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Article ; Online: In-Hospital Mobility Variations Across Primary Diagnoses Among Older Adults.

Valiani, Vincenzo / Gao, Shiyao / Chen, Zhiguo / Swami, Sunil / Harle, Christopher A / Lipori, Gigi / Sourdet, Sandrine / Wu, Samuel / Nayfield, Susan G / Sabbá, Carlo / Pahor, Marco / Manini, Todd M

Journal of the American Medical Directors Association

2016 Volume 17, Issue 5, Page(s) 465.e1–8

Abstract: Objectives: To examine the relationship between primary diagnoses and mobility impairment and recovery among hospitalized older adults.: Design: Prospective cohort study.: Setting: UF Health Shands Hospital, an 852-bed level I trauma center ... ...

Abstract	Objectives: To examine the relationship between primary diagnoses and mobility impairment and recovery among hospitalized older adults. Design: Prospective cohort study. Setting: UF Health Shands Hospital, an 852-bed level I trauma center located in Gainesville, Florida. Participants: A total of 18,551 older adults (≥65 years) with 29,148 hospitalizations between January 2009 and April 2014. Measurements: Incident and discharge mobility impairment and recovery were assessed using the Braden activity subscale score that was recorded by the nursing staff at every shift change: approximately 3 times per day. Primary diagnosis ICD-9 codes were used as predictors and recategorized by using the Agency for Health Care Research and Quality Clinical Classification Software. Results: Of the 15,498 hospital records in which the patient was initially observed to "walk frequently," 3186 (20.6%) developed incident mobility impairment (chair-fast or bedfast). Primary diagnoses with a surgical or invasive procedure were the most prevalent (77.2%) among the hospital observations with incident mobility impairment; otherwise, primary diagnoses without surgery were much more associated with discharge mobility impairment (59%). The highest incidence of mobility impairment occurred in patients with heart valve disorders and aortic and peripheral/visceral artery aneurysms (6.24 and 6.05 events per 30 person-days, respectively); septicemia showed the highest incidence rate for mobility limitation at discharge (0.94 events per 30 person-days). Mobility impairment was observed in 13,650 (46.8% of total) records at admission and 5930 (43.44%) were observed to recover to a state of walking occasionally or frequently. Osteoarthritis and cancer of gastrointestinal organs/peritoneum had the highest incidence rate for mobility recovery (7.68 and 5.63 events per 30 person-days respectively). Conclusions: Approximately 1 of 5 patients who were mobile at admission became significantly impaired during hospitalization. However, approximately half (43.4%) of patients observed to have mobility impairment at admission recovered during hospitalization. Conditions most associated with mobility impairment and recovery are varied, but older patients hospitalized for septicemia and cardiovascular diseases with surgery (heart valve disorders and aortic/peripheral/visceral artery aneurysms) appear to be at most risk for incident mobility impairment that did not recover at discharge.
MeSH term(s)	Aged ; Aged, 80 and over ; Behavior Observation Techniques ; Comorbidity ; Female ; Florida/epidemiology ; Hospital Mortality/trends ; Hospitalization ; Humans ; International Classification of Diseases ; Male ; Medical Records ; Mobility Limitation ; Prospective Studies ; Walking
Language	English
Publishing date	2016--01
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2171030-2
ISSN	1538-9375 ; 1525-8610
ISSN (online)	1538-9375
ISSN	1525-8610
DOI	10.1016/j.jamda.2016.02.003
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Book ; Conference proceedings: Hereditary breast, ovarian, and colon cancer

Giusti, Ruthann M / Nayfield, Susan G

proceedings of a workshop held at the Sheraton Washington Hotel, Washington, D.C., April 27-29, 1994

(Journal of the National Cancer Institute. Monographs, ; no. 17 ; NIH publication ; no. 94-03837)

1995

Institution	National Cancer Institute (U.S.) National Center for Human Genome Research (U.S.)
Event/congress	Workshop on Hereditary Breast, Ovarian, and Colon Cancer (1994, WashingtonD.C.)
Author's details	sponsors, National Cancer Institute, National Center for Human Genome Research ; scientific editors, Ruthann M. Giusti, Susan G. Nayfield
Series title	Journal of the National Cancer Institute. Monographs, ; no. 17 NIH publication ; no. 94-03837
MeSH term(s)	Breast Neoplasms/genetics ; Colonic Neoplasms/genetics ; Genetic Testing/methods ; Ovarian Neoplasms/genetics
Language	English
Size	vii, 137 p. :, ill.
Publisher	National Cancer Institute
Publishing place	Bethesda, MD
Document type	Book ; Conference proceedings
Database	Catalogue of the US National Library of Medicine (NLM)

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Article ; Online: Fatigue in a representative population of older persons and its association with functional impairment, functional limitation, and disability.

