A5035221383- Health Systems, Economic Evaluations, Quality of Life
- Frailty in Older Adults
- Health disparities and outcomes
- Chronic Disease Management Strategies
- Geriatric Care and Nursing Homes
- Dementia and Cognitive Impairment Research
- Nutrition and Health in Aging
- Pharmaceutical Practices and Patient Outcomes
- Balance, Gait, and Falls Prevention
- Palliative Care and End-of-Life Issues
- Advanced Causal Inference Techniques
- Healthcare Policy and Management
- Intensive Care Unit Cognitive Disorders
- Rheumatoid Arthritis Research and Therapies
- Osteoarthritis Treatment and Mechanisms
- Global Health Care Issues
- Milk Quality and Mastitis in Dairy Cows
- Statistical Methods and Bayesian Inference
- Aging and Gerontology Research
- Intergenerational Family Dynamics and Caregiving
- Genetic and phenotypic traits in livestock
- Blood Pressure and Hypertension Studies
- Statistical Methods and Inference
- Cardiac Health and Mental Health
- Immune Response and Inflammation
Yale University
2016-2025
Yale Cancer Center
2006-2024
Cedars-Sinai Medical Center
2023
Johnson University
2023
Rutgers, The State University of New Jersey
2023
Rutgers Sexual and Reproductive Health and Rights
2023
Fairview Southdale Hospital
2023
Cleveland Clinic
2023
American College of Rheumatology
2018-2023
Advisory Board Company (United States)
2023
The questions patients are asked about their preferences with regard to life-sustaining treatment usually focus on specific interventions, but the outcomes of and likelihood affect patients' preferences.
<h3>Background:</h3> Little is known about the natural course of frailty. We performed a prospective study to determine transition rates between frailty states and evaluate effect preceding state on subsequent transitions. <h3>Methods:</h3> studied 754 community-living persons, aged 70 years or older, who were nondisabled in 4 essential activities daily living. Frailty, assessed every 18 months for 54 months, was defined basis weight loss, exhaustion, low physical activity, muscle weakness,...
Functional decline in physically frail, elderly persons is associated with substantial morbidity. It uncertain whether such functional can be prevented.
Despite the importance of functional status to older persons and their families, little is known about course disability at end life.We evaluated data on 383 decedents from a longitudinal study involving 754 community-dwelling persons. None subjects had in essential activities daily living beginning study, level was ascertained during monthly interviews for more than 10 years. Information conditions leading death obtained certificates comprehensive assessments that were completed 18-month...
Abstract We evaluated TLR function in primary human dendritic cells (DCs) from 104 young (age 21–30 y) and older (≥65 individuals. used multicolor flow cytometry intracellular cytokine staining of myeloid DCs (mDCs) plasmacytoid (pDCs) found substantial decreases compared with individuals TNF-α, IL-6, and/or IL-12 (p40) production mDCs TNF-α IFN-α pDCs response to TLR1/2, TLR2/6, TLR3, TLR5, TLR8 engagement TLR7 TLR9 pDCs. These differences were highly significant after adjustment for...
ability in essential activities of daily living, such as bathing, dressing, walking, and transferring, is common associated with increased mortality, institutionalization, greater use formal informal home services. 1Active life expectancy, a metric that often used by policy makers to forecast the functional health older persons, based on disability. 2,3ccording several conceptual models, 4,5 disability thought arise when vulnerable host exposed new or worsening insult intervening...
The effects of aging on human TLR function remain incompletely understood. We assessed and expression in peripheral blood monocytes from 159 subjects 2 age categories, 21-30 >65 years age, using a multivariable mixed effect model. Using flow cytometry to assess TLR-induced cytokine production, we observed substantial, highly significant defect TLR1/2-induced TNF-alpha (p = 0.0003) IL-6 < 0.0001) older adults compared with young controls. In contrast findings aged mice, other (including...
Little is known about the deleterious effects of injurious falls relative to those other disabling conditions or whether these are driven largely by hip fractures. From a cohort 754 community-living elders New Haven, Connecticut, we matched 122 hospitalizations for an fall (59 hip-fracture and 63 fall-related injuries) 241 non–fall-related hospitalizations. Participants (mean age: 85.7 years) were evaluated monthly disability in 13 activities admission nursing home from 1998 2010. For both...
Multimorbidity-having two or more coexisting chronic conditions-is highly prevalent, costly, and disabling to older adults. Questions remain regarding diseases accumulation over time whether this differs by racial ethnic background. Answering knowledge gap, study identifies differences in rates of disease multimorbidity development among non-Hispanic white, black, Hispanic participants starting middle-age followed up 16 years.We analyzed data from the Health Retirement Study (HRS), a...
