Category: Health in Aging

What Influences Older Adults’ Preferences for Care?

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Journal of the American Geriatrics Society Research Summary

We all know that family and friends are important, and that the people close to us have a big impact on our health. Now, a team of researchers has found that family support is also important when older people with advanced illnesses think about how the type of care they would prefer as they age.

 Understanding how we would prefer to be cared for as we age is vital to providing person-centered care. Person-centered care puts individual values and preferences at the heart of care decisions.  It focuses attention on the health and life goals we have individually.  Person-centered care is considered a gold standard for health care.

Until now, we haven’t had a good understanding of how older adults form care preferences. To learn more about care preferences and how they might be influenced for older adults with advanced illnesses, a team of researchers from the United Kingdom searched for existing medical studies about the topic and collected the results. They published their findings in the Journal of the American Geriatrics Society.

The research team looked at 57 studies about the preferences of older adults with advanced illness.  They included research that investigated preferences for where people wanted to be cared for, the kinds of communication and decision-making they wanted, and what quality of life they hoped to have over time. Continue reading →

Dementia Increases the Risk of 30-Day Readmission to the Hospital After Discharge

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Journal of the American Geriatrics Society Research Summary

About 25 percent of older adults admitted to hospitals have dementia and are at increased risk for serious problems like in-hospital falls and delirium (the medical term for an abrupt, rapid change in mental function). As a result, older adults with dementia are more likely to do poorly during hospital stays compared to older adults without dementia.

Until now, little was known about the effects of dementia on early hospital readmission. Researchers in Japan recently published the results of a study to learn more about the effects of dementia and being admitted to the hospital within 30 days of a previous hospital discharge (the medical term for leaving the hospital once your care is considered complete). Their study was published in the Journal of the American Geriatrics Society.

The researchers studied information from people 65-years-old and older who had been discharged from hospitals between 2014 and 2015, and then followed them for six months. The researchers were looking for unplanned readmissions to the hospital within 30 days of the patient’s discharge. Continue reading →

End-of-Life Hospital and Healthcare Use Among Older Adults with Alzheimer’s Disease

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Journal of the American Geriatrics Society Research Summary

Because people are now living longer and often healthier lives, the rate of some illnesses that are more likely to develop with age has risen. These illnesses include dementia. In fact, the number of us living with dementia was already 47 million worldwide in 2015. It could reach 131 million by 2050.

Dementia is a general term that includes different types of mental decline. The most common type of dementia is Alzheimer’s disease, which accounts for 60 to 80 percent of all dementia cases.

As Alzheimer’s disease worsens, older adults may become more likely to have trouble performing daily activities, can develop trouble swallowing, and may become less active. This increases the risk for other concerns like infections. These infections, such as pneumonia, can increase the risk for death. As a result, the cause of death for people living with Alzheimer’s disease is often infections or some other cause, rather than the Alzheimer’s disease itself.

A team of researchers from Belgium recently studied how people with Alzheimer’s disease use medical services during their final months. The goal was to learn more about the best ways to help older adults with dementia at the end of their lives. Their study was published in the Journal of the American Geriatrics Society. Continue reading →

Older Adults Who are Stronger and Able to Function Well Have Better Outcomes When Hospitalized with Critical Illnesses

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JAGS graphicJournal of the American Geriatrics Society Research Summary

Older adults are more likely than younger adults to develop critical illnesses that require hospitalization and intensive care. These illnesses include severe pneumonia and other serious respiratory conditions, congestive heart failure, heart attacks, and sepsis (a life-threatening complication from bacterial infections).

Until now, the role of strength before hospitalization has not been well-studied. Strength’s effects on how well older adults do following an intensive care unit (ICU) stay also have not been well-studied. To fill this knowledge gap, a research team created a study. The study wasto learn how older adults’ strength before they became ill affected how long they stayed in the hospital after being admitted to an ICU. They also learned whether or not the older adults died while in the hospital or within a year after discharge. Their study was published in the Journal of the American Geriatrics Society.

The researchers enrolled 575 people who had been admitted to the ICU one or more times. Participants were between the ages of 70 and 79 and lived in Memphis, TN, and Pittsburgh, PA, between March 1997 and July 1998. The participants had taken strength tests within two years before their admission to the ICU. Tests included walking 20 meters (about 64 feet), completing repeated chair stands, and assessing balance and grip strength.

