Scholars@Duke
Christopher Barrett Bowling

Christopher Barrett Bowling

Associate Professor of Medicine
Medicine, Geriatrics and Palliative Care

Selected Publications

Long-term Monitoring of Blood Pressure in Older Adults: A Focus on Self-Measured Blood Pressure Monitoring.

Journal Article Clinics in geriatric medicine · November 2024 Hypertension is among the most common chronic conditions in older adults. Effective treatment exists, yet many older adults do not achieve recommended control of their blood pressure (BP). Self-measured blood pressure (SMBP) monitoring, in which patients c ... Full text Cite

Financial hardship after COVID-19 infection among US Veterans: a national prospective cohort study.

Journal Article BMC Health Serv Res · August 19, 2024 BACKGROUND: Research suggests an association between COVID-19 infection and certain financial hardships in the shorter term and among single-state and privately insured samples. Whether COVID-19 is associated with financial hardship in the longer-term or a ... Full text Link to item Cite

Trajectories of Physical Resilience Among Older Veterans With Stage 4 CKD.

Journal Article Am J Kidney Dis · August 2024 RATIONALE & OBJECTIVE: Although functional impairment is common among older adults with chronic kidney disease (CKD), functional reserve before an acute health event and physical resilience after the event have not been characterized in this population. Th ... Full text Link to item Cite

Fluid Cognition Among Individuals With Systemic Lupus Erythematosus.

Journal Article Arthritis Care Res (Hoboken) · August 2024 OBJECTIVE: We sought to describe fluid cognition and its correlates among individuals with systemic lupus erythematosus (SLE). METHODS: Participants (n = 199) were recruited from a population-based cohort for a single study visit (October 2019 to May 2022) ... Full text Link to item Cite

Trends in the Prevalence of Multiple Chronic Conditions Among US Adults With Hypertension From 1999-2000 Through 2017-2020.

Journal Article Am J Hypertens · June 14, 2024 BACKGROUND: The prevalence of many chronic conditions has increased among US adults. Many adults with hypertension have other chronic conditions. METHODS: We estimated changes in the age-adjusted prevalence of multiple (≥3) chronic conditions, not includin ... Full text Link to item Cite

Factors Associated With Hospital Admission in the Last Month: A Retrospective Single Center Analysis.

Journal Article J Pain Symptom Manage · June 2024 CONTEXT: Driven by concerns about care quality, patient experience, and national metrics, health systems are increasingly focusing on identifying risk factors for patients who are hospitalized in the last month of life. OBJECTIVE: To evaluate patient facto ... Full text Link to item Cite

Maintenance of Normal Blood Pressure From Middle to Older Age: Results From the Atherosclerosis Risk in Communities Study.

Journal Article Hypertension · June 2024 BACKGROUND: It is unknown whether maintaining normal blood pressure (BP) from middle to older age is associated with improved health outcomes. METHODS: We estimated the proportion of Atherosclerosis Risk in Communities study participants who maintained nor ... Full text Link to item Cite

Impact of SARS-CoV-2 Infection on Long-Term Depression Symptoms among Veterans.

Journal Article J Gen Intern Med · June 2024 BACKGROUND: Prior research demonstrates that SARS-COV-2 infection can be associated with a broad range of mental health outcomes including depression symptoms. Veterans, in particular, may be at elevated risk of increased depression following SARS-COV-2 in ... Full text Link to item Cite

Patient-Centered Quality Measures for Dialysis Care: A Report of a Kidney Disease Outcomes Quality Initiative (KDOQI) Scientific Workshop Sponsored by the National Kidney Foundation.

Conference Am J Kidney Dis · May 2024 Providing high-quality patient-centered care is the central mission of dialysis facilities. Assessing quality and patient-centeredness of dialysis care is necessary for continuous dialysis facility improvement. Based predominantly on readily measured items ... Full text Link to item Cite

Physical Performance in a Diverse, Population-Based Cohort of Individuals With Systemic Lupus Erythematosus.

Journal Article Arthritis care & research · April 2024 ObjectiveTo report the burden and correlates of poor physical performance in a diverse cohort of individuals with systemic lupus erythematosus (SLE).MethodsIn this single-visit study of 446 individuals with SLE from a population-based met ... Full text Cite

Self-Reported Everyday Functioning After COVID-19 Infection.

Journal Article JAMA Netw Open · March 4, 2024 IMPORTANCE: Changes in everyday functioning are crucial to assessing the long-term impact of COVID-19 infection. OBJECTIVE: To examine the impact of COVID-19 infection on everyday functioning 18 months after infection among veterans with and without histor ... Full text Link to item Cite

Risk of Suicide-Related Outcomes After SARS-COV-2 Infection: Results from a Nationwide Observational Matched Cohort of US Veterans.

Journal Article J Gen Intern Med · March 2024 BACKGROUND: Negative mental health-related effects of SARS-COV-2 infection are increasingly evident. However, the impact on suicide-related outcomes is poorly understood, especially among populations at elevated risk. OBJECTIVE: To determine risk of suicid ... Full text Link to item Cite

Changes in Outpatient Health Care Use After COVID-19 Infection Among Veterans.

