National Healthcare Quality and Disparities Report
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AHRQ Research Studies Date
Topics
- Adverse Drug Events (ADE) (1)
- Adverse Events (1)
- Caregiving (3)
- Case Study (1)
- Chronic Conditions (1)
- (-) Dementia (11)
- Diagnostic Safety and Quality (2)
- (-) Elderly (11)
- Evidence-Based Practice (5)
- Guidelines (2)
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- Neurological Disorders (9)
- Nursing Homes (1)
- Outcomes (1)
- Patient-Centered Outcomes Research (3)
- Patient and Family Engagement (1)
- Prevention (2)
- Quality Improvement (1)
- Quality of Care (1)
- Quality of Life (1)
- Research Methodologies (1)
- Screening (2)
- Telehealth (1)
- Treatments (1)
- U.S. Preventive Services Task Force (USPSTF) (2)
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 11 of 11 Research Studies DisplayedBajaj 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
Roberts ET, McGarry BE, Glynn A
Cognition and take-up of the Medicare Savings Programs.
In this study, the investigators examined the association between cognition and Medicare Savings Program (MSP) enrollment among elderly Medicare beneficiaries who qualified for these programs. They also examined enrollment in the Low-Income Subsidy (LIS), a separate program that provides premium and cost-sharing assistance in Medicare Part D that Medicare beneficiaries automatically received if they are enrolled in an MSP.
AHRQ-funded; HS026727.
Citation: Roberts ET, McGarry BE, Glynn A .
Cognition and take-up of the Medicare Savings Programs.
JAMA Intern Med 2020 Nov;180(11):1529-31. doi: 10.1001/jamainternmed.2020.2783..
Keywords: Elderly, Medicare, Health Insurance, Healthcare Costs, Low-Income, Dementia, Neurological Disorders
Armstrong MJ, Gamez N, Alliance S
Research priorities of caregivers and individuals with dementia with Lewy bodies: an interview study.
The authors investigated the research priorities of individuals and caregivers living with dementia with Lewy bodies (DLB). Through telephone interviews, they found that individuals with DLB and caregivers identified research needs and highlighted DLB symptoms needing additional research. They recommended that funding be informed by the priorities of all relevant stakeholders and support research investigating causes, natural history, biomarkers, and treatment in addition to research targeting themes regarding living with disease.
AHRQ-funded; HS024159.
Citation: Armstrong MJ, Gamez N, Alliance S .
Research priorities of caregivers and individuals with dementia with Lewy bodies: an interview study.
PLoS One 2020 Oct 7;15(10):e0239279. doi: 10.1371/journal.pone.0239279..
Keywords: Caregiving, Dementia, Neurological Disorders, Patient and Family Engagement, Elderly, Research Methodologies
Merrilees JJ, Bernstein A, Dulaney S
The Care Ecosystem: promoting self-efficacy among dementia family caregivers.
The authors illustrated specific psychosocial interventions aimed at improving self-efficacy among family caregivers enrolled in the Care Ecosystem, a model of navigated care designed to support persons with dementia and their primary caregivers. They identified three categories of Care Team Navigator intervention: emotional, informational, and instrumental support, which are consistent with a psychosocial approach to building self-efficacy. They concluded that their findings demonstrated how a model of navigated care can positively impact self-efficacy among dementia family caregivers.
AHRQ-funded; HS022241.
Citation: Merrilees JJ, Bernstein A, Dulaney S .
The Care Ecosystem: promoting self-efficacy among dementia family caregivers.
Dementia 2020 Aug;19(6):1955-73. doi: 10.1177/1471301218814121..
Keywords: Elderly, Caregiving, Dementia
H H, Caton Gilstrap L
AHRQ Author: Tracer H
Screening for cognitive impairment in older adults.
This evidence-based approach paper focuses on putting prevention into action. It discusses screening for cognitive impairment in older adults. It provides case study, case study questions and a discussion.
AHRQ-authored.
Citation: H H, Caton Gilstrap L .
Screening for cognitive impairment in older adults.
Am Fam Physician 2020 Jun 15;101(12):753-54..
Keywords: U.S. Preventive Services Task Force (USPSTF), Dementia, Neurological Disorders, Elderly, Screening, Prevention, Case Study, Evidence-Based Practice, Guidelines
Crystal S, Jarrín OF, Rosenthal M
National partnership to improve dementia care in nursing homes campaign: state and facility strategies, impact, and antipsychotic reduction outcomes.
This study examines the success of the national partnership campaign to reduce prescription of antipsychotic medications to elderly nursing home residents with dementia. Antipsychotic medications have been shown to increase mortality. Use of these medications had increased 23.9% in dementia patients by 2011. The campaign reduced use by 40.1% to 14.3% by the second quarter of 2019. The campaign measured progress with public reporting of quality measures, increased regulatory scrutiny, and accompanying state and facility initiatives. Sedative-hypnotic medication use also decreased in tandem with antipsychotic reduction suggesting that the campaign increased attention to the use of other risky psychotropic medications.
AHRQ-funded; HS023464; HS022406; HS023258; HS021112.
Citation: Crystal S, Jarrín OF, Rosenthal M .
National partnership to improve dementia care in nursing homes campaign: state and facility strategies, impact, and antipsychotic reduction outcomes.
Innov Aging 2020 Jun 2;4(3):igaa018. doi: 10.1093/geroni/igaa018..
