Predilection for Perplexion: Preoperative microstructural damage is linked to postoperative delirium.

Postoperative delirium is the most common postsurgical complication in older adults and is associated with an increased risk of long-term cognitive decline and Alzheimer's disease (AD) and related dementias (ADRD). However, the neurological basis of this increased risk-whether postoperative delirium unmasks latent preoperative pathology or leads to AD-relevant pathology after perioperative brain injury-remains unclear. Recent advancements in neuroimaging techniques now enable the detection of subtle brain features or damage that may underlie clinical symptoms.

Geriatrics-Focused vs Traditional Primary Care in the Veterans Affairs Health Care System.

Importance: Older adults often require specialized health care expertise, but the effects of geriatrics-focused models of primary care have not been fully evaluated.

Objective: To compare the effects of geriatrics-focused primary care vs traditional primary care for older patients in the Veterans Affairs (VA) health care system.

Design, Setting, And Participants: In this cohort study, geriatrics-focused primary care and traditional primary care patient dyads matched on variables associated with geriatrics-focused primary care entry and outcomes were enrolled from VA medical centers with operational geriatrics-focused primary care clinics serving 500 or more patients annually in fiscal year 2016.

Advancing Delirium Treatment Trials in Older Adults: Recommendations for Future Trials From the Network for Investigation of Delirium: Unifying Scientists (NIDUS).

Objectives: To summarize the delirium treatment trial literature, identify the unique challenges in delirium treatment trials, and formulate recommendations to address each in older adults.

Design: A 39-member interprofessional and international expert working group of clinicians (physicians, nurses, and pharmacists) and nonclinicians (biostatisticians, epidemiologists, and trial methodologists) was convened. Four expert panels were assembled to explore key subtopics (pharmacological/nonpharmacologic treatment, methodological challenges, and novel research designs).

Development of a physical performance summary score in middle age: Findings from the CARDIA Function study.

Few physical performance batteries exist that appropriately evaluate physical limitations in middle-aged adults. We aimed to develop a physical performance summary score that is appropriate for use in epidemiology studies of middle-aged adults using data from the Coronary Artery Risk Development in Young Adults (CARDIA) Function study, which assessed self-reported function (PROMIS-SF20a) and physical performance measures (gait speed, balance, lower-body strength, grip strength, and cardiovascular endurance). The CARDIA Physical Performance (CAPP) score was developed using sex-specific quartiles, assigning points based on these quartiles (0 for not attempted, 1-4 for each quartile), and summing points across all performance measures (0-20, higher scores reflect greater performance).

Social Engagement and Neurocognition in Latino and Non-Latino White Older Persons with HIV.

The present study investigated differences in the quantity and quality of social engagement, and their associations with neurocognition among older Latino and non-Latino White persons with HIV (PWH). Participants were age 50 + community-dwelling PWH living in southern California (n = 116; 50% Latino [53% Spanish-speaking], 50% non-Latino White; Age: M = 58.03; Education: M = 13.

Black Carbon Air Pollution and Incident Mortality among the Advance-Aged Adults in China: A Prospective Cohort Study.

Background: We aimed to assess associations between black carbon (BC) and non-accidental mortality among advance-aged adults in China.

Methods: We conducted a prospective cohort study in 22 provinces of Chinese Longitudinal Healthy Longevity Survey. We calculated concentrations of 3-year average BC, fine particulate matter (PM2.

The CALERIE Genomic Data Resource.

Caloric restriction (CR) slows biological aging and prolongs healthy lifespan in model organisms. Findings from the CALERIE randomized, controlled trial of long-term CR in healthy, nonobese humans broadly supports a similar pattern of effects in humans. To expand our understanding of the molecular pathways and biological processes underpinning CR effects in humans, we generated a series of genomic datasets from stored biospecimens collected from n = 218 participants during the trial.

Associations of frailty with survival, hospitalization, functional decline, and toxicity among older adults with advanced non-small cell lung cancer.

Introduction: Among older adults with cancer receiving chemotherapy, frailty indices predict OS and toxicity. Given the increased use of immunotherapy and targeted therapy for advanced non-small cell lung cancer (aNSCLC), we evaluated frailty and Karnofsky Performance Status (KPS) among older adults with aNSCLC receiving chemotherapy, immunotherapy, and/or targeted therapy.

Methods: Patients aged ≥ 65 with aNSCLC starting systemic therapy with non-curative intent underwent geriatric assessments over 6 months.

Cohort Profile: Baseline Characteristics of Veterans from Improving Veteran Access to Integrated Management of Back Pain (AIM-Back) - an Embedded Pragmatic, Cluster Randomized Trial in the United States.

