Cognitive impairment and dementia in a nationally representative sample of older adults receiving care for incident TBI.

Background: Cognitive problems are thought to increase vulnerability to geriatric traumatic brain injury (TBI) due to increased fall risk, but little is known about prevalence of cognitive impairment and Alzheimer’s disease and related dementias (ADRD) among elders who receive treatment for a TBI.

Method: Enrollees 65 and older in the nationally representative Health and Retirement Study (HRS) who consented to link survey data to Medicare claims and without a TBI prior to enrollment were studied. We used claims 2000‐2018 to obtain incident TBI diagnoses, defined using inpatient and outpatient International Classification of Disease (ICD) 9 and 10 codes received the same day as an emergency room (ER) visit code and a computed tomography (CT) scan code.

Association of Social Determinants of Health with Acute TBI Care Among U.S. Older Adults.

Background: Older adults have the highest incidence of traumatic brain injury (I‐TBI), which is associated with increased Alzheimer’s disease and related dementia (ADRD) risk. Timely medical assessment, including computed tomography (CT) or magnetic resonance imaging (MRI), is vital for optimal I‐TBI care and recovery. The current study builds on our recent work by examining social determinants of comprehensiveness of I‐TBI care amongst older adults.

Delirium risk profiles in a population-based study of United States older adults undergoing common noncardiac surgeries.

Background: Older adults often require surgical care and are at elevated risk of delirium. We explored delirium risk profiles across the population of U.S.

The Neighborhood Environment and Handgrip Strength: Longitudinal Findings From the Health and Retirement Study.

Background: Muscle strength, as measured by handgrip strength (HGS), is associated with physical function and mortality. Yet the environmental context that influences muscle strength is poorly understood. We evaluated built and social neighborhood characteristics and their association with muscle strength over time.

Geriatric conditions and healthcare utilization among older adults living in subsidized housing.

Background: Nearly 2.9 million older Americans with lower incomes live in subsidized housing. While regional and single-site studies show that this group has higher rates of healthcare utilization compared to older adults in the general community, little is known about healthcare utilization nationally nor associated risk factors.

Incidence of Traumatic Brain Injury in a Longitudinal Cohort of Older Adults.

Importance: Traumatic brain injury (TBI) occurs at the highest rate in older adulthood and increases risk for cognitive impairment and dementia.

Objectives: To update existing TBI surveillance data to capture nonhospital settings and to explore how social determinants of health (SDOH) are associated with TBI incidence among older adults.

Design, Setting, And Participants: This nationally representative longitudinal cohort study assessed participants for 18 years, from August 2000 through December 2018, using data from the Health and Retirement Study (HRS) and linked Medicare claims dates.

Long-term cognitive outcome after elective hip or knee total joint arthroplasty: A population-based observational study.

Background: One year after elective hip or knee total joint arthroplasty (TJA), >30% of older adults meet criteria for postoperative neurocognitive disorder. However, this is not contextualized with long-term cognitive outcomes in comparable surgical and nonsurgical controls. We analyzed population-based data to compare long-term cognitive outcomes in older adults after TJA, other surgeries, and with and without arthritis pain.

Around the EQUATOR with Clin-STAR: Prediction modeling opportunities and challenges in aging research.

The 2015 Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) Statement was published to improve reporting transparency for prediction modeling studies. The objective of this review is to highlight methodologic challenges that aging-focused researchers will encounter when designing and reporting studies involving prediction models for older adults and provide guidance for addressing these challenges. In following the 22-item TRIPOD checklist, researchers must consider the representativeness of cohorts used (e.

Preoperative Factors Predict Memory Decline After Coronary Artery Bypass Grafting or Percutaneous Coronary Intervention in an Epidemiological Cohort of Older Adults.

Background Durable memory decline may occur in older adults after surgical (coronary artery bypass grafting [CABG]) or nonsurgical (percutaneous coronary intervention) coronary revascularization. However, it is unknown whether individual memory risk can be predicted. We reanalyzed an epidemiological cohort of older adults to predict memory decline at ≈1 year after revascularization.

A comprehensive prognostic tool for older adults: Predicting death, ADL disability, and walking disability simultaneously.

Background: Many clinical and financial decisions for older adults depend on the future risk of disability and mortality. Prognostic tools for long-term disability risk in a general population are lacking. We aimed to create a comprehensive prognostic tool that predicts the risk of mortality, of activities of daily living (ADL) disability, and walking disability simultaneously using the same set of variables.

Changes in the Hierarchy of Functional Impairment From Middle Age to Older Age.

Background: Understanding the hierarchy of functional impairment in older adults has helped illuminate mechanisms of impairment and inform interventions, but little is known about whether hierarchies vary by age. We compared the pattern of new-onset impairments in activities of daily living (ADLs) and instrumental ADLs (IADLs) from middle age through older age.

Methods: We conducted a cohort study using nationally representative data from 32 486 individuals enrolled in the Health and Retirement Study.

Association of Coronary Artery Bypass Grafting vs Percutaneous Coronary Intervention With Memory Decline in Older Adults Undergoing Coronary Revascularization.

Importance: It is uncertain whether coronary artery bypass grafting (CABG) is associated with cognitive decline in older adults compared with a nonsurgical method of coronary revascularization (percutaneous coronary intervention [PCI]).

Objective: To compare the change in the rate of memory decline after CABG vs PCI.