Keywords: Elderly, Nursing Homes, Long-Term Care, Dementia, Neurological Disorders, Quality Improvement, Quality of Care, Medication, Mortality
Fink HA, Linskens EJ, Silverman PC
Accuracy of biomarker testing for neuropathologically defined Alzheimer disease in older adults with dementia
This study is a systematic review of biomarker and test accuracy for identification of Alzheimer Disease (AD) in older adults. Studies with low or medium risk of bias were analyzed, and two reviewers rated risk of bias. Fifteen brain imaging studies and 9 cerebrospinal fluid (CSF) studies met analysis criteria and were included. The meta-analysis found that in methodologically heterogeneous studies of uncertain applicability to typical clinical settings, the biomarkers amyloid PET, 18F-FDG proton emission tomography (PET), and magnetic resonance imaging (MRI) were highly sensitive for neuropathologic AD. Single studies suggested that adding amyloid PET, 18F-FDG PET, and CSF test combinations may add accuracy to clinical evaluation.
AHRQ-funded; 290201500008I.
Citation: Fink HA, Linskens EJ, Silverman PC .
Accuracy of biomarker testing for neuropathologically defined Alzheimer disease in older adults with dementia
Ann Intern Med 2020 May 19;172(10):669-77. doi: 10.7326/m19-3888..
Keywords: Elderly, Dementia, Neurological Disorders, Imaging, Diagnostic Safety and Quality, Patient-Centered Outcomes Research, Evidence-Based Practice
Fink HA, Linskens EJ, MacDonald R
Benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia
This is a systematic review and meta-analysis of the benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia (CATD). Studies with low or medium risk of bias (ROB) were analyzed and rated. The analysis concluded there was a slight reduction in short-term cognitive decline with cholinesterase inhibitors and memantime, and cholinesterase inhibitors slightly reduced reported functional decline. There was mostly insufficient evidence on drug treatment of behavioral and psychological symptoms of dementia and on supplements for all outcomes.
AHRQ-funded; 290201500008I.
Citation: Fink HA, Linskens EJ, MacDonald R .
Benefits and harms of prescription drugs and supplements for treatment of clinical Alzheimer-type dementia
Ann Intern Med 2020 May 19;172(10):656-68. doi: 10.7326/m19-3887..
Keywords: Elderly, Dementia, Neurological Disorders, Medication, Patient-Centered Outcomes Research, Evidence-Based Practice, Outcomes, Adverse Drug Events (ADE), Adverse Events, Treatments
Hemmy LS, Linskens EJ, Silverman PC
Brief cognitive tests for distinguishing clinical Alzheimer-type dementia from mild cognitive impairment or normal cognition in older adults with suspected cognitive impairment.
Researchers summarized evidence on accuracy and harms of brief cognitive tests for clinical Alzheimer-type dementia (CATD) in older adults with suspected cognitive impairment. They encountered the following limitations: small studies, few test metrics being evaluated by multiple studies, and few studies directly comparing different tests, scores, cut points, or test combinations. They concluded that many brief, single cognitive tests accurately distinguish CATD from normal cognition in older adults but are less accurate in distinguishing mild CATD from normal cognition or CATD from mild cognitive impairment.
AHRQ-funded; 290201500008I.
Citation: Hemmy LS, Linskens EJ, Silverman PC .
Brief cognitive tests for distinguishing clinical Alzheimer-type dementia from mild cognitive impairment or normal cognition in older adults with suspected cognitive impairment.
Ann Intern Med 2020 May 19;172(10):678-87. doi: 10.7326/m19-3889..
Keywords: Dementia, Neurological Disorders, Diagnostic Safety and Quality, Elderly, Evidence-Based Practice, Patient-Centered Outcomes Research
Patnode CD, Perdue LA, Rossom RC
Screening for cognitive impairment in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to systematically review the test accuracy of cognitive screening instruments and benefits and harms of interventions to treat cognitive impairment in older adults (>/=65 years) to inform the US Preventive Services Task Force. The investigators concluded that screening instruments could adequately detect cognitive impairment. They indicated that there was no empirical evidence, however, that screening for cognitive impairment improved patient or caregiver outcomes or causes harm.
AHRQ-funded; 290201500007I.
Citation: Patnode CD, Perdue LA, Rossom RC .
Screening for cognitive impairment in older adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Feb 25;323(8):764-85. doi: 10.1001/jama.2019.22258..
Keywords: U.S. Preventive Services Task Force (USPSTF), Dementia, Neurological Disorders, Elderly, Guidelines, Screening, Prevention, Evidence-Based Practice
Mitchell LL, Peterson CM, Rud SR
"It's like a cyber-security blanket": the utility of remote activity monitoring in family dementia care.
Technologies have emerged that aim to help older persons with Alzheimer's disease and related dementias (ADRDs) remain at home while also supporting their caregiving family members. The current study evaluated the acceptability and utility of an in-home remote activity monitoring (RAM) system for 30 family caregivers of persons with ADRD via quantitative survey data collected over a 6-month period and qualitative survey and interview data collected for up to 18 months.
AHRQ-funded; HS022836.
Citation: Mitchell LL, Peterson CM, Rud SR .
"It's like a cyber-security blanket": the utility of remote activity monitoring in family dementia care.
J Appl Gerontol 2020 Jan;39(1):86-98. doi: 10.1177/0733464818760238..
Keywords: Elderly, Dementia, Caregiving, Telehealth, Health Information Technology (HIT)