Public Health.

Background: Dementia is underdiagnosed by the healthcare system, and MCI is rarely identified. Thus, while interventions to reduce cognitive decline are becoming increasingly available, it is not clear how appropriate individuals will be evaluated for treatment opportunities. A first step to improving diagnosis is understanding how older individuals with dementia or MCI interact with the healthcare system, especially ambulatory evaluation and management (E&M) visits, the backbone of healthcare.

Effects of Nursing Home Changes in Antipsychotic Use on Outcomes Among Residents With Dementia.

Objectives: Little information exists on whether nationwide efforts to reduce antipsychotic use among nursing home (NH) residents with Alzheimer's disease and related dementias improved mortality and hospitalization outcomes for residents. Our objective was to examine the effect of NH decreases in antipsychotic use on outcomes for residents with Alzheimer's disease and related dementias.

Design: Observational nationwide study that emulated a series of cluster randomized trials.

Transfers among Vulnerable Long-Term Nursing Home Residents.

Objectives: To determine whether the risk of nursing home-to-nursing home transfer is higher among long-term nursing home residents with intellectual and developmental disabilities (IDD), or serious mental illness (SMI), and/or Alzheimer's disease and related dementias (ADRD), relative to residents without these clinical diagnoses, and to assess the factors associated with transfer overall and for residents with these diagnoses.

Design: Cross-sectional cohort study of nursing home residents in 2019.

Setting And Participants: Michigan long-term nursing home residents identified from the Minimum Data Set.

Estimates of intra-cluster correlation coefficients from 2018 USA Medicare data to inform the design of cluster randomized trials in Alzheimer's and related dementias.

Background: Cluster randomized trials (CRTs) are increasingly important for evaluating interventions embedded in health care systems. An essential parameter in sample size calculation to detect both overall and heterogeneous treatment effects for CRTs is the intra-cluster correlation coefficient (ICC) of both outcome and covariates of interest. However, obtaining advance estimates for the ICC can be challenging.

Association between Family Household Income and Cognitive Resilience among Older US Adults: A Cross-Sectional Study.

Cognitive resilience has emerged as a mechanism that may help explain individual differences in cognitive function associated with aging and/or pathology. It is unknown whether an association exists between family income level and cognitive resilience. We performed a cross-sectional study to estimate the relationship between family income level and high cognitive resilience using the National Health and Nutrition Examination Survey (NHANES) among older adults (age≥60).