Journal Article JAMA Netw Open · February 5, 2024 IMPORTANCE: The association of COVID-19 infection with outpatient care utilization is unclear. Many studies reported population surveillance studies rather than comparing outpatient health care use between COVID-19-infected and uninfected cohorts. OBJECTIV ... Full text Link to item Cite

Multimorbidity trajectories in early adulthood and middle age: Findings from the CARDIA prospective cohort study.

Journal Article J Multimorb Comorb · 2024 BACKGROUND: Multimorbidity research has focused on the prevalence and consequences of multimorbidity in older populations. Less is known about the accumulation of chronic conditions earlier in the life course. METHODS: We identified patterns of longitudina ... Full text Link to item Cite

Multimorbidity is associated with lower total 24-hour movement activity among US adults.

Journal Article Prev Med Rep · December 2023 OBJECTIVE: Having chronic conditions may result in reduced physical and cognitive function but less is known about multimorbidity with daily movement. We examined the association of multimorbidity and device-measured total daily movement in a nationally re ... Full text Link to item Cite

Late Mortality After COVID-19 Infection Among US Veterans vs Risk-Matched Comparators: A 2-Year Cohort Analysis.

Journal Article JAMA Intern Med · October 1, 2023 IMPORTANCE: Despite growing evidence of persistent problems after acute COVID-19, how long the excess mortality risk associated with COVID-19 persists is unknown. OBJECTIVE: To measure the time course of differential mortality among Veterans who had a firs ... Full text Link to item Cite

Phenotypes of Symptom, Function, and Medication Burden in Older Adults with Nondialysis Advanced Kidney Disease.

Journal Article Kidney360 · October 1, 2023 KEY POINTS: There are three distinct classes of symptoms, functional impairment, and medication burden among older adults with advanced kidney disease. One class with Complex Needs with pain and psychological symptoms, functional difficulties, and polyphar ... Full text Link to item Cite

Epidemiology of Community-Acquired Acute Kidney Injury Among US Veterans.

Journal Article Am J Kidney Dis · September 2023 RATIONALE & OBJECTIVE: Community-acquired acute kidney injury (CA-AKI) develops outside of the hospital and is the most common form of AKI globally. National estimates of CA-AKI in the United States are absent due to limited availability of laboratory data ... Full text Link to item Cite

Remote Administration of Physical and Cognitive Performance Assessments in a Predominantly Black Cohort of Persons With Systemic Lupus Erythematosus.

Journal Article ACR Open Rheumatol · September 2023 OBJECTIVE: In a study of physical and cognitive functioning among predominantly Black individuals with systemic lupus erythematosus (SLE), we compared remotely administered physical and cognitive performance assessments to those collected in person. METHOD ... Full text Link to item Cite

Research Inclusion Across the Lifespan: A Good Start, but There Is More Work to Be Done.

Journal Article J Gen Intern Med · June 2023 While older adults account for a disproportionate amount of healthcare spending, they are often underrepresented in clinical research needed to guide clinical care. The purpose of this perspective is to make readers aware of new data on age at enrollment f ... Full text Open Access Link to item Cite

Comparison of Blood Pressure Measurements from Clinical Practice and a Research Study At Kaiser Permanente Southern California.

Journal Article Am J Hypertens · May 21, 2023 BACKGROUND: Accurate blood pressure (BP) measurement is essential to identify and manage hypertension. Prior studies have reported a difference between BP measured in routine patient care and in research studies. We aimed to investigate the agreement betwe ... Full text Link to item Cite

Design and analysis of outcomes following SARS-CoV-2 infection in veterans.

Journal Article BMC Med Res Methodol · April 4, 2023 BACKGROUND: Understanding how SARS-CoV-2 infection impacts long-term patient outcomes requires identification of comparable persons with and without infection. We report the design and implementation of a matching strategy employed by the Department of Vet ... Full text Link to item Cite

Racial inequality in functional trajectories between Black and White U.S. veterans.

Journal Article J Am Geriatr Soc · April 2023 BACKGROUND: Racial inequality in functional trajectories has been well documented in the U.S. civilian population but has not been explored among Veterans. Our objectives were to: (1) assess how functional trajectories differed for Black and White Veterans ... Full text Link to item Cite

Changes in Fall Rates From Before to During the COVID-19 Pandemic: Findings From the Prospective AMBROSIA Study.

Journal Article J Gerontol A Biol Sci Med Sci · March 30, 2023 BACKGROUND: Coronavirus disease 2019 (COVID-19) social distancing policies resulted in reductions in community movement, however, fall rates during this time have not been described. METHODS: This prospective study included adults ≥65 years old participati ... Full text Link to item Cite

Rates of and Factors Associated With Primary and Booster COVID-19 Vaccine Receipt by US Veterans, December 2020 to June 2022.

