Prolonged mechanical ventilation and caregiver strain: Home vs. long-term care facility.

Objective: The number of patients treated with prolonged mechanical ventilation (PMV) is steadily rising. Traditionally treated within specialized long-term care facilities (LTCFs), healthcare providers are increasingly promoting homecare as a technologically safe, humane, and cheaper alternative. Little is known concerning their informal caregivers (ICGs), despite their crucial role in facilitating care.

Optimism and Longevity Beyond Age 85.

Background: Optimism is associated with health benefits and improved survival among adults older than 65 years. Whether or not optimism beyond age 85 continues to confer survival benefits is poorly documented. We examine the hypothesis that being optimistic at ages 85 and 90 is associated with improved survival.

[LONELINESS, FUNCTION AND LONGEVITY: THE JERUSALEM LONGITUDINAL COHORT STUDY].

Aims: To assess the association between subjective loneliness among the elderly (whether an individual feels lonely) with functional status and longevity after adjustment for potential confounders.

Background: While objective measures of loneliness among older people have been found to be associated with functional decline and increased mortality, little is known concerning the relationship between subjective loneliness, function, morbidity and longevity.

Methods: Subjective loneliness, health variables, functional status and mortality were assessed through the Jerusalem Longitudinal Cohort Study (1990-2015), a prospective longitudinal study.

Prolonged Mechanical Ventilation: Symptomatology, Well-Being, and Attitudes to Life.

Objective: Although prolonged mechanical ventilation (PMV) is increasingly common, little is known concerning patient symptom burden or attitudes toward PMV. This study aims to describe the mood, well-being, distressing symptoms, and attitudes toward prolonged ventilation among PMV patients treated either at home or long-term acute care (LTAC).

Design: An observational study.

Prolonged Mechanical Ventilation: A Comparison of Patients Treated at Home Compared With Hospital Long-Term Care.

Objective: To compare the characteristics of patients treated with invasive prolonged mechanical ventilation (PMV) at home or in hospital long-term care (HLTC), specifically focusing on medical and functional status, caregiver strain, 6-month outcomes, and health maintenance organization (HMO) costs.

Design: Observational study.

Setting: A single HLTC and home hospital, serving a defined catchment area in the greater Jerusalem area, Israel.

Longitudinal changes in cardiac function in the very elderly: the Jerusalem longitudinal cohort study.

Background: People over the age of 85 are a rapidly growing age group with a high incidence of congestive heart failure (CHF), in particular heart failure with preserved ejection fraction (HFpEF). The diagnosis of CHF is challenging and longitudinal data assessing cardiac structure and function are necessary to distinguish physiologic from pathologic cardiac aging. The objective of the study was to determine longitudinal changes in cardiac struture and function from ages 85 to 94 years using home echocardiography.

Left atrial function and mortality in the oldest old.

Background: Previous studies demonstrated that left atrium (LA) size is associated with mortality in an elderly population. It remains unclear whether indices of LA function including reservoir, conduit, or booster elements of LA function provide incremental prognostic information.

Hypothesis: Echocardiographic measures of the various parameters of LA function would predict 5-year mortality in a community-dwelling population of 85 to 86 year olds independently of LA volume.

Cardiac structure and function predicts functional decline in the oldest old.

Background This study examined the association between cardiac structure and function and the deterioration in activities of daily living (ADLs) in an age-homogenous, community-dwelling population of patients born in 1920-1921 over a five-year follow-up period. Design Longitudinal cohort study. Methods Patients were recruited from the Jerusalem Longitudinal Cohort Study, which has followed an age-homogenous cohort of Jerusalem residents born in 1920-1921.

Frequency of Leaving the House and Mortality from Age 70 to 95.

Objectives: To determine the association between frequency of leaving the house and mortality.

Design: Prospective follow-up of an age-homogenous, representative, community-dwelling birth cohort (born 1920-21) from the Jerusalem Longitudinal Study (1990-2015).

Setting: Home.

Hypertension and Its Treatment at Age 90 Years: Is There an Association with 5-Year Mortality?

Objective: To determine the association between hypertension at age 90 years, treatment, and 5-year mortality.

Design: A prospective observational study of a representative community-dwelling birth cohort (born 1920-1921) by the Jerusalem Longitudinal Study (1990-2015).

Setting: Home-assessment.

Handgrip Strength in Old and Very Old Adults: Mood, Cognition, Function, and Mortality.

Objectives: To determine the trajectory of handgrip strength (HGS) from age 70 to 90 and its association with mood, cognition, functional status, and mortality.

Design: Prospective follow-up of an age-homogenous representative community-dwelling cohort (born 1920-21) in the Jerusalem Longitudinal Cohort Study (1990-2015).

