A new editorial and corresponding virtual journal issue offer a look back at 20 of the most important studies impacting older adult care as published by the Journal of the American Geriatrics Society (JAGS) from 2000 to 2015.
This retrospective on nearly two decades of scholarship provides perspective on how geriatrics, gerontology, and long-term care evolved since the new millennium, and where and why that progress continues to impact the present and future of eldercare expertise. Thomas T. Yoshikawa, MD, AGSF--who served as Editor-in-Chief of JAGS during this timeframe--authored the editorial outlining article selections with current Executive Editor Joseph G. Ouslander, MD, AGSF, and new JAGS Editor-in-Chief William B. Applegate, MD, MPH, MACP, AGSF.
"The past 15 years represent remarkable progress toward improving the health and quality-of-life of older adults, largely through carefully designed and implemented research studies," notes Ellen Flaherty, PhD, APRN, AGSF, President of the American Geriatrics Society (AGS). "This review is a true microcosm of how the geriatrics evidence base has developed and evolved over time: its papers focus on everything from cognition and physical disabilities to frailty, medications, and hospitalization and transitional care."
Added AGS CEO Nancy E. Lundebjerg, MPA: "This virtual issue offers an important look at how geriatrics expertise has grown, and we're confident that the next 15 years will see equally vibrant improvements to healthcare practice, models, and systems of care--all with a laser-focus on improving the health and well-being of older adults."
More than 30 members of the journal's editorial board submitted votes for seminal studies from a pool of more than 150 articles cited most frequently on an annual basis from 2000 through 2015. Both the committee and their final list of top papers as compiled by Dr. Yoshikawa, Dr. Ouslander, and Dr. Applegate reflect the depth and breadth of geriatrics, not only across research areas of interest but also across professions and specialties. The virtual issue, available online with time-limited free, open access from JAGS, includes a reflection on the impact of each selected study, as noted below:
The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool for Mild Cognitive Impairment
Mild cognitive impairment (MCI) is more common than dementia in older adults, and the MoCA's more challenging tasks produce superior sensitivity for MCI compared to other screening tests.
American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults
The AGS Beers Criteria have become one of the most widely used clinical tools for determining medications that could be potentially harmful to older persons.
Transitional Care of Older Adults Hospitalized with Heart Failure: A Randomized, Controlled Trial
This study formed the basis of Dr. Mary Naylor's Transitional Care Model, which has been disseminated widely throughout the U.S. as a result of evolving Medicare payment models.
Potentially Avoidable Hospitalizations of Nursing Home Residents: Frequency, Causes, and Costs
This study provided the data for an expert panel to make recommendations that evolved into the Interventions to Reduce Acute Care Transfers (INTERACT) quality improvement program, which is being widely used in the U.S. and abroad.
Ten-Year Effects of the Advanced Cognitive Training for Independent and Vital Elderly Cognitive Training Trial on Cognition and Everyday Functioning in Older Adults
This study confirmed that cognitive performance could improve for older adults with structured training. The results seeded the expansion of training tools and new studies demonstrating important benefits like better driving performance.
Geriatric Syndromes: Clinical, Research, and Policy Implications of a Core Geriatric Concept
This seminal paper has formed the basis of many current clinical care and research initiatives for older adults living with more than one chronic condition.
The Hospital Elder Life Program: A Model of Care to Prevent Cognitive and Functional Decline in Older Hospitalized Patients
The HELP interventions and protocols have had widespread influence on many adaptations, guidelines, pathways, and standing order sets for delirium, a sudden change in mental function that can occur frequently in older people.
Guideline for the Prevention of Falls in Older Persons
This guideline formed the basis for current fall prevention guidelines and provided a research agenda that is still ongoing.
Reducing Delirium After Hip Fracture: A Randomized Trial
This study provided a model for improving outcomes for a vulnerable hospitalized population and has led to the widespread adoption of geriatrics-orthopedics co-management services in many medical centers.
Pharmacological Management of Persistent Pain in Older Persons
This guideline remains an important management tool for treating older adults with persistent pain.
Physical Performance Measures in the Clinical Setting
In the years since this article was published, both gait (walking) speed and physical performance have become important measures of older adult health.
Effective Exercise for the Prevention of Falls: A Systematic Review and Meta-Analysis
This study reinforces the use of tai chi and similar balance training in fall prevention.
Summary of the Updated American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Person
This guideline ideally forms the basis of all initiatives to manage fall risk and prevent falls in older adults.
Low Relative Skeletal Muscle Mass (Sarcopenia) in Older Persons is Associated with Functional Impairment and Physical Disability
This study demonstrates the independent connection between low skeletal muscle mass (also known as sarcopenia) and functional impairment and disability. It hypothesizes that sarcopenia may be a potentially reversible cause of disability, particularly in older women.
Effects of Exercise Training on Frailty in Community-Dwelling Older Adults: Results of a Randomized, Controlled Trial
This may be the first study to provide evidence of the efficacy of a multidimensional high-intensity training regimen for reducing frailty and improving oxygen uptake in frail community-dwelling people.
The Mini-Cog as a Screen for Dementia: Validation in a Population-Based Sample
This study provided key evidence supporting the adoption of the Mini-Cog in healthcare and clinical training settings, as well as its place in evidence reviews and best practice statements, among other milestones.
Research Agenda for Frailty in Older Adults: Toward a Better Understanding of Physiology and Etiology: Summary from the American Geriatrics Society/National Institute on Aging Research Conference on Frailty in Older Adults
Many of the conference recommendations and concepts included in this article have led to a better definition of frailty and its consequences, and have helped translate that progress into implementation in clinical practice.
Operationalization of Frailty Using Eight Commonly Used Scales and Comparison of Their Ability to Predict All-Cause Mortality
Frailty scales are increasingly used in clinical research and at times in clinical practice to define which older persons are most at risk for adverse clinical outcomes and disability.
Delirium is Independently Associated with Poor Functional Recovery After Hip Fracture
This was one of the first studies demonstrating the importance of delirium in functional recovery after hospitalization. Screening for delirium post-surgery in older people is now common practice.
The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) Approach: Preliminary Data from the Implementation of a Centers for Medicare and Medicaid Services Nursing Facility Demonstration Project
The success of OPTIMISTIC and other similar interventions in the Centers for Medicare and Medicaid Services Nursing Facility Demonstration Project has resulted in a second round of funding to build on these interventions, thereby improving care and saving billions of dollars over the next decade.
About the American Geriatrics Society
Founded in 1942, the American Geriatrics Society (AGS) is a nationwide, not-for-profit society of geriatrics healthcare professionals dedicated to improving the health, independence, and quality of life of older people. Its nearly 6,000 members include geriatricians, geriatric nurses, social workers, family practitioners, physician assistants, pharmacists, and internists. The Society provides leadership to healthcare professionals, policymakers, and the public by implementing and advocating for programs in patient care, research, professional and public education, and public policy. For more information, visit americangeriatrics.org.
About the Journal of the American Geriatrics Society
Included in more than 9,000 library collections around the world, the Journal of the American Geriatrics Society (JAGS) highlights emerging insights on principles of aging, approaches to older patients, geriatric syndromes, geriatric psychiatry, and geriatric diseases and disorders. First published in 1953, JAGS is now one of the oldest and most impactful publications on gerontology and geriatrics, according to ISI Journal Citation Reports®. Visit wileyonlinelibrary.com/journal/JGS for more details.