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Discontinuing the Term "Stakeholder" From the NIA IMPACT Collaboratory Engaging Partners Team: An Example of the Process of Language Change in an Organization. 从 NIA IMPACT 协作参与伙伴团队中取消 "利益相关者 "一词:一个组织语言变化过程的实例。
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-04 DOI: 10.1016/j.jagp.2024.08.016
Evan Plys, Karen O Moss, Kristen Jacklin, Molita Yazzie, Ellen Tambor, Erin Luers, Linda Elam, Nina Ahmad, Zachary J Kunicki, Carolyn Malone, Gary Epstein-Lubow

In this paper, we describe our process of changing language of the National Institute on Aging Imbedded Pragmatic Alzheimer's disease and AD-related dementias Clinical Trials Collaboratory (NIA IMPACT Collaboratory) "Stakeholder Engagement Team" to "Engaging Partners Team" in response to feedback from community partners regarding the problematic connotations of the term "stakeholder." We present a brief history of the term "stakeholder" and its use in clinical and community-engaged research. Then, we summarize critiques of this term, including its colonial history and potential to reinforce complacency with generational traumas, particularly among Indigenous peoples and communities. We conclude with a detailed overview of our team and organization's multi-step process to discontinue use of the term "stakeholder," in alignment with a theoretical model of organizational behavior change. This paper highlights the importance of critically evaluating language and responding to community partners. We hope our process can guide other researchers and organizations.

在本文中,我们介绍了美国国家老龄化研究所嵌入式实用阿尔茨海默病和与阿尔茨海默病相关的痴呆症临床试验协作组(NIA IMPACT Collaboratory)将 "利益相关者参与团队 "改为 "参与合作伙伴团队 "的过程,以回应社区合作伙伴对 "利益相关者 "一词存在问题内涵的反馈意见。我们简要介绍了 "利益相关者 "一词的历史及其在临床和社区参与式研究中的使用。然后,我们总结了对这一术语的批评,包括其殖民历史以及对世代创伤的自满情绪,特别是在土著人民和社区中。最后,我们详细概述了我们团队和组织为停止使用 "利益相关者 "一词而采取的多步骤过程,该过程与组织行为改变的理论模型相一致。本文强调了批判性评估语言和回应社区合作伙伴的重要性。我们希望我们的过程能够为其他研究人员和组织提供指导。
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引用次数: 0
“We Don't Really Do That in Geriatrics” Commentary on Long-Acting Injectable Antipsychotics in the Geriatric Population: A Longitudinal Study "我们在老年病学中并没有真正这样做",关于老年病学人群中的长效注射抗精神病药物的评论:纵向研究
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-02 DOI: 10.1016/j.jagp.2024.08.012
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引用次数: 0
Community Delivery of Problem Adaptation Therapy (PATH) 社区提供问题适应疗法(PATH)
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-09-02 DOI: 10.1016/j.jagp.2024.08.011
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引用次数: 0
AJGP Solicits Papers Aimed to Enrich Geriatric Psychiatry AJGP 征集旨在丰富老年精神病学的论文。
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-30 DOI: 10.1016/j.jagp.2024.08.018
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引用次数: 0
Information for Subscribers 订户须知
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-30 DOI: 10.1016/S1064-7481(24)00416-0
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引用次数: 0
Delirium and dementia: Two of a kind?: Commentary on: Long-term impact of delirium on the risk of dementia in hospitalized older patients: a real-world multicenter study Gyubeom hwang, MD ChulHyoung Park, MD Rae Woong Park Sang Joon Son, MD, PhD Hyun Woong Roh, MD, PhD Jae Yeon Hwang, MD, PhD Jae-Won Jang, MD, PhD Young Tak, Jo, MD, PhD Gihwan Byeon, MD HyunChul Youn, MD, PhD. American Journal of Geriatric Psychiatry. 谵妄和痴呆:同类?评论:谵妄对住院老年患者痴呆风险的长期影响:真实世界多中心研究 Gyubeom hwang,医学博士 ChulHyoung Park,医学博士 Rae Woong Park Sang Joon Son,医学博士 Hyun Woong Roh,医学博士 Jae Yeon Hwang,医学博士 Jae-Won Jang,医学博士 Young Tak, Jo,医学博士 Gihwan Byeon,医学博士 HyunChul Youn,医学博士。美国老年精神病学杂志》。
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-26 DOI: 10.1016/j.jagp.2024.08.007
Aartjan Tf Beekman
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引用次数: 0
How should Null Findings be Interpreted? 如何解读无效结论?
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-23 DOI: 10.1016/j.jagp.2024.08.006
Jeannie-Marie Leoutsakos
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引用次数: 0
Surviving Cancer and the Risk of Developing Dementia: Is There a True Risk? 癌症幸存者与患痴呆症的风险:是否存在真正的风险?
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-22 DOI: 10.1016/j.jagp.2024.08.001
Aartjan Tf Beekman
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引用次数: 0
Long-Term Impact of Delirium on the Risk of Dementia in Hospitalized Older Patients: A Real-World Multicenter Study. 谵妄对住院老年患者痴呆风险的长期影响:一项真实世界多中心研究
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-21 DOI: 10.1016/j.jagp.2024.08.004
Gyubeom Hwang, ChulHyoung Park, Sang Joon Son, Hyun Woong Roh, Jae Yeon Hwang, Jae-Won Jang, Young Tak Jo, Gihwan Byeon, HyunChul Youn, Rae Woong Park

