Longitudinal sequencing of cardiometabolic multimorbidity among older adults and association with subsequent dementia onset.

Background: Patterns of development of cardiometabolic multimorbidity (CMM) and the impact of specific cardiometabolic disease combinations on cognitive function are not well understood. This study utilizes sequence analysis to describe the ordering and timing of cardiometabolic disease accumulation over a five-year period and to assess both sociodemographic predictors and cognitive outcomes of typical cardiometabolic disease sequences.

Methods: We analyzed data from the National Health and Aging Trends Study (2011-2022), including respondents aged ≥65 years without CMM or cognitive impairment at baseline (N = 4956).

Contribution of chronic conditions to mortality: Differences by race and ethnicity.

Background: Racial and ethnic health disparities are persistent in the United States. The accumulation of chronic conditions and mortality are important contributors to these observed inequities.

Methods: We assessed the contribution of coexisting conditions to mortality among Hispanic, non-Hispanic White, and non-Hispanic Black older adults born in the United States.

Social Support and Social Strain Sources as Predictors of Multimorbidity Changes in Middle-Aged and Older Adults.

ObjectivesThis study examines whether social strain and support from various sources are associated with accumulation of chronic conditions in older adults.MethodsGrowth mixture modeling was used to investigate which network sources of support and strain were related to morbidity accumulation over 12 years among 5,321 individuals over age 50 in the Health and Retirement Study.ResultsHigher overall social support-comfort provided by others-was associated with a greater likelihood of belonging to the low morbidity trajectory class versus the high and increasing morbidity classes, but overall social strain-tense or conflictual interactions-was not.

Prescription-based association of P-glycoprotein substrates with Alzheimer's disease risk: A nested case-control study.

BackgroundP-glycoprotein (P-gp) is linked to Alzheimer's disease (AD), as P-gp contributes to clearance of amyloid-β (Aβ) from the CNS. Thus, other P-gp substrates (Pgp-S) could affect Aβ clearance, either negatively through competitive inhibition or positively via cooperative transport, impacting risk for AD.ObjectiveWe probed impacts of Pgp-S on AD risk by querying AD rates among individuals prescribed medications that are considered Pgp-S.

Exploring Racial Disparities in Chronic Pain Management.

Introduction: Addressing racial disparities in chronic pain management referrals and prescribing is critical for ensuring equitable healthcare outcomes. Understanding these disparities is crucial for developing effective, patient-centered treatment strategies.

Patients And Methods: A cross-sectional retrospective study of 19,919 patients diagnosed with chronic non-cancer pain between 7/1/2020 and 7/1/2022 was conducted at a major academic medical center.

Informal Care Receiving Among Older Adults: The Role of Multimorbidity and Intersectional Social Position.

Background And Objectives: Older adults with distinct multimorbidity combinations may require varying intensities of informal care and these needs may vary in important ways by race/ethnicity and sex. This study aims to examine informal care-receiving characteristics among older adults with varying multimorbidity patterns and race/ethnicity-sex characteristics.

Research Design And Methods: A total of 4,875 participants from the National Health and Aging Trends Study were included.

Cardiometabolic Multimorbidity and Dementia Onset Among Middle-Aged and Older Adults: Differences by Race/Ethnicity.

Background: Racial/ethnic minoritized groups in the United States have a higher prevalence of cardiometabolic multimorbidity and experience a higher risk of dementia. This study evaluates the relationship between cardiometabolic multimorbidity and dementia onset according to racial/ethnic group in a nationally representative cohort of U.S.

Exploring Perceived Limitations to Daily Activities Due to Chronic Conditions: A Person-Centered Approach to Measuring Multimorbidity Severity.

Background: Person-centered approaches to measuring severity of multimorbidity (≥ 2 chronic conditions) can help clinicians assess the individual experience of multimorbidity and inform effective caregiving and intervention strategies. We examine how limitations in everyday activities attributable to specific chronic conditions act independently and in tandem to influence individual perceptions of multimorbidity severity.

