Metformin use and health care utilization in patients with coexisting chronic obstructive pulmonary disease and diabetes mellitus.

Background: Chronic obstructive pulmonary disease (COPD) is associated with persistent systemic inflammation. Anti-inflammatory therapies have been shown to decrease acute exacerbations of COPD. The antidiabetic medication metformin decreases oxidative stress and inflammation and may benefit patients with COPD.

Physical Performance Trajectories and Mortality Among Older Mexican Americans.

Background: We sought to identify distinct trajectory classes of physical performance in Mexican Americans aged 75 years and older and to examine whether these trajectories predict mortality.

Methods: We used four waves of Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) data for adults 75 years and older from 2004-2005 to 2013. Latent growth curve analysis was used to identify distinct trajectory classes.

Factors Associated With Variation in Long-term Acute Care Hospital vs Skilled Nursing Facility Use Among Hospitalized Older Adults.

Importance: Despite providing an overlapping level of care, it is unknown why hospitalized older adults are transferred to long-term acute care hospitals (LTACs) vs less costly skilled nursing facilities (SNFs) for postacute care.

Objective: To examine factors associated with variation in LTAC vs SNF transfer among hospitalized older adults.

Design, Setting, And Participants: We conducted this retrospective observational cohort study of hospitalized older adults (≥65 years) transferred to an LTAC vs SNF during fiscal year 2012 using national 5% Medicare data.

Preferences for Communicating about Breast Cancer Screening Among Racially/Ethnically Diverse Older Women.

Differences exist across breast cancer screening guidelines regarding frequency of screening and age of discontinuation for older women (≥70 years) at average risk for breast cancer. These differences highlight concerns about the benefits and harms of screening, and may negatively impact older women's ability to make informed screening decisions. This study examined preferences for communicating about screening mammography among racially/ethnically diverse, older women.

Functional Status Is Associated With 30-Day Potentially Preventable Readmissions Following Skilled Nursing Facility Discharge Among Medicare Beneficiaries.

Objectives: The objectives of this study were to determine the association between patients' functional status at discharge from skilled nursing facility (SNF) care and 30-day potentially preventable hospital readmissions, and to examine common reasons for potentially preventable readmissions.

Design: Retrospective cohort study.

Setting: SNFs and acute care hospitals submitting claims to Medicare.

Resistance Training with Single vs. Multi-joint Exercises at Equal Total Load Volume: Effects on Body Composition, Cardiorespiratory Fitness, and Muscle Strength.

The present study aimed to compare the effects of equal-volume resistance training performed with single-joint (SJ) or multi-joint exercises (MJ) on VOmax, muscle strength and body composition in physically active males. Thirty-six participants were divided in two groups: SJ group ( = 18, 182.1 ± 5.

Prevalence and Trends in Morbidity and Disability Among Older Mexican Americans in the Southwestern United States, 1993-2013.

This study examines the prevalence of morbidity and disability among older Mexican Americans using 5-year age groups. Twenty-year panel data from the Hispanic Established Populations for the Epidemiological Study of the Elderly are used to make detailed comparisons by nativity and gender. Results show that prevalence rates for most chronic conditions for both males and females do not vary by nativity.

Association of Hospitalist Years of Experience With Mortality in the Hospitalized Medicare Population.

Importance: Substantial numbers of hospitalists are fresh graduates of residency training programs. Current data about the effect of hospitalist years of experience on patient outcomes are lacking.

Objective: To describe the association of hospitalist years of experience with 30-day mortality and hospital mortality of their patients.

Decline in opioid prescribing after federal rescheduling of hydrocodone products.

Purpose: To examine differences in opioid prescribing by patient characteristics and variation in hydrocodone combination product (HCP) prescribing attributed to states, before and after the 2014 Drug Enforcement Administration's reclassification of HCP from schedule III to the more restrictive schedule II.

Methods: We used 2013 to 2015 data for 9 202 958 patients aged 18 to 64 from a large nationally representative commercial health insurance program to assess the temporal trends in the monthly rate of opioid prescribing.

Results: HCP prescribing decreased by 26% from June 2013 to June 2015; the rate of prescriptions for any opioid decreased by 11%.

Factors influencing recurrent emergency department visits for epistaxis in the elderly.

Objective: Our objective is to determine the risk factors associated with recurrent epistaxis requiring emergency department (ED) visits in the elderly.

Methods: We used a 5% national sample of Medicare data from January 2012 through December 2013. Our cohort included patients with a new diagnosis of epistaxis in the ED, defined as no epistaxis in the prior 12 months.

New Institutionalization in Long-Term Care After Hospital Discharge to Skilled Nursing Facility.

Background/objectives: Approximately half of individuals newly admitted to long-term care (LTC) nursing homes (NHs) experienced a prior hospitalization followed by discharge to a skilled nursing facility (SNF). The objective was to examine characteristics associated with new institutionalizations of older adults on this care trajectory.

