Social Engagement and Cognitive Function of Older Adults in Mexico and the United States: How Universal Is the Interdependence in Couples?

Objectives: Increased social engagement in older adults has been linked to positive cognitive outcomes; however, it is unclear if the social engagement of husbands and wives influences their own cognition as well as each other's cognition. Moreover, it is unknown if any such patterns persist in different country contexts.

Methods: Data from the 2001 Mexican Health and Aging Study (MHAS) and the 2000 Health and Retirement Study (HRS) were combined, and comparable samples of married couples without cognitive impairment at baseline were drawn.

Variation among hospitals in the continuity of care for older hospitalized patients: a cross-sectional cohort study.

Background: Little is known about how continuity of care for hospitalized patients varies among hospitals. We describe the number of different general internal medicine physicians seeing hospitalized patients during a medical admission and how that varies by hospital.

Methods: We conducted a retrospective study of a national 20% sample of Medicare inpatients from 01/01/16 to 12/31/18.

Malnutrition Risk among Older Mexican Adults in the Mexican Health and Aging Study.

Few studies assess the malnutrition risk of older Mexican adults because most studies do not assess nutritional status. This study proposes a modified version of the Mini Nutritional Assessment (MNA) to assess the risk of malnutrition among older Mexicans adults in the Mexican Health and Aging Study (MHAS). Data comes from the 2012, 2015, and 2018 waves of the MHAS, a nationally representative study of Mexicans aged 50 and older.

Intranasal Oxytocin Improves Lean Muscle Mass and Lowers LDL Cholesterol in Older Adults with Sarcopenic Obesity: A Pilot Randomized Controlled Trial.

Objectives: Obesity is associated with sarcopenia in older adults, and weight loss can lead to further muscle mass loss. Oxytocin decreases with age, and animal studies suggest that oxytocin administration has trophic effects on skeletal muscle cells and reduces adiposity. We conducted a clinical trial to examine the safety and preliminary efficacy of intranasal oxytocin for older adults with sarcopenic obesity.

Important-performance analysis to conceptualize goal priorities in community dwelling stroke survivors.

Background: It is important for clinicians to have a better understanding of stroke survivor's goals. Important performance analysis (IPA) is a tool that could be utilized to identify goal priorities in rehabilitation.

Objectives: To examine the utility of the IPA method to identify goal priorities in a diverse group of community dwelling stroke survivors.

Smoking and risk of COVID-19 hospitalization.

Rationale: The association between smoking status and severe Coronavirus Disease 2019 (COVID-19) remains controversial.

Objective: To assess the risk of hospitalization (as a marker of severe COVID-19) in patients by smoking status: former, current and never smokers, who tested positive for the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV2) at an academic medical center in the United States.

Methods: We conducted a retrospective cohort study in patients with SARS-COV2 between March-1-2020 and January-31-2021 to identify the risk of hospitalization due to COVID-19 by smoking status.

Gender differences in activity-limiting pain trajectories over a 17-year period in the Mexican Health and Aging Study.

Pain increases with age, disproportionately affects women, and is a major contributor to decreased quality of life. Because pain is dynamic, trajectories are important to consider. Few studies have examined longitudinal trajectories of pain, by gender, in Mexico.

Antibodies: Friends, Foes, or Both? Lessons From COVID-19 for the Rheumatologist.

Antibodies are a fundamental tool to fight infections but are intrinsically built as a double-edged sword. One side recognizes the microbial antigen, and the other gives a call to arms to fight infection by recruiting immune cells and triggering inflammation. A balanced immune response must combine a potent neutralizing antibody and a swift disposal of the invading agent by innate immune cells with the least tissue damage possible.

Relationship Between Nursing Home Compare Improvement in Function Quality Measure and Physical Recovery After Hip Replacement.

Objective: To determine whether patients with a total or partial hip replacement admitted to a skilled nursing facility (SNF) after the improvement in function quality measure was added to Nursing Home Compare in July 2016 have greater physical recovery than patients admitted before July 2016.

Design: Pre (January 1, 2015-June 30, 2016) vs post (July 1, 2016-December 31, 2017) design.

Setting: Skilled nursing facilities (n=12,829).

Risk Factors Associated With SARS-CoV-2 Infections, Hospitalization, and Mortality Among US Nursing Home Residents.

Importance: Nursing home residents account for approximately 40% of deaths from SARS-CoV-2.

Objective: To identify risk factors for SARS-CoV-2 incidence, hospitalization, and mortality among nursing home residents in the US.

Design, Setting, And Participants: This retrospective longitudinal cohort study was conducted in long-stay residents aged 65 years or older with fee-for-service Medicare residing in 15 038 US nursing homes from April 1, 2020, to September 30, 2020.

Overdose deaths from nonprescribed prescription opioids, heroin, and other synthetic opioids in Medicare beneficiaries.

Importance: Opioid use disorder in the United States' Medicare population increased from 10 to 24 per 1000 from 2012 to 2018. Understanding the changes in the patterns of opioid overdose mortality over time holds broad clinical and public health relevance.

Objective: To examine trends and correlates of opioid overdose deaths from nonprescribed prescription opioids, heroin, and other synthetic opioids.

Potentially inappropriate medication prescribing by nurse practitioners and physicians.