Journal Article JAMA Netw Open · February 1, 2023 IMPORTANCE: COVID-19 vaccination rates remain suboptimal in the US. Identifying factors associated with vaccination can highlight existing gaps and guide targeted interventions to improve vaccination access and uptake. OBJECTIVE: To describe incidence and ... Full text Link to item Cite

Comprehension, Utility, and Acceptability of a Multidomain Physical Functioning Report for Systemic Lupus Erythematosus Patients and Their Providers.

Journal Article Arthritis Care Res (Hoboken) · January 2023 OBJECTIVE: Patient-provider discussions about functioning are often outside the scope of usual care for systemic lupus erythematosus (SLE), and tools to facilitate such discussions are lacking. The present study was undertaken to assess the comprehension, ... Full text Link to item Cite

Reserve and resilience in CKD: concept introduction and baseline results from the Physical REsilience Prediction in Advanced REnal Disease (PREPARED) study.

Journal Article BMC Nephrol · December 31, 2022 BACKGROUND: The purpose of this manuscript is to introduce reserve and resilience as novel concepts in chronic kidney disease (CKD) research and present baseline data from a unique prospective cohort study designed to characterize recovery from functional ... Full text Link to item Cite

Effectiveness of mRNA COVID-19 Vaccine Boosters Against Infection, Hospitalization, and Death: A Target Trial Emulation in the Omicron (B.1.1.529) Variant Era.

Journal Article Ann Intern Med · December 2022 BACKGROUND: The effectiveness of a third mRNA COVID-19 vaccine dose (booster dose) against the Omicron (B.1.1.529) variant is uncertain, especially in older, high-risk populations. OBJECTIVE: To determine mRNA booster vaccine effectiveness (VE) against SAR ... Full text Link to item Cite

Consensus elements for observational research on COVID-19-related long-term outcomes.

Journal Article Medicine (Baltimore) · November 18, 2022 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its long-term outcomes may be jointly caused by a wide range of clinical, social, and economic characteristics. Studies aiming to identify mechanisms for SARS-CoV-2 morbidity and mo ... Full text Link to item Cite

Complexity and Challenges of the Clinical Diagnosis and Management of Long COVID.

Journal Article JAMA Netw Open · November 1, 2022 IMPORTANCE: There is increasing recognition of the long-term health effects of SARS-CoV-2 infection (sometimes called long COVID). However, little is yet known about the clinical diagnosis and management of long COVID within health systems. OBJECTIVE: To d ... Full text Link to item Cite

Cognitive Problems and Their Clinical Assessment in Systemic Lupus Erythematosus: Contrasting Patient and Provider Views.

Journal Article Arthritis Care Res (Hoboken) · September 2022 OBJECTIVE: Systemic lupus erythematosus (SLE) is a complex chronic disease associated with reduced cognitive functioning. Patients with SLE report cognitive symptoms, but cognitive assessment is not routine in SLE and little is known about day-to-day cogni ... Full text Link to item Cite

Rates and Factors Associated With Documentation of Diagnostic Codes for Long COVID in the National Veterans Affairs Health Care System.

Journal Article JAMA network open · July 2022 ImportanceSome persons infected with SARS-CoV-2 experience symptoms or impairments many months after acute infection.ObjectivesTo determine the rates, clinical setting, and factors associated with documented receipt of COVID-19-related ca ... Full text Cite

Age-Specific Prevalence and Factors Associated With Normal Blood Pressure Among US Adults.

Journal Article Am J Hypertens · April 2, 2022 BACKGROUND: The mean systolic blood pressure (SBP) for US adults increases with age. Determining characteristics of US adults ≥65 years with normal blood pressure (BP) may inform approaches to prevent this increase. METHODS: We analyzed US National Health ... Full text Link to item Cite

Unintended Consequences of COVID-19 Social Distancing Among Older Adults With Kidney Disease.

Journal Article The journals of gerontology. Series A, Biological sciences and medical sciences · April 2022 BackgroundWhile social distancing policies protect older adults with advanced chronic kidney disease (CKD) from exposure to COVID-19, reduced social interaction may also have unintended consequences.MethodsTo identify subgroups of patient ... Full text Cite

Insomnia Diagnosis, Prescribed Hypnotic Medication Use, and Risk for Serious Fall Injuries In the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.

Journal Article Sleep · March 11, 2022 STUDY OBJECTIVES: Insomnia is common among older adults and associated with an increased risk for falls. Determining if falls are more strongly associated with insomnia or prescribed hypnotic medications could be used to guide interventions to reduce falls ... Full text Link to item Cite

Association of COVID-19 pandemic-related concern and health routine changes with functioning among individuals with systemic lupus erythematosus.

Journal Article Lupus Sci Med · February 2022 OBJECTIVE: To examine whether pandemic-related issues were associated with physical functioning, community mobility and cognition among individuals with SLE. METHODS: Participants were recruited (6 October 2020-11 November 2021) for this cross-sectional st ... Full text Link to item Cite

The potential of mHealth for older adults on dialysis and their care partners: What's been done and where do we go from here?

