Older adults with cardiovascular disease (CVD) contend with deficits across multiple domains of health due to age-related physiological changes and the impact of CVD. Multimorbidity, polypharmacy, cognitive changes, and diminished functional capacity, along with changes in the social environment, result in complexity that makes provision of CVD care to older adults challenging. In this review, we first describe the history of geriatric cardiology, an orientation that acknowledges the unique needs of older adults with CVD. Then, we introduce 5 essential principles for meeting the needs of older adults with CVD: 1) recognize and consider the potential impact of multicomplexity; 2) evaluate and integrate constructs of cognition into decision-making; 3) evaluate and integrate physical function into decision-making; 4) incorporate social environmental factors into management decisions; and 5) elicit patient priorities and health goals and align with care plan. Finally, we review future steps to maximize care provision to this growing population.
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http://dx.doi.org/10.1016/j.jacadv.2022.100070 | DOI Listing |
JAMA Netw Open
December 2024
Department of Health Policy and Management, Bloomberg School of Public Health, The Johns Hopkins University, Baltimore, Maryland.
Importance: The number of older adults in long-term correctional facilities (prisons) has increased rapidly in recent years. The cognitive and functional status of this population is not well understood due to limitations in the availability of longitudinal data.
Objective: To comparatively examine the prevalence and disability status of the population of adults 55 years and older in prisons and adults living in community settings for a 14-year period (2008-2022).
JAMA Netw Open
December 2024
Department of Epidemiology and Health Care Atlas, Central Research Institute of Ambulatory Health Care, Berlin, Germany.
Importance: A growing body of literature suggests the presence of a prodromal period with nonspecific signs and symptoms before onset of multiple sclerosis (MS).
Objective: To systematically assess diseases and symptoms diagnosed in the 5 years before a first MS- or central nervous system (CNS) demyelinating disease-related diagnostic code in pediatric patients compared with controls without MS and controls with another immune-mediated disorder, juvenile idiopathic arthritis (JIA).
Design, Setting, And Participants: This population-based, matched case-control study included children and adolescents (aged <18 years) in Germany with statutory health insurance from January 2010 to December 2020.
JAMA Netw Open
December 2024
Department of Surgery, University of Vermont, Burlington.
Importance: The 2009 US Preventive Services Task Force breast cancer screening guideline changes led to decreases in screening mammography, raising concern about potential increases in late-stage disease and more invasive surgical treatments.
Objective: To investigate the incidence of breast cancer by stage at diagnosis and surgical treatment before and after the 2009 guideline changes.
Design, Setting, And Participants: This population-based, epidemiologic cohort study of women aged 40 years or older used 2004 to 2019 data from the National Cancer Institute's Surveillance, Epidemiology, and End Results Program.
JAMA Health Forum
December 2024
Department of Health Policy and Management, Yale School of Public Health, New Haven, Connecticut.
Importance: More than one-quarter of US residents live in states or localities that restrict sales of flavored electronic nicotine delivery systems (ENDS), often as a means to reduce youth vaping. Yet, how these policies affect young adult vaping and smoking remains unclear.
Objective: To estimate the effects of ENDS flavor restrictions on ENDS use and cigarette smoking among young adults (age 18-29 years) in the US.
Drugs Aging
December 2024
Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
Introduction: Medication regimen complexity may be an important risk factor for adverse outcomes in older adults with heart failure. However, increasing complexity is often necessary when prescribing guideline-directed medical therapy at the time of a heart failure hospitalization. We sought to determine whether increased medication regimen complexity following a heart failure hospitalization was associated with worse post-hospitalization outcomes.
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