Frailty in older adults with systemic lupus erythematosus and emergency department utilization: an administrative claims data analysis of Medicare beneficiaries.

Introduction / Objectives: While presence of concomitant SLE and frailty has been associated with greater emergency department (ED) use than SLE alone in young/mid-aged adults, whether frailty increases ED use in older adults with SLE remains unknown. In a nationally representative United States administrative claims dataset, we investigated the association of frailty duration with use of ED services in the SLE population compared with individuals without systemic rheumatic disease (SRD).

Method: We identified Medicare beneficiaries ≥ 65 years with SLE and matched them (1:4) by age and gender with non-SRD comparators with osteoarthritis.

Correlates of neurocognitive performance in older adults with chronic pain and negative emotions: baseline data from the problem adaptation therapy for pain (PATH-pain) randomized controlled trial.

Chronic pain is highly prevalent among older adults, is associated with cognitive deficits, and is commonly treated in primary care. We sought to document the extent of impairment across specific neurocognitive domains and its correlates among older adults with chronic pain in primary care. We analyzed baseline data from the Problem Adaptation Therapy for Pain trial, which examined a psychosocial intervention to improve emotion regulation in 100 adults ≥ 60 years with comorbid chronic pain and negative emotions, who did not have evidence of moderate-to-severe cognitive impairment.

What Makes Life Go Well? A Network Topic Modeling Analysis of Well-Being Practices in Adults with Chronic Pain.

Objective: This study leverages natural language processing techniques to identify specific practices older adults with chronic pain adopt to enhance well-being.

Method: We applied network topic modeling to open-ended survey responses from 683 adults (57% female) who reported experiencing chronic pain in the Midlife in the United States (MIDUS) study, analyzing responses to the question "What do you do to make your life go well?" Structural equation modeling was used to examine the relationships between identified topics and measures of pain interference and prescription pain medication use, adjusting for sociodemographics and well-being indicators.

Results: The analyses revealed twelve key topics, including avoiding stress, maintaining social connections, and practicing spirituality and faith.

Targeting Daily Positive Events to Improve Emotional and Functional Well-Being in Adults With Fibromyalgia: Insights From the LARKSPUR Randomized Controlled Trial.

Background: Fibromyalgia is a chronic pain condition characterized by widespread musculoskeletal pain, fatigue, and cognitive difficulties, affecting individuals across all age groups. Positive affect (PA) interventions have shown promise in enhancing emotional well-being and pain management in patients with diverse chronic pain conditions. However, the efficacy of internet-delivered PA interventions for individuals with fibromyalgia remains understudied.

Corrigendum: Loneliness and global cognitive functioning in racially and ethnically diverse US midlife and older adults.

[This corrects the article DOI: 10.3389/fpsyg.2024.

Loneliness and pain among community-dwelling middle-aged and older Black, Latino, and White adults in the United States.

Background: Prior research has demonstrated a strong and independent association between loneliness and pain, but few studies to date have explored this relationship in racially and ethnically diverse groups of midlife and older adults. We drew on the diathesis stress model of chronic pain and cumulative inequality theory to examine the relationship of loneliness and the presence and intensity of pain in a nationally representative sample of Black, Latino, and White adults aged 50 or older in the United States.

Methods: Data were from Wave 3 of the National Social Life, Health, and Aging Project ( = 2,706).

Clinician Perspectives on Palliative Care for Older Adults With Serious Mental Illnesses: A Multisite Qualitative Study.

Objectives: Approximately 5.5% of the population live with serious mental illnesses (SMI). Older adults with SMI experience a high burden of serious medical illnesses and disparities in advance care planning, symptom management, and caregiver support.

The Promise of Ecological Momentary Assessment to Improve Depression Management for Older Adults in Primary Care.

Among older adults, depression is a common, morbid, and costly disorder. Older adults with depression are overwhelmingly treated by primary care providers with poor rates of remission and treatment response, despite attempts to improve care delivery through behavioral health integration and care management models. Given one in 10 older adults in primary care settings meet criteria for depression, there is a pressing need to improve the efficacy of depression treatment among affected individuals.

Mind the Gap: Understanding Palliative Care Clinician Attitudes Toward Mental Health Training.

Palliative care (PC) clinicians provide mental healthcare to individuals with serious illnesses. Despite this, there is limited knowledge regarding their mental health training opportunities. To identify predictors of satisfaction with mental health training opportunities and assess the relationship between training opportunities and clinician comfort in managing mental health comorbidities, we conducted a secondary analysis of a nationwide survey involving 708 PC clinicians.

Loneliness and global cognitive functioning in racially and ethnically diverse US midlife and older adults.

Introduction: Few studies have examined the association of loneliness and cognitive functioning in the US. We used two common measures of loneliness and examined their association in a large sample of US Black, Latino, and White adults (ages ≥ 50).

Methods: We analyzed Wave 3 of the National Social Life, Health, and Aging Project ( = 2,757).

Social support and physical activity: does general health matter?

Background: Physical activity levels remain suboptimal in older adults. Exploration of potentially modifiable factors such as social support is needed to inform the development and implementation of patient-oriented physical activity interventions for older adults. The impact of general health on the relationship between social support and physical activity is not well understood.

