Aging & Gerontology Research

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Hip Fractures Lower in Nursing Home Residents with Multiple Sclerosis 














Hip fractures are common in nursing home residents and associated with functional dependence and elevated mortality. Multiple sclerosis (MS) is a chronic, immune-mediated and degenerative disease of the central nervous system, characterized by disability progression over time. Although hip fracture risk is high in young people with MS, this research has not been examined in an institutionalized aging population with MS. This study, led by Tingting Zhang, assistant professor of health services, policy, and practice and published in Disability and Health Journal, sought to compare the incidence of hip fracture between nursing home residents with and without MS; and identify clinical characteristics associated with 2-year hip fracture risk in long-term NH residents with MS. READ MORE

Studying a music program for nursing home residents with dementia

With a new grant from the National Institute on Aging, researchers plan to conduct a randomized trial of whether a nursing home program that involves listening to a personalized music playlist can improve care and outcomes among residents with dementia. “While MUSIC & MEMORY has been introduced to many residents with dementia living in nursing homes over the past few years, there is little systematic data on how the program is implemented nor on how it affects the behavior of the population of nursing home residents with dementia,” said Vincent Mor, professor of health services, policy and practice at Brown’s School of Public Health and principal investigator on the grant of up to $3.7 million over five years. “Our study will remedy this by systematically documenting how well the program is able to positively affect the lives of people who are exposed.” READ MORE

Simulation shows the high cost of dementia, especially for families

A new simulation by Eric Jutkowitz, an assistant professor of health services, policy and practice, of how the costs and the course of the dementia epidemic affect U.S. families finds that neurodegenerative conditions can more than double the health care expenditures of aging and that the vast majority of that financial burden remains with families rather than government insurance programs. READ MORE

High-dose Flu Vaccine Reduces Hospital Visits for Nursing Home Residents

Lead author Dr. Stefan Gravenstein, a professor at both the Warren Alpert Medical School and the School of Public Health at Brown University, said that while a prior study showed that older individuals could respond better to the high-dose vaccine, that study focused on relatively healthy older adults.

“It still needed to be established that it would help even the frailest folks, like those who reside in nursing homes,” Gravenstein said. “In our study, a quarter of the sample was over 90. So we asked if the high-dose vaccine also would work better than regular-dose vaccine in the population we consider least able to respond. This paper says yes, it can.” READ MORE

Metformin Safety Warnings and Diabetes Drug Prescribing Patterns for Older Nursing Home Residents

Diabetes mellitus is common in U.S. nursing homes, and the mainstay treatment, metformin, has U.S. Food and Drug Administration boxed warnings indicating safety concerns in those with advanced age, heart failure, or renal disease. Little is known about treatment selection in this setting, especially for metformin. This study, supported by an Agency for Healthcare Research and Quality award, and led by Andrew Zullo, investigator in the department of health services, policy and practice, quantified the determinants of initiating sulfonylureas over metformin with the aim of understanding the impact of FDA-labeled boxed warnings in older NH residents. READ MORE

Video Education Program to Support Advanced Care Planning in Nursing Homes

Over the past three decades, nursing homes have evolved into complex healthcare systems serving nearly 4 million individuals annually. Given the increasing clinical complexity and advanced disease of the population, nursing homes are often charged with guiding patients through challenging decisions about the direction of their treatment. Advanced care planning is the process of communication between providers and patients/families to identify anticipated medical decisions and clarify treatment preferences. Unfortunately, advanced care planning in this setting remains suboptimal.  The purpose of this paper, published in Clinical Trials and led by Vincent Mor, Professor of Health Services, Policy & Practice, was to describe the design and rationale of PRagmatic trial Of Video Education in Nursing Homes (PROVEN), a pragmatic cluster randomized controlled trial to evaluate an advance care planning video program.  READ MORE

Innovative Methodology to Identify Medicare Beneficiaries Residing in Large Assisted Living Facilities

The purpose of this study, published in Medical Careand led by Kali Thomas, Assistant Professor of Health Services, Policy and Practice, and faculty member in the Center for Gerontology and Healthcare Research, was to develop and test a novel methodology to identify residents in large assisted living facilities using secondary data sources, specifically the 9-digit ZIP code reported in Medicare enrollment records. READ MORE

Palliative Care in Nursing Homes Found to Cut Hospitalizations

The purpose of this study, published in the Journal of the American Geriatrics Society and led by Susan Miller, professor of health services, policy and practice, was to evaluate how receipt and timing of nursing home palliative care consultations are associated with end-of-life care transitions and acute care more