Journal Article Front Nephrol · 2022 Self-care, or the dynamic, daily process of becoming actively involved in one's own care, is paramount to prevent and manage complications of end-stage kidney disease. However, many older dialysis patients face distinctive challenges to adequate engagement ... Full text Link to item Cite

Sustained SBP control and long-term nursing home admission among Medicare beneficiaries.

Journal Article J Hypertens · November 1, 2021 OBJECTIVES: Sustaining SBP control reduces the risk for cardiovascular events that impair function but its association with nursing home admission has not been well studied. METHODS: We conducted an analysis of sustained SBP control and long-term nursing h ... Full text Link to item Cite

Changes in the associations of race and rurality with SARS-CoV-2 infection, mortality, and case fatality in the United States from February 2020 to March 2021: A population-based cohort study.

Journal Article PLoS Med · October 2021 BACKGROUND: We examined whether key sociodemographic and clinical risk factors for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and mortality changed over time in a population-based cohort study. METHODS AND FINDINGS: In a cohort ... Full text Link to item Cite

Association of Sustained Blood Pressure Control with Lower Risk for High-Cost Multimorbidities Among Medicare Beneficiaries in ALLHAT.

Journal Article J Gen Intern Med · August 2021 BACKGROUND: Clustering of chronic conditions is associated with high healthcare costs. Sustaining blood pressure (BP) control could be a strategy to prevent high-cost multimorbidity clusters. OBJECTIVE: To determine the association between sustained systol ... Full text Link to item Cite

Blood Pressure Control Among Older Adults With Hypertension: Narrative Review and Introduction of a Framework for Improving Care.

Journal Article American journal of hypertension · April 2021 Although antihypertensive medications are effective, inexpensive, and recommended by clinical practice guidelines, a large percentage of older adults with hypertension have uncontrolled blood pressure (BP). Improving BP control in this population may requi ... Full text Cite

Patient and provider perceptions of a novel cognitive functioning report for patients with systemic lupus erythematosus: a qualitative study.

Journal Article Lupus Sci Med · February 2021 OBJECTIVE: To determine whether and how cognitive assessment data should be included in a report for patients with SLE and their providers. METHODS: Leveraging experiences from prior studies, we created a cognitive report that included a hypothetical patie ... Full text Link to item Cite

Kidney Disease

Chapter · January 1, 2021 Chronic kidney disease (CKD) is common among older adults and associated with adverse health outcomes. Despite the high burden of CKD at older ages, the general approach to kidney disease is based on evidence from young and middle-aged adults and may not a ... Full text Cite

Association of Sustained Blood Pressure Control with Multimorbidity Progression Among Older Adults.

Journal Article J Am Geriatr Soc · September 2020 BACKGROUND/OBJECTIVES: Due to the high costs and excess mortality associated with multimorbidity, there is a need to develop approaches for delaying its progression. High blood pressure (BP) is a common chronic condition and a risk factor for many addition ... Full text Link to item Cite

Association of Poverty Income Ratio with Physical Functioning in a Cohort of Patients with Systemic Lupus Erythematosus.

Conference J Rheumatol · July 1, 2020 OBJECTIVE: To examine the association of income relative to the poverty threshold [poverty income ratio (PIR)] with self-reported physical functioning (PF) in a cohort of patients with systemic lupus erythematosus. METHODS: We used cross-sectional data on ... Full text Link to item Cite

Association of peripheral artery disease with life-space mobility restriction and mortality in community-dwelling older adults.

Journal Article J Vasc Surg · June 2020 OBJECTIVE: Symptomatic peripheral artery disease (PAD) impairs walking, but data on the impact of PAD on community mobility is limited. Life-space mobility measures the distance, frequency, and assistance needed as older adults move through geographic area ... Full text Link to item Cite

A Novel Approach to Developing a Discordance Index for Older Adults With Chronic Kidney Disease.

Journal Article J Gerontol A Biol Sci Med Sci · February 14, 2020 BACKGROUND: Older adults with chronic kidney disease (CKD)-discordant conditions (comorbid conditions with treatment recommendations that potentially complicate CKD management) have higher risk of hospitalization and death. Our goal is to develop a CKD-Dis ... Full text Link to item Cite

Delivery of a patient-friendly functioning report to improve patient-centeredness of dialysis care: a pilot study.

Journal Article BMC Health Serv Res · November 27, 2019 BACKGROUND: Provider recognition of level of functioning may be suboptimal in the dialysis setting, and this lack of recognition may lead to less patient-centered care. We aimed to assess whether delivery of an app-based, individualized functioning report ... Full text Link to item Cite

Prevalence of Activity Limitations and Association with Multimorbidity Among US Adults 50 to 64 Years Old.

Journal Article J Gen Intern Med · November 2019 BACKGROUND: Functional limitations may be more common in middle-aged adults than previously recognized. However, there are few published data on the prevalence of activity limitations, and their association with multimorbidity, among adults 50 to 64 years ... Full text Link to item Cite

Targeting Fall Risk in CKD.

Journal Article Clin J Am Soc Nephrol · July 5, 2019 Full text Link to item Cite

Shared patient and provider values in end-stage renal disease decision making: Identifying the tensions.