Design: Retrospective cohort study.

Trajectories Over the First Year of Long-Term Care Nursing Home Residence.

Objectives: To describe the trajectories in the first year after individuals are admitted to long-term care nursing homes.

Design: Retrospective cohort study.

Setting: US long-term care facilities.

Projecting diabetes prevalence among Mexicans aged 50 years and older: the Future Elderly Model-Mexico (FEM-Mexico).

Objective: Diabetes has been growing as a major health problem and a significant burden on the population and on health systems of developing countries like Mexico that are also ageing fast. The goal of the study was to estimate the future prevalence of diabetes among Mexico's older adults to assess the current and future health and economic burden of diabetes.

Design: A simulation study using longitudinal data from three waves (2001, 2003 and 2012) of the Mexican Health and Aging Study and adapting the Future Elderly Model to simulate four scenarios of hypothetical interventions that would reduce diabetes incidence and to project the future diabetes prevalence rates among populations 50 years and older.

Coordination Impairments Are Associated With Falling Among Older Adults.

Unlabelled: Background/Study Context: Approximately one third of older adults over the age of 65, and over 40% of those over 80 years, fall each year, leading to fractures, morbidity, and mortality. Annual direct medical costs due to falls in the United States are approximately $19.2 billion.

MyoVision: software for automated high-content analysis of skeletal muscle immunohistochemistry.

Analysis of skeletal muscle cross sections is an important experimental technique in muscle biology. Many aspects of immunohistochemistry and fluorescence microscopy can now be automated, but most image quantification techniques still require extensive human input, slowing progress and introducing the possibility of user bias. MyoVision is a new software package that was developed to overcome these limitations.

Acetylcholinesterase Inhibitors: Beneficial Effects on Comorbidities in Patients With Alzheimer's Disease.

Elderly patients with Alzheimer's disease (AD) and other dementias are at high risk of polypharmacy and excessive polypharmacy for common coexisting medical conditions. Polypharmacy increases the risk of drug-drug and drug-disease interactions in these patients who may not be able to communicate early symptoms of adverse drug events. Three acetylcholinesterase inhibitors (ACHEIs) have been approved for AD: donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne).

Racial/Ethnic and Nativity Differences in Cognitive Life Expectancies Among Older Adults in the United States.

Background And Objectives: To document racial/ethnic and nativity differences by gender in cognitive life expectancies among older adults in the United States.

Research Design And Methods: Sullivan-based life tables were used to estimate cognitively normal, cognitively impaired/no dementia (CIND), and dementia life expectancies by gender for White, Black, U.S.

Processes and Outcomes of Congestive Heart Failure Care by Different Types of Primary Care Models.

Background: Having nurse practitioners (NPs) as primary care providers for patients with congestive heart failure (CHF) is 1 way to address the growing shortage of primary care physicians (PCPs).

Methods And Results: We used inverse probability of treatment weighted with propensity score to examine the processes and outcomes of care for patients under 3 care models. Approximately 72.

Cancer and All-cause Mortality in Bladder Cancer Patients Undergoing Radical Cystectomy: Development and Validation of a Nomogram for Treatment Decision-making.

Objective: To develop and validate a nomogram assessing cancer and all-cause mortality following radical cystectomy. Given concerns regarding the morbidity associated with surgery, there is a need for incorporation of cancer-specific and competing risks into patient counseling and recommendations.

Materials And Methods: A total of 5325 and 1257 diagnosed with clinical stage T2-T4a muscle-invasive bladder cancer from January 1, 2006 to December 31, 2011 from Surveillance, Epidemiology, and End Results-Medicare and Texas Cancer Registry-Medicare linked data, respectively.

The Effects of Chronic Medical Conditions and Obesity on Self-Reported Disability in Older Mexican Americans.

We investigated the effect of chronic medical conditions including obesity on self-reported disability and mobility in Mexican Americans aged 75 or over using data from the Hispanic Established Population for the Epidemiological Study of the Elderly (Hispanic EPESE) Wave 5 (2004-2005). Disability was assessed with a modified version of the Katz activities of daily living (ADL) scale and mobility was assessed with the Rosow Breslau scale of gross mobility function. The percentage of participants needing assistance with ADLs were as follows: 26.

Increased Utilization of Positron Emission Tomography/Computed Tomography (PET/CT) Imaging and Its Economic Impact for Patients Diagnosed With Bladder Cancer.

Background: The purpose of this study was to examine temporal nationwide utilization patterns and predictors for use of positron emission tomography/computed tomography (PET/CT) in comparison with magnetic resonance imaging (MRI) and computed tomography (CT) among patients diagnosed with bladder cancer.

Materials And Methods: A total of 36,855 patients aged 66 years or older diagnosed with clinical stage TI-IV, N0M0 bladder cancer from 2004 to 2011 were analyzed. We used multivariable logistic regression analyses to discern factors associated with receipt of imaging within 12 months from diagnosis.