Background: The association between delirium and dementia has been suggested, but mostly in the postoperative setting. This study aims to explore this relationship in a broader inpatient population, leveraging extensive real-world data to provide a more generalized understanding.

Methods: In this retrospective cohort study, electronic health records of 11,970,475 hospitalized patients aged over 60 from nine institutions in South Korea were analyzed. Patients with and without delirium were identified, and propensity score matching (PSM) was used to create comparable groups. A 10-year longitudinal analysis was conducted using the Cox proportional hazards model, which calculated the hazard ratio (HR) and 95% confidence interval (CI). Additionally, a meta-analysis was performed, aggregating results from all nine medical institutions. Lastly, we conducted various subgroup and sensitivity analyses to demonstrate the consistency of our study results across diverse conditions.

Results: After 1:1 PSM, a total of 47,306 patients were matched in both the delirium and nondelirium groups. Both groups had a median age group of 75-79 years, with 43.1% being female. The delirium group showed a significantly higher risk of all dementia compared with the nondelirium group (HR: 2.70 [95% CI: 2.27-3.20]). The incidence risk for different types of dementia was also notably higher in the delirium group (all dementia or mild cognitive impairment, HR: 2.46 [95% CI: 2.10-2.88]; Alzheimer's disease, HR: 2.74 [95% CI: 2.40-3.13]; vascular dementia, HR: 2.55 [95% CI: 2.07-3.13]). This pattern was consistent across all subgroup and sensitivity analyses.

Conclusions: Delirium significantly increases the risk of onset for all types of dementia. These findings highlight the importance of early detection of delirium and prompt intervention. Further research studies are warranted to investigate the mechanisms linking delirium and dementia.

背景:谵妄与痴呆之间的关系已被提出,但主要是在术后环境中。本研究旨在利用广泛的真实世界数据,在更广泛的住院人群中探讨这种关系,以提供更普遍的认识:在这项回顾性队列研究中,分析了韩国九家医疗机构的 11970475 名 60 岁以上住院患者的电子健康记录。确定了有谵妄和无谵妄的患者,并使用倾向得分匹配法(PSM)创建了可比组别。采用考克斯比例危险模型进行了为期10年的纵向分析,计算出了危险比(HR)和95%置信区间(CI)。此外,我们还进行了一项荟萃分析,汇总了所有九家医疗机构的结果。最后,我们还进行了各种亚组和敏感性分析,以证明我们的研究结果在不同情况下的一致性:经过 1:1 PSM,谵妄组和非谵妄组共匹配了 47,306 名患者。两组患者的年龄中位数均为 75-79 岁,女性占 43.1%。与非谵妄组相比,谵妄组患所有痴呆症的风险明显更高(HR:2.70 [95% CI:2.27-3.20])。不同类型痴呆的发病风险在谵妄组也明显较高(所有痴呆或轻度认知障碍,HR:2.46 [95% CI:2.10-2.88];阿尔茨海默病,HR:2.74 [95% CI:2.40-3.13];血管性痴呆,HR:2.55 [95% CI:2.07-3.13])。这一模式在所有亚组和敏感性分析中都是一致的:结论:谵妄会大大增加所有类型痴呆症的发病风险。这些发现强调了早期发现谵妄和及时干预的重要性。有必要开展进一步研究,探讨谵妄与痴呆症之间的关联机制。
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引用次数: 0
Association of Cognitive Frailty With Subsequent All-Cause Mortality Among Middle-Aged and Older Adults in 17 Countries. 17 个国家的中老年人认知能力衰弱与后续全因死亡率的关系。
IF 4.4 2区 医学 Q1 GERIATRICS & GERONTOLOGY Pub Date : 2024-08-21 DOI: 10.1016/j.jagp.2024.08.009
Yemin Yuan, Huaxin Si, Zhenyu Shi, Yanshang Wang, Yiqi Xia, Xiaolong Guan, Ping He

