2.2 years, respectively. For women, the average systolic and diastolic blood pressure was 138.5 ± 23.9 mmHg and 76.8 ± 9.3 mmHg, respectively. For men, the average systolic and diastolic blood pressure was 134.8 ± 20.5 mmHg and 75.6 ± 8.8 mmHg, respectively. The overall prevalence of hypertension among the sample was 53.7% (95% CI = 51.9%, 55.5%). For females and males, the ov","PeriodicalId":17240,"journal":{"name":"Journal of the American Geriatrics Society","volume":"74 1","pages":"256-258"},"PeriodicalIF":4.5,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145254246","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号