Prevalence of undiagnosed dementia among older hospitalized patients: variation by social and demographic factors.

Background: The profound impact of dementia on acute care, compounded by frequent underdiagnosis, is a significant challenge, especially among certain ethnic and minority groups, and remains largely unexplored in hospital settings. We used data from a multicentric study comprising 43 public and private hospitals in five countries to estimate the prevalence of undiagnosed dementia across different sociodemographic measures.

Method: The CHANGE (Creating a Hospital Assessment Network in Geriatrics) Study, an ongoing cohort designed to identify age‐related conditions like dementia, included patients aged ≥65 years admitted to 43 acute hospitals throughout Brazil and four other countries: Angola, Chile, Colombia, and Portugal.

Online, Community‐Based Workshop for Rural Family Caregivers of Persons Living with Dementia in the United States: Results of a National Randomized Controlled Trial.

Background: Family caregivers of persons living with dementia (PLWD) in rural areas of the United States (U.S.) are isolated, under‐served, and experience poor health outcomes.

"I Aim to Fulfill My Promise": Dementia Caregiving from the Perspective of Spouses and Partners.

In the United States, spouses provide 17% of in-home care for people living with dementia. Negative impacts of dementia care on spouses/partners are well-documented, but we lack information about the holistic experience for spouses/partners. We conducted a secondary thematic analysis of data from two observational studies about everyday music engagement and dementia care at home.

"Unjustified Partiality or Impartial Bias? Reckoning with Age and Disability Discrimination in Cancer Clinical Trials".

In this issue, Zakout discusses European Union (EU) legal provisions for inclusion of patients of all types in clinical trials. Shee highlights the unfortunate failure to include adequate numbers of older adults and adults with disabilities in clinical trials of anti-cancer agents. We agree with her argument that this is an ethical issue as well as a scientific and clinical issue.

The Association Between Accelerated Biological Aging and Cardiovascular Outcomes in Older Adults with Hypertension.

Background: Current hypertension treatments rely on chronological age, which may not reflect individual differences in aging and its impact on cardiovascular health. This study aimed to determine whether biological age can predict adverse outcomes in older adults with hypertension, independent of traditional risk factors including chronological age.

Methods: An analysis of a prospective cohort was conducted using data from the Health and Retirement Study, a longitudinal survey of older adults in the United States.

UroARC: A Novel Surgical Risk Calculator for Older Adults Undergoing Suprapubic Tube Placement.

Objective: To develop a surgical risk calculator for older adults undergoing suprapubic tube (SPT) placement that specifically factors in frailty, a key predictor of surgical risk in this vulnerable and heterogenous population.

Methods: Medicare MedPAR, Outpatient, and Carrier files for beneficiaries undergoing SPT placement between 2014-2016 were examined. The Claims-Based Frailty Index (CFI), a validated measure of frailty, was used to calculate baseline frailty for each beneficiary.

Associations of Resilience, Perceived Control of Health, and Depression with Geriatric Outcomes after Surgery.

Objective: To identify if depression, resilience, and perceived control of health are related to 2.5-year mortality and instrumental activities of daily living (IADL) decline among older adults after surgery.

Summary Background Data: The relationships of psychosocial factors with postoperative mortality and IADL decline among older adults are understudied.

Pain management inequities by demographic and geriatric-related variables in older adult inpatients.

Background: Pain is ubiquitous, yet understudied. The objective of this study was to analyze inequities in pain assessment and management for hospitalized older adults focusing on demographic and geriatric-related variables.

Methods: This was a retrospective cohort study from January 2013 through September 2021 of all adults 65 years or older on the general medicine service at UCSF Medical Center.

Development of the UroARC Surgical Calculator: A Novel Risk Calculator for Older Adults Undergoing Surgery for Bladder Outlet Obstruction.

Purpose: Bladder outlet obstruction (BOO) is common in older adults. Many older adults who pursue surgery have additional vulnerabilities affecting surgical risk, including frailty. A clinical tool that builds on frailty to predict surgical outcomes for the spectrum of BOO procedures would be helpful to aid in surgical decision-making but does not currently exist.

