National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (2)
- Adverse Events (1)
- Behavioral Health (3)
- Caregiving (2)
- Comparative Effectiveness (3)
- (-) Dementia (28)
- Diabetes (1)
- Diagnostic Safety and Quality (1)
- Disparities (1)
- Elderly (16)
- Evidence-Based Practice (4)
- Falls (1)
- Guidelines (1)
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- Healthcare Delivery (1)
- Healthcare Utilization (2)
- Heart Disease and Health (1)
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- Hospital Readmissions (1)
- Implementation (1)
- Injuries and Wounds (1)
- Lifestyle Changes (1)
- Long-Term Care (5)
- Medicare (1)
- Medication (7)
- Medication: Safety (1)
- Mortality (1)
- Neurological Disorders (9)
- Nursing (1)
- Nursing Homes (9)
- Patient-Centered Outcomes Research (2)
- Patient and Family Engagement (1)
- Patient Safety (1)
- Policy (1)
- Prevention (3)
- Public Reporting (1)
- Quality Measures (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (2)
- Risk (4)
- Sex Factors (1)
- Stress (1)
- Vitamins and Supplements (1)
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 25 of 28 Research Studies DisplayedMarcum ZA, Walker R, Bobb JF
Serum cholesterol and incident Alzheimer's disease: findings from the adult changes in thought study.
The purpose of this prospective population-based cohort study was to evaluate associations between high-density lipoprotein cholesterol (HDL) and non-HDL-C levels at specific ages and subsequent Alzheimer's disease (AD) risk. The investigators concluded that people with low (120 mg/dL) and high (210 mg/dL) non-HDL-C levels during their 60s and 70s had modestly higher risk of AD than those with intermediate (160 mg/dL) levels.
AHRQ-funded; HS022982.
Citation: Marcum ZA, Walker R, Bobb JF .
Serum cholesterol and incident Alzheimer's disease: findings from the adult changes in thought study.
J Am Geriatr Soc 2018 Dec;66(12):2344-52. doi: 10.1111/jgs.15581..
Keywords: Heart Disease and Health, Dementia, Elderly, Risk
Albrecht JS, Hanna M, Kim D
Predicting diagnosis of Alzheimer's disease and related dementias using administrative claims.
The objective of this study is to see if a better predictive model could be created for earlier diagnosis of Alzheimer disease and related dementia (ADRD) using the amount of health care utilization (HCU) in individuals prior to diagnosis. A case-control study was conducted including individuals with and without mild cognitive impairment who were diagnosed between 2011 and 2014. They were matched to controls without ADRD and were able to obtain moderate accuracy.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Hanna M, Kim D .
Predicting diagnosis of Alzheimer's disease and related dementias using administrative claims.
J Manag Care Spec Pharm 2018 Nov;24(11):1138-45. doi: 10.18553/jmcp.2018.24.11.1138..
Keywords: Dementia, Diagnostic Safety and Quality, Neurological Disorders
Albrecht JS, Hanna M, Kim D
Increased health care utilization in dementia subtypes before diagnosis.
The objectives of this study were to identify Alzheimer disease and related dementia (ADRD) subtypes and: (1) characterize all-cause and (2) disease-specific health care utilization (HCU) during the 3 years preceding diagnosis, and (3) determine if HCU varied by ADRD subtype. Among other results, the investigators found that HCU increased over time, was highest in the outpatient setting, and varied by ADRD subtype.
AHRQ-funded; HS024560.
Citation: Albrecht JS, Hanna M, Kim D .
Increased health care utilization in dementia subtypes before diagnosis.
Alzheimer Dis Assoc Disord 2018 Oct-Dec;32(4):326-32. doi: 10.1097/wad.0000000000000277..
Keywords: Dementia, Healthcare Utilization
Joyce NR, McGuire TG, Bartels SJ
The impact of dementia special care units on quality of care: an instrumental variables analysis.
The purpose of this study was to compare the quality of care following admission to a nursing home (NH) with and without a dementia special care unit (SCU) for residents with dementia. The investigators found that facilities with an SCU provided better quality of care as measured by several validated quality indicators. The authors suggested that given the aging population, policies to promote the expansion and use of dementia SCUs may be warranted.
AHRQ-funded; HS022998.
Citation: Joyce NR, McGuire TG, Bartels SJ .
The impact of dementia special care units on quality of care: an instrumental variables analysis.
Health Serv Res 2018 Oct;53(5):3657-79. doi: 10.1111/1475-6773.12867..
Keywords: Dementia, Elderly, Quality of Care, Long-Term Care, Nursing Homes
Lee AK, Rawlings AM, Lee CJ
Severe hypoglycaemia, mild cognitive impairment, dementia and brain volumes in older adults with type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) cohort study.