Physical pain among family caregivers to older adults: A scoping review of the literature.

Background And Objectives: Scholarship on the health of family caregivers to older adults continues to expand. Although existing research suggests that many family caregivers experience pain, which impacts their ability to perform caregiving tasks and is associated with care recipients' unmet needs, the scope of research on family caregivers' pain remains poorly characterized. We conducted a scoping review of research on pain among family caregivers to older adults to characterize existing evidence and identify knowledge gaps.

Program of All-Inclusive Care for the Elderly: an untapped setting for research to advance pain care in older persons.

The Program of All-Inclusive Care for the Elderly (PACE) is a community-based care model in the United States that provides comprehensive health and social services to frail, nursing home-eligible adults aged 55 years and older. PACE organizations aim to support adequate pain control in their participants, yet few evidence-based pain interventions have been adopted or integrated into this setting. This article provides a roadmap for researchers who are interested in collaborating with PACE organizations to embed and evaluate evidence-based pain tools and interventions.

Interventions for behavioral health comorbidities in the hospice setting: a scoping review.

Background: Behavioral health (BH) comorbidities in hospice patients are widespread and impact important outcomes, including symptom burden, quality of life, and caregiver wellbeing. However, evidence-based BH interventions tailored for the hospice setting remain understudied.

Methods: We conducted a scoping review with the objective of mapping studies of interventions for BH comorbidities in the hospice setting.

Association of phenotypic frailty and hand grip strength with telomere length in SLE.

Objective: Frailty and objective hand grip strength (one of the components of the frailty phenotype) are both risk factors for worse health outcomes in SLE. Whether telomere length, an established cellular senescence marker, is a biologic correlate of the frailty phenotype and hand grip strength in patients with SLE is not clear. First, we aimed to evaluate differences in telomere length between frail and non-frail women with SLE and then assessed whether frailty or hand grip strength is differentially associated with telomere length after adjusting for relevant confounders.

Mental Health Service Integration in Hospice Organizations: A National Survey of Hospice Clinicians and Medical Leadership.

Unmet mental health needs are associated with a range of negative consequences for individuals at the end of life. Despite the high prevalence of mental health needs among individuals enrolled in hospice, there is a paucity of data describing mental health service integration in hospices in the United States. 1.

Adaptive Care Planning: A paradigm shift.

A key challenge of implementing advance care planning lies in the fact that decisions made in advance require patients and their family members to imagine what their clinical picture will look like rather than knowing or experiencing the clinical circumstances as they unfold. Even more important is the acknowledgment of the unpredictability of a given clinical course. This type of situation requires adaptiveness and flexibility in decision-making that frequently occurs in the moment(s) triggered by changes in health state(s).

Mental Health Integration and Delivery in the Hospice and Palliative Medicine Setting: A National Survey of Clinicians.

Context: Mental health comorbidities among individuals with serious illness are prevalent and negatively impact outcomes. Mental healthcare is a core domain of palliative care, but little is known about the experiences of palliative care clinicians delivering such care.

Objectives: This national survey aimed to characterize the frequency with which palliative care providers encounter and manage common psychiatric comorbidities, evaluate the degree of mental health integration in their practice settings, and prioritize strategies to meet the mental health needs of palliative care patients.

Prevalence Estimates of Arthritis and Activity-Limiting Pain Among Family Caregivers to Older Adults.

Background And Objectives: Little is known about the prevalence of physical pain among family caregivers to older adults. We used national survey data to assess the relative prevalence of caregivers' arthritis and activity-limiting bothersome pain by caregiver and care-recipient characteristics to identify which caregivers may be at a higher risk for physical pain.

Research Design And Methods: We analyzed data collected from 1,930 caregivers who participated in the National Study on Caregiving (2017).

Comparison of two frailty definitions in women with systemic lupus erythematosus.

Objectives: Frailty is a risk factor for adverse health in SLE. The Fried phenotype (FP) and the SLICC Frailty Index (SLICC-FI) are common frailty metrics reflecting distinct approaches to frailty assessment. We aimed to (1) compare frailty prevalence according to both metrics in women with SLE and describe differences between frail and non-frail participants using each method and (2) evaluate for cross-sectional associations between each metric and self-reported disability.

Hospice and Palliative Medicine Fellowship Training in Mental Health: A Survey of Program Directors.

Context: Psychological and psychiatric care is a core domain of palliative care. Despite a high burden of mental health comorbidity among individuals with serious illness, the Accreditation Council of Graduate Medical Education gives little guidance about training hospice and palliative medicine (HPM) fellows in this domain of care. Currently, there is a lack of empiric data on HPM physician fellowship training in mental health topics.

Geriatric Psychiatrists' Perspectives on Palliative Care: Results From A National Survey.

Objectives: Older adults with psychiatric illnesses often have medical comorbidities that require symptom management and impact prognosis. Geriatric psychiatrists are uniquely positioned to meet the palliative care needs of such patients. This study aims to characterize palliative care needs of geriatric psychiatry patients and utilization of primary palliative care skills and subspecialty referral among geriatric psychiatrists.