Background: Potentially inappropriate medication (PIM) use is a risk factor for hospitalization and mortality. However, there were few studies focusing on the impact of provider type on PIM use.

Objective: We aimed to estimate the initial and refill PIM prescribing rate for physician visits and nurse practitioner (NP) visits and the impact of provider type on PIM prescribing.

A multi-center trial of exercise and testosterone therapy in women after hip fracture: Design, methods and impact of the COVID-19 pandemic.

Background: Up to 75% of hip fracture patients never recover to their pre-fracture functional status. Supervised exercise that includes strength training can improve functional recovery after hip fracture. The role of testosterone replacement for augmenting the effects of exercise in older women after hip fracture is unknown.

Factors associated with pain at the end-of-life among older adults in Mexico.

Objectives: The goal of care at the end-of-life has changed in recent years to encompass not only the relief of suffering but also improve the quality of death. Palliative care offers a coordinated and multidisciplinary approach to improving the quality of life and quality of care of individuals and their families facing illness at the end-of-life. This manuscript examines the end-of-life of older adults in Mexico and the factors associated with pain in this period of their life.

US national trends in prescription opioid use after burn injury, 2007 to 2017.

Background: Opioid misuse and overdose in the United States remain a public health emergency. Overprescribing has been recognized as a significant contributor to the epidemic. Opioids are the mainstay for pain management after burn; however, to date, no large-scale nationally representative study has evaluated outpatient opioid prescribing practices in this population.

Depressive symptoms predict low physical performance among older Mexican Americans.

Background: Depressive symptoms are common in older adults and predict functional dependency.

Aims: To examine the ability of depressive symptoms to predict low physical performance over 20 years of follow-up among older Mexican Americans who scored moderate to high in the Short Physical Performance Battery (SPPB) test and were non-disabled at baseline.

Methods: Data were from the Hispanic Established Population for the Epidemiologic Study of the Elderly.

The impact of long-term opioid use on the risk and severity of COVID-19.

Based on evidence of the immunosuppressive effects of chronic opioids, long-term users of prescription and illicit opioids comprise an unrecognized but growing population of Americans with compromised immune function and respiratory depression who may be at high risk of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)-related hospitalization, prolonged ICU stay, adverse events, and death. This perspective is of broad clinical and public health importance because the US has the highest population of long-term users of prescription opioids, a sequel of a decade-long practice of opioid overprescribing in the US. For long-term opioid users who are hospitalized for COVID-19, clinicians face clinical challenges arising from the suppressive effects of opioids on the respiratory and immune functions, as well as the potential for adverse drug-drug interaction when opioids have to be continued in long-term users.

Association between vision impairment and cognitive decline in older adults with stroke: Health and Retirement Study.

Stroke survivors may experience multiple residual symptoms post-stroke, including vision impairment (VI) and cognitive decline. Prior studies have shown that VI is associated with cognitive decline, but have not evaluated the contribution of VI to post-stroke cognitive changes. We used data from four waves (2010-2016) of the Health and Retirement Study to investigate the cognitive trajectories of stroke survivors with and without VI.

Assessing Association Between Team Structure and Health Outcome and Cost by Social Network Analysis.

Background/objective: To assess the impact of team structure composition and degree of collaboration among various providers on process and outcomes of primary care.

Design: Cross-sectional study.

Setting: Data from 20% randomly selected primary care service areas in the 2015 Medicare claims were used to identify primary care practices.

Trends in Urine Drug Testing Among Long-term Opioid Users, 2012-2018.

Introduction: Long-term opioid therapy increases the risk of opioid overdose death. Government agencies and medical societies, including the Center for Disease Control and Prevention and the American Society for Clinical Oncology, emphasized risk mitigation strategies, including urine drug testing, in published guidelines. Urine drug testing rates, time trends, and covariates among long-term opioid therapy users were examined to gauge guideline adherence.

How to Identify Team-based Primary Care in the United States Using Medicare Data.

Background: Studying team-based primary care using 100% national outpatient Medicare data is not feasible, due to limitations in the availability of this dataset to researchers.

Methods: We assessed whether analyses using different sets of Medicare data can produce results similar to those from analyses using 100% data from an entire state, in identifying primary care teams through social network analysis. First, we used data from 100% Medicare beneficiaries, restricted to those within a primary care services area (PCSA), to identify primary care teams.

Proximity to Oil Refineries and Risk of Cancer: A Population-Based Analysis.

Background: The association between proximity to oil refineries and cancer rate is largely unknown. We sought to compare the rate of cancer (bladder, breast, colon, lung, lymphoma, and prostate) according to proximity to an oil refinery in Texas.

Methods: A total of 6 302 265 persons aged 20 years or older resided within 30 miles of an oil refinery from 2010 to 2014.

Associations between spousal caregiving and health among older adults in Mexico: A targeted estimation approach.

Objective: To evaluate associations between spousal caregiving and mental and physical health among older adults in Mexico.

Methods: Data come from the Mexican Health & Aging Study, a national population-based study of adults ≥50 years and their spouses (2001-2015). We compared outcomes for spousal caregivers to outcomes for those whose spouses had difficulty with at least one basic or instrumental activity of daily living (I/ADL) but were not providing care; the control group conventionally includes all married respondents regardless of spouse's need for care.