Vestergaard, Sonja / Nayfield, Susan G / Patel, Kushang V / Eldadah, Basil / Cesari, Matteo / Ferrucci, Luigi / Ceresini, Graziano / Guralnik, Jack M

The journals of gerontology. Series A, Biological sciences and medical sciences

2009 Volume 64, Issue 1, Page(s) 76–82

Abstract: Background: Older persons often complain of fatigue, but the functional consequences of this symptom are unclear. The aim of the present study was to evaluate fatigue and its association with measures of physical function and disability in a ... ...

Abstract	Background: Older persons often complain of fatigue, but the functional consequences of this symptom are unclear. The aim of the present study was to evaluate fatigue and its association with measures of physical function and disability in a representative sample of the older population. Methods: Cross-sectional data from a population-based sample of 1,055 Italian men and women aged 65 and older were analyzed. Fatigue was defined according to two questions evaluating whether participants felt that "everything was an effort" and/or they "could not get going" on three or more days in the past week. Objective measures of physical function were handgrip strength, the Short Physical Performance Battery (SPPB), and 400-m walking speed. Disability was defined as the inability to complete the 400-m walk test and self-reported difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL). Results: The prevalence of fatigue was higher in women (29%) than in men (15%). In age-adjusted analyses, fatigued men and women had weaker handgrip strength, lower SPPB score, slower walking speed, and higher mobility, ADL, and IADL disability than nonfatigued persons. Further adjustment for health behaviors, diseases, inflammatory markers, and thyroid function generally reduced the relationship between fatigue and functional outcomes, but fatigue remained significantly associated with SPPB score, walking speed, and mobility and IADL disability. Conclusions: Older persons who report fatigue had significantly poorer functional status than those who did not report this symptom. The causal link between fatigue and these outcomes should be further investigated.
MeSH term(s)	Aged ; Aged, 80 and over ; Cross-Sectional Studies ; Disability Evaluation ; Fatigue/epidemiology ; Fatigue/physiopathology ; Fatigue/rehabilitation ; Female ; Humans ; Italy/epidemiology ; Male ; Motor Activity/physiology ; Muscle Strength/physiology ; Population Surveillance ; Prevalence ; Prospective Studies
Language	English
Publishing date	2009-01-27
Publishing country	United States
Document type	Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, N.I.H., Intramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1223643-3
ISSN	1758-535X ; 1079-5006
ISSN (online)	1758-535X
ISSN	1079-5006
DOI	10.1093/gerona/gln017
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Article ; Online: Biological, clinical, and psychosocial correlates at the interface of cancer and aging research.

Dale, William / Mohile, Supriya G / Eldadah, Basil A / Trimble, Edward L / Schilsky, Richard L / Cohen, Harvey J / Muss, Hyman B / Schmader, Kenneth E / Ferrell, Betty / Extermann, Martine / Nayfield, Susan G / Hurria, Arti

Journal of the National Cancer Institute

2012 Volume 104, Issue 8, Page(s) 581–589

Abstract: In September 2010, the Cancer and Aging Research Group, in collaboration with the National Cancer Institute and the National Institute on Aging, conducted the first of three planned conferences to discuss research methodology to generate the highest ... ...

Abstract	In September 2010, the Cancer and Aging Research Group, in collaboration with the National Cancer Institute and the National Institute on Aging, conducted the first of three planned conferences to discuss research methodology to generate the highest quality research in older adults with cancer and then disseminate these findings among those working in the fields of cancer and aging. Conference speakers discussed the current level of research evidence in geriatric oncology, outlined the current knowledge gaps, and put forth principles for research designs and strategies that would address these gaps within the next 10 years. It was agreed that future oncology research trials that enroll older adults should include: (1) improved standardized geriatric assessment of older oncology patients, (2) substantially enhanced biological assessment of older oncology patients, (3) specific trials for the most vulnerable and/or those older than 75 years, and (4) research infrastructure that specifically targets older adults and substantially strengthened geriatrics and oncology research collaborations. This initial conference laid the foundation for the next two meetings, which will address the research designs and collaborations needed to enhance therapeutic and intervention trials in older adults with cancer.
MeSH term(s)	Advisory Committees ; Age Factors ; Aged ; Aging/metabolism ; Aging/psychology ; Biomedical Research/trends ; Clinical Trials as Topic/trends ; Frail Elderly ; Geriatric Assessment ; Health Services for the Aged ; Humans ; Middle Aged ; Neoplasms/metabolism ; Neoplasms/psychology ; Research Design ; United States
Language	English
Publishing date	2012-03-27
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2992-0
ISSN	1460-2105 ; 0027-8874 ; 0198-0157
ISSN (online)	1460-2105
ISSN	0027-8874 ; 0198-0157
DOI	10.1093/jnci/djs145
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Article ; Online: Workshop on idiopathic pulmonary fibrosis in older adults.