Journal Article Patient Educ Couns · July 2019 OBJECTIVE: To examine concordance and tensions in values among stakeholder groups across the shared decision making process for end-stage renal disease patients treated with hemodialysis. METHODS: A thematic analysis of transcripts from three stakeholder g ... Full text Link to item Cite

Recent History of Serious Fall Injuries and Posttransplant Outcomes Among US Kidney Transplant Recipients.

Journal Article Transplantation · May 2019 BACKGROUND: Serious fall injuries are associated with poor outcomes among dialysis patients, but whether these associations hold in patients with a history of serious fall injury before kidney transplantation is unknown. METHODS: In national administrative ... Full text Link to item Cite

Sustained blood pressure control and coronary heart disease, stroke, heart failure, and mortality: An observational analysis of ALLHAT.

Journal Article J Clin Hypertens (Greenwich) · April 2019 Achieving blood pressure (BP) control is associated with lower cardiovascular disease (CVD) risk, but less is known about CVD risk associated with sustained BP control over time. This observational analysis of the Antihypertensive and Lipid-Lowering Treatm ... Full text Link to item Cite

COGNITIVE FUNCTION AND DEPRESSION IN PATIENTS WITH FIBROMUSCULAR DYSPLASIA

Conference Journal of the American College of Cardiology · March 2019 Full text Cite

The 5Ts: Preliminary Development of a Framework to Support Inclusion of Older Adults in Research.

Journal Article J Am Geriatr Soc · February 2019 BACKGROUND/OBJECTIVES: To address the underrepresentation of older adults in clinical research, the National Institutes of Health will require investigators to include individuals across the lifespan. As investigators from other fields endeavor to recruit ... Full text Link to item Cite

Geriatric Assessment of Physical and Cognitive Functioning in a Diverse Cohort of Systemic Lupus Erythematosus Patients: A Pilot Study.

Journal Article Arthritis Care Res (Hoboken) · October 2018 OBJECTIVE: To use multidomain functional assessment, which is commonly performed in geriatric patients but is novel in patients with systemic lupus erythematosus (SLE), to better understand functional impairment in patients with SLE. METHODS: We recruited ... Full text Link to item Cite

Serious Fall Injury History and Adverse Health Outcomes After Initiating Hemodialysis Among Older U.S. Adults.

Journal Article J Gerontol A Biol Sci Med Sci · August 10, 2018 BACKGROUND: Although older adults with predialysis chronic kidney disease are at higher risk for falls, the prognostic significance of a serious fall injury prior to dialysis initiation has not been well described in the end-stage renal disease population. ... Full text Link to item Cite

Patient discourse on chronic kidney disease monitoring: a qualitative study at a Veterans Affairs Renal Clinic.

Journal Article BMC Nephrol · July 19, 2018 BACKGROUND: Knowing how chronic kidney disease (CKD) patients talk about their encounters with providers (i.e., their discourse) can inform the important clinical goal of engaging patients in their chronic disease self-management. The aim of this study was ... Full text Link to item Cite

Association of Serious Fall Injuries among United States End Stage Kidney Disease Patients with Access to Kidney Transplantation.

Journal Article Clin J Am Soc Nephrol · April 6, 2018 BACKGROUND AND OBJECTIVES: Serious fall injuries in the setting of ESKD may be associated with poor access to kidney transplant. We explored the burden of serious fall injuries among patients on dialysis and patients on the deceased donor waitlist and the ... Full text Link to item Cite

Perceived stress and reported cognitive symptoms among Georgia patients with systemic lupus erythematosus.

Journal Article Lupus · September 2017 Objective To examine associations of perceived stress with cognitive symptoms among adults with systemic lupus erythematosus (SLE). Methods Among 777 adult (≥18 years) SLE patients, the association of Perceived Stress Scale (PSS) scores with two self-repor ... Full text Link to item Cite

Blood Pressure, Antihypertensive Polypharmacy, Frailty, and Risk for Serious Fall Injuries Among Older Treated Adults With Hypertension.

Journal Article Hypertension · August 2017 Antihypertensive medication and low systolic blood pressure (BP) and diastolic BP have been associated with an increased falls risk in some studies. Many older adults have indicators of frailty, which may increase their risk for falls. We contrasted the as ... Full text Link to item Cite

Serious Fall Injuries Before and After Initiation of Hemodialysis Among Older ESRD Patients in the United States: A Retrospective Cohort Study.

Journal Article Am J Kidney Dis · July 2017 BACKGROUND: Because initiation of dialysis therapy often occurs in the setting of acute illness and may signal worsening health and functional decline, we examined whether rates of serious fall injuries among older hemodialysis patients differ before and a ... Full text Link to item Cite

Older Patients' Perspectives on Managing Complexity in CKD Self-Management.

Journal Article Clin J Am Soc Nephrol · April 3, 2017 BACKGROUND AND OBJECTIVES: Patients with CKD are asked to perform self-management tasks including dietary changes, adhering to medications, avoiding nephrotoxic drugs, and self-monitoring hypertension and diabetes. Given the effect of aging on functional c ... Full text Link to item Cite

Association of Multimorbidity with Mortality and Healthcare Utilization in Chronic Kidney Disease.

