National Healthcare Quality and Disparities Report
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Topics
- Adverse Events (1)
- Back Health and Pain (1)
- Behavioral Health (1)
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- Cancer: Prostate Cancer (1)
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- (-) Elderly (21)
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- Long-Term Care (1)
- Mortality (1)
- Neurological Disorders (1)
- Nursing Homes (2)
- Outcomes (1)
- Pain (1)
- Quality of Care (1)
- (-) Quality of Life (21)
- Racial and Ethnic Minorities (1)
- Screening (1)
- Sexual Health (1)
- Shared Decision Making (2)
- Surgery (2)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 21 of 21 Research Studies DisplayedTsang M, DeBoer RJ, Garrett SB
Decision-making about clinical trial options among older patients with metastatic cancer who have exhausted standard therapies.
The purpose of this study was to examine the potential reasons for and responses to older adults’ under enrollment in phase 1 cancer clinical trials. The researchers conducted 101 in-depth qualitative interviews with 39 adults aged 65 and older with advanced cancer and asked about their experiences with the trials. The data was analyzed to identify the participants’ understanding of clinical research, their perceptions of early phase trials, and their experiences with enrollment in the trials. The study found that participants over the age of 70 were less enthusiastic about participation in clinical trials, although they did not mention age as a limitation to participation. Findings indicated that participation in clinical trials was an interactive, ongoing process, in which older adults relied on their oncologist for guidance and discussion. The researchers concluded that older adults rely on their oncologist to navigate the perceived complexities of phase 1 trial enrollment, and that acknowledgement of those complexities via shared decision-making can help prevent under-enrollment.
AHRQ-funded; HS022241.
Citation: Tsang M, DeBoer RJ, Garrett SB .
Decision-making about clinical trial options among older patients with metastatic cancer who have exhausted standard therapies.
J Geriatr Oncol 2022 Jun;13(5):594-99. doi: 10.1016/j.jgo.2022.01.012..
Keywords: Elderly, Cancer, Shared Decision Making, Quality of Life
Zimmerman S, Carder P, Schwartz L
The imperative to reimagine assisted living.
Assisted living (AL) has existed in the United States for decades, evolving in response to older adults' need for supportive care and distaste for nursing homes and older models of congregate care. AL is state-regulated, provides at least 2 meals a day, around-the-clock supervision, and help with personal care, but is not licensed as a nursing home. This article presents the background regarding those tensions, as well as potential solutions that have been borne out, paving the path to a better future of assisted living.
AHRQ-funded; HS026893.
Citation: Zimmerman S, Carder P, Schwartz L .
The imperative to reimagine assisted living.
J Am Med Dir Assoc 2022 Feb;23(2):225-34. doi: 10.1016/j.jamda.2021.12.004..
Keywords: Elderly, Long-Term Care, Healthcare Delivery, Workforce, Quality of Care, Quality of Life, Healthcare Costs
Osterman CK, Deal AM, McCloskey H
Impairment and longitudinal recovery of older adults treated with radical cystectomy for muscle invasive bladder cancer.
Treatment for muscle invasive bladder cancer includes radical cystectomy, a major surgery that can be associated with significant toxicity. Limited data exist related to changes in patient global health status and recovery following radical cystectomy. In this study, the investigators used geriatric assessment to longitudinally compare health related impairments in older and younger patients with muscle invasive bladder cancer who undergo radical cystectomy.
AHRQ-funded; HS024134.
Citation: Osterman CK, Deal AM, McCloskey H .
Impairment and longitudinal recovery of older adults treated with radical cystectomy for muscle invasive bladder cancer.
J Urol 2021 Jan;205(1):94-99. doi: 10.1097/ju.0000000000001323..
Keywords: Elderly, Cancer, Surgery, Adverse Events, Quality of Life
Bajaj JS, Duarte-Rojo A, Xie JJ
Minimal hepatic encephalopathy and mild cognitive impairment worsen quality of life in elderly patients with cirrhosis.
