2024
In-Hospital Delirium and Disability and Cognitive Impairment After COVID-19 Hospitalization
Kaushik R, McAvay G, Murphy T, Acampora D, Araujo K, Charpentier P, Chattopadhyay S, Geda M, Gill T, Kaminski T, Lee S, Li J, Cohen A, Hajduk A, Ferrante L. In-Hospital Delirium and Disability and Cognitive Impairment After COVID-19 Hospitalization. JAMA Network Open 2024, 7: e2419640. PMID: 38954414, PMCID: PMC11220565, DOI: 10.1001/jamanetworkopen.2024.19640.Peer-Reviewed Original ResearchConceptsIn-hospital deliriumChart-Based Delirium Identification InstrumentOlder adultsFunctional disabilityCOVID-19 hospitalizationCognitive impairmentCohort studyAssociated with increased functional disabilityHospitalized older adultsIncreased functional disabilityAssociation of deliriumPostdischarge follow-upRisk of deliriumTertiary care systemFollow-upPresence of cognitive impairmentProspective cohort studyLogistic regression modelsOlder survivorsCare systemIncreasing cognitive impairmentMain OutcomesCOVID-19Hospital dischargePrimary outcomeAssociations of Social Support With Physical and Mental Health Symptom Burden After COVID-19 Hospitalization Among Older Adults
Lee S, McAvay G, Geda M, Chattopadhyay S, Acampora D, Araujo K, Charpentier P, Gill T, Hajduk A, Cohen A, Ferrante L. Associations of Social Support With Physical and Mental Health Symptom Burden After COVID-19 Hospitalization Among Older Adults. The Journals Of Gerontology Series A 2024, 79: glae092. PMID: 38558166, PMCID: PMC11059296, DOI: 10.1093/gerona/glae092.Peer-Reviewed Original ResearchConceptsLow social supportMental health symptomsSocial supportSymptom burdenHealth symptomsFollow-up assessmentCOVID-19 hospitalizationMedical Outcomes Study Social Support SurveyPhysical symptomsAssociation of social supportEdmonton Symptom Assessment SystemPatient Health Questionnaire-4Burden of physical symptomsMental health symptom burdenModified Edmonton Symptom Assessment SystemSocial Support SurveyParticipants' mean ageAssociated with higher burdenSupport SurveyOlder survivorsSymptom managementOlder AdultsMental healthHispanic ethnicityLongitudinal associations
2022
Rationale, Design, and Characteristics of the VALIANT (COVID‐19 in Older Adults: A Longitudinal Assessment) Cohort
Cohen A, McAvay G, Geda M, Chattopadhyay S, Lee S, Acampora D, Araujo K, Charpentier P, Gill T, Hajduk A, Ferrante L. Rationale, Design, and Characteristics of the VALIANT (COVID‐19 in Older Adults: A Longitudinal Assessment) Cohort. Journal Of The American Geriatrics Society 2022, 71: 832-844. PMID: 36544250, PMCID: PMC9877652, DOI: 10.1111/jgs.18146.Peer-Reviewed Original ResearchConceptsPatient-centered outcomesCOVID-19 hospitalizationCognitive impairmentPhysical functionOlder COVID-19 survivorsCOVID-19-related symptomsCOVID-19Older adultsIntensive care unitCOVID-19 survivorsPersistent cognitive impairmentSix-month followMost older adultsThird of participantsElectronic health recordsStepdown unitAcute illnessBurdensome symptomsCare unitSupplemental oxygenMedian lengthProspective studyMean ageBlack raceBaseline interviewBenefits and harms of oral anticoagulants for atrial fibrillation in nursing home residents with advanced dementia
Ouellet GM, O'Leary JR, Leggett CG, Skinner J, Tinetti ME, Cohen AB. Benefits and harms of oral anticoagulants for atrial fibrillation in nursing home residents with advanced dementia. Journal Of The American Geriatrics Society 2022, 71: 561-568. PMID: 36310367, PMCID: PMC9957933, DOI: 10.1111/jgs.18108.Peer-Reviewed Original ResearchConceptsNursing home residentsAtrial fibrillationAdvanced dementiaHome residentsStroke riskLong-stay nursing home residentsMedicare Part D claimsDementia-related mortalityGuideline-recommended thresholdHarms of anticoagulationRetrospective cohort studyMultivariable survival analysisValvular heart diseaseRisk of deathPart D claimsMonths of lifeMinimum Data SetAnticoagulant discontinuationAnticoagulated individualsMean CHAVASc scoreCause mortalityMultivariable adjustmentOral anticoagulantsCohort studyThe association between beta‐blockers and outcomes in patients with heart failure and concurrent Alzheimer's disease and related dementias
