Associations of Days Spent at Home Before Hip Fracture With Post-Fracture Days at Home and 1-Year Mortality Among Medicare Beneficiaries Living with Alzheimer’s Disease or Related Dementias
dc.contributor.author | Falvey, Jason R. | |
dc.contributor.author | Chen, Chixiang | |
dc.contributor.author | Johnson, Abree | |
dc.contributor.author | Ryan, Kathleen A. | |
dc.contributor.author | Shardell, Michelle | |
dc.contributor.author | Ren, Haoyu | |
dc.contributor.author | Reider, Lisa | |
dc.contributor.author | Magaziner, Jay | |
dc.date.accessioned | 2023-07-21T20:20:35Z | |
dc.date.available | 2023-07-21T20:20:35Z | |
dc.date.issued | 2023-07-04 | |
dc.description.abstract | BACKGROUND Hip fracture is a disabling event experienced disproportionately by older adults with Alzheimer’s disease or related dementias (ADRD). Claims information recorded prior to a hip fracture could provide valuable insights into recovery potential for these patients. Thus, our objective was to identify distinct trajectories of claims-based days at home (DAH) before a hip fracture among older adults with ARD and evaluate associations with post-fracture DAH and 1-year mortality. METHODS We conducted a cohort study of 16,576 Medicare beneficiaries living with ADRD who experienced hip fracture between 2010-2017. Growth mixture modeling was used to estimate trajectories of DAH assessed from 180 days prior to fracture until index fracture admission, and their joint associations with post-fracture DAH trajectories and 1-year mortality. RESULTS Before a hip fracture, a model with 3 distinct latent DAH trajectories was the best fit. Trajectories were characterized based on their temporal patterns as Consistently High (n=14,980, 90.3%), Low but Increasing (n=809, 5.3%), or Low and Decreasing (n=787, 4.7%). Membership in the Low and Decreasing pre-fracture DAH trajectory was associated with less favorable post-fracture DAH trajectories, and a 65% higher 1-year mortality rate (hazard ratio 1.65, 95% confidence interval 1.45-1.87) as compared to those in the Consistently High trajectory. Similar albeit weaker associations with these outcomes were observed for hip fracture survivors in the Low but Improving pre-fracture DAH trajectory. Conclusions Distinct pre-fracture DAH trajectories among hip fracture survivors with ADRD are strongly linked to post-fracture DAH and 1-year mortality, which could guide development of tailored interventions. | en_US |
dc.description.sponsorship | Dr. Falvey was supported during the study by a Paul B. Beeson Emerging Leaders in Aging Award (K76AG074926) from the NIA and by the Maryland Claude D. Pepper Older Americans Independence Center of the NIA (P30 AG028747). Dr. Magaziner was supported during the study by the Maryland Claude D. Pepper Older Americans Independence Center of the NIA (P30 AG028747). Dr. Shardell was supported by NIA grants RF1 NS128360, R03 AG070178, P30 AG028747-15S, and R01 AG048069. We also acknowledge the support of the University of Maryland, Baltimore, Institute for Clinical & Translational Research (ICTR) and the National Center for Advancing Translational Sciences (NCATS) Clinical Translational Science Award (CTSA) (1UL1TR003098) in helping secure Medicare data and providing support for analysis. | en_US |
dc.description.uri | https://academic.oup.com/biomedgerontology/advance-article-abstract/doi/10.1093/gerona/glad158/7218970 | en_US |
dc.format.extent | 31 pages | en_US |
dc.genre | journal articles | en_US |
dc.genre | postprints | en_US |
dc.identifier | doi:10.13016/m2yi1k-yyke | |
dc.identifier.citation | Falvey, Jason R, Chixiang Chen, Abree Johnson, Kathleen A Ryan, Michelle Shardell, Haoyu Ren, Lisa Reider, and Jay Magaziner. “Associations of Days Spent at Home Before Hip Fracture With Post-Fracture Days at Home and 1-Year Mortality Among Medicare Beneficiaries Living with Alzheimer’s Disease or Related Dementias.” The Journals of Gerontology: Series A, July 4, 2023, glad158. https://doi.org/10.1093/gerona/glad158. | en_US |
dc.identifier.uri | https://doi.org/10.1093/gerona/glad158 | |
dc.identifier.uri | http://hdl.handle.net/11603/28835 | |
dc.language.iso | en_US | en_US |
dc.publisher | Oxford University Press | en_US |
dc.relation.isAvailableAt | The University of Maryland, Baltimore County (UMBC) | |
dc.relation.ispartof | UMBC Mathematics Department Collection | |
dc.relation.ispartof | UMBC Student Collection | |
dc.rights | This is a pre-copyedited, author-produced version of an article accepted for publication in The Journals of Gerontology: Series A following peer review. The version of record Falvey, Jason R, Chixiang Chen, Abree Johnson, Kathleen A Ryan, Michelle Shardell, Haoyu Ren, Lisa Reider, and Jay Magaziner. “Associations of Days Spent at Home Before Hip Fracture With Post-Fracture Days at Home and 1-Year Mortality Among Medicare Beneficiaries Living with Alzheimer’s Disease or Related Dementias.” The Journals of Gerontology: Series A, July 4, 2023, glad158. https://doi.org/10.1093/gerona/glad158. is available online at: https://doi.org/10.1093/gerona/glad158 | en_US |
dc.rights | Access to this item will begin on 07/04/2024 | |
dc.title | Associations of Days Spent at Home Before Hip Fracture With Post-Fracture Days at Home and 1-Year Mortality Among Medicare Beneficiaries Living with Alzheimer’s Disease or Related Dementias | en_US |
dc.type | Text | en_US |