In this study, the investigators aimed to evaluate the link between severe hypoglycaemia and domain-specific cognitive decline, smaller brain volumes and dementia in adults with type 2 diabetes. The investigators concluded that their results demonstrated a strong link between severe hypoglycaemia and poor cognitive outcomes, suggesting a need for discussion of appropriate diabetes treatments for high-risk older adults.
AHRQ-funded; HS018542.
Citation: Lee AK, Rawlings AM, Lee CJ .
Severe hypoglycaemia, mild cognitive impairment, dementia and brain volumes in older adults with type 2 diabetes: the Atherosclerosis Risk in Communities (ARIC) cohort study.
Diabetologia 2018 Sep;61(9):1956-65. doi: 10.1007/s00125-018-4668-1..
Keywords: Dementia, Diabetes, Elderly, Neurological Disorders, Risk
Parker WF, Georges RJ, Gao YN
Association between groundwater lithium and the diagnosis of bipolar disorder and dementia in the United States.
This study examined the association between groundwater lithium and the diagnoses of bipolar disorder and dementia in the United States, with adjustment for local health care resources and demographics. Data on groundwater lithium concentrations was collected by the US Geological Survey, and diagnoses were identified from inpatient hospital, long-term care, and other therapy claims files from several sources. The results of the study indicate that, in spite of the substantial variations in groundwater lithium exposure, no significant association between exposure and the risk of bipolar disorder or dementia after adjustment for county-level demographics and health care resource was found. The authors note that therapeutic lithium doses are orders of magnitude larger than groundwater lithium concentrations, which makes a true causal relationship between groundwater lithium and mental health dubious.
AHRQ-funded; HS000084.
Citation: Parker WF, Georges RJ, Gao YN .
Association between groundwater lithium and the diagnosis of bipolar disorder and dementia in the United States.
JAMA Psychiatry 2018 Jul;75(7):751-54. doi: 10.1001/jamapsychiatry.2018.1020..
Keywords: Dementia, Behavioral Health, Neurological Disorders, Risk
McCreedy E, Loomer L, Palmer JA
Representation in the care planning process for nursing home residents with dementia.
This study examined the participation of residents, family members, or representatives in nursing home (NH) long-term care planning for residents with cognitive impairment. A large for-profit NH system was used to recruit study participants. A sample of 18,552 long-stay NH residents in 2016 were surveyed. Of residents with no cognitive impairment, 8% had family or representative participation in care planning, compared with 26% of residents with severe impairments. Family participation was greater in NHs with more social workers.
AHRQ-funded; HS000011.
Citation: McCreedy E, Loomer L, Palmer JA .
Representation in the care planning process for nursing home residents with dementia.
J Am Med Dir Assoc 2018 May;19(5):415-21. doi: 10.1016/j.jamda.2018.01.004..
Keywords: Dementia, Nursing Homes, Long-Term Care, Patient and Family Engagement, Neurological Disorders
Gilmore-Bykovskyi A, Johnson R, Walljasper L
Underreporting of gender and race/ethnicity differences in NIH-funded dementia caregiver support interventions.
The objective of this study was to determine the inclusion and reporting rates among NIH-funded dementia caregiver support interventions. Findings suggested limited NIH guideline compliance that may reflect a lack of awareness regarding potential gender disparities in caregiving roles. In order to ensure NIH guideline compliance, shared investments from researchers, editors, and reviewers to make certain that group differences are systematically identified and reported are recommended.
AHRQ-funded; HS022548.
Citation: Gilmore-Bykovskyi A, Johnson R, Walljasper L .
Underreporting of gender and race/ethnicity differences in NIH-funded dementia caregiver support interventions.
Am J Alzheimers Dis Other Demen 2018 May;33(3):145-52. doi: 10.1177/1533317517749465..
Keywords: Caregiving, Sex Factors, Racial and Ethnic Minorities, Guidelines, Dementia, Disparities
Callahan CM, Bateman DR, Wang S
State of science: bridging the science-practice gap in aging, dementia and mental health.
This article describes why new models of care in aging, dementia, and mental health diffuse inadequately into the healthcare systems and communities where they might benefit older adults. The investigators review a general framework for the diffusion of innovations and highlight the importance of other features of innovations that deter or facilitate diffusion.
AHRQ-funded; HS024384.
Citation: Callahan CM, Bateman DR, Wang S .
State of science: bridging the science-practice gap in aging, dementia and mental health.
J Am Geriatr Soc 2018 Apr;66(Suppl 1):S28-s35. doi: 10.1111/jgs.15320..