Gilstrap L, Cohen A, Ouellet GM, Goyal P, Gladders B, Flint D, Skinner J. The association between beta‐blockers and outcomes in patients with heart failure and concurrent Alzheimer's disease and related dementias. Journal Of The American Geriatrics Society 2022, 71: 404-413. PMID: 36240493, DOI: 10.1111/jgs.18086.Peer-Reviewed Original ResearchConceptsHigh riskBB useHeart failureAlzheimer's diseaseLong-term mortality ratesConcurrent Alzheimer's diseaseBeta-blocker useReduced ejection fractionMedicare Part ARisk/benefitBB therapyEjection fractionContemporary patientsHFrEFHigh prevalenceSimilar riskMortality ratePatientsCognitive impairmentMortalityDiseaseADRDRiskTherapyOutcomesEmergency department‐to‐community care transition barriers: A qualitative study of older adults
Gettel CJ, Serina PT, Uzamere I, Hernandez‐Bigos K, Venkatesh AK, Rising KL, Goldberg EM, Feder SL, Cohen AB, Hwang U. Emergency department‐to‐community care transition barriers: A qualitative study of older adults. Journal Of The American Geriatrics Society 2022, 70: 3152-3162. PMID: 35779278, PMCID: PMC9669106, DOI: 10.1111/jgs.17950.Peer-Reviewed Original ResearchConceptsCare transitionsOlder adultsClinical careImmediate post-discharge periodED discharge processEmergency clinical careEmergency department visitsPost-discharge periodAdverse health outcomesOutpatient clinical careDepartment visitsIntact patientsEmergency departmentHealth outcomesOlder adults' willingnessU.S. healthcare systemBaseline activityEffective interventionsIntervention developmentHealthcare systemAdultsCareAdults' willingnessSymptom explanationsEDAssociations between hospitalist physician workload, length of stay, and return to the hospital
Djulbegovic M, Chen K, Cohen AB, Heacock D, Canavan M, Cushing W, Agarwal R, Simonov M, Chaudhry SI. Associations between hospitalist physician workload, length of stay, and return to the hospital. Journal Of Hospital Medicine 2022, 17: 445-455. PMID: 35662410, PMCID: PMC9248905, DOI: 10.1002/jhm.12847.Peer-Reviewed Original ResearchConceptsLength of stayEmergency departmentPhysician workloadYale-New Haven HospitalMedian patient ageSeverity of illnessElectronic health record dataNumber of patientsHealth record dataWeekend admissionHospital daysPatient ageClinical outcomesObservational studyHospitalist serviceMAIN OUTCOMEPatient complexityHospitalist workloadSociodemographic factorsPatient encountersPatientsLogistic regressionMultilevel PoissonRecord dataOutcomesPerceived dementia risk and advance care planning among older adults
Lee YK, Fried TR, Costello DM, Hajduk AM, O'Leary JR, Cohen AB. Perceived dementia risk and advance care planning among older adults. Journal Of The American Geriatrics Society 2022, 70: 1481-1486. PMID: 35274737, PMCID: PMC9106856, DOI: 10.1111/jgs.17721.Peer-Reviewed Original ResearchConceptsAdvance care planningDementia riskOlder adultsTreatment preferencesCare planningForm of ACPMultivariable-adjusted logistic regressionDurable powerCross-sectional studyCommunity-dwelling adultsHealth behavior modelsMedical conditionsLower oddsACP activityCognitive impairmentLogistic regressionDementiaAdultsHealthcare decisionsSubstantial minorityLiving willsRiskRetirement StudyAppointmentsAssociation
2021
Characteristics of Older Adults Who Cannot Identify a Healthcare Agent
