Advancing Delirium Treatment Trials in Older Adults: Recommendations for Future Trials From the Network for Investigation of Delirium: Unifying Scientists (NIDUS).

Objectives: To summarize the delirium treatment trial literature, identify the unique challenges in delirium treatment trials, and formulate recommendations to address each in older adults.

Design: A 39-member interprofessional and international expert working group of clinicians (physicians, nurses, and pharmacists) and nonclinicians (biostatisticians, epidemiologists, and trial methodologists) was convened. Four expert panels were assembled to explore key subtopics (pharmacological/nonpharmacologic treatment, methodological challenges, and novel research designs).

Rates and Predictors of Performance Validity Test Failure in Adults Treated for Post-COVID-19 Condition: a Brief Report.

>objective: Cognitive dysfunction is a common symptom of post-COVID-19 condition (PCC). Few studies have examined rates and predictors of cognitive performance validity test (PVT) failure in patients seeking treatment for PCC.

>methods: We report the rates of PVT failure in 323 patients who received care in a long-COVID-19 clinic for any post-COVID-19 health concern and underwent routine telephone cognitive testing that included two embedded PVTs.

Increasing Representation/Inclusivity Of Older Adults And Investigators From Minoritized Groups In Aging Research.

The National Institute on Aging (NIA) plays a pivotal role in advancing scientific research, developing training and the science workforce, and promoting public health initiatives. However, the benefits of the NIA's work have not been equally distributed among all older adult population groups, highlighting persistent disparities in chronic illness burden and access to healthcare and research. As the NIA commemorates its 50th anniversary, this milestone presents an opportunity to reflect on its consequential initiatives and accomplishments while also strategizing for the robust inclusion of underrepresented and minoritized populations and the future health of our Nation's older adult population.

Housing Instability and Outcomes Among Patients With Access-Sensitive Surgical Conditions.

Introduction: Housing instability is a significant contributor to poor health but remains understudied among surgical patients. We evaluated the association between housing instability and rates of unplanned surgical procedures, as well as resultant health and financial outcomes, for patients with access-sensitive conditions.

Methods: Using the Healthcare Cost and Utilization Project National Inpatient Sample, we identified patients who underwent one of four selected procedures for access-sensitive surgical conditions (abdominal aortic aneurysm repair, colectomy, incisional hernia repair, and lower extremity bypass).

Scoping Review: Association of Inpatient Hospital Design Features With Patients' Clinical Outcomes.

To identify associations between inpatient hospital design features and empirical patient clinical outcomes as well as changes over time. A growing body of literature has emerged evaluating the association of hospital design features with measurable clinical outcomes during inpatient hospital admissions. However, there has been limited effort to evaluate the scope and quality of studies examining individual, inpatient hospital design features on empirical patient clinical outcomes.

World delirium awareness and quality survey in 2023-a worldwide point prevalence study.

Background: Delirium, an acute brain dysfunction, is proposed to be highly prevalent in clinical care and shown to significantly increase the risk of mortality and dementia.

Objectives: To report on the global prevalence of clinically documented delirium and delirium-related clinical practices in wards caring for paediatric and adult patients in healthcare facilities.

Design: A prospective, cross-sectional, 39-question survey completed on World Delirium Awareness Day, 15 March 2023.

Dementia.

Dementia, or major neurocognitive disorder, is defined as a decline in 1 or more cognitive domains that causes impairment in everyday function. Alzheimer disease is the most common type of dementia in the United States, with an estimated 6.9 million adults who have Alzheimer disease and are 65 years or older.

Preoperative Neurofilament Light Associated With Postoperative Delirium in Hip Fracture Repair Patients Without Dementia.

Background: Delirium commonly occurs in older adults following surgery; although its pathophysiology is not fully understood, underlying neurodegeneration is a risk factor.

Objective: Examine the association of preoperative levels of markers of neuronal damage, neurofilament light (NfL) and phosphorylated tau (p-tau), with postoperative delirium.

Methods: Preoperative cerebrospinal fluid (CSF) and plasma were obtained from 158 patients undergoing hip fracture repair and enrolled in the clinical trial "A STrategy to Reduce the Incidence of Postoperative Delirium in Elderly Patients.

Prevalence of Hearing Loss and Hearing Aid Use Among Persons Living With Dementia in the US.

Importance: Dementia and hearing loss are prevalent and represent public health priorities, but little is known about the prevalence of hearing loss among persons living with dementia at a population level.

Objective: To estimate the prevalence of hearing loss and hearing aid use among a nationally representative sample of persons living with dementia.