Objectives: Cognitive frailty refers to the co-occurrence of cognitive impairment and frailty without concurrent Alzheimer's disease or dementia. Studies of cognitive frailty and mortality have been limited to single country or older people. However, frailty and cognitive decline may occur much earlier. We aimed to examine the association between different cognitive frailty status and subsequent all-cause mortality among middle-aged and older people in 17 countries.

Methods: Participants aged 50 and over were drawn from six prospective cohorts of aging. We classified participants according to their cognitive impairment and frailty status into the following groups: none, only cognitive impairment, only frailty and cognitive frailty. Competing-risks regression models were used to evaluate the association of different cognitive frailty status at baseline with subsequent all-cause mortality.

Results: The cognitive frailty group had a higher mortality risk compared to those without cognitive impairment and frailty groups. Meta-analysis results showed participants with cognitive frailty (pooled subhazard ratio [SHR] = 2.34, 95% confidence interval [CI]: 2.01-2.72, I2 = 68.0%) had a higher mortality risk compared with those with only cognitive impairment status (pooled SHR = 1.36, 95% CI: 1.25-1.48, I2 = 3.0%) or only frailty status (pooled SHR = 1.83, 95% CI: 1.72-1.95, I2 = 31.0%). The association between cognitive frailty and mortality were stronger among those who were aged 70 years and older, males, single and nonconsumers of alcohol.

Conclusions: Cognitive frailty, frailty or cognitive impairment alone, is associated with an increased risk of all-cause mortality in Asian, European and American countries. Physical and cognitive function screening should be conducted as early as possible in middle-aged and older people, and targeted intervention approaches should be developed to reduce the incidence of adverse health outcomes.

目的:认知虚弱指的是在没有并发阿尔茨海默病或痴呆症的情况下同时出现认知障碍和虚弱。有关认知虚弱和死亡率的研究仅限于单一国家或老年人。然而,虚弱和认知衰退可能发生得更早。我们旨在研究 17 个国家的中老年人不同的认知虚弱状况与随后的全因死亡率之间的关系:我们从六个老龄化前瞻性队列中抽取了 50 岁及以上的参与者。我们根据参与者的认知障碍和虚弱状态将其分为以下几组:无、仅认知障碍、仅虚弱和认知虚弱。我们使用竞争风险回归模型来评估不同基线认知虚弱状态与后续全因死亡率的关系:结果:与无认知障碍组和认知虚弱组相比,认知虚弱组的死亡风险更高。元分析结果显示,与仅有认知功能障碍状态(汇总子危险比 [SHR] = 1.36,95% 置信区间 [CI]:1.25-1.48,I2 = 3.0%)或仅有虚弱状态(汇总子危险比 [SHR] = 1.83,95% 置信区间 [CI]:1.72-1.95,I2 = 31.0%)的参与者相比,认知功能虚弱参与者的死亡风险更高(汇总子危险比 [SHR] = 2.34,95% 置信区间 [CI]:2.01-2.72,I2 = 68.0%)。认知虚弱与死亡率之间的关系在 70 岁及以上、男性、单身和不饮酒者中更为密切:结论:在亚洲、欧洲和美洲国家,认知虚弱、虚弱或认知障碍与全因死亡风险增加有关。应尽早对中老年人进行身体和认知功能筛查,并制定有针对性的干预方法,以降低不良健康后果的发生率。
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American Journal of Geriatric Psychiatry
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