A5053775264- Frailty in Older Adults
- Cancer survivorship and care
- Palliative Care and End-of-Life Issues
- Health Systems, Economic Evaluations, Quality of Life
- Nutrition and Health in Aging
- Geriatric Care and Nursing Homes
- Cancer-related cognitive impairment studies
- Intergenerational Family Dynamics and Caregiving
- Healthcare Policy and Management
- Dementia and Cognitive Impairment Research
- Inflammatory Biomarkers in Disease Prognosis
- Primary Care and Health Outcomes
- Health disparities and outcomes
- Economic and Financial Impacts of Cancer
- Pharmaceutical Practices and Patient Outcomes
- Tryptophan and brain disorders
- Health and Wellbeing Research
- Blood Pressure and Hypertension Studies
- Grief, Bereavement, and Mental Health
- Intensive Care Unit Cognitive Disorders
- Chronic Disease Management Strategies
- Patient Dignity and Privacy
- Gun Ownership and Violence Research
- Migration, Aging, and Tourism Studies
- Sleep and related disorders
Huzhou University
2024
University of Michigan
2020-2024
Third People's Hospital of Huzhou
2024
National Cancer Institute
2024
Michigan United
2021-2024
Michigan Medicine
2022
University of Rochester
2017-2020
Canandaigua VA Medical Center
2020
University of Rochester Medical Center
2018-2020
<h3>Importance</h3> Financial toxicity (FT), unintended and unanticipated financial burden experienced by cancer patients undergoing care, is associated with negative consequences increased risk of mortality. Older (≥70 years) are at for FT, yet data limited on FT whether oncologists discuss their patients. <h3>Objective</h3> To examine the prevalence in older adults advanced cancer, its association health-related quality life (HRQoL), cost conversations between <h3>Design, Setting,...
Abstract Background Many U.S. caregivers provide care to the generation above and below simultaneously, described as “sandwich” caregivers. We seek first national estimates characterizing sandwich older adults for whom they care. Methods used 2015 National Study of Caregiving (NSOC) Health Aging Trends (NHATS) compare individual (demographic, socio‐economic, health, caregiving characteristics) caregiving‐related experience (financial emotional difficulties, caregiver role overload gains,...
With rapid urbanisation, millions of people from rural areas have migrated to major cities for employment, leaving their young children at home. This labour migration creates substantial mental and physical challenges these left-behind children. study establishes two empirical models comparing the health status with that in without migrant parents urban areas. Our findings reveal parental negatively affects height weight indices The effects are particularly prominent younger children, when...
Abstract Background Ensuring older patients with advanced cancer and their oncologists have similar beliefs about curability is important. We investigated discordance in patient-oncologist caregiver-oncologist dyads. Materials Methods used baseline data from a cluster randomized trial assessing whether geriatric assessment improves communication quality of life caregivers. Patients were aged ≥70 years incurable community oncology practices. Patients, caregivers, asked: “What do you believe...
OBJECTIVES To evaluate relationships between frailty and cognition longitudinally in adults 50 years older with breast cancer receiving chemotherapy. DESIGN Secondary analysis of a prospective longitudinal observational study. SETTING University Rochester NCI Community Oncology Research Program community oncology clinics. PARTICIPANTS Patients age adjuvant/neoadjuvant chemotherapy (n = 376) age‐matched controls without 234). MEASUREMENTS Frailty was assessed using modified score from...
Little is known about the effects of chemotherapeutic drugs on DNA methylation status leukocytes, which may be predictive treatment benefits and toxicities. Based a prospective national study, we characterize changes in leukocyte methylome from pre- to post-chemotherapy (approximately 4 months apart) 93 patients treated for early stage breast cancer 48 matched non-cancer controls. We further examined significant with perceived cognitive impairment, clinically problem related chemotherapy....
Background Older patients with advanced cancer who are 100% certain they will be cured pose unique challenges for clinical decision making, but to the authors’ knowledge, prevalence and correlates of absolute certainty about curability (ACC) unknown. Methods Cross‐sectional data were collected in a geriatric assessment trial. ACC was assessed by asking patients, “What do you believe chances that your go away never come back treatment?” Response options (coded as ACC), >50%, 50/50,...
Frailty is associated with an increased risk of chemotherapy toxicity. Cellular markers inflammation can help identify patients frailty characteristics. However, the role cellular in identifying at developing chemotherapy-induced and their clinical utility are not fully understood.This study was a secondary analysis large nationwide cohort women stage I-IIIC breast cancer (n = 581, mean age 53.4; range 22-81). Measures were completed pre-chemotherapy (T1), post-chemotherapy (T2), 6 months...