Design, Setting, And Participants: In this cross-sectional study, we analyzed data from Medicare beneficiaries who participated in round 11 of the National Health and Aging Trends Study (NHATS).

The Relationship between Delirium and Dementia.

Delirium and dementia are common causes of cognitive impairment in older adults. They are distinct but interrelated. Delirium, an acute confusional state, has been linked to the chronic and progressive loss of cognitive ability seen in dementia.

Incidence of post-operative delirium increases as severity of frailty increases.

Objective: The surgical population is ageing and often frail. Frailty increases the risk for poor post-operative outcomes such as delirium, which carries significant morbidity, mortality and cost. Frailty is often measured in a binary manner, limiting pre-operative counselling.

Methylphenidate for the Treatment of Post-COVID Cognitive Dysfunction (Brain Fog).

A substantial number of patients develop cognitive dysfunction after contracting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), significantly contributing to long-coronavirus disease (COVID) morbidity. Despite the urgent and overwhelming clinical need, there are currently no proven interventions to treat post-COVID cognitive dysfunction (PCCD). Psychostimulants like methylphenidate may enhance both noradrenergic and dopaminergic pathways in mesolimbic and pre-frontal areas, thus improving memory and cognition.

The Medicare annual wellness visit: An opportunity to improve health system identification of hearing loss?

Background: Hearing loss is prevalent and consequential but under-diagnosed and managed. The Medicare Annual Wellness Visit (AWV) health risk assessment elicits patient-reported hearing concerns but whether such information affects documentation, diagnosis, or referral is unknown.

Methods: We use 5 years of electronic medical record (EMR) data (2017-2022) for a sample of 13,776 older primary care patients.

Racial/ethnic differences in neuropsychiatric disturbances associated with incident dementia.

Introduction: Neuropsychiatric symptoms (NPS) are nearly universal in dementia; some cross-sectional studies of NPS in dementia have found racial/ethnic differences, though it is unknown if NPS prevalence differs among racial/ethnic groups before and after dementia diagnosis.

Methods: Participants were followed annually at Alzheimer's Disease Centers and were assessed on the Neuropsychiatric Inventory-Questionnaire (NPI-Q) with at least one follow-up visit at which they were diagnosed with dementia. Descriptive statistics were generated by race/ethnicity.

A world-wide study on delirium assessments and presence of protocols.

Background: Delirium is a common complication of older people in hospitals, rehabilitation and long-term facilities.

Objective: To assess the worldwide use of validated delirium assessment tools and the presence of delirium management protocols.

Design: Secondary analysis of a worldwide one-day point prevalence study on World Delirium Awareness Day, 15 March 2023.

Delirium in the United States: Results From the 2023 Cross-Sectional World Delirium Awareness Day Prevalence Study.

Background: Delirium is an acute brain dysfunction associated with an increased risk of mortality and future dementia.

Objectives: To describe the prevalence of clinically documented delirium in the United States on World Delirium Awareness Day 2023.

Methods: This is a sub-analysis of a prospective, cross-sectional, online, international survey.

Hearing loss and cognitive decline: Prioritizing equity in a world in which hearing health matters.

Alzheimer's disease and related dementias (ADRDs) and age-related hearing loss are the intersection of two major public health challenges. With age as the primary risk factor for both disease processes, the burden of ADRDs and age-related hearing loss is growing, and each field maintains significant barriers to broadscale identification and management that is affordable and accessible. With the disproportionate burden of ADRDs among racial and ethnic minority older adults and existing disparities within hearing care, both areas face challenges in achieving equitable access and outcomes across diverse populations.

Managing Delirium in the Emergency Department: An Updated Narrative Review.

Purpose Of Review: Emergency departments (EDs) are facing an epidemic of overcrowding and ED boarding, particularly of older adults who often present with, or develop, delirium in the ED. Delirium is associated with increased complications, longer hospital length of stay, mortality, and costs to the healthcare system. However, we only have limited knowledge of how to successfully prevent and treat delirium in the ED in a pragmatic, sustainable, and cost-effective way.

The Annual Wellness Visit Health Risk Assessment: Potential of Patient Portal-Based Completion and Patient-Oriented Education and Support.

Background And Objectives: Patient portals are secure online platforms that allow patients to perform electronic health management tasks and engage in bidirectional information exchange with their care team. Some health systems administer Medicare Annual Wellness Visit (AWV) health risk assessments through the patient portal. Scalable opportunities from portal-based administration of risk assessments are not well understood.