When It Comes to Older Adults, Language Matters: <i>Journal of the American Geriatrics Society</i> Adopts Modified American Medical Association Style

Lundebjerg, Nancy E.; Trucil, Daniel E.; Hammond, Emily C.; Applegate, William B.

doi:10.1111/jgs.14941

Cited by 80 publications

(77 citation statements)

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“…In response to this type of concern, the Journal of the American Geriatrics Society recently changed its author guidelines to curb the use of negative, even catastrophic, aging-related terms (such as the common metaphor of the silver “tsunami”), which have been determined to be damaging to perceptions of aging [48]. In our study, the metaphor of a “rickety car running out of gas”[37] to describe a person who is frail depecited undesirable, body-centric traits of deterioration.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the use of the term and the figurative language used to characterize “frailty” must be done with thoughtfulness and precision; otherwise, alternative terms to capture the notion of critical declines in age-related physical and cognitive functions may be warranted. The following passage reinforces this idea: “A new metaphor dramatically shifts perceptions of aging… by comparing the process of aging to building momentum, researchers as communicators can open a new way to thinking and talking about aging—something counter to currently available cultural idioms such as “fighting” aging or the importance of “staying young.” An innovative test of how messaging can affect people’s implicit associations showed that this metaphor reduced ageist attitudes by a remarkable 30%.” [48]…”

Section: Discussionmentioning

confidence: 99%

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The Use of Figurative Language to Describe Frailty in Older Adults

et al. 2018

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Introduction: Frailty affects 15% of non-institutionalized older adults in the United States, yet confusion remains in defining and, in turn, assessing frailty. Figurative language, such as metaphor, can help to explain difficult scientific concepts and to form new theories. We aimed to examine the use of figurative language to describe frailty and to identify themes in the way figurative expressions are used. Understanding how frailty is described figuratively may offer insights for developing useful communication approaches in research settings. Methods: We performed a comprehensive review of editorials in the scientific literature to explore figurative language used to describe frailty in older adults. We categorized themes among the figurative expressions, which may help to inform how to effectively communicate about frailty. Results: We found 24 editorials containing 32 figurative expressions. The figurative expressions conceptualized frailty in six ways: 1) a complex, multifaceted concept; 2) an important issue in health and medicine; 3) indicative of something that is failing or faulty; 4) indicative of fragility; 5) representative of vulnerable, ignored persons; and 6) an opportunity for self-awareness and reflection. Discussion: Our review highlights the heterogeneity in depictions of frailty, which is consonant with the lack of a standardized definition of frailty. We also found a novel aspect to the concept of frailty, which merits attention: frailty characterized as an opportunity for self-awareness and reflection. Figurative language, which often juxtaposes familiar with challenging, complex concepts, can offer insights on issues in frailty research and holds potential as a tool for researchers to improve communication about this important and debated medical condition.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The Use of Figurative Language to Describe Frailty in Older Adults

et al. 2018

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“…2,7 First, earlier this year (as summarized in JAGS), we sent a series of letters to President Trump and leaders in the Senate and House of Representatives conveying our interest in collaborating on federal programs and policies that are important to older adults. 7 In the letters, we adapted the "social justice frame" that FWI proposed.…”

Section: 3mentioning

confidence: 99%

“…Although the need for antibiotic stewardship in NHs is well recognized, effective and financially resourceful interventions specific to NHs are largely unknown and absent. 2 We applaud the authors for describing the prescribing pathway with regard to "upstream events" related to the diagnosis of the UTI and "downstream events" related to the appropriate treatment of the presumed UTI. 1 As the authors describe, diagnosing a UTI and deciding when to treat older adults is challenging and is often based on nonspecific signs and symptoms.…”

Section: 10mentioning

confidence: 99%

“…2 Our goal is to reduce our reliance on terms that might impede others from hearing what geriatrics experts have to say because of the language we use. 2,3 We are delighted to report that the Editors-in-Chief of our other AGS journals followed our lead, and we hope other journals will too. [4][5][6] We want to be clear that the AGS and its journals will not stop talking about age-related disability, frailty, functional limitations, multimorbidity, decline, and death.…”

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confidence: 99%

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Reply to: Language Matters, So Geriatricians Should Talk of Declining Health and Death