Abstract Background Aging-related deficits that eventually manifest as frailty may be associated with poor emotional health in older patients advanced cancer. This study aimed to examine the relationship between and this population. Methods was a secondary analysis of baseline data from nationwide cluster randomized trial. Patients were aged ≥70 years incurable stage III/IV solid tumors or lymphomas, had ≥1 geriatric assessment (GA) domain impairment, completed Geriatric Depression Scale,...
Abstract Background Inflammation may contribute to cognitive difficulties in patients with breast cancer. We tested 2 hypotheses: inflammation is elevated cancer vs noncancer control participants and associated worse attention processing speed over the course of chemotherapy. Methods Serum cytokines (interleukin [IL]–4, 6, 8, 10; tumor necrosis factor [TNF]–α) soluble receptors [sTNFRI, II]) were measured 519 females before after chemotherapy 338 without serving as participants. Attention by...
Abstract Background/objectives As home becomes the most common place of death in United States, information about caregiver support and is critical to improve patient experiences at end life. We seek examine (1) association between family care availability death; (2) caregiving intensity associated with death. Design 2017 National Health Aging Trends Study Caregiving; nationally representative cross‐sectional study deceased older adults last‐month‐of‐life (LML) caregivers. Setting States;...
To estimate the causal impact of continuity care (COC) on total, institutional, and noninstitutional cost among community-dwelling older veterans with dementia.Combined Veterans Health Administration (VHA) Medicare data in Fiscal Years (FYs) 2014-2015.FY 2014 COC was measured by Bice-Boxerman Continuity Care (BBC) index a 0-1 scale. FY 2015 total combined VHA cost, institutional acute inpatient, emergency department [ED], long-/short-stay nursing home, long-term (LTC) for medical (like...
A geriatric assessment (GA) intervention improves communication about aging-related concerns, but its effect on in patients with various levels of frailty is unknown.
To determine dementia prevalence and costs attributable to using Veterans Health Administration (VHA) data with without Medicare data.VHA inpatient, outpatient, purchased care other enrollment, claims, assessments in fiscal year (FY) 2013.Analyses were conducted VHA alone combined data. Dementia was identified from a sanctioned list of ICD-9 diagnoses. Attributable cost estimated recycled predictions.Veterans age 65 older who used enrolled Traditional FY 2013 (1.9 million).VHA records...
Poor sleep is common among older adults with chronic health conditions and their spousal caregivers. However, dyadic patterns spouses are underexplored within the literature. This study examines characteristics associated contextual factors care dyads.Participants included 462 adult dyads from 2015 National Health Aging Trends Study of Caregiving (mean ages recipients/caregivers = 79 76 years, respectively; 22% were living dementia). Self-reported frequency (a) trouble falling back asleep...
This study examines the association of partner Medicare Advantage plan status over 1 year with beneficiary and characteristics.
Abstract Objectives To provide a longitudinal analysis of how functional decline over time among older adults affects provision family and unpaid care, overall stratified by dementia status. Methods Longitudinal cohorts community-dwelling ≥65 years between 2015 2017 from the National Health Aging Trends Study (NHATS; n = 5,103) their caregivers Caregiving (n 862 for 595 NHATS care recipients). A panel data fixed-effects model was used to examine increases in mobility, self-care, household...
<h3>Importance</h3> The functional status and physical performance of older adults with cancer are underassessed undertreated despite the high prevalence impaired in this population their associations chemotherapy-induced toxic effects mortality. <h3>Objective</h3> To examine association between providing oncologists a geriatric assessment (GA) summary recommendations having oncologist-patient conversations about performance. <h3>Design, Setting, Participants</h3> Data for secondary analysis...
Background: Hospitalization is a difficult experience, especially for patients with dementia. Understanding whether better continuity of care (COC) reduces hospitalizations can indicate interventions that might help curb hospitalizations. Objective: To estimate the causal impact COC on and different reasons hospitalization among community-dwelling older veterans Research Design: Population-based observational study using nationwide Veterans Health Administration data linked to Medicare...
Falls are a modifiable source of morbidity for older adults with cancer, yet underassessed in oncology practice. In this secondary analysis nationwide cluster-randomized controlled trial, we examined characteristics associated patient-oncologist conversations about falls, and whether oncologist knowledge geriatric assessment (GA) resulted more conversations.Eligible patients (ClinicalTrials.gov identifier: NCT02107443) were age ≥ 70 years, had stage III/IV solid tumor or lymphoma, being...