Researchers investigated the performance of elderly patients with cirrhosis on tests for minimal hepatic encephalopathy (MHE) and predementia mild cognitive impairment (MCI) and their effects on quality of life (QOL). They found that, in a multicenter study of elderly patients with cirrhosis and controls, the presence of MHE, regardless of MCI, was associated with poor cognition and QOL. They created adjusted norms that defined the high sensitivity of EncephalApp for the detection of MHE in older individuals and validated it in a separate cohort.
AHRQ-funded; HS025412.
Citation: Bajaj JS, Duarte-Rojo A, Xie JJ .
Minimal hepatic encephalopathy and mild cognitive impairment worsen quality of life in elderly patients with cirrhosis.
Clin Gastroenterol Hepatol 2020 Dec;18(13):3008-16.e2. doi: 10.1016/j.cgh.2020.03.033..
Keywords: Elderly, Chronic Conditions, Quality of Life, Dementia, Neurological Disorders
Dresden SM, Lo AX, Lindquist LA
The impact of Geriatric Emergency Department Innovations (GEDI) on health services use, health related quality of life, and costs: protocol for a randomized controlled trial.
The objective of this randomized controlled trial is to evaluate the efficacy of the Geriatric Emergency Department Innovations (GEDI) program, an ED nurse-led geriatric assessment and care coordination program, in decreasing unnecessary health services use and improving Health-Related Quality-of-Life (HRQoL) for older adults in the ED. Community-dwelling older adults aged 65 and older who are vulnerable or frail according to the Clinical Frailty Scale during an ED visit will be randomized to either GEDI or to usual ED care. The primary outcome is hospitalization or death within 30 days of the ED visit. Secondary outcomes include health service use outcomes, healthcare costs, and HRQoL outcomes.
AHRQ-funded; HS026489.
Citation: Dresden SM, Lo AX, Lindquist LA .
The impact of Geriatric Emergency Department Innovations (GEDI) on health services use, health related quality of life, and costs: protocol for a randomized controlled trial.
Contemp Clin Trials 2020 Oct;97:106125. doi: 10.1016/j.cct.2020.106125..
Keywords: Elderly, Emergency Department, Quality of Life, Hospitalization, Hospital Discharge
Abedini NC, Choi H, Wei MY
The relationship of loneliness to end-of-life experience in older Americans: a cohort study.
This study examined the relationship of loneliness to end-of-life-experiences for older Americans. Cohort data of decedents older than 50 years old was analyzed from the Health and Retirement Study (HRS). Individuals were characterized as lonely based on the three-item Revised University of California, Los Angeles Loneliness Scale from the most recent HRS survey taken before death. Individuals who were lonely were more likely to die in a nursing home and also have been on life support in the last 2 years of life. There were no other significant differences between lonely and nonlonely people.
AHRQ-funded; HS025891.
Citation: Abedini NC, Choi H, Wei MY .
The relationship of loneliness to end-of-life experience in older Americans: a cohort study.
J Am Geriatr Soc 2020 May;68(5):1064-71. doi: 10.1111/jgs.16354.
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Keywords: Elderly, Quality of Life
Rundell SD, Resnik L, Heagerty PJ
Comparing the performance of comorbidity indices in predicting functional status, health-related quality of life, and total health care use in older adults with back pain.
The purpose of this prospective cohort study was to determine how well the functional comorbidity index (FCI) predicted outcomes in older adults with back pain compared to Quan's modification of the Charlson comorbidity index (Quan-Charlson comorbidity index) and the Elixhauser comorbidity index. The investigators concluded that all indices performed similarly in predicting outcomes. The authors indicated that there is still a need to develop better function-based risk-adjustment models that improve prediction of functional outcomes versus standard comorbidity indices.
AHRQ-funded; HS019222; HS022972.
Citation: Rundell SD, Resnik L, Heagerty PJ .