Scholars argue about whether age stereotypes (beliefs old people) are becoming more negative or positive over time. No previous study has systematically tested the trend of than 20 years, due to lack suitable data. Our aim was fill this gap by investigating have changed last two centuries and, if so, what may be associated with change. We hypothesized that increased in negativity due, part, increasing medicalization aging. This applied computational linguistics recently compiled Corpus...
Injuries from falls are major contributors to complications and death in older adults. Despite evidence efficacy trials that many can be prevented, rates of resulting injury have not declined.
Abstract INTRODUCTION Multimorbidity is associated with increased risk of dementia, but previous estimation the joint contribution constituent conditions to dementia incidence did not model additive contributions or temporal proximity in sequential onset conditions. METHODS Data were analyzed from 9944 Health and Retirement Study participants Medicare fee‐for‐service beneficiaries, ages 68–99, without Alzheimer's disease related dementias (ADRD) at baseline, 1998–2016. ADRD chronic condition...
Falling is a common and morbid condition among elderly persons. Effective strategies to prevent falls have been identified but are underutilized.
To examine the longitudinal relationship between cumulative exposure to anticholinergic medications and memory executive function in older men.Prospective cohort study.A Department of Veterans Affairs primary care clinic.Five hundred forty-four community-dwelling men aged 65 with diagnosed hypertension.The outcomes were measured using Hopkins Verbal Recall Test (HVRT) for short-term instrumental activity daily living (IADL) scale at baseline during follow-up. Anticholinergic medication use...
OBJECTIVES: To determine the rates of clinically meaningful transitions in mobility disability; evaluate how these differ according to age, sex, and physical frailty; depict duration resulting episodes disability. DESIGN: Prospective cohort study. SETTING: General community greater New Haven, Connecticut, from March 1998 October 2004. PARTICIPANTS: Seven hundred fifty‐four community‐living older persons, aged 70 older, who were nondisabled (i.e., required no personal assistance) four...
This study sought to identify modifiable risk factors for pneumonia in elderly nursing home residents.A cohort of 613 residents (age, >65 years) 5 homes the New Haven, Connecticut, area was followed-up prospectively from February 2001 through March 2003. The primary outcome radiographically documented within a 12-month surveillance period. Baseline were evaluated their independent association with pneumonia.Of residents, 131 (21%) died, and an additional 112 (18%) developed case during Among...
To ascertain the effect of common chronic conditions on mortality in older persons with colorectal cancer.Retrospective cohort study.Population-based cancer registry.Patients Surveillance Epidemiology and End Results-Medicare linked database who were aged 67 had a primary diagnosis Stage 1 to 3 during 1993 through 1999.Chronic identified using claims data, vital status was determined from Medicare enrollment files. After estimating adjusted hazard ratios for associated each condition Cox...
Scientific evidence should guide clinical care, but special methodological challenges influence interpretation of the medical literature pertaining to older adults. Missing data, ranging from lack individual items in questionnaires complete loss follow-up, affect quality and are more likely occur studies adults because have health functional problems that interfere with all aspects data collection than do younger people. The purpose this article is promote knowledge about risks consequences...
Innate immunity, including Toll-like receptor (TLR)-mediated expression of the B7 costimulatory molecules CD80 and CD86, is critical for vaccine immunity. We examined whether CD86 vary with aging predict response to trivalent inactivated influenza vaccine.One hundred sixty-two subjects between 21 30 years age (the young group) or > =65 older enrolled before vaccination. determined TLR-induced monocyte CD80/CD86 by flow cytometry antibody responses hemagglutination inhibition.The mean...
Background: Relatively little is known about why older persons develop long-term disability in community mobility. Objective: To identify the risk factors and precipitants for walking a quarter mile driving car. Design: Prospective cohort study from March 1998 to December 2009. Setting: Greater New Haven, Connecticut. Participants: 641 persons, aged 70 years or older, who were active drivers nondisabled mile. Persons physically frail oversampled. Measurements: Candidate assessed every 18...
Aging is accompanied by a progressive decline in immune function. Studies have shown age-related decreases the expression and signaling efficiency of Toll-like receptors (TLRs) monocytes dendritic cells dysregulation macrophage TLR3. Using multivariable mixed effect model, we report highly significant increase TLR5-induced production IL-8 from older individuals (P < 0.0001). Elevated increased TLR5, both protein mRNA, levels TLR5-mediated phosphorylation MAPK p38 ERK. We noted incomplete...