The researchers learned that:

  • Participants with the slowest walk speeds had an 80 percent higher risk of dying within 30 days of their ICU admission. They had twice the risk of dying within one year of their ICU admission, compared to participants with the fastest walk speeds.
  • Participants with the poorest balance had a 77 percent higher risk of dying within 30 days of their hospital admission compared to participants with the fastest walk speeds.
  • Participants whose balance was rated as “moderate” had a 52 percent higher chance of dying within 30 days of their ICU admission.

What’s more, the researchers found that older adults who were weaker had longer hospital stays.

The researchers also noted that slower pre-hospital walk speed in particular was very strongly linked both to death and longer hospital stays.

This summary is from “The Influence of Pre-hospital Function and Strength on Outcomes of Older Critically Ill Adults.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are D. Clark Files, MD; Rebecca Neiberg, MS; Julia Rushing, MStat; Peter E. Morris, MD; Michael P. Young, MD; Hilsa Ayonayon, PhD; Tamara Harris, MD; Anne Newman, MD, MPH; Susan Rubin, MD; Eric Shiroma, MEd; Denise Houston, PhD; Michael E. Miller, PhD; and Stephen B. Kritchevsky, PhD.

Can Special Training Improve Memory and Thinking Abilities in Older Adults with Mild Cognitive Impairment?

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JAGS graphicJournal of the American Geriatrics Society Research Summary

Cognition is the ability to think and make decisions. Medication-free treatments that maintain cognitive health as we age are attracting the attention of medical experts. Maintaining the ability to think clearly and make decisions is crucial to older adults’ well-being and vitality.

Mild cognitive impairment (MCI) is a condition that affects people who are in the early stages of dementia or Alzheimer’s disease. People with MCI may have mild memory loss or other difficulties completing tasks that involve cognitive abilities. MCI may eventually develop into dementia or Alzheimer’s disease. Depression and anxiety also can accompany MCI. Having these conditions can increase the risk of mental decline as people age.

A new, first-of-its-kind study was published in the Journal of the American Geriatrics Society by scientists from research centers in Montreal and Quebec City, Canada. They designed a study to learn whether cognitive training, a medication-free treatment, could improve MCI. Studies show that activities that stimulate your brain, such as cognitive training, can protect against a decline in your mental abilities. Even older adults who have MCI can still learn and use new mental skills.

For their study, researchers recruited 145 older adults around the age of 72 from Canadian memory clinics. The participants had been diagnosed with MCI, and were assigned to one of three groups. Each group included four or five participants, and met for eight weekly sessions for 120 minutes.

The three groups were:

  • Cognitive training group. Members of this group participated in the MEMO program (MEMO stands for a French phrase that translates to “training method for optimal memory”). They received special training to improve their memory and attention span.
  • Psycho-social group. Participants in this group were encouraged to improve their general well-being. They learned to focus on the positive aspects of their lives and find ways to increase positive situations.
  • Control group. Participants had no contact with researchers and didn’t follow a program.

During the time the training sessions took place, 128 of the participants completed the project. After six months, 104 completed all the sessions they were assigned.

People in the MEMO group increased their memory scores by 35 to 40 percent, said Sylvie Belleville, PhD, a senior author of the study. “Most importantly, they maintained their scores over a six-month period.”

What’s more, the improvement was the largest for older adults with “delayed recall.” This means memory for words measured just 10 minutes after people have studied them. Because delayed memory is one of the earliest signs of Alzheimer’s disease, this was a key finding.

Those who participated in the MEMO group said they used the training they learned in their daily lives. The training gave them different ways to remember things. For example, they learned to use visual images to remember names of new people, and to use associations to remember shopping lists. These lessons allowed them to continue maintaining their memory improvements after the study ended.

The people in the psycho-social group and the control group didn’t experience memory benefits or improvement in their mood.

This summary is from “MEMO+: efficacy, durability and impact of cognitive training and psychosocial intervention in MCI.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Sylvie Belleville, PhD; Carol Hudon, PhD; Nathalie Bier, PhD; Catherine Brodeur, MD; Brigitte Gilbert, PhD; Sébastien Grenier, PhD; Marie-Christine Ouellet, PhD; Chantal Viscogliosi, PhD; and Serge Gauthier, MD.