Comparing the performance of comorbidity indices in predicting functional status, health-related quality of life, and total health care use in older adults with back pain.
J Orthop Sports Phys Ther 2020 Mar;50(3):143-48. doi: 10.2519/jospt.2020.8764..
Keywords: Elderly, Back Health and Pain, Pain, Chronic Conditions, Quality of Life, Healthcare Utilization, Health Status
Smith JW, Knight Davis J, Quatman-Yates CC
Loss of community-dwelling status among survivors of high-acuity emergency general surgery disease.
The purpose of this study was to examine the loss of community-dwelling status 9 months after hospitalization for high-acuity emergency general surgery (HA-EGS) disease among older Americans. The investigators concluded that older Americans, known to prioritize living in the community, will experience substantial loss of independence due to HA-EGS. They indicate that long-term expectations after surviving HA-EGS must be framed from the perspective of the outcomes that older patients value the most.
AHRQ-funded; HS022694.
Citation: Smith JW, Knight Davis J, Quatman-Yates CC .
Loss of community-dwelling status among survivors of high-acuity emergency general surgery disease.
J Am Geriatr Soc 2019 Nov;67(11):2289-97. doi: 10.1111/jgs.16046..
Keywords: Elderly, Surgery, Outcomes, Quality of Life
Burgdorf J, Roth DL, Riffin C
Factors associated with receipt of training among caregivers of older adults.
Emerging evidence suggests that support of family caregivers, including education and training, can improve health outcomes for caregivers and care recipients. In this paper, the authors examine whether caregiver characteristics are associated with receipt of training. The investigators found that 93% of older adults’ family caregivers did not report receiving role-related training.
AHRQ-funded; HS000029.
Citation: Burgdorf J, Roth DL, Riffin C .
Factors associated with receipt of training among caregivers of older adults.
JAMA Intern Med 2019 Jun;179(6):833-35. doi: 10.1001/jamainternmed.2018.8694.
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Keywords: Caregiving, Training, Education: Patient and Caregiver, Home Healthcare, Quality of Life, Elderly
Baughman KR, Ludwick R, Jarjoura D
Advance care planning in skilled nursing facilities: a multisite examination of professional judgments.
Lack of advance care planning (ACP) may increase hospitalizations and impact the quality of life for skilled nursing facility (SNF) residents, especially African American residents who may be less likely to receive ACP discussions. In this study, the investigators examined the professional judgments of skilled nursing facility providers to see if race of SNF residents and providers, and risk for hospitalization for residents influenced professional judgments as to when ACP was needed.
AHRQ-funded; HS022162.
Citation: Baughman KR, Ludwick R, Jarjoura D .
Advance care planning in skilled nursing facilities: a multisite examination of professional judgments.
Gerontologist 2019 Mar 14;59(2):338-46. doi: 10.1093/geront/gnx129..
Keywords: Elderly, Hospitalization, Nursing Homes, Quality of Life, Racial and Ethnic Minorities
Wu S, Leff B
Frailty measurement and its contribution to clinical care and health services: a commentary.
Frailty is associated with poorer quality of life and higher healthcare utilization and spending. Despite its importance, no clear consensus exists on the definition of frailty. The recent IJHPR article by Buch et al. significantly contributes to the advancement of Israel's understanding of frailty by estimating for the first time the prevalence of frailty in the country. This commentary discusses the context of past and current advancements in measuring frailty and discusses how frailty measurement can contribute to both clinical care and the organization of health services to care for frail older adults in Israel and other developed countries.
AHRQ-funded; HS000029.
Citation: Wu S, Leff B .
Frailty measurement and its contribution to clinical care and health services: a commentary.
Isr J Health Policy Res 2018 May 23;7(1):27. doi: 10.1186/s13584-018-0225-0.
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Keywords: Elderly, Health Services Research (HSR), Quality of Life
McCreedy EM, Weinstein BE, Chodosh J
Hearing loss: why does it matter for nursing homes?
