Trends in tobacco use and tobacco cessation counselling codes among Medicare beneficiaries, 2001-2014.

Background: Analysis of Medicare data is often used to determine epidemiology, healthcare utilization and effectiveness of disease treatments. We were interested in whether Medicare data could be used to estimate prevalence of tobacco use. Currently, data regarding tobacco use is derived from Behavioral Risk Factor Surveillance System (BRFSS) survey data.

Effect of essential amino acid supplementation and aerobic exercise on insulin sensitivity in healthy older adults: A randomized clinical trial.

Background & Aims: The combination of prolonged essential amino acid (EAA) supplementation and aerobic exercise training (Ex) improves muscle protein metabolism, strength and function in healthy older adults. However, excess EAA intake may worsen insulin sensitivity. Here we report the effects of EAA supplementation (EAA, n = 11), placebo (PLA, n = 10), aerobic exercise with placebo (Ex + PLA, n = 11) or Ex with EAA supplementation (Ex + EAA, n = 10) for 22 weeks on insulin sensitivity in non-diabetic older adults.

Effect of Retail Clinic Use on Continuity of Care Among Medicare Beneficiaries.

Purpose: We examined the relationship between retail clinic use and primary care physician (PCP) continuity among Medicare enrollees in the Houston metropolitan area.

Methods: We identified retail clinic providers in the study area using a 2015 health care provider database. Medicare claims data from enrollees who received care from retail clinics in 2015 were compared with propensity score-matched sample of enrollees who received no care from retail clinics.

Comparison of Costs of Radical Cystectomy vs Trimodal Therapy for Patients With Localized Muscle-Invasive Bladder Cancer.

Importance: Earlier studies on the cost of muscle-invasive bladder cancer treatments lack granularity and are limited to 180 days.

Objective: To compare the 1-year costs associated with trimodal therapy vs radical cystectomy, accounting for survival and intensity effects on total costs.

Design, Setting, And Participants: This population-based cohort study used the US Surveillance, Epidemiology, and End Results-Medicare database and included 2963 patients aged 66 to 85 years who had received a diagnosis of clinical stage T2 to T4a muscle-invasive bladder cancer from January 1, 2002, through December 31, 2011.

Association between cannabis laws and opioid prescriptions among privately insured adults in the US.

We examine the association between opioid prescription patterns in privately insured adults and changes in state cannabis laws among five age groups (18-25, 26-35 36-45, 46-55 and 56-64 years). Using the 2016 Clinformatics Data Mart, a nationwide commercial health insurance database, we performed a cross-sectional analysis of two types of opioid prescribing (>30-day and >90-day prescriptions) among all adults aged 18-64 based on the stringency of cannabis laws. We found a significant interaction between age and cannabis law on opioid prescriptions.

Moderate-intensity aerobic exercise improves skeletal muscle quality in older adults.

Sarcopenia, age-associated involuntary loss of muscle and strength, can progress to clinically relevant functional decline. Resistance exercise attenuates muscle and strength loss but may not be feasible for some older adults. Aerobic exercise training (AET) improves cardiopulmonary health; however, effects on protein turnover, muscle mass, and strength are less clear.

Variation Among Primary Care Physicians in 30-Day Readmissions.

Background: Whether readmission rates vary by primary care physician (PCP) is unknown, although federal policy holds PCPs accountable for reducing readmissions.

Objective: To determine whether 30-day readmission rates vary by PCP.

Design: Retrospective cohort study using marginal models and multilevel logistic regression with 100% of data on Texas Medicare claims from 2008 to 2015.

Association of Opioid and Benzodiazepine Use with Adverse Respiratory Events in Older Adults with Chronic Obstructive Pulmonary Disease.

Older adults with chronic obstructive pulmonary disease (COPD) are at substantially increased risk for medication-related adverse events. Two frequently prescribed classes of drugs that pose a particular risk to this patient group are opioids and benzodiazepines. Research on this topic has yielded conflicting findings.

Whey Protein Hydrolysate Increases Amino Acid Uptake, mTORC1 Signaling, and Protein Synthesis in Skeletal Muscle of Healthy Young Men in a Randomized Crossover Trial.

Background: Muscle protein synthesis (MPS) can be stimulated by ingestion of protein sources, such as whey, casein, or soy. Protein supplementation can enhance muscle protein synthesis after exercise and may preserve skeletal muscle mass and function in aging adults. Therefore, identifying protein sources with higher anabolic potency is of high significance.

Discriminative Ability of Montreal Cognitive Assessment Subtests and Items in Racial and Ethnic Minority Groups.

Introduction: The Montreal Cognitive Assessment (MoCA) is a popular screening tool for Mild Cognitive Impairment (MCI). The psychometric properties of the MoCA have not been widely examined in minority groups. We aimed to analyze the discriminate ability of subtests and items by race and ethnicity given gold-standard clinical diagnosis of cognitive status.

Long-Term Opioid Therapy in Older Cancer Survivors: A Retrospective Cohort Study.

Objectives: To examine the rates and predictors of long-term opioid therapy in older cancer survivors.

Design: Retrospective cohort study.