Cohen AB, Paiva AL, Redding CA, Fried TR. Characteristics of Older Adults Who Cannot Identify a Healthcare Agent. Journal Of General Internal Medicine 2021, 37: 1313-1314. PMID: 33904034, PMCID: PMC8971249, DOI: 10.1007/s11606-021-06798-2.Peer-Reviewed Original ResearchDemographic Characteristics Driving Disparities in Receipt of Long-term Services and Supports in the Community Setting
Travers JL, Naylor MD, Coe NB, Meng C, Li F, Cohen AB. Demographic Characteristics Driving Disparities in Receipt of Long-term Services and Supports in the Community Setting. Medical Care 2021, 59: 537-542. PMID: 33827107, PMCID: PMC8119333, DOI: 10.1097/mlr.0000000000001544.Peer-Reviewed Original ResearchConceptsMinority older adultsWhite older adultsOlder adultsFunctional limitation scoresLimitation scoresUnadjusted analysesDaily livingFunctional limitationsNH careAlzheimer's diseaseCommunity settingsMarital statusAdultsAdult nursingFunctional needsRetirement StudyCareNursingMinority groupsGroupDisparitiesLong-term serviceDifferencesDementiaDisease
2020
Cognitively Impaired Older Persons' and Caregivers' Perspectives on Dementia‐Specific Advance Care Planning
Fried TR, Cohen AB, Harris JE, Moreines L. Cognitively Impaired Older Persons' and Caregivers' Perspectives on Dementia‐Specific Advance Care Planning. Journal Of The American Geriatrics Society 2020, 69: 932-937. PMID: 33216955, PMCID: PMC8300881, DOI: 10.1111/jgs.16953.Peer-Reviewed Original ResearchGuardianship and End‐of‐Life Care for Veterans with Dementia in Nursing Homes
Cohen AB, Han L, OʼLeary JR, Fried TR. Guardianship and End‐of‐Life Care for Veterans with Dementia in Nursing Homes. Journal Of The American Geriatrics Society 2020, 69: 342-348. PMID: 33170957, PMCID: PMC7902349, DOI: 10.1111/jgs.16900.Peer-Reviewed Original ResearchConceptsDays of lifeHospital deathHigh-intensity treatmentMechanical ventilationTube placementHome residentsCardiopulmonary resuscitationNursing homesIntensive care unit admissionMinimum Data Set assessmentsCare unit admissionRetrospective cohort studyNursing home residentsHigh-intensity endMore nursing homesUnit admissionICU admissionCohort studySecondary outcomesPrimary outcomeHospital transferLife hospitalizationsSevere dementiaLife careDementia severityOlder Adults without Desired Surrogates in a Nationally Representative Sample
Cohen AB, Costello DM, OʼLeary JR, Fried TR. Older Adults without Desired Surrogates in a Nationally Representative Sample. Journal Of The American Geriatrics Society 2020, 69: 114-121. PMID: 32898285, PMCID: PMC7854949, DOI: 10.1111/jgs.16813.Peer-Reviewed Original ResearchConceptsNuclear familiesOlder adultsNational Social LifeNationally Representative SampleSocial lifeCommunity-dwelling older adultsRepresentative sampleSocial connectednessCross-sectional studyHealth care agentCare agentsCognitive impairmentLogistic regressionLow indicatorsAdultsRespondentsConfidantsIntact capacityMedical decisions
2019
End‐of‐Life Decision Making and Treatment for Patients with Professional Guardians
Cohen AB, Benjamin AZ, Fried TR. End‐of‐Life Decision Making and Treatment for Patients with Professional Guardians. Journal Of The American Geriatrics Society 2019, 67: 2161-2166. PMID: 31301189, PMCID: PMC6800801, DOI: 10.1111/jgs.16072.Peer-Reviewed Original ResearchConceptsHigh-intensity treatmentPatient preferencesHospice careVeterans Affairs Connecticut Healthcare SystemUnderwent cardiopulmonary resuscitationRetrospective cohort studyIntensive care unitLast monthAdvance care planningLife decisionsDecedent patientsLife decision makingChart reviewCohort studyCare unitTreatment outcomesCardiopulmonary resuscitationOutpatient facilitiesLife careCare planningVA recordsVA facilitiesProfessional guardiansPatientsOlder adultsCharacteristics of Patients With Professional Guardians in the Department of Veterans Affairs Health Care System.