Design, Setting, And Participants: Retrospective cohort study of community-dwelling participants in the Health and Retirement Study, who underwent CABG or PCI between 1998 and 2015 at age 65 years or older.

A Novel Method for Identifying a Parsimonious and Accurate Predictive Model for Multiple Clinical Outcomes.

Background And Objective: Most methods for developing clinical prognostic models focus on identifying parsimonious and accurate models to predict a single outcome; however, patients and providers often want to predict multiple outcomes simultaneously. As an example, for older adults one is often interested in predicting nursing home admission as well as mortality. We propose and evaluate a novel predictor-selection computing method for multiple outcomes and provide the code for its implementation.

A Novel Metric for Developing Easy-to-Use and Accurate Clinical Prediction Models: The Time-cost Information Criterion.

Background: Guidelines recommend that clinicians use clinical prediction models to estimate future risk to guide decisions. For example, predicted fracture risk is a major factor in the decision to initiate bisphosphonate medications. However, current methods for developing prediction models often lead to models that are accurate but difficult to use in clinical settings.

Changes in functional status associated with radiation for prostate cancer in older veterans.

Background: Although older men value maintaining independence and avoiding functional decline, little is known about their functional trajectories with receipt of prostate radiation.

Methods: We performed a retrospective cohort study including veterans age 65+ with localized prostate cancer who resided in a VA nursing facility while receiving prostate radiation from 2005 to 2015. We evaluated the change in Minimum Data Set (MDS) activities of daily living (ADL) score during 6 months from the start of treatment.

Defining intraspecific conservation units in the endemic Cuban Rock Iguanas (Cyclura nubila nubila).

Defining conservation units is an important step in species management and requires interpretation of the genetic diversity and ecological function of the taxon being considered. We used the endemic Cuban Rock Iguanas (Cyclura nubila nubila) as a model to highlight this challenge and examined patterns of its intraspecific genetic diversity across Cuba. We evaluated nuclear (microsatellite loci) and mitochondrial diversity across eight populations from the island and its off-shore cays, and applied the population genetics results for assignment of Management Unit (MU) status and Evolutionary Significant Units (ESUs) based on phylogeographic and time of divergence information.

Association of Functional Impairment in Middle Age With Hospitalization, Nursing Home Admission, and Death.

Importance: Difficulty performing daily activities such as bathing and dressing ("functional impairment") affects nearly 15% of middle-aged adults. Older adults who develop such difficulties, often because of frailty and other age-related conditions, are at increased risk of acute care use, nursing home admission, and death. However, it is unknown if functional impairments that develop among middle-aged people, which may have different antecedents, have similar prognostic significance.

Cognitive Change After Cardiac Surgery Versus Cardiac Catheterization: A Population-Based Study.

Background: Despite concern that cardiac surgery may adversely affect cognition, little evidence is available from population-based studies using presurgery data. With the use of the Health and Retirement Study, we compared memory change after participant-reported cardiac catheterization or cardiac surgery.

Methods: Participants were community-dwelling adults aged 65 years and older who self-reported cardiac catheterization or "heart surgery" at any biennial Health and Retirement Study interview between 2000 and 2014.

'Til Death Do Us Part: End-of-Life Experiences of Married Couples in a Nationally Representative Survey.

Objectives: To determine whether end-of-life (EOL) experiences in the first spouse in a marriage are associated with EOL experiences in the other spouse.

Design: Nationally representative, longitudinal survey.

Setting: Health and Retirement Study, Waves 1992-2012 linked to Medicare claims PARTICIPANTS: Community-dwelling older adults who died (N=4,558), representing 2,279 married heterosexual couples.

Functional Impairment and Decline in Middle Age: A Cohort Study.

Background: Difficulties with daily functioning are common in middle-aged adults. However, little is known about the epidemiology or clinical course of these problems, including the extent to which they share common features with functional impairment in older adults.

Objective: To determine the epidemiology and clinical course of functional impairment and decline in middle age.

Wealth-Associated Disparities in Death and Disability in the United States and England.

Importance: Low income has been associated with poor health outcomes. Owing to retirement, wealth may be a better marker of financial resources among older adults.

Objective: To determine the association of wealth with mortality and disability among older adults in the United States and England.

Triglyceride Synthesis by DGAT1 Protects Adipocytes from Lipid-Induced ER Stress during Lipolysis.

Triglyceride (TG) storage in adipose tissue provides the major reservoir for metabolic energy in mammals. During lipolysis, fatty acids (FAs) are hydrolyzed from adipocyte TG stores and transported to other tissues for fuel. For unclear reasons, a large portion of hydrolyzed FAs in adipocytes is re-esterified to TGs in a "futile," ATP-consuming, energy dissipating cycle.

Association Between Persistent Pain and Memory Decline and Dementia in a Longitudinal Cohort of Elders.

Importance: Chronic pain is common among the elderly and is associated with cognitive deficits in cross-sectional studies; the population-level association between chronic pain and longitudinal cognition is unknown.

Objective: To determine the population-level association between persistent pain, which may reflect chronic pain, and subsequent cognitive decline.

Design, Setting, And Participants: Cohort study with biennial interviews of 10 065 community-dwelling older adults in the nationally representative Health and Retirement Study who were 62 years or older in 2000 and answered pain and cognition questions in both 1998 and 2000.