Effects of Calorie Restriction in Obese Older Adults: The CROSSROADS Randomized Controlled Trial.

Background: We lack a comprehensive assessment of the risks and benefits of calorie restriction in older adults at high risk for cardiometabolic disease. Calorie restriction may reduce visceral adipose tissue (VAT) but also have negative effects on lean mass and quality of life.

Methods: We conducted a 52-week, randomized controlled trial involving 164 older adults with obesity taking at least one medication for hyperlipidemia, hypertension, or diabetes.

Calorie restriction in overweight seniors: response of older adults to a dieting study: the CROSSROADS randomized controlled clinical trial.

We conducted a study designed to evaluate whether the benefits of intentional weight loss exceed the potential risks in a group of community-dwelling obese older adults who were at increased risk for cardiometabolic disease. The CROSSROADS trial used a prospective randomized controlled design to compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition and adipose tissue deposition (Specific Aim #1: To compare the effects of changes in diet composition alone or combined with weight loss with an exercise only control intervention on body composition, namely visceral adipose tissue), cardiometabolic disease risk (Specific Aim #2: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on cardiometabolic disease risk), and functional status and quality of life (Specific Aim #3: To compare the effects of a change in diet composition alone or combined with weight loss with an exercise only control intervention on functional status and quality of life). Participants were randomly assigned to one of three groups: Exercise Only (Control) Intervention, Exercise + Diet Quality + Weight Maintenance Intervention, or Exercise + Diet Quality + Weight Loss Intervention.

Symptom burden predicts hospitalization independent of comorbidity in community-dwelling older adults.

Objectives: To determine whether cumulative symptom burden predicts hospitalization or emergency department (ED) visits in a cohort of older adults.

Design: Prospective, observational study with a baseline in-home assessment of symptom burden.

Setting: Central Alabama.

The E-coach transition support computer telephony implementation study: protocol of a randomized trial.

Background: Patients requiring complex care are at high risk during the transition from one setting of care to another. Effective interventions to support care transitions have been designed but are very resource intensive. Telemonitoring has been considered as an approach to enhance care transition support, but many telemonitoring systems require special equipment or web-based interfaces to interact with patients and caregivers.

Inflammatory biomarkers as predictors of hospitalization and death in community-dwelling older adults.

Individuals with multimorbidity may be at increased risk of hospitalization and death. Comorbidity indexes do not capture severity of illness or healthcare utilization; however, inflammation biomarkers that are not disease-specific may predict hospitalization and death in older adults. We sought to predict hospitalization and mortality of older adults using inflammation biomarkers.

Visual acuity's association with levels of leisure-time physical activity in community-dwelling older adults.

Little is known about the effect of reduced vision on physical activity in older adults. This study evaluates the association of visual acuity level, self-reported vision, and ocular disease conditions with leisure-time physical activity and calculated caloric expenditure. A cross-sectional study of 911 subjects 65 yr and older from the University of Alabama at Birmingham Study of Aging (SOA) cohort was conducted evaluating the association of vision-related variables to weekly kilocalorie expenditure calculated from the 17-item Leisure Time Physical Activity Questionnaire.

Body mass index, weight loss, and mortality in community-dwelling older adults.

Background: The relationship between body mass index (BMI), weight loss, and mortality in older adults is not entirely clear. The purpose of this article is to evaluate the associations between BMI, weight loss (either intentional or unintentional), and 3-year mortality in a cohort of older adults participating in the University of Alabama at Birmingham (UAB) Study of Aging.

Methods: This article reports on 983 community-dwelling older adults who were enrolled in the UAB Study of Aging, a longitudinal observational study of mobility among older African American and white adults.

Substantial daily pain among nursing home residents.

Objective: To evaluate the prevalence of substantial daily pain among nursing home residents aged 65 and older.

Design, Setting, And Methods: The Minimum Data Set (MDS) annual or admission assessment, available September 2002, for Alabama nursing home residents was used. Logistic regression was used to examine the association of such pain with nursing home characteristics as well as resident-specific factors.

Pain and pain medication use in community-dwelling older adults.

Background: Pain is a common symptom and significant problem for older adults; up to one half of community-dwelling older adults have pain that interferes with normal function.

Objective: The goal of this study was to investigate the prevalence of pain among a racially and gender-balanced sample of community-dwelling older adults and evaluate sociodemographic factors associated with the reporting of pain. Both nonprescription (over-the-counter [OTC]) and prescription pain medications used by the participants and the sociodemographic factors associated with having medication prescribed were considered.

Social isolation, support, and capital and nutritional risk in an older sample: ethnic and gender differences.

This study examines the relationships that exist between social isolation, support, and capital and nutritional risk in older black and white women and men. The paper reports on 1000 community-dwelling older adults aged 65 and older enrolled in the University of Alabama at Birmingham (UAB) Study of Aging, a longitudinal observational study of mobility among older black and white participants in the USA. Black women were at greatest nutritional risk; and black women and men were the groups most likely to be socially isolated and to possess the least amounts of social support and social capital.

Measuring life-space mobility in community-dwelling older adults.

Objectives: To evaluate the validity and reliability of a standardized approach for assessing life-space mobility (the University of Alabama at Birmingham Study of Aging Life-Space Assessment (LSA)) and its ability to detect changes in life-space over time in community-dwelling older adults.

Design: Prospective, observational cohort study.

Setting: Five counties (three rural and two urban) in central Alabama.

Age-related underutilization of angiotensin-converting enzyme inhibitors in older hospitalized heart failure patients.

Background: The extent to which age plays a role in the underutilization of angiotensin-converting enzyme (ACE) inhibitors in heart failure patients has not been well studied.

Methods: We studied age-related variation in the use of ACE inhibitors in older Medicare beneficiaries discharged alive in Alabama with a diagnosis of heart failure with left ventricular systolic dysfunction.

Results: A total of 285 patients had a mean age +/- SD of 78 +/- 6.

Age-related underutilization of left ventricular function evaluation in older heart failure patients.

Background: Underutilization of left ventricular function (LVF) evaluation in older patients with heart failure has been well documented, but age-related variation in the use of LVF evaluation has not been.

Methods: We studied age-related variation of LVF evaluation in older Medicare-beneficiaries discharged with a diagnosis of heart failure in 1994 in Alabama.

Results: A total of 1,090 patients had a mean +/- SD age of 79 +/- 7.

Coordination and advocacy for rural elders (CARE): a model of rural case management with veterans.

Purpose: To describe a pilot initiative sponsored by the Veterans Health Administration (VHA) to improve the health and community tenure of frail older veterans living in rural counties 50-100 miles from two host VHA medical centers.

Design And Methods: Veterans aged 75 and older who scored at risk of repeated hospital admission on the PRA-Plus telephone questionnaire were targeted and visited by evaluators who administered a comprehensive health questionnaire prior to being assessed at home by the Coordination and Advocacy for Rural Elders (CARE) program clinical teams. Guided by current state-of-the-art practices, the nurse-social worker teams performed in-home standardized assessments using the MDS-HC, developed patient-specific care plans, and mobilized family, community, and VHA resources to implement plans.