Keywords: Elderly, Dementia, Behavioral Health, Healthcare Delivery, Neurological Disorders, Implementation, Evidence-Based Practice
Agimi Y, Albert SM, Youk AO
AHRQ Author: Steiner CA
Dementia and motor vehicle crash hospitalizations: role of physician reporting laws.
This study sought to determine the effect of physician reporting laws and state licensing requirements on crash hospitalizations among drivers with dementia. It concluded that physician reporting laws, mandated or legally protected, were not associated with a lower likelihood of dementia among crash hospitalized drivers. Vision testing at in-person renewal and in-person renewal requirements were significantly related with a lower prevalence of dementia in hospitalized older drivers.
AHRQ-authored.
Citation: Agimi Y, Albert SM, Youk AO .
Dementia and motor vehicle crash hospitalizations: role of physician reporting laws.
Neurology 2018 Feb 27;90(9):e808-e13. doi: 10.1212/wnl.0000000000005022.
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Keywords: Dementia, Elderly, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Policy
Butler M, McCreedy E, Nelson VA
Does cognitive training prevent cognitive decline?: A systematic review.
This review summarized evidence on the effects of cognitive training on cognitive performance and incident dementia outcomes for adults with normal cognition or mild cognitive impairment (MCI). It concluded that results for populations with MCI suggested no effect of training on performance (low-strength and insufficient evidence). Evidence for prevention of cognitive decline or dementia was insufficient.
AHRQ-funded; 290201500008I.
Citation: Butler M, McCreedy E, Nelson VA .
Does cognitive training prevent cognitive decline?: A systematic review.
Ann Intern Med 2018 Jan 2;168(1):63-68. doi: 10.7326/m17-1531.
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Keywords: Dementia, Evidence-Based Practice, Neurological Disorders, Prevention
Butler M, Nelson VA, Davila H
Over-the-counter supplement interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review.
This review summarizes the evidence on efficacy and harms of over-the-counter (OTC) supplements to prevent or delay cognitive decline, mild cognitive impairment (MCI), or clinical Alzheimer-type dementia in adults with normal cognition or MCI but no dementia diagnosis. It concluded that evidence is insufficient to recommend any OTC supplement for cognitive protection in adults with normal cognition or MCI.
AHRQ-funded; 290201500008I.
Citation: Butler M, Nelson VA, Davila H .
Over-the-counter supplement interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review.
Ann Intern Med 2018 Jan 2;168(1):52-62. doi: 10.7326/m17-1530.
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Keywords: Dementia, Evidence-Based Practice, Prevention, Neurological Disorders
Fink HA, Jutkowitz E, McCarten JR
Pharmacologic interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review.
This review summarized current evidence on the efficacy and harms of pharmacologic interventions to prevent or delay cognitive decline, mild cognitive impairment (MCI), or dementia in adults with normal cognition or MCI. It concluded that evidence does not support use of the studied pharmacologic treatments for cognitive protection in persons with normal cognition or MCI.
AHRQ-funded; 290201500008I.
Citation: Fink HA, Jutkowitz E, McCarten JR .
Pharmacologic interventions to prevent cognitive decline, mild cognitive impairment, and clinical Alzheimer-type dementia: a systematic review.
Ann Intern Med 2018 Jan 2;168(1):39-51. doi: 10.7326/m17-1529.
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Keywords: Comparative Effectiveness, Dementia, Medication, Patient-Centered Outcomes Research, Prevention
Brasure M, Desai P, Davila H
Physical activity interventions in preventing cognitive decline and Alzheimer-type dementia: a systematic review.
This systematic review assessed the effectiveness of physical activity interventions in slowing cognitive decline and delaying the onset of cognitive impairment and dementia in adults without diagnosed cognitive impairments. Evidence was insufficient to draw conclusions about the effectiveness of aerobic training, resistance training, or tai chi for improving cognition. ALSO, Evidence regarding effects on dementia prevention was insufficient for all physical activity interventions.
AHRQ-funded; 290201500008I.
Citation: Brasure M, Desai P, Davila H .
Physical activity interventions in preventing cognitive decline and Alzheimer-type dementia: a systematic review.
Ann Intern Med 2018 Jan 2;168(1):30-38. doi: 10.7326/m17-1528.
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Keywords: Comparative Effectiveness, Dementia, Evidence-Based Practice, Lifestyle Changes, Patient-Centered Outcomes Research
Lee SJ, Larson EB, Dublin S
A cohort study of healthcare utilization in older adults with undiagnosed dementia.
