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10 Years of INTERACT: The Push for Better SNF Care

Caring for the Ages
June 1, 2019

Ten years ago, Joseph G. Ouslander, MD, a geriatrician at Florida Atlantic University (FAU), published the findings of a pilot project that tested tools and strategies to help nursing home staff reduce potentially avoidable hospitalizations. The six-month quality improvement project in Georgia led to a 50% reduction in overall hospitalizations in three nursing homes selected based on their high hospitalization rates (J Am Med Dir Assn 2009;10:644–652).

8 Tips to Avoid Being Sued in the Nursing Home: Attorneys Offer Expert Insight on Improving Care and Avoiding Lawsuits

Caring for the Ages
June 1, 2019

LOS ANGELES — Don’t feel like you have to provide perfect care, but do make sure you’re responsible and responsive. And always — always! — be honest, even when you think you’re in trouble.

Dementia Cafés as a Community Resource for Persons With Early-Stage Cognitive Disorders: A Nationwide Survey in Japan

JAMDA
May 31, 2019

Dementia cafés are expected to serve as a new community resource based on the national dementia strategy in Japan. The objective of the present study was to examine effective ways to manage dementia cafés through an overview of dementia cafés in Japan and an analysis of the factors related to their effectiveness on attendees.

Gender Differences in Trajectories of Lower Extremity Function in Older Adults: Findings From the International Mobility in Aging Study

JAMDA
May 31, 2019

We examined the lower extremity function trajectories of older men and women over 4 years and baseline predictors of these trajectories.

Coexistence of Chronic Musculoskeletal Pain and Depressive Symptoms and Their Combined and Individual Effects on Onset of Disability in Older Adults: A Cohort Study

JAMDA
May 31, 2019

Coexistence of chronic musculoskeletal pain and depressive symptoms is common, and their combined effect on adverse events warrants investigation. The purpose of this study was to investigate the individual and combined effect of chronic musculoskeletal pain and depressive symptoms on the onset of disability, which is a crucial outcome in older adults.

Response to the Letter to the Editor “Antidepressant and Risk of Dementia: Confounding by Indication”

JAMDA
May 31, 2019

The response letter to our recent article raises the concern that the severity of depression may affect the risk of dementia, so confounding by indication may also be a potential limitation of this study. Therefore, we would like to further explain this point with more evidence from the existing literature.

Response to: “Oldest Old With Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Noninvasive Ventilation: 2 Planets Approaching”

JAMDA
May 31, 2019

We are thankful for the interest in our work and for the stimulating comments on our study.1 We agree with the authors regarding the complex clinical conditions of the hospitalized oldest old, and our study population, with a mean age of 87 years, stressed out this aspect. High comorbidity, according to the Geriatric Index of Comorbidity (GIC), and functional impairment were found in almost three-quarters of patients, and almost half of them had a cognitive decline. The aim of our study was to investigate the most relevant predictors of in-hospital mortality and need for post-acute care...

Oldest Old With Acute Exacerbation of Chronic Obstructive Pulmonary Disease and Noninvasive Ventilation: 2 Planets Approaching

JAMDA
May 31, 2019

We read with great interest the article of Spannella et al1 on the predictors of in-hospital mortality and need for post-acute care in acute exacerbation of chronic obstructive pulmonary disease (COPD) in the oldest adults. Furthermore, in our opinion, there are some uncertainties to clarify. The hospitalized oldest old patients represent a very complicated planet for the presence of frailty, the long-term cognitive impairment, the incidence of delirium, the malnutrition, the comorbidities, the problematic decision-making process, the disability, the life expectancy evaluation, the...

Antidepressant and Risk of Dementia: Confounding by Indication

JAMDA
May 31, 2019

The meta-analysis by Chan et al1 highlighted the uncertain role of antidepressants in dementia prevention, which is pertinent considering that depression has been identified as a potentially modifiable risk factor of dementia in a recent Lancet Commission.2 By pooling the risk estimates from 4 longitudinal studies, Chan et al suggested that antidepressant use may be associated with a higher risk of dementia among patients with depression, and that future research is needed to investigate the benefit-risk ratio of antidepressant use in at-risk patients.

Response to Resolution A19 Regarding “Stopping Eating and Drinking by Advance Directives”

JAMDA
May 31, 2019

In March 2019, the Society for Post-Acute and Long-Term Care Medicine's (AMDA's) House of Delegates adopted Resolution A19 as policy, which AMDA's Ethics Committee had proposed.1 We appreciate their effort to address a difficult issue. But we disagree both with their categorical rejection of “Stopping Eating and Drinking by Advanced Directives” (SED by AD) and with their categorical insistence that feeding must continue for all advanced dementia patients until their behavior manifests refusal or distress.