Castriotta, Richard J / Eldadah, Basil A / Foster, W Michael / Halter, Jeffrey B / Hazzard, William R / Kiley, James P / King, Talmadge E / Horne, Frances McFarland / Nayfield, Susan G / Reynolds, Herbert Y / Schmader, Kenneth E / Toews, Galen B / High, Kevin P

Chest

2010 Volume 138, Issue 3, Page(s) 693–703

Abstract: Idiopathic pulmonary fibrosis (IPF), a heterogeneous disease with respect to clinical presentation and rates of progression, disproportionately affects older adults. The diagnosis of IPF is descriptive, based on clinical, radiologic, and histopathologic ... ...

Abstract	Idiopathic pulmonary fibrosis (IPF), a heterogeneous disease with respect to clinical presentation and rates of progression, disproportionately affects older adults. The diagnosis of IPF is descriptive, based on clinical, radiologic, and histopathologic examination, and definitive diagnosis is hampered by poor interobserver agreement and lack of a consensus definition. There are no effective treatments. Cellular, molecular, genetic, and environmental risk factors have been identified for IPF, but the initiating event and the characteristics of preclinical stages are not known. IPF is predominantly a disease of older adults, and the processes underlying normal aging might significantly influence the development of IPF. Yet, the biology of aging and the principles of medical care for this population have been typically ignored in basic, translational, or clinical IPF research. In August 2009, the Association of Specialty Professors, in collaboration with the American College of Chest Physicians, the American Geriatrics Society, the National Institute on Aging, and the National Heart, Lung, and Blood Institute, held a workshop, summarized herein, to review what is known, to identify research gaps at the interface of aging and IPF, and to suggest priority areas for future research. Efforts to answer the questions identified will require the integration of geriatrics, gerontology, and pulmonary research, but these efforts have great potential to improve care for patients with IPF.
MeSH term(s)	Aged ; Aging/physiology ; Biomedical Research/organization & administration ; Geriatrics/organization & administration ; Health Priorities/organization & administration ; Humans ; Idiopathic Pulmonary Fibrosis/diagnosis ; Idiopathic Pulmonary Fibrosis/etiology ; Idiopathic Pulmonary Fibrosis/therapy ; Middle Aged
Language	English
Publishing date	2010-09-07
Publishing country	United States
Document type	Consensus Development Conference ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1032552-9
ISSN	1931-3543 ; 0012-3692
ISSN (online)	1931-3543
ISSN	0012-3692
DOI	10.1378/chest.09-3006
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Article ; Online: Prediction, progression, and outcomes of chronic kidney disease in older adults.

Anderson, Sharon / Halter, Jeffrey B / Hazzard, William R / Himmelfarb, Jonathan / Horne, Frances McFarland / Kaysen, George A / Kusek, John W / Nayfield, Susan G / Schmader, Kenneth / Tian, Ying / Ashworth, John R / Clayton, Charles P / Parker, Ryan P / Tarver, Erika D / Woolard, Nancy F / High, Kevin P

Journal of the American Society of Nephrology : JASN

2009 Volume 20, Issue 6, Page(s) 1199–1209

Abstract: Chronic kidney disease is a large and growing problem among aging populations. Although progression of chronic kidney disease to end-stage renal disease (ESRD) is a costly and important clinical event with substantial morbidity, it appears less ... ...