Setting: Texas, United States.

Trends in lung cancer screening in the United States, 2016-2017.

Background: Lung cancer is the most common cancer killer annually, yet the overall rate of eligible patients who undergo screening with low-dose computed tomography (LDCT) is low. Our goal was to determine factors which were associated with the probability of obtaining lung cancer screening.

Methods: The Clinformatics Data Mart (CDM) database, a national commercial health insurance database with over 18,000,000 enrollees, was queried to determine the rate of LDCT screening and factors which influenced receiving LDCT screening.

Systematic Review of Factors Associated with the Utilization of Radical Cystectomy for Bladder Cancer.

Context: Despite established guidelines for the treatment of muscle-invasive bladder cancer, it has been reported that radical cystectomy (RC) is markedly underused, especially among patients of advanced age and those with higher comorbidity burden and lower access to care. Understanding the interactions between patient, provider, and hospital factors may inform targeted interventions to optimize RC utilization.

Objective: To systematically review the literature regarding factors associated with RC utilization.

Having an Adult Child in the United States, Physical Functioning, and Unmet Needs for Care Among Older Mexican Adults.

Background: Migration of adult children may impact the health of aging parents who remain in low- and middle-income countries. Prior studies have uncovered mixed associations between adult child migration status and physical functioning of older parents; none to our knowledge has examined the impact on unmet caregiving needs.

Methods: Data come from a population-based study of Mexican adults ≥50 years.

The Influence of Meal Frequency and Timing on Health in Humans: The Role of Fasting.

The influence of meal frequency and timing on health and disease has been a topic of interest for many years. While epidemiological evidence indicates an association between higher meal frequencies and lower disease risk, experimental trials have shown conflicting results. Furthermore, recent prospective research has demonstrated a significant increase in disease risk with a high meal frequency (≥6 meals/day) as compared to a low meal frequency (1⁻2 meals/day).

A Phase I Randomized Clinical Trial of Evidence-Based, Pragmatic Interventions to Improve Functional Recovery After Hospitalization in Geriatric Patients.

Background: Physical function declines during hospitalization in geriatric patients, increasing the risk of loss of independence. There is a need for evidence-based, pragmatic interventions to improve functional recovery of older adults following acute hospitalization. Here, we report the results of a Phase I randomized clinical trial designed to determine safety and effect size of protein supplementation, exercise, and testosterone interventions on 30-day post-discharge functional recovery and readmissions in geriatric patients.

Use of Lung Cancer Screening With Low-Dose Computed Tomography in the Medicare Population.

Objective: To describe rates of low-dose computed tomography (LDCT) and all chest computerized tomography (CT) before and after Centers for Medicare and Medicaid Services (CMS) initiated reimbursement and requirements for screening and to describe factors associated with receipt of LDCT.

Patients And Methods: Retrospective cross-sectional study of Medicare enrollees aged 55 to 77 in Parts A and B Medicare without HMO enrollment in a 20% national sample (n=3,887,430 in 2010, 4,200,875 in 2015, and 4,145,542 in 2016). The outcomes were receipt of LDCT and any chest CT from January 1, 2010, to December 31, 2016.

The Importance of Resistance Exercise Training to Combat Neuromuscular Aging.

Older adults undergoing age-related decrements in muscle health can benefit substantially from resistance exercise training, a potent stimulus for whole muscle and myofiber hypertrophy, neuromuscular performance gains, and improved functional mobility. With the use of advancing technologies, research continues to elucidate the mechanisms of and heterogeneity in adaptations to resistance exercise training beyond differences in exercise prescription. This review highlights the current knowledge in these areas and emphasizes knowledge gaps that require future attention of the field.

Association of Chronic Opioid Use With Presidential Voting Patterns in US Counties in 2016.

Importance: The causes of the opioid epidemic are incompletely understood.

Objective: To explore the overlap between the geographic distribution of US counties with high opioid use and the vote for the Republican candidate in the 2016 presidential election.

Design, Setting, And Participants: A cross-sectional analysis to explore the extent to which individual- and county-level demographic and economic measures explain the association of opioid use with the 2016 presidential vote at the county level, using rate of prescriptions for at least a 90-day supply of opioids in 2015.

Use of the Shared Decision-Making Visit for Lung Cancer Screening Among Medicare Enrollees.

This study analyzes Medicare data from 2015 and 2016 to estimate the percentage of Medicare enrollees who underwent low-dose computed tomographic screening for lung cancer during this period and had participated in a shared decision-making visit to discuss the benefits and risks of the procedure before screening.

Late life depressive symptoms and cognitive function among older Mexican adults: the past and the present.

: To evaluate associations between depression and individual cognitive domains and how changes in depressive symptoms relate to cognition three years later in the context of Mexico, a developing country experiencing rapid aging.: Data comes from the 2012 and 2015 waves of the Mexican Health and Aging Study ( = 12,898, age 50+). Depression is ascertained using a modified Center for Epidemiologic Studies - Depression Scale.

Erratum: A Comprehensive Analysis of Morbidity Life Expectancies Among Older Hispanic Subgroups in the United States: Variation by Nativity and Country of Origin.

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