Journal of the American Geriatrics Society最新文献

Background: Opioid use disorder (OUD) among older adults is a fast-growing public health problem. However, little is known about treatment outcomes among older adults in office-based buprenorphine programs. Thus, our objective was to examine how age is associated with buprenorphine treatment outcomes among adults with OUD who initiate buprenorphine treatment in primary care.

Methods: This was a retrospective cohort study of all adults with OUD who initiated buprenorphine at an office-based treatment program in the Bronx, NY between June 1, 2015 and December 31, 2017. Using cox proportional hazards analysis and logistic regression models, the primary outcome was buprenorphine treatment retention based on electronic health record (EHR) prescription orders. The main independent variable was age at initiation of buprenorphine treatment, categorized as age < 40, age 40-49, age 50-59, and age ≥ 60. Covariates included patient demographics, cannabis use at treatment intake, and history of OUD treatment with methadone.

Results: The cohort included 239 patients of which 70 (29%) were age 50-59 and 24 (10%) were age ≥ 60. Compared to being age < 40, being age 50-59 was associated with a 27% decreased risk of treatment discontinuation (aHR of 0.63; 95% CI, 0.42-0.95) and greater odds of treatment retention at 1 year (aOR 2.23, 95% CI, 1.15-4.67) and 2 years (aOR 2.20; 95% CI, 1.03-4.74). Compared to being age < 40, being age ≥ 60 had similar, but nonsignificant findings.

Conclusions: In office-based buprenorphine treatment, being age 50-59 was associated with more than 25% decreased risk of treatment discontinuation and over twice the odds of long-term retention in treatment than adults age < 40. While not statistically significant, likely due to their smaller sample size, adults aged ≥ 60 had similar findings. These findings highlight the success of buprenorphine treatment for OUD once it is initiated in adults over age 50.

Background: The growing older adult population in the United States creates a demand for professionals in the field of aging, though this remains a space that is overlooked by young adults beginning their career exploration. Perfect Pair is a nonprofit organization that connects older adults with college students to foster intergenerational connections. In this retrospective study, we assessed the impact that participation in Perfect Pair's programming had on college students' interest in working in the aging field as a future career.

Participants and setting: Study participants included current and past college student participants of the Perfect Pair program across 17 college chapters.

Methods: We administered a retrospective survey that assessed participants' attitudes toward a career in aging. Survey questions included pre-post and post-program questions assessed by a Likert scale, and data was analyzed by non-parametric statistical analysis.

Results: The survey was completed by 100 participants, a response rate of 10.1%. We found statistically significant differences between general members and students who engaged more with the program, such as "matched" members who met weekly with an older adult and executive board members who led their college chapter. Members that were more involved showed higher perceived preparedness to work with older adults in the future (p < 0.001) and engagement with issues associated with aging (p = 0.002). Overall, all members of the program reported an increase in their interest in working with older adults after participating in Perfect Pair (p < 0.001). This is corroborated by narrative responses, where students share excitement to pursue a career in aging.

Conclusion: Perfect Pair encourages and prepares college students to pursue a career in aging and engages them in issues associated with aging. This has strong implications for future intergenerational programming that aims to promote workforce development in the aging space.

Background: In 2015, the Netherlands implemented long-term care (LTC) reforms to promote aging-in-place, potentially impacting nursing home (NH) access for older individuals with dementia. This study examines how the reform affected NH admission rates and waiting list prevalence for this population.

Methods: We performed interrupted time series analyses to evaluate trends in NH admissions (2011-2019, Statistics Netherlands) and waiting list prevalence (2013-2018, National Healthcare Institute) before and after the 2015 LTC reform. Incidence rate ratios (IRR) were calculated for monthly NH admission rates and waiting list prevalence.

Results: Among 270,706 older people with dementia, the reform was negatively associated with NH admission rates (IRR 0.610 [0.547-0.681]), halting the pre-reform decline and stabilizing the post-reform trend (IRR 1.001 [0.999-1.002]). The reform was positively associated with NH waiting list prevalence (IRR 1.159 [1.048-1.282]).

Conclusion: Among older Dutch people with dementia, the 2015 Dutch LTC reform was associated with fewer NH admissions and longer waiting lists. While stabilization of the NH admissions may reflect prioritization of persons with dementia within stricter eligibility criteria, the concurrent rise in waiting list prevalence suggests that institutional capacity did not keep pace with persistent need. As a result, many older people with dementia remain longer in the community, raising concerns regarding their health and safety as well as the burden on their informal caregivers.