Journal Article J Am Geriatr Soc · April 2017 OBJECTIVES: Chronic kidney disease (CKD) almost universally occurs in individuals with other medical problems. However, few studies have described CKD-related multimorbidity using a framework that identifies chronic conditions as concordant (having overlap ... Full text Link to item Cite

Kidney Disease in the Elderly

Chapter · January 1, 2017 This chapter describes the high prevalence of chronic kidney disease in older adults, age differences in rates of progression to end-stage renal disease, clinical significance of moderate reductions in estimated glomerular filtration rate in older adults, ... Full text Cite

Association of Nondisease-Specific Problems with Mortality, Long-Term Care, and Functional Impairment among Older Adults Who Require Skilled Nursing Care after Dialysis Initiation.

Journal Article Clin J Am Soc Nephrol · December 7, 2016 BACKGROUND AND OBJECTIVES: The majority of older adults who initiate dialysis do so during a hospitalization, and these patients may require post-acute skilled nursing facility (SNF) care. For these patients, a focus on nondisease-specific problems, includ ... Full text Link to item Cite

Incorporating Geriatric Assessment into a Nephrology Clinic: Preliminary Data from Two Models of Care.

Journal Article J Am Geriatr Soc · October 2016 Older adults with advanced chronic kidney disease (CKD) experience functional impairment that can complicate CKD management. Failure to recognize functional impairment may put these individuals at risk of further functional decline, nursing home placement, ... Full text Link to item Cite

OS 16-06 RISK FACTORS FOR SERIOUS FALL INJURIES FOLLOWING INITIATION OF ANTIHYPERTENSIVE MEDICATION.

Journal Article J Hypertens · September 2016 OBJECTIVE: To identify risk factors for serious fall injuries following initiation of antihypertensive medication among older adults. DESIGN AND METHOD: We conducted a retrospective cohort study using a 5% random sample of people with Medicare health insur ... Full text Link to item Cite

Association of Reduced eGFR and Albuminuria with Serious Fall Injuries among Older Adults.

Journal Article Clin J Am Soc Nephrol · July 7, 2016 BACKGROUND AND OBJECTIVES: Falls are common and associated with adverse outcomes in patients on dialysis. Limited data are available in earlier stages of CKD. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We analyzed data from 8744 Reasons for Geographic ... Full text Link to item Cite

Short-Term Risk of Serious Fall Injuries in Older Adults Initiating and Intensifying Treatment With Antihypertensive Medication.

Journal Article Circ Cardiovasc Qual Outcomes · May 2016 BACKGROUND: Antihypertensive medication use has been associated with an increased risk of falls in some but not all studies. Few data are available on the short-term risk of falls after antihypertensive medication initiation and intensification. METHODS AN ... Full text Link to item Cite

Caring for patients with kidney disease: shifting the paradigm from evidence-based medicine to patient-centered care.

Journal Article Nephrol Dial Transplant · March 2016 The last several decades have witnessed the emergence of evidence-based medicine as the dominant paradigm for medical teaching, research and practice. Under an evidence-based approach, populations rather than individuals become the primary focus of investi ... Full text Link to item Cite

The role of cystatin-C in the confirmation of reduced glomerular filtration rate among the oldest old.

Journal Article Arch Med Sci · February 1, 2016 INTRODUCTION: Current guidelines suggest using cystatin-C to confirm a reduced creatinine-based estimated glomerular filtration rate (eGFRcr) when the latter is thought to be inaccurate. Older adults have reduced muscle mass, which may affect the accuracy ... Full text Link to item Cite

White-Coat Effect Among Older Adults: Data From the Jackson Heart Study.

Journal Article J Clin Hypertens (Greenwich) · February 2016 Many adults with elevated clinic blood pressure (BP) have lower BP when measured outside the clinic. This phenomenon, the "white-coat effect," may be larger among older adults, a population more susceptible to the adverse effects of low BP. The authors ana ... Full text Link to item Cite

Association of age with health-related quality of life in a cohort of patients with systemic lupus erythematosus: the Georgians Organized Against Lupus study.

Journal Article Lupus Sci Med · 2016 OBJECTIVE: To examine whether older age was associated with lower health-related quality of life (HRQOL) among patients with systemic lupus erythematosus (SLE) and whether differential disease-related damage and activity explained these associations. METHO ... Full text Link to item Cite

Kidney disease

Chapter · January 1, 2016 Chronic kidney disease (CKD) is common among older adults and associated with adverse health outcomes. Despite the high burden of CKD at older ages, the general approach to kidney disease is based on evidence from young and middle-aged adults and may not a ... Full text Cite

The Utility of Ambulatory Blood Pressure Monitoring for Diagnosing White Coat Hypertension in Older Adults.