Methods: Data from the Panel Study of Income Dynamics (2005-2021) were used to investigate self-reported limitations in normal daily activities resulting from nine chronic conditions (hypertension, arthritis, diabetes, heart condition [heart disease/heart attack], cancer, lung disease, stroke, depression, and memory loss) in 4 318 adults aged 55-95 (18 878 person-wave observations).

The extent and burden of high multimorbidity on older adults in the US: a descriptive analysis of Medicare beneficiaries.

Background: The impact of multimorbidity (≥ 2 chronic diseases) on the well-being of older adults is substantial but variable. The burden of multimorbidity varies by the number and kinds of conditions, and timing of onset. The impact varies by age, race, ethnicity, socioeconomic status, and health indicators.

The Impact of Nurse Residency Programs on Patient Quality and Safety Outcomes: A Review of the Literature.

Schools of nursing are struggling to prepare registered nurses to practice in today's complex healthcare settings. Nurse residency programs are a good solution to support the transition to practice. Nursing education leaders must be informed of the nursing quality and safety outcomes of nurse residency programs.

ADVANCE: a biomedical informatics approach to investigate acute kidney injury in infants.

Background: Acute kidney injury (AKI) occurs in up to half of infants admitted to the neonatal intensive care unit (NICU) and is associated with increased risks of death and more days of mechanical ventilation, hospitalization, and vasopressor drug support. Our objective was to build a granular relational database to study the impact that AKI has on infants admitted to Level-IV NICUs.

Methods: A relational database was created by linking data from the Children's Hospitals Neonatal Database with AKI-focused data from electronic health records from 9 centers.

Multimorbidity and associated informal care receiving characteristics for US older adults: a latent class analysis.

Background: Older adults with varying patterns of multimorbidity may require distinct types of care and rely on informal caregiving to meet their care needs. This study aims to identify groups of older adults with distinct, empirically-determined multimorbidity patterns and compare characteristics of informal care received among estimated classes.

Methods: Data are from the 2011 National Health and Aging Trends Study (NHATS).

Mental-somatic multimorbidity in trajectories of cognitive function for middle-aged and older adults.

Introduction: Multimorbidity may confer higher risk for cognitive decline than any single constituent disease. This study aims to identify distinct trajectories of cognitive impairment probability among middle-aged and older adults, and to assess the effect of changes in mental-somatic multimorbidity on these distinct trajectories.

Methods: Data from the Health and Retirement Study (1998-2016) were employed to estimate group-based trajectory models identifying distinct trajectories of cognitive impairment probability.

Recommendations on Methods for Assessing Multimorbidity Changes Over Time: Aligning the Method to the Purpose.

Background: The rapidly growing field of multimorbidity research demonstrates that changes in multimorbidity in mid- and late-life have far reaching effects on important person-centered outcomes, such as health-related quality of life. However, there are few organizing frameworks and comparatively little work weighing the merits and limitations of various quantitative methods applied to the longitudinal study of multimorbidity.

Methods: We identify and discuss methods aligned to specific research objectives with the goals of (i) establishing a common language for assessing longitudinal changes in multimorbidity, (ii) illuminating gaps in our knowledge regarding multimorbidity progression and critical periods of change, and (iii) informing research to identify groups that experience different rates and divergent etiological pathways of disease progression linked to deterioration in important health-related outcomes.

A Joint Model for Disability, Self-Rated Health, and Mortality Among Medicare Beneficiaries-Differences by Chronic Disease and Race/Ethnicity.

Objectives: Quantifying interdependence in multiple patient-centered outcomes is important for understanding health declines among older adults.

Methods: Medicare-linked National Health and Aging Trends Study data (2011-2015) were used to estimate a joint longitudinal logistic regression model of disability in activities of daily living (ADL), fair/poor self-rated health (SRH), and mortality. We calculated personalized concurrent risk (PCR) and typical concurrent risk (TCR) using regression coefficients.

Study design and baseline to evaluate water service provision among peri-urban communities in Kasai Oriental, Democratic Republic of the Congo.