Abstract	Chronic kidney disease is a large and growing problem among aging populations. Although progression of chronic kidney disease to end-stage renal disease (ESRD) is a costly and important clinical event with substantial morbidity, it appears less frequently in aging people compared with cardiovascular mortality. The measurement of kidney function and management of kidney disease in older individuals remain challenging, partly because the pathophysiologic mechanisms underlying age-related decline in kidney function, the interactions between age and other risk factors in renal progression, and the associations of chronic kidney disease with other comorbidities in older people are understudied and poorly understood. The Association of Specialty Professors, the American Society of Nephrology, the American Geriatrics Society, the National Institute on Aging, and the National Institute of Diabetes and Digestive and Kidney Diseases held a workshop, summarized in this article, to review what is known about chronic kidney disease, identify research gaps and resources available to address them, and identify priority areas for future research. Answers to emerging research questions will support the integration of geriatrics and nephrology and thus improve care for older patients at risk for chronic kidney disease.
MeSH term(s)	Acute Kidney Injury/complications ; Aged ; Aging/physiology ; Biomedical Research ; Cardiovascular Diseases/complications ; Cardiovascular Diseases/mortality ; Comorbidity ; Disease Progression ; Humans ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/etiology ; Renal Insufficiency, Chronic/genetics ; Renal Insufficiency, Chronic/mortality ; Renal Insufficiency, Chronic/therapy
Language	English
Publishing date	2009-05-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1085942-1
ISSN	1533-3450 ; 1046-6673
ISSN (online)	1533-3450
ISSN	1046-6673
DOI	10.1681/ASN.2008080860
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Article ; Online ; Conference proceedings: Workshop on immunizations in older adults: identifying future research agendas.

Journal of the American Geriatrics Society

2010 Volume 58, Issue 4, Page(s) 765–776

Abstract: Goals for immunization in older adults may differ from those in young adults and children, in whom complete prevention of disease is the objective. Often, reduced hospitalization and death but also averting exacerbation of underlying chronic illness, ... ...

Abstract	Goals for immunization in older adults may differ from those in young adults and children, in whom complete prevention of disease is the objective. Often, reduced hospitalization and death but also averting exacerbation of underlying chronic illness, functional decline, and frailty are important goals in the older age group. Because of the effect of age on dendritic cell function, T cell-mediated immune suppression, reduced proliferative capacity of T cells, and other immune responses, the efficacy of vaccines often wanes with advanced age. This article summarizes the discussion and proceedings of a workshop organized by the Association of Specialty Professors, the Infectious Diseases Society of America, the American Geriatrics Society, the National Institute on Aging, and the National Institute of Allergy and Infectious Diseases. Leading researchers and clinicians in the fields of immunology, epidemiology, infectious diseases, geriatrics, and gerontology reviewed the current status of vaccines in older adults, identified knowledge gaps, and suggest priority areas for future research. The goal of the workshop was to identify what is known about immunizations (efficacy, effect, and current schedule) in older adults and to recommend priorities for future research. Investigation in the areas identified has the potential to enhance understanding of the immune process in aging individuals, inform vaccine development, and lead to more-effective strategies to reduce the risk of vaccine-preventable illness in older adults.
MeSH term(s)	Adaptive Immunity/immunology ; Aged/physiology ; Aging/immunology ; Antigen-Presenting Cells/immunology ; B-Lymphocytes/immunology ; Centers for Disease Control and Prevention (U.S.) ; Evidence-Based Practice/organization & administration ; Forecasting ; Geriatrics/organization & administration ; Health Planning Guidelines ; Health Services Needs and Demand ; Humans ; Immunization Schedule ; Research/organization & administration ; T-Lymphocytes/immunology ; Telomere/immunology ; United States ; Vaccination/methods
Language	English
Publishing date	2010-04
Publishing country	United States
Document type	Congresses ; Research Support, Non-U.S. Gov't
ZDB-ID	80363-7
ISSN	1532-5415 ; 0002-8614
ISSN (online)	1532-5415
ISSN	0002-8614
DOI	10.1111/j.1532-5415.2010.02772.x
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Article ; Online: Aging and infectious diseases: workshop on HIV infection and aging: what is known and future research directions.

Effros, Rita B / Fletcher, Courtney V / Gebo, Kelly / Halter, Jeffrey B / Hazzard, William R / Horne, Frances McFarland / Huebner, Robin E / Janoff, Edward N / Justice, Amy C / Kuritzkes, Daniel / Nayfield, Susan G / Plaeger, Susan F / Schmader, Kenneth E / Ashworth, John R / Campanelli, Christine / Clayton, Charles P / Rada, Beth / Woolard, Nancy F / High, Kevin P

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

2008 Volume 47, Issue 4, Page(s) 542–553

Abstract: Highly active antiretroviral treatment has resulted in dramatically increased life expectancy among patients with HIV infection who are now aging while receiving treatment and are at risk of developing chronic diseases associated with advanced age. ... ...

