Hyperkyphosis is a widely recognized yet largely ignored condition. Although there are no uniform diagnostic criteria for hyperkyphosis, current studies estimate its prevalence among older adults at 20% to 40%. The causes and consequences of hyperkyphosis are not well understood. Some physicians think that fractures cause hyperkyphosis and that management strategies should focus solely on diagnosis and treatment for osteoporosis. Recent studies, however, demonstrate that many older adults who are most affected by hyperkyphosis do not have vertebral fractures. Hyperkyphosis may be independently associated with an increased risk for adverse health outcomes, including impaired pulmonary function, decreased physical function capabilities, and future fractures. With the growing older population, we now need research that leads to a deeper understanding of the causes, consequences, and treatment of this common condition.

The present study examines language samples from the Nun Study. Measures of grammatical complexity and idea density were obtained from autobiographies written over a 60-year span. Participants who had met criteria for dementia were contrasted with those who did not. Grammatical complexity initially averaged 4.78 (on a 0-to-7-point scale) for participants who did not meet criteria for dementia and declined .04 units per year; grammatical complexity for participants who met criteria for dementia initially averaged 3.86 and declined .03 units per year. Idea density averaged 5.35 propositions per 10 words initially for participants who did not meet criteria for dementia and declined an average of .03 units per year, whereas idea density averaged 4.34 propositions per 10 words initially for participants who met criteria for dementia and declined .02 units per year. Adult experiences, in general, did not moderate these declines.

Objectives Determine the relationship of clinically diagnosed catheter-associated urinary tract infection (CAUTI) to standardized criteria and assess microorganism-level differences in symptom burden in a cohort of catheterized nursing home (NH) residents. Design Post-hoc analysis of a prospective longitudinal study. Setting Twelve NHs in Southeast Michigan. Participants 233 NH residents with indwelling urinary catheters. Measurements Clinical and demographic data, including CAUTI epidemiology and symptoms, were obtained at study enrollment, 14 days, and monthly thereafter for up to one year. Results One hundred twenty participants with an indwelling catheter (51%) were prescribed systemic antibiotics for 182 clinically diagnosed CAUTIs. Participants were predominantly white (90%), male (52%), with a mean age of 73.7 years. Common signs and symptoms were acute change in mental status (28%), fever (21%), and leukocytosis (13%). Forty percent of clinically diagnosed CAUTIs met Loeb’s minimum criteria, 32% met National Health Safety Network (NHSN) criteria, and 50% met either Loeb’s minimum or NHSN criteria. CAUTIs involving Staphylococcus aureus and Enterococcus spp. were least likely to meet criteria. CAUTIs involving K. pneumoniae were most likely to meet Loeb’s minimum criteria (OR=9.7 [95% CI, 2.3–40.3]), possibly due to an association with acute change in mental status (OR=5.9 [95% CI, 1.8–19.4]). Conclusion Fifty percent of clinically diagnosed CAUTIs met standardized criteria, which represents an improvement in antibiotic prescribing practices. At the microorganism-level, our exploratory data indicates that symptom burden may differ between microorganisms. Exploration of CAUTI signs and symptoms associated with specific microorganisms may yield beneficial information to refine existing tools guiding appropriate antibiotic treatment.

It is in the public interest to address augmented reality games before social norms develop that encourage unsafe practices. Now is the time to develop appropriate controls.