Purpose: AIM-Back is an embedded pragmatic clinical trial (ePCT) with cluster randomization designed to increase access and compare the effectiveness of two different non-pharmacological care pathways for low back pain (LBP) delivered within the Veteran Administration Health Care System (VAHCS). This manuscript describes baseline characteristics of AIM-Back participants as well as the representativeness of those referred to the AIM-Back program by sex, age, race, and ethnicity, relative to Veterans with low back pain at participating clinics.

Participants: To be eligible for AIM-Back, Veterans were referred to the randomized pathway at their clinic by trained primary care providers (Referral cohort).

Preoperative dysphagia and adverse postoperative outcomes in middle aged and older adults.

Background: Dysphagia is a swallowing impairment with adverse health consequences. The impact of preoperative dysphagia on postoperative outcomes is not known. This study will examine the association between preoperative dysphagia and postoperative outcomes.

Exploring facilitators and barriers to daily chlorhexidine gluconate bathing in adult patients undergoing hematopoietic stem cell transplantation.

Unlabelled: Hematopoietic cell transplantation (HCT) is a promising treatment for hematologic malignancies, but intensive conditioning leads to immunosuppression and susceptibility to healthcare-associated infections (HAI). Despite standard prevention measures, bloodstream infections (BSI) impact a significant percentage of immunocompromised HCT patients. Incidence of BSI can be mitigated by chlorhexidine gluconate (CHG) bathing-an underutilized infection-prevention strategy.

Quality of life, religion/spirituality, and dementia risk among Black people in the US.

Objectives: Black people in the United States (US) experience an increased risk of being diagnosed with Alzheimer's disease and related dementias (ADRD). More research is needed on psychosocial factors that may contribute to racial disparities in rates of ADRD. Past work has identified a relationship between quality of life (QoL) and ADRD risk and also found that religion/spirituality (R/S) participation protects against ADRD.

Association Between Socioeconomic Disadvantage and Risks of Early and Recurrent Admissions Among Patients With Newly Diagnosed Heart Failure.

Background: Socioeconomic disadvantage is associated with greater risks of hospital readmission and mortality among patients with heart failure (HF). However, it is less clear whether socioeconomic disadvantage has an immediate and lasting impact on the risk of admissions after the diagnosis of HF.

Methods: We used electronic health record data of patients aged 65 years and older with newly diagnosed HF between January 2015 and July 2018 in the Duke University Health System, with up to 8 years of follow-up.

Head and neck cancer mortality in the United States: Regional differences in hospice use and place of death.

Background: With more than 15,000 annual deaths from head and neck cancer (HNC), an important aspect of end-of-life care for these patients is place of death. Recent evidence suggests an increasing preference for home/hospice at end of life; however, it is unclear whether there is variation in home/hospice use based on region or urban status. We described differences in the place of death of HNC patients based on their region and urban status.

Received Self-Care Support and Psychosocial Health Among Older Adults with Non-Dialysis-Dependent Chronic Kidney Disease.

Older age is linked with poorer self-care in the chronic kidney disease (CKD) setting. Informal health supporters (family members and friends) are critical sources of self-care support, but much remains unclear about the characteristics and implications of received support among this patient population. We examined how received self-care support (amount and type) related to positive (CKD management self-efficacy) and negative (depressive symptoms) psychosocial health correlates of self-care in 536 adults aged 65 years and older with non-dialysis-dependent CKD.

Accelerated epigenetic aging and prospective morbidity and mortality among U.S. veterans.

Epigenetic measures of aging derived from DNA methylation are promising biomarkers associated with prospective morbidity and mortality, but require validation in real-world medical settings. Using data from 2,216 post-9/11 veterans, we examined whether accelerated DunedinPACE aging scores were associated with chronic disease morbidity, predicted healthcare costs, and mortality assessed over an average of 13.1 years of follow up in VA electronic health records.

Safety of Simultaneous Vaccination With Adjuvanted Zoster Vaccine and Adjuvanted Influenza Vaccine: A Randomized Clinical Trial.

Importance: Quadrivalent adjuvanted inactivated influenza vaccine (aIIV4) and adjuvanted recombinant zoster vaccine (RZV) contain novel adjuvants. Data are limited on the comparative safety, reactogenicity, and health-related quality of life (HRQOL) effects of the simultaneous administration of these vaccines.

Objective: To compare the safety and reactogenicity after simultaneous doses of RZV and aIIV4 administration (opposite arms) with simultaneous doses of RZV with quadrivalent high-dose inactivated influenza vaccine [HD-IIV4]).

Priority areas for outcomes improvement among older adults undergoing inpatient general surgery inclusive of geriatric-pertinent complications.

Background: Comprehensive studies on priority areas for improving geriatric surgery outcomes, inclusive of geriatric-pertinent data, are limited.

Methods: The ACS NSQIP geriatric database (2014-2018) was used to abstract older adults (≥65 years) undergoing inpatient general surgery procedures. Thirty-day complication, functional decline, and mortality rates were analyzed, with a focus on two geriatric-pertinent complications: delirium and new/worsening pressure ulcers.