Cohen AB, Trentalange M, Benjamin AZ, Fried TR. Characteristics of Patients With Professional Guardians in the Department of Veterans Affairs Health Care System. JAMA Internal Medicine 2019, 179: 107-108. PMID: 30398533, PMCID: PMC6500761, DOI: 10.1001/jamainternmed.2018.4849.Peer-Reviewed Original Research
2017
Avoiding Hospitalizations From Nursing Homes for Potentially Burdensome Care: Results of a Qualitative Study
Cohen AB, Knobf MT, Fried TR. Avoiding Hospitalizations From Nursing Homes for Potentially Burdensome Care: Results of a Qualitative Study. JAMA Internal Medicine 2017, 177: 137-139. PMID: 27893891, PMCID: PMC5345121, DOI: 10.1001/jamainternmed.2016.7128.Peer-Reviewed Original Research
2016
Methodology to Estimate the Longitudinal Average Attributable Fraction of Guideline-recommended Medications for Death in Older Adults With Multiple Chronic Conditions
Allore HG, Zhan Y, Cohen AB, Tinetti ME, Trentalange M, McAvay G. Methodology to Estimate the Longitudinal Average Attributable Fraction of Guideline-recommended Medications for Death in Older Adults With Multiple Chronic Conditions. The Journals Of Gerontology Series A 2016, 71: 1113-1116. PMID: 26748093, PMCID: PMC4945884, DOI: 10.1093/gerona/glv223.Peer-Reviewed Original ResearchMeSH KeywordsAdrenergic beta-AntagonistsAgedAged, 80 and overCardiovascular DiseasesDrug PrescriptionsDrug Therapy, CombinationFemaleFollow-Up StudiesHumansMaleMedicareMultiple Chronic ConditionsPractice Guidelines as TopicRetrospective StudiesSurveys and QuestionnairesSurvival RateThiazidesTreatment OutcomeUnited StatesConceptsMultiple chronic conditionsAverage attributable fractionChronic conditionsAttributable fractionCardiovascular conditionsHeart failureMedicare Current Beneficiary Survey participantsRenin-angiotensin system blockersGuideline-recommended medicationsMore chronic conditionsAge-stratified modelsSystem blockersBeta blockersCardiovascular medicationsOral medicationsAtrial fibrillationMedication effectsMedicationsAge strataParticipant characteristicsOlder adultsSurvivalThiazidesBlockersAge
2015
Association between guideline recommended drugs and death in older adults with multiple chronic conditions: population based cohort study
Tinetti ME, McAvay G, Trentalange M, Cohen AB, Allore HG. Association between guideline recommended drugs and death in older adults with multiple chronic conditions: population based cohort study. The BMJ 2015, 351: h4984. PMID: 26432468, PMCID: PMC4591503, DOI: 10.1136/bmj.h4984.Peer-Reviewed Original ResearchConceptsSerotonin-norepinephrine reuptake inhibitorsMultiple chronic conditionsSelective serotonin reuptake inhibitorsAdjusted hazard ratioRisk of deathCalcium channel blockersChronic conditionsHazard ratioΒ-blockersCohort studyReuptake inhibitorsAtrial fibrillationOlder adultsChannel blockersCardiovascular drugsSSRIs/serotonin-norepinephrine reuptake inhibitorsRenin-angiotensin system blockersNorepinephrine reuptake inhibitorsSerotonin reuptake inhibitorsCommon combinationRAS blockersSystem blockersStudy drugHeart failureThromboembolic diseaseGuardianship and End-of-Life Decision Making
Cohen AB, Wright MS, Cooney L, Fried T. Guardianship and End-of-Life Decision Making. JAMA Internal Medicine 2015, 175: 1687-1691. PMID: 26258634, PMCID: PMC4683611, DOI: 10.1001/jamainternmed.2015.3956.Peer-Reviewed Original ResearchConceptsLegal casesProfessional guardiansLife decisionsRecent legal casesImpaired decision-making capacityDecision-making capacityLife-sustaining treatmentJudicial reviewGuardian's authoritySurrogate decision makersVulnerable personsComprehensive standardsGuardiansAuthoritiesStatutesBroader frameworkPreexisting relationshipDecisionsLife treatmentMedical decisionsSuch situationsCourtGuardianshipLawRightsPatients With Next-of-Kin Relationships Outside the Nuclear Family
Cohen AB, Trentalange M, Fried T. Patients With Next-of-Kin Relationships Outside the Nuclear Family. JAMA 2015, 313: 1369-1370. PMID: 25849183, PMCID: PMC4678873, DOI: 10.1001/jama.2015.2409.Peer-Reviewed Original Research