This paper examines the impact of hearing loss on residents in nursing home settings and provides an estimate of prevalence using the Minimum Data Set (MDS v.3.0). They outline steps to mitigate hearing loss and discuss solutions that may be inexpensive and low-tech.
AHRQ-funded; HS000011.
Citation: McCreedy EM, Weinstein BE, Chodosh J .
Hearing loss: why does it matter for nursing homes?
J Am Med Dir Assoc 2018 Apr;19(4):323-27. doi: 10.1016/j.jamda.2017.12.007..
Keywords: Nursing Homes, Elderly, Quality of Life, Depression, Behavioral Health
Barile JP, Horner-Johnson W, Krahn G
Measurement characteristics for two health-related quality of life measures in older adults: the SF-36 and the CDC Healthy Days items.
This study assessed the extent to which the SF-36 and the Centers for Disease Control and Prevention (CDC) Healthy Days items measure the same aspects of health. It found that the CDC Healthy Days items measure similar domains as the SF-36 but appear to assess health-related quality of life without regard to limitations in functioning.
AHRQ-funded; HS022981.
Citation: Barile JP, Horner-Johnson W, Krahn G .
Measurement characteristics for two health-related quality of life measures in older adults: the SF-36 and the CDC Healthy Days items.
Disabil Health J 2016 Oct;9(4):567-74. doi: 10.1016/j.dhjo.2016.04.008.
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Keywords: Disabilities, Elderly, Health Status, Quality of Life
Gaugler JE
Driving and other important activities in older adulthood.
In this editorial, the author introduced the June 2016 issue by discussing driving as a key indicator of independence. He continued by discussing related articles that appear in this issue along with articles covering other potentially health-promoting activities enjoyed by older persons.
AHRQ-funded; HS022836.
Citation: Gaugler JE .
Driving and other important activities in older adulthood.
J Appl Gerontol 2016 Jun;35(6):579-82. doi: 10.1177/0733464816647560.
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Keywords: Elderly, Health Promotion, Health Status, Quality of Life
Groessl EJ, Kaplan RM, Castro Sweet CM
AHRQ Author: Kaplan RM
Cost-effectiveness of the LIFE physical activity intervention for older adults at increased risk for mobility disability.
The study objective was to examine the resources required to deliver the physical activity (PA) intervention and calculate the incremental cost-effectiveness compared with a health education intervention. They found that the average cost per participant over 2.6 years was US $3,302 and US $1,001 for the PA and health education interventions, respectively. PA participants accrued 0.047 per person more Quality-Adjusted Life-Years than health education participants.
AHRQ-authored.
Citation: Groessl EJ, Kaplan RM, Castro Sweet CM .
Cost-effectiveness of the LIFE physical activity intervention for older adults at increased risk for mobility disability.
J Gerontol A Biol Sci Med Sci 2016 May;71(5):656-62. doi: 10.1093/gerona/glw001.
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Keywords: Elderly, Lifestyle Changes, Health Promotion, Healthcare Costs, Quality of Life
Nikolich-Zugich J, Goldman DP, Cohen PR
Preparing for an aging world: engaging biogerontologists, geriatricians, and the society.
This perspective article summarizes a workshop discussion in Tucson in April, 2014, on biomedical approaches to best extend healthspan as way to reduce age-related dysfunction and disability. It further specifies the action items necessary to unite health professionals, scientists, and society to partner around the exciting and palpable opportunities to extend healthspan.
AHRQ-funded; HS022763.
Citation: Nikolich-Zugich J, Goldman DP, Cohen PR .
Preparing for an aging world: engaging biogerontologists, geriatricians, and the society.
J Gerontol A Biol Sci Med Sci 2016 Apr;71(4):435-44. doi: 10.1093/gerona/glv164.
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Keywords: Elderly, Quality of Life, Health Status, Health Promotion
Cantor SB, Deshmukh AA, Krahn MD
Use of forecasted assessment of quality of life to validate time-trade-off utilities and a prostate cancer screening decision-analytic model.