Journal Article Curr Hypertens Rep · November 2015 The beneficial effect of antihypertensive medication on reducing the risk of cardiovascular disease (CVD) events is supported by data from randomized controlled trials of older adults with hypertension. However, in clinical practice, overtreatment of hyper ... Full text Link to item Cite

Effect of Falls on Frequency of Atrial Fibrillation and Mortality Risk (from the REasons for Geographic And Racial Differences in Stroke Study).

Journal Article Am J Cardiol · October 15, 2015 It is unclear if patients who have atrial fibrillation (AF) have a greater fall risk compared with those in the general population and if falls increase mortality beyond that observed in AF. A total of 24,117 (mean age 65 ± 9.3 years; 55% women; 38% black) ... Full text Link to item Cite

Underreporting of nursing home utilization on the CMS-2728 in older incident dialysis patients and implications for assessing mortality risk.

Journal Article BMC Nephrol · March 21, 2015 BACKGROUND: The usage of nursing home (NH) services is a marker of frailty among older adults. Although the Centers for Medicare & Medicaid Services (CMS) revised the Medical Evidence Report Form CMS-2728 in 2005 to include data collection on NH institutio ... Full text Link to item Cite

Validation study of medicare claims to identify older US adults with CKD using the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study.

Journal Article Am J Kidney Dis · February 2015 BACKGROUND: Health care claims data may provide a cost-efficient approach for studying chronic kidney disease (CKD). STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: We compared characteristics and outcomes for individuals with CKD defined u ... Full text Link to item Cite

Nondisease-specific problems and all-cause mortality among older adults with CKD: the REGARDS Study.

Journal Article Clin J Am Soc Nephrol · October 7, 2014 BACKGROUND AND OBJECTIVES: The term "nondisease-specific" has been used to describe problems that cross multiple domains of health and are not necessarily the result of a single underlying disease. Although individuals with reduced eGFR and elevated albumi ... Full text Link to item Cite

Systolic blood pressure goals to reduce cardiovascular disease among older adults.

Journal Article Am J Med Sci · August 2014 The 2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults Report From the Panel Members Appointed to the Eighth Joint National Committee (JNC 8) was recently published. This guideline recommended that older adults (≥60 years) wi ... Full text Link to item Cite

Prevalence, trends and functional impairment associated with reduced estimated glomerular filtration rate and albuminuria among the oldest-old U.S. adults.

Journal Article Am J Med Sci · August 2014 BACKGROUND: The prevalence of reduced estimated glomerular filtration rate (eGFR) among U.S. adults aged 80 years and older increased between 1988 to 1994 and 2005 to 2010. Trends in the prevalence of albuminuria over this time period have not been reporte ... Full text Link to item Cite

Incident ESRD and treatment-resistant hypertension: the reasons for geographic and racial differences in stroke (REGARDS) study.

Journal Article Am J Kidney Dis · May 2014 BACKGROUND: Studies suggest that treatment-resistant hypertension is common and increasing in prevalence among US adults. Although hypertension is a risk factor for end-stage renal disease (ESRD), few data are available for the association between treatmen ... Full text Link to item Cite

Trends in hypertension prevalence, awareness, treatment, and control among US adults 80 years and older, 1988-2010.

Journal Article J Clin Hypertens (Greenwich) · April 2014 The authors examined trends in systolic blood pressure (SBP) and diastolic blood pressure (DBP) and the prevalence, awareness, treatment, and control of hypertension in 1988-1994 (n=1164), 1999-2004 (n=1,026), and 2005-2010 (n=1048) among US adults 80 year ... Full text Link to item Cite

Community mobility among older adults with reduced kidney function: a study of life-space.

Journal Article Am J Kidney Dis · March 2014 BACKGROUND: Life-Space Assessment captures community mobility and social participation and quantifies the distance, frequency, and independence obtained as an older adult moves through his or her environment. Reduced estimated glomerular filtration rate (e ... Full text Link to item Cite

Prevalence of frailty indicators and association with socioeconomic status in middle-aged and older adults in a swiss region with universal health insurance coverage: a population-based cross-sectional study.

Journal Article J Aging Res · 2014 Frailty prevalence in older adults has been reported but is largely unknown in middle-aged adults. We determined the prevalence of frailty indicators among middle-aged and older adults from a general Swiss population characterized by universal health insur ... Full text Link to item Cite

Correlates of ADL difficulty in a large hemodialysis cohort.

Journal Article Hemodial Int · January 2014 Needing assistance with activities of daily living (ADL) is an early indicator of functional decline and has important implications for individuals' quality of life. However, correlates of need for ADL assistance have received limited attention among patie ... Full text Link to item Cite

Prevalence of apparent treatment-resistant hypertension among individuals with CKD.

Journal Article Clin J Am Soc Nephrol · September 2013 BACKGROUND AND OBJECTIVES: Apparent treatment-resistant hypertension is defined as systolic/diastolic BP ≥ 140/90 mmHg with concurrent use of three or more antihypertensive medication classes or use of four or more antihypertensive medication classes regar ... Full text Link to item Cite

Effects of enalapril in systolic heart failure patients with and without chronic kidney disease: insights from the SOLVD Treatment trial.