The effect of dementia on patterns of healthcare use in older adults with diabetes.

Background: For persons with diabetes, incidence of dementia has been associated with increased hospitalization; however, little is known about healthcare use preceding and following incident dementia. We describe healthcare utilization in the 3 years pre- and post-incident dementia among older adults with diabetes.

Methods: We used the National Health and Aging Trends Study (NHATS) linked to Medicare fee-for-service claims from 2011 to 2018.

Survival, Function, and Cognition After Hospitalization in Long-Term Acute Care Hospitals.

Importance: More than 70 000 Medicare beneficiaries receive care in long-term acute care hospitals (LTCHs) annually for prolonged acute illness. However, little is known about long-term functional and cognitive outcomes of middle-aged and older adults after hospitalization in an LTCH.

Objective: To describe survival, functional, and cognitive status after LTCH hospitalization and to identify factors associated with an adverse outcome.

Sacral neuromodulation in nursing home residents: Predictors of success and complications in a national cohort of older adults.

Aims: There is limited evidence to support the efficacy of sacral neuromodulation (SNM) for older adults with overactive bladder (OAB). This study aims to report outcomes following SNM among nursing home (NH) residents, a vulnerable population with high rates of frailty and comorbidity.

Methods: This is a retrospective cohort study of long-stay NH residents who underwent a trial of percutaneous nerve evaluation (PNE) or Stage 1 permanent lead placement (Stage 1) between 2014 and 2016.

One-Year Recovery Among Survivors of Prolonged Severe COVID-19: A National Multicenter Cohort.

Objectives: Understanding the long-term effects of severe COVID-19 illness on survivors is essential for effective pandemic recovery planning. Therefore, we investigated impairments among hospitalized adults discharged to long-term acute care hospitals (LTACHs) for prolonged severe COVID-19 illness who survived 1 year.

Design: The Recovery After Transfer to an LTACH for COVID-19 (RAFT COVID) study was a national, multicenter, prospective longitudinal cohort study.

Long-term outcomes after rehabilitation in Medicare Advantage and fee-for-service beneficiaries.

Background: Financial incentives in capitated Medicare Advantage (MA) plans may lead to inadequate rehabilitation. We therefore investigated if MA enrollees had worse long-term physical performance and functional outcomes after rehabilitation.

Methods: We conducted a retrospective cohort study of Medicare beneficiaries in the nationally representative National Health and Aging Trends Study.

"There's So Much That They're Enduring": Experiences of Older Adults Undergoing Major Elective Surgery.

Objective: This qualitative study aimed to explore the psychosocial experience of older adults undergoing major elective surgery from the perspective of both the patient and family caregiver.

Summary Background Data: Older adults face unique psychological and social vulnerabilities that can increase susceptibility to poor health outcomes. How these vulnerabilities influence surgical treatment and recovery is understudied in the geriatric surgical population.

Estimating Vitamin K Antagonist Anticoagulation Benefit in People With Atrial Fibrillation Accounting for Competing Risks: Evidence From 12 Randomized Trials.

Background: Patients with atrial fibrillation have a high mortality rate that is only partially attributable to vascular outcomes. The competing risk of death may affect the expected anticoagulant benefit. We determined if competing risks materially affect the guideline-endorsed estimate of anticoagulant benefit.

Music Engagement as Part of Everyday Life in Dementia Caregiving Relationships at Home.

Background And Objectives: Emerging evidence suggests music-based interventions can improve the well-being of people living with dementia, but little is known about the ways in which music might support dementia caregiving relationships as part of everyday life at home. This study examined music engagement in the context of daily life to identify patterns of music engagement and potential targets for the design of music-based interventions to support well-being.

Research Design And Methods: This ethnographic, in-home study of people living with dementia and their family and professional care partners used methods from ethnomusicology, including semistructured interviews and in-home participant observation with a focus on music engagement.