The study objective was to determine healthcare utilization rates among patients with undiagnosed dementia. In terms of healthcare utilization, participants with undiagnosed dementia appear to be an intermediate group between participants with diagnosed dementia and those with no dementia. Participants with diagnosed dementia had 2.5 emergency department visits over 2 years, compared to 1.7 visits for undiagnosed dementia and 0.8 visits for participants with no dementia.
AHRQ-funded; HS022982.
Citation: Lee SJ, Larson EB, Dublin S .
A cohort study of healthcare utilization in older adults with undiagnosed dementia.
J Gen Intern Med 2018 Jan;33(1):13-15. doi: 10.1007/s11606-017-4162-3.
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Keywords: Elderly, Dementia, Healthcare Utilization
Blackburn J, Zheng Q, Grabowski DC
Nursing home chain affiliation and its impact on specialty service designation for Alzheimer disease.
Specialty care units (SCUs) in nursing homes (NHs) grew in popularity during the 1990s to attract residents while national policies and treatment paradigms changed. Alzheimer disease has consistently been the dominant form of SCU. This study explored the extent to which chain affiliation, which is common among NHs, affected SCU bed designation.
AHRQ-funded; HS023009.
Citation: Blackburn J, Zheng Q, Grabowski DC .
Nursing home chain affiliation and its impact on specialty service designation for Alzheimer disease.
Inquiry 2018 Jan-Dec;55:46958018787992. doi: 10.1177/0046958018787992..
Keywords: Elderly, Nursing Homes, Long-Term Care, Dementia, Neurological Disorders
Bali V, Chatterjee S, Carnahan RM
Risk of dementia among elderly nursing home patients using paroxetine and other selective serotonin reuptake inhibitors.
This study evaluated the comparative risk of dementia associated with use of paroxetine and other selective serotonin reuptake inhibitors (SSRIs) among elderly nursing home patients. It found that compared with use of other SSRIs, use of paroxetine was not associated with higher risk of dementia among elderly nursing home patients with depression.
AHRQ-funded; HS021264.
Citation: Bali V, Chatterjee S, Carnahan RM .
Risk of dementia among elderly nursing home patients using paroxetine and other selective serotonin reuptake inhibitors.
Psychiatr Serv 2015 Dec;66(12):1333-40. doi: 10.1176/appi.ps.201500011.
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Keywords: Adverse Drug Events (ADE), Dementia, Elderly, Nursing Homes, Medication
Konetzka RT, Brauner DJ, Coca Perraillon M
The role of severe dementia in nursing home report cards.
This article examined the intended and unintended effects of quality reporting for nursing home residents with severe dementia relative to other residents, using a difference-in-differences design to examine selected reported and unreported quality measures. The results indicate that prior to public reporting, nursing home residents with severe dementia were at significantly higher risk of poor outcomes on most reported quality measures.
AHRQ-funded; HS018718.
Citation: Konetzka RT, Brauner DJ, Coca Perraillon M .
The role of severe dementia in nursing home report cards.
Med Care Res Rev 2015 Oct;72(5):562-79. doi: 10.1177/1077558715588436.
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Keywords: Dementia, Nursing Homes, Long-Term Care, Quality Measures
Gerhard T, Devanand DP, Huang C
Lithium treatment and risk for dementia in adults with bipolar disorder: population-based cohort study.
This study examined the association of lithium and dementia risk in a large claims-based US cohort of publicly insured older adults with bipolar disorder. It found that compared with non-use, 301–365 days of lithium exposure was associated with significantly reduced dementia risk. No corresponding association was observed for shorter lithium exposures.
AHRQ-funded; HS021112.
Citation: Gerhard T, Devanand DP, Huang C .
Lithium treatment and risk for dementia in adults with bipolar disorder: population-based cohort study.
Br J Psychiatry 2015 Jul;207(1):46-51. doi: 10.1192/bjp.bp.114.154047..
Keywords: Dementia, Risk, Behavioral Health, Medication
Daly JM, Bay CP, Levy BT
Caring for people with dementia and challenging behaviors in nursing homes: a needs assessment geriatric nursing.
The authors conducted a needs assessment of directors of nursing (DON) in Iowa nursing homes in relation to caring for patients with Behavioral and Psychological Symptoms of Dementia. They found that facilities with a larger proportion of patients with challenging behaviors being treated with non-drug approaches instead of antipsychotics had DONs who were more likely to be confident in non-drug management strategies and have knowledge about the FDA antipsychotic medications risks.
AHRQ-funded; HS019355.
Citation: Daly JM, Bay CP, Levy BT .
Caring for people with dementia and challenging behaviors in nursing homes: a needs assessment geriatric nursing.
Geriatr Nurs 2015 May-Jun;36(3):182-91. doi: 10.1016/j.gerinurse.2015.01.001.