Journal Article Int J Cardiol · July 15, 2013 BACKGROUND: Angiotensin-converting enzyme inhibitors improve outcomes in systolic heart failure (SHF). However, doubts linger about their effect in SHF patients with chronic kidney disease (CKD). METHODS: In the Studies of Left Ventricular Dysfunction (SOL ... Full text Link to item Cite

Low hemoglobin levels and recurrent falls in U.S. men and women: prospective findings from the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort.

Journal Article Am J Med Sci · June 2013 BACKGROUND: There are few data available on low hemoglobin and incident falls in the general U.S. population. METHODS: Of 30,239 black and white U.S. adults ≥45 years in the population-based REasons for Geographic And Racial Differences in Stroke study, 16 ... Full text Link to item Cite

Nondisease-specific problems and all-cause mortality in the REasons for Geographic and Racial Differences in Stroke study.

Journal Article J Am Geriatr Soc · May 2013 OBJECTIVES: To evaluate the association between six nondisease-specific problems (problems that cross multiple domains of health) and mortality in middle-aged and older adults. DESIGN: Prospective, observational cohort. SETTING: U.S. population sample. PAR ... Full text Link to item Cite

Geographic variation in CKD prevalence and ESRD incidence in the United States: results from the reasons for geographic and racial differences in stroke (REGARDS) study.

Journal Article Am J Kidney Dis · March 2013 BACKGROUND: It is not known whether geographic differences in the prevalence of chronic kidney disease exist and are associated with end-stage renal disease (ESRD) incidence rates across the United States. STUDY DESIGN: Cross-sectional and ecologic. SETTIN ... Full text Link to item Cite

Kidney disease in the elderly

Chapter · January 1, 2013 Full text Cite

Metabolic complications in elderly adults with CKD.

Journal Article Am J Kidney Dis · December 2012 Full text Link to item Cite

Epidemiology of chronic kidney disease among older adults: a focus on the oldest old.

Journal Article J Gerontol A Biol Sci Med Sci · December 2012 The National Kidney Foundation (NKF), Kidney Disease Outcomes Quality Initiative (KDOQI) Clinical Practice Guidelines for Chronic Kidney Disease: Evaluation, Classification, and Stratification expanded the focus of chronic kidney disease (CKD) management f ... Full text Link to item Cite

Impairment of activities of daily living and incident heart failure in community-dwelling older adults.

Journal Article Eur J Heart Fail · June 2012 AIMS: Instrumental activities of daily living (IADLs) are tasks that are necessary for independent community living. These tasks often require intact physical and cognitive function, the impairment of which may adversely affect health in older adults. In t ... Full text Link to item Cite

Managing older adults with CKD: individualized versus disease-based approaches.

Journal Article Am J Kidney Dis · February 2012 The last decade has seen the evolution and ongoing refinement of a disease-oriented approach to chronic kidney disease (CKD). Disease-oriented models of care assume a direct causal association between observed signs and symptoms and underlying disease path ... Full text Link to item Cite

Age-specific associations of reduced estimated glomerular filtration rate with concurrent chronic kidney disease complications.

Journal Article Clin J Am Soc Nephrol · December 2011 BACKGROUND AND OBJECTIVES: It has been suggested that moderate reductions in estimated GFR (eGFR) among older adults may not reflect chronic kidney disease (CKD). DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We examined age-specific (<60, 60 to 69, 70 to ... Full text Link to item Cite

Age-specific association of reduced estimated glomerular filtration rate and albuminuria with all-cause mortality.

Journal Article Clin J Am Soc Nephrol · September 2011 BACKGROUND AND OBJECTIVES: It has been suggested that reduced estimated GFR (eGFR) among older adults does not necessarily reflect a pathologic phenomenon. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We examined the association between eGFR and albumin- ... Full text Link to item Cite

Impact of chronic kidney disease on activities of daily living in community-dwelling older adults.

Journal Article J Gerontol A Biol Sci Med Sci · June 2011 BACKGROUND: Although chronic kidney disease (CKD) is associated with poor physical function, less is known about the longitudinal association between CKD and the decline of instrumental activities of daily living (IADL) and basic activities of daily living ... Full text Link to item Cite

Relationship between stage of kidney disease and incident heart failure in older adults.

Journal Article Am J Nephrol · 2011 BACKGROUND: The relationship between stage of chronic kidney disease (CKD) and incident heart failure (HF) remains unclear. METHODS: Of the 5,795 community-dwelling adults ≥65 years in the Cardiovascular Health Study, 5,450 were free of prevalent HF and ha ... Full text Link to item Cite

Hypokalemia and outcomes in patients with chronic heart failure and chronic kidney disease: findings from propensity-matched studies.

Journal Article Circ Heart Fail · March 2010 BACKGROUND: Little is known about the effects of hypokalemia on outcomes in patients with chronic heart failure (HF) and chronic kidney disease. METHODS AND RESULTS: Of the 7788 patients with chronic HF in the Digitalis Investigation Group trial, 2793 had ... Full text Link to item Cite