Lundebjerg

Trucil

Applegate

2017

J American Geriatrics Society

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Our editorial began a multiyear effort to reframe how policy-makers and the general public view older people. 2 Our goal is to reduce our reliance on terms that might impede others from hearing what geriatrics experts have to say because of the language we use. 2,3 We are delighted to report that the Editors-in-Chief of our other AGS journals followed our lead, and we hope other journals will too. [4][5][6] We want to be clear that the AGS and its journals will not stop talking about age-related disability, frailty, functional limitations, multimorbidity, decline, and death. Supporting frail older adults is the substance of what our members do and is the focus of our own policy and educational work. In this context, we see the LAO-FWI recommendations as an opportunity to become better communicators and potentially to reach a wider audience when sharing our work and the passion of our members. One clear message from the FWI reports is that the aging community needs to do a better job of meeting our audiences halfway by using language that resonates with average Americans and policy-makers and that invites them into the conversation as partners for meaningful change.2,3 That means remaining realistic about what aging entails, but it also means educating the general public using new techniques that can open doors to a new understanding of what "aging" really means. 2,3As we have worked with the LAO-FWI recommendations, we have learned that we may not be able to use all of the new frames available to us, and we have identified some adaptations that will serve us in good stead as we move into the next phase of this work.A couple examples of incremental adjustments we have made when contextualizing (or framing) aging to help our external audiences (policy-makers and the public) better hear what we have to say are in order.2,7 First, earlier this year (as summarized in JAGS), we sent a series of letters to President Trump and leaders in the Senate and House of Representatives conveying our interest in collaborating on federal programs and policies that are important to older adults. 7 In the letters, we adapted the "social justice frame" that FWI proposed. 3,8 That frame helped us convey a simple message: Supporting social justice for us all as we age is our best chance for ensuring that all older Americans can remain in their homes and communities. 7 We then examined our advocacy on behalf of the geriatrics workforce through the lens of the LAO-FWI collaboration. After reviewing FWI recommendations, we identified that our framing of workforce issues could be improved. 3 We found value in the "building momentum" metaphor that FWI proposed. This metaphor emphasizes that we can "gather momentum through the build-up of experience and insights" over time, which makes a compelling case for the important roles geriatrics healthcare professionals play in keeping health care attuned to concepts like frailty, which will play an increasingly significant role in quality care as more of us age. 9,10The AGS is committed to evolving...

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All-Cause and Cancer-Specific Death of Older Adults Following Surgery for Cancer

et al. 2021

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Cancer (RESTORE-Cancer) GroupIMPORTANCE Cancer care has inherent complexities in older adults, including balancing risks of cancer and noncancer death. A poor understanding of cause-specific outcomes may lead to overtreatment and undertreatment.OBJECTIVE To examine all-cause and cancer-specific death throughout 5 years for older adults after cancer resection. DESIGN, SETTING, AND PARTICIPANTSThis population-based cohort study was conducted in Ontario, Canada, using the administrative databases stored at ICES (formerly the Institute for Clinical Evaluative Sciences). All adults 70 years or older who underwent resection for a new diagnosis of cancer between January 1, 2007, and December 31, 2017, were included. Patients were followed up until death or censored at date of last contact of December 31, 2018. EXPOSURES Cancer resection.MAIN OUTCOME AND MEASURES Using a competing risks approach, the cumulative incidence of cancer and noncancer death was estimated and stratified by important prognostic factors. Multivariable subdistribution hazard models were fit to explore prognostic factors. RESULTSOf 82 037 older adults who underwent surgery (all older than 70 years; 52 119 [63.5%] female), 16 900 of 34 044 deaths (49.6%) were cancer related at a median (interquartile range) follow-up of 46 (23-80) months. At 5 years, estimated cumulative incidence of cancer death (20.7%; 95% CI, 20.4%-21.0%) exceeded noncancer death (16.5%; 95% CI, 16.2%-16.8%) among all patients. However, noncancer deaths exceeded cancer deaths starting at 3 years after surgery in breast, prostate, and melanoma skin cancers, patients older than 85 years, and those with frailty. Cancer type, advancing age, and frailty were independently associated with cause-specific death.CONCLUSIONS AND RELEVANCE At the population level, the relative burden of cancer deaths exceeds noncancer deaths for older adults selected for surgery. No subgroup had a higher burden of noncancer death early after surgery, even in more vulnerable patients. This cause-specific overall prognosis information should be used for patient counseling, to assess patterns of over-or undertreatment in older adults with cancer at the system level, and to guide targets for system-level improvements to refine selection criteria and perioperative care pathways for older adults with cancer.

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When It Comes to Older Adults, Language Matters: Journal of the American Geriatrics Society Adopts Modified American Medical Association Style

Cited by 80 publications

References 1 publication

The Use of Figurative Language to Describe Frailty in Older Adults

The Use of Figurative Language to Describe Frailty in Older Adults

Reply to: Language Matters, So Geriatricians Should Talk of Declining Health and Death

All-Cause and Cancer-Specific Death of Older Adults Following Surgery for Cancer

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