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Keywords: Elderly, Dementia, Nursing Homes, Long-Term Care, Nursing
Park Y, Franklin JM, Schneeweiss S
Antipsychotics and mortality: adjusting for mortality risk scores to address confounding by terminal illness.
The researchers sought to determine whether adjustment for prognostic indices specifically developed for nursing home populations affect the magnitude of previously observed associations between mortality and conventional and atypical antipsychotics. They concluded that although causality cannot be proven based on nonrandomized studies, this study adds to the body of evidence rejecting explanations other than causality for the greater mortality risk associated with conventional antipsychotics than with atypical antipsychotics.
AHRQ-funded; HS017918; HS02112.
Citation: Park Y, Franklin JM, Schneeweiss S .
Antipsychotics and mortality: adjusting for mortality risk scores to address confounding by terminal illness.
J Am Geriatr Soc 2015 Mar;63(3):516-23. doi: 10.1111/jgs.13326..
Keywords: Nursing Homes, Mortality, Medication, Elderly, Dementia
Daiello LA, Gongvatana A, Dunsiger S
Association of fish oil supplement use with preservation of brain volume and cognitive function.
The aim of this study was to investigate whether the use of fish oil supplements (FOSs) is associated with concomitant reduction in cognitive decline and brain atrophy in older adults. It found that FOS use during follow-up was associated with significantly lower mean cognitive subscale of the Alzheimer’s Disease Assessment Scale and higher Mini-Mental State Examination scores among those with normal cognition.
AHRQ-funded; HS017735.
Citation: Daiello LA, Gongvatana A, Dunsiger S .
Association of fish oil supplement use with preservation of brain volume and cognitive function.
Alzheimers Dement 2015 Feb;11(2):226-35. doi: 10.1016/j.jalz.2014.02.005..
Keywords: Dementia, Elderly, Vitamins and Supplements
Campbell NL, Skaar TC, Perkins AJ
Characterization of hepatic enzyme activity in older adults with dementia: potential impact on personalizing pharmacotherapy.
The purpose of this study was to determine the frequency of pharmacogenomic variants and concurrent medications that may alter the efficacy and tolerability of acetylcholinesterase inhibitors (AChEIs). Its results indicate that both pharmacogenomic variants and concomitant medications may affect the pharmacokinetics and ultimately the efficacy and tolerability of Alzheimer’s disease medications.
AHRQ-funded; HS019818.
Citation: Campbell NL, Skaar TC, Perkins AJ .
Characterization of hepatic enzyme activity in older adults with dementia: potential impact on personalizing pharmacotherapy.
Clin Interv Aging 2015 Jan 14;10:269-75. doi: 10.2147/cia.s65980..
Keywords: Elderly, Dementia, Comparative Effectiveness, Medication
Aspinall SL, Zhao X, Semia TP
Epidemiology of drug-disease interactions in older veteran nursing home residents.
The objective of this study was to assess the prevalence of and factors associated with potentially inappropriate drug– disease combinations according to the AGS 2012 Beers criteria that are clinically important in elderly adults residing in Veterans Affairs Community Living Centers. It found that drug-disease interactions were common in older residents with dementia or cognitive impairment or a history of falls or hip fracture.
AHRQ-funded; HS018721.
Citation: Aspinall SL, Zhao X, Semia TP .
Epidemiology of drug-disease interactions in older veteran nursing home residents.
J Am Geriatr Soc 2015 Jan;63(1):77-84. doi: 10.1111/jgs.13197..
Keywords: Adverse Drug Events (ADE), Adverse Events, Dementia, Elderly, Falls, Injuries and Wounds, Medication, Medication: Safety, Neurological Disorders, Nursing Homes, Patient Safety
Sentell TL, Valcour N, Ahn HJ
High rates of Native Hawaiian and older Japanese adults hospitalized with dementia in Hawaii.
This study compared rates of inpatients with a dementia diagnosis for disaggregated Asian and Pacific Islanders (Native Hawaiian, Chinese, Japanese, Filipino) with those of whites according to age for all adults hospitalized in Hawaii; Native Hawaiians with dementia were significantly more likely to be hospitalized and to be hospitalized at younger ages than individuals of other races and ethnicities.
AHRQ-funded; HS019990.
Citation: Sentell TL, Valcour N, Ahn HJ .
High rates of Native Hawaiian and older Japanese adults hospitalized with dementia in Hawaii.
J Am Geriatr Soc 2015 Jan;63(1):158-64. doi: 10.1111/jgs.13182..
Keywords: Dementia, Racial and Ethnic Minorities, Hospitalization