Abstract	Highly active antiretroviral treatment has resulted in dramatically increased life expectancy among patients with HIV infection who are now aging while receiving treatment and are at risk of developing chronic diseases associated with advanced age. Similarities between aging and the courses of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome suggest that HIV infection compresses the aging process, perhaps accelerating comorbidities and frailty. In a workshop organized by the Association of Specialty Professors, the Infectious Diseases Society of America, the HIV Medical Association, the National Institute on Aging, and the National Institute on Allergy and Infectious Diseases, researchers in infectious diseases, geriatrics, immunology, and gerontology met to review what is known about HIV infection and aging, to identify research gaps, and to suggest high priority topics for future research. Answers to the questions posed are likely to help prioritize and balance strategies to slow the progression of HIV infection, to address comorbidities and drug toxicity, and to enhance understanding about both HIV infection and aging.
MeSH term(s)	Adolescent ; Adult ; Age Distribution ; Aged ; Aging/immunology ; Antiretroviral Therapy, Highly Active ; Child ; HIV Infections/complications ; HIV Infections/drug therapy ; HIV Infections/immunology ; HIV Infections/virology ; HIV-1/drug effects ; Humans ; Immunity ; Kidney Diseases ; Liver Diseases ; Metabolic Diseases ; Middle Aged ; Research/trends
Language	English
Publishing date	2008-07-31
Publishing country	United States
Document type	Congress ; Research Support, Non-U.S. Gov't
ZDB-ID	1099781-7
ISSN	1537-6591 ; 1058-4838
ISSN (online)	1537-6591
ISSN	1058-4838
DOI	10.1086/590150
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Article ; Online: Large prospective study of ovarian cancer screening in high-risk women: CA125 cut-point defined by menopausal status.

Skates, Steven J / Mai, Phuong / Horick, Nora K / Piedmonte, Marion / Drescher, Charles W / Isaacs, Claudine / Armstrong, Deborah K / Buys, Saundra S / Rodriguez, Gustavo C / Horowitz, Ira R / Berchuck, Andrew / Daly, Mary B / Domchek, Susan / Cohn, David E / Van Le, Linda / Schorge, John O / Newland, William / Davidson, Susan A / Barnes, Mack /

Brewster, Wendy / Azodi, Masoud / Nerenstone, Stacy / Kauff, Noah D / Fabian, Carol J / Sluss, Patrick M / Nayfield, Susan G / Kasten, Carol H / Finkelstein, Dianne M / Greene, Mark H / Lu, Karen

Cancer prevention research (Philadelphia, Pa.)

2011 Volume 4, Issue 9, Page(s) 1401–1408

Abstract: Previous screening trials for early detection of ovarian cancer in postmenopausal women have used the standard CA125 cut-point of 35 U/mL, the 98th percentile in this population yielding a 2% false positive rate, whereas the same cut-point in trials of ... ...

Abstract	Previous screening trials for early detection of ovarian cancer in postmenopausal women have used the standard CA125 cut-point of 35 U/mL, the 98th percentile in this population yielding a 2% false positive rate, whereas the same cut-point in trials of premenopausal women results in substantially higher false positive rates. We investigated demographic and clinical factors predicting CA125 distributions, including 98th percentiles, in a large population of high-risk women participating in two ovarian cancer screening studies with common eligibility criteria and screening protocols. Baseline CA125 values and clinical and demographic data from 3,692 women participating in screening studies conducted by the National Cancer Institute-sponsored Cancer Genetics Network and Gynecologic Oncology Group were combined for this preplanned analysis. Because of the large effect of menopausal status on CA125 levels, statistical analyses were conducted separately in pre- and postmenopausal subjects to determine the impact of other baseline factors on predicted CA125 cut-points on the basis of 98th percentile. The primary clinical factor affecting CA125 cut-points was menopausal status, with premenopausal women having a significantly higher cut-point of 50 U/mL, while in postmenopausal subjects the standard cut-point of 35 U/mL was recapitulated. In premenopausal women, current oral contraceptive (OC) users had a cut-point of 40 U/mL. To achieve a 2% false positive rate in ovarian cancer screening trials and in high-risk women choosing to be screened, the cut-point for initial CA125 testing should be personalized primarily for menopausal status (50 for premenopausal women, 40 for premenopausal on OC, and 35 for postmenopausal women).
MeSH term(s)	Adult ; Aged ; CA-125 Antigen/biosynthesis ; Contraceptives, Oral/pharmacology ; Ethnic Groups ; Female ; Humans ; Menopause ; Middle Aged ; Multivariate Analysis ; Ovarian Neoplasms/blood ; Ovarian Neoplasms/diagnosis ; Ovarian Neoplasms/metabolism ; Postmenopause ; Premenopause ; Prospective Studies ; Risk
Chemical Substances	CA-125 Antigen ; Contraceptives, Oral
Language	English
Publishing date	2011-09-04
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	2434717-6
ISSN	1940-6215 ; 1940-6207
ISSN (online)	1940-6215
ISSN	1940-6207
DOI	10.1158/1940-6207.CAPR-10-0402
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