Setting: Home-based assessment.

Prevalence of orthostatic hypertension in the very elderly and its relationship to all-cause mortality.

Objective: To investigate the association with mortality of orthostatic hypertension (OHYPER) amongst the oldest old.

Methods: Two waves of community-dwelling residents born in 1920-1921 were examined at age of 85 (n = 1004) and 90 (n = 437). OHYPER, orthostatic hypotension (OHYPO), or orthostatic normotension (ONORMO) were so classified when difference of standing-sitting SBP either increased or decreased by at least 20 mmHg or not.

Cardiac Structure and Function and Frailty in Subjects Aged 85 and 86 Years.

Frailty is a biologic syndrome reflecting a state of decreased physiological reserve of increasing importance in cardiovascular disease given the aging of the population. The relation between frailty and indexes of cardiac structure and function remains unclear, particularly in the "oldest old." The objective of this study was to examine the association between cardiac function and frailty in an age-homogenous, community-dwelling population of subjects aged 85 and 86 years.

Left Ventricular Mass as a Risk Factor in the Oldest Old.

In middle-aged and "young elderly" cohorts, higher left ventricular mass (LVM) is associated with worse outcomes. The authors examined LVM and 5-year mortality among community-dwelling 85-year-old patients. A representative sample (n=526, born 1920-1921) from the Jerusalem Longitudinal Cohort Study underwent echocardiography at age 85.

Prevalence of pain with advancing age brief report.

Background: The epidemiology of chronic pain with advancing age remains poorly established. Although most studies have examined somatic (musculoskeletal and joint) pain, visceral pain (such as headache and abdominal pain) has warranted less attention. We present longitudinal data from age 70 to 90 years concerning chronic musculoskeletal/joint pain, abdominal pain, and headache.

Gender differences in survival in old age.

Background: Although increased survival among females is observed throughout much of adult life, supporting evidence among the oldest old is lacking.

Objective: We examined the hypothesis that gender differences in survival diminish with advancing age.

Methods: The Jerusalem Longitudinal Study follows a representative cohort born 1920-1921, comprehensively assessed at ages 70, 78, 85, and 90 (n=463, 927, 1224, and 673, respectively).

Pulmonary artery systolic pressure and mortality in the oldest old.

Objectives: The objectives of the study were to assess pulmonary artery systolic pressure, its association with clinical and echocardiographic variables and its impact on 5-year mortality in a community-dwelling population of the oldest old.

Methods: Subjects were recruited from the Jerusalem Longitudinal Cohort Study. Echocardiography was performed at home, with standard measurements being taken including tricuspid regurgitation (TR) velocity (n = 300).

Diabetes Mellitus, Physical Activity, and Longevity Between the Ages of 70 and 90.

Objectives: To determine the effect of physical activity (PA) on survival in older adults (70-90) with diabetes mellitus (DM).

Design: The Jerusalem Longitudinal Cohort Study (1990-2010) prospectively follows up a representative cohort born in 1920-1921.

Setting: Home-based assessment.

Cholesterol, statins, and longevity from age 70 to 90 years.

Background: The importance of cholesterol as a risk factor among older people, particularly among the very old, is controversial. Whether or not hypercholesterolemia warrants medical concern, and whether statins are beneficial among very old people, remain unresolved common clinical dilemmas. This study examines whether increased total cholesterol (TC) was associated with higher mortality from age 70 to 90, and if statins had a protective effect.

Loneliness, health, and longevity.

Background: Objective measures of loneliness and poor social contacts are associated with negative health outcomes. However, the influence of subjective loneliness among elderly persons is poorly documented. We hypothesized that loneliness among persons aged 70-90 years is associated with subsequent decline in health, function, and longevity.

Depression and health service utilization from age 70 to 85: the Jerusalem Longitudinal Study.

Background: Health service utilization rises with age, and yet, its determinants are poorly understood. Our objective was to examine the association between depression and health service utilization from age 70-85.

Methods: A representative sample (born 1920-1921) from the Jerusalem Longitudinal Cohort Study (1990-2010) was assessed at age 70, 78, and 85 for depression (using the Brief Symptoms Inventory); emergency room (ER) visits, and hospitalization in the previous year; social, functional, and medical domains.

Prevalence and prognosis of aortic valve disease in subjects older than 85 years of age.

Although degenerative aortic valve disease is common with increasing age, limited data exist regarding prevalence and prognosis of aortic valve disease among the oldest old. Subjects were recruited from the Jerusalem Longitudinal Cohort Study. Echocardiography was performed at home in 498 randomly selected subjects.