Cervical spondylotic myelopathy, or CSM, occurs when the spinal cord becomes compressed as people age and is the most common cause of spinal cord dysfunction worldwide. A PCORI-funded study -- conducted by a team at the Lahey Clinic in Massachusetts -- examined patient-reported outcomes one year after surgery among patients who received any of the three common surgical treatments for CSM. As reported in JAMA, compared with the other two types of surgery, patients with dorsal laminoplasty had better physical function and fewer problems from surgery. They were also less likely to report using opioids for pain, having imaging tests, and having ongoing physical therapy.

As reported in Depression and Anxiety, a research team at Wake Forest University found that cognitive behavioral therapy (CBT) and yoga were both effective at reducing worry and anxiety in older adults, while CBT improved sleep more than yoga. In the study, the team -- led by Gretchen Brenes, PhD -- assigned half of the older adults to CBT or yoga by chance; the other half chose between CBT and yoga. These results held regardless of whether the participants chose their treatment or were assigned treatment at random.

Age-related challenges—including memory loss, limited caregiver availability, or chronic conditions—can affect how older adults respond to treatment for cancer, but physicians sometimes aren’t aware of them. The COACH Study wanted to see if a report about issues related to a patient’s age would improve care-planning communication among the patient, caregiver, and doctor. As reported in JAMA Oncology, compared with patients without a report, patients who had one were engaged in and more satisfied with conversations with their physician.

In a paper in the New England Journal of Medicine, the PCORI- and National Institutes of Health-funded STRIDE Study reported that having nurses tailor and administer fall-prevention plans for older adults at high risk resulted in about an 8 percent to 10 percent reduction in serious fall injuries, but this effect was not statistically significant. The paper discusses potential barriers to care and other factors that could account for why a more significant reduction in serious fall injuries was not seen when risk-reduction strategies shown to be effective in previous studies were deployed this way in real-world circumstances and settings.

The first phase of this PCORI-funded study asked older adult patients and family caregivers which outcomes of transitions in care between different settings matter most to them, a question that previous research has not thoroughly explored. The study identified three outcomes: feeling prepared to implement their care plans, accountability from care settings, and feeling their healthcare providers care about them. These early findings are part of a larger, ongoing study.

The PCORI-funded PROSPER study compared outcomes of older adults who have atrial fibrillation and have had a stroke. In a new paper published in JAMA Neurology, the research team reports that patients who were prescribed direct oral anticoagulants when discharged from the hospital following a stroke had relatively better outcomes—including more days at home and fewer adverse events—than patients prescribed the blood thinner warfarin. This reinforces findings from prior research on the subject.