We present a study design and baseline results to establish the impact of interventions on peri-urban water access, security and quality in Kasai Oriental province of the Democratic Republic of the Congo. In standard development practice, program performance is tracked via monitoring and evaluation frameworks of varying sophistication and rigor. Monitoring and evaluation, while usually occurring nearly concurrently with program delivery, may or may not measure parameters that can identify performance with respect to the project's overall goals.

Racial, ethnic, and socioeconomic disparities in trajectories of morbidity accumulation among older Americans.

Introduction: Multimorbidity, the presence of multiple chronic health conditions, generally starts in middle and older age but there is considerable heterogeneity in the trajectory of morbidity accumulation. This study aimed to clarify the number of distinct trajectories and the potential associations between race/ethnicity and socioeconomic status and these trajectories.

Methods: Data from 13,699 respondents (age ≥51) in the Health and Retirement Study between 1998 and 2016 were analyzed with growth mixture models.

Depressive Multimorbidity and Trajectories of Functional Status among Older Americans: Differences by Racial/Ethnic Group.

Objective: This study aims to evaluate the impact of depressive multimorbidity (ie, including depressive symptoms) on the long-term development of activities of daily living (ADL) and instrumental activities of daily living (IADL) limitations according to racial/ethnic group in a representative sample of US older adults.

Design: Prospective, observational, population-based 16-year follow-up study of nationally representative sample.

Setting And Participants: Sample of older non-Hispanic Black, Hispanic, and nonHispanic White Americans from the Health and Retirement Study (2000‒2016, N = 16,364, community-dwelling adults ≥65 years of age).

Interprofessional Naloxone Student Training to Manage Suspected Opioid Overdose.

Purpose: The study purpose was to examine the effect of interprofessional naloxone training on students' knowledge, confidence, and interprofessional collaboration competency. The overarching goal was to decrease mortality related to opioid overdoses.

Design/methods: A training session for interprofessional students consisted of a lecture presentation, demonstration, and hands-on practice regarding appropriate administration of naloxone for suspected opioid overdose.

Multidimensional trajectories of multimorbidity, functional status, cognitive performance, and depressive symptoms among diverse groups of older adults.

Background: Inter-relationships between multimorbidity and geriatric syndromes are poorly understood. This study assesses heterogeneity in joint trajectories of somatic disease, functional status, cognitive performance, and depressive symptomatology.

Methods: We analyzed 16 years of longitudinal data from the Health and Retirement Study (HRS, 1998-2016) for n = 11,565 older adults (≥65 years) in the United States.

Trajectories of cognitive functioning in later life: Disparities by race/ethnicity, educational attainment, sex, and multimorbidity combinations.

Evaluating multimorbidity combinations, racial/ethnic background, educational attainment, and sex associations with age-related cognitive changes is critical to clarifying the health, sociodemographic, and socioeconomic mechanisms associated with cognitive function in later life. Data from the 2011-2018 National Health and Aging Trends Study for respondents aged 65 years and older (N = 10,548, mean age = 77.5) were analyzed using linear mixed effect models.

The importance of chronic conditions for potentially avoidable hospitalizations among non-Hispanic Black and non-Hispanic White older adults in the US: a cross-sectional observational study.

Background: Non-Hispanic (NH) Black older adults experience substantially higher rates of potentially avoidable hospitalization compared to NH White older adults. This study explores the top three chronic conditions preceding hospitalization and potentially avoidable hospitalization among NH White and NH Black Medicare beneficiaries in the United States.

Methods: Data on 4993 individuals (4,420 NH White and 573 NH Black individuals) aged ≥ 65 years from 2014 Medicare claims were linked with sociodemographic data from previous rounds of the Health and Retirement Study.

Effect of a low-cost, behaviour-change intervention on latrine use and safe disposal of child faeces in rural Odisha, India: a cluster-randomised controlled trial.

Background: Uptake of Government-promoted sanitation remains a challenge in India. We aimed to investigate a low-cost, theory-driven, behavioural intervention designed to increase latrine use and safe disposal of child faeces in India.

Methods: We did a cluster-randomised controlled trial between Jan 30, 2018, and Feb 18, 2019, in 66 rural villages in Puri, Odisha, India.