The researchers sought to determine whether the forecasted assessment of how someone would feel in a future health state can be predictive of utilities (e.g. as elicited by the time-trade-off method) and also predictive of optimal decisions as determined by a decision-analytic model. They concluded that anticipated difficulty adjusting to adverse health effects were highly related to preferences and could be used as a proxy measure of utility.
AHRQ-funded; HS08992.
Citation: Cantor SB, Deshmukh AA, Krahn MD .
Use of forecasted assessment of quality of life to validate time-trade-off utilities and a prostate cancer screening decision-analytic model.
Health Expect 2015 Oct;18(5):1610-20. doi: 10.1111/hex.12150.
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Keywords: Shared Decision Making, Cancer: Prostate Cancer, Elderly, Quality of Life, Screening
Thomas HN, Hess R, Thurston RC
Correlates of sexual activity and satisfaction in midlife and older women.
The authors gave updated prevalence estimates of sexual activity among women and elucidated factors associated with sexual activity and sexual satisfaction. Using the National Survey of Midlife Development in the United States, they found that a considerable proportion of midlife and older women remain sexually active if they have a partner available. Additionally, psychosocial factors matter more to sexual satisfaction than aging among midlife and older women.
AHRQ-funded; HS022989.
Citation: Thomas HN, Hess R, Thurston RC .
Correlates of sexual activity and satisfaction in midlife and older women.
Ann Fam Med 2015 Jul-Aug;13(4):336-42. doi: 10.1370/afm.1820.
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Keywords: Elderly, Women, Sexual Health, Quality of Life
Gustafson DH Sr, McTavish F, Gustafson DH Jr
The effect of an information and communication technology (ICT) on older adults' quality of life: study protocol for a randomized control trial.
The goal of this study is to test the effects of a technology called Elder Tree designed for and used by older adults and their family caregivers. The primary purpose of Elder Tree, a web-based information and communication technology (ICT), is to improve older adult quality of life. Recruitment for the trial began in November 2013 and the intervention period will end in November 2016.
AHRQ-funded; HS019917.
Citation: Gustafson DH Sr, McTavish F, Gustafson DH Jr .
The effect of an information and communication technology (ICT) on older adults' quality of life: study protocol for a randomized control trial.
Trials 2015 Apr 25;16:191. doi: 10.1186/s13063-015-0713-2..
Keywords: Communication, Elderly, Health Information Technology (HIT), Quality of Life
Pergolotti M, Cutchin MP
The Possibilities for Activity Scale (PActS): Development, validity, and reliability.
This study aimed to develop and validate a measure of perceived occupational possibilities: the Possibilities for Activity Scale (PActS). The PActS demonstrated promising internal consistency reliability and construct-related structural and known-groups validity. The PActS appears to be a useful measure of internalized occupational possibilities for participation in activity for older adults with cancer.
AHRQ-funded; HS000032.
Citation: Pergolotti M, Cutchin MP .
The Possibilities for Activity Scale (PActS): Development, validity, and reliability.
Can J Occup Ther 2015 Apr;82(2):85-92..
Keywords: Cancer, Quality of Life, Elderly
Arvold ND, Wang Y, Zigler C
Hospitalization burden and survival among older glioblastoma patients.
The researchers performed a retrospective cohort study among patients aged 65 years and older with glioblastoma diagnosed between 1999 and 2007. They found that higher comorbidity score and black race were associated with an increased risk of being hospitalized for at least 25% of remaining life, whereas radiation, temozolomide, and extensive surgery were associated with a decreased risk.
AHRQ-funded; HS021991.
Citation: Arvold ND, Wang Y, Zigler C .
Hospitalization burden and survival among older glioblastoma patients.
Neuro Oncol 2014 Nov;16(11):1530-40. doi: 10.1093/neuonc/nou060.
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Keywords: Cancer, Elderly, Hospitalization, Mortality, Quality of Life