{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:58:11Z","timestamp":1753876691333,"version":"3.41.2"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T00:00:00Z","timestamp":1743638400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100008510","name":"University of Maryland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008510","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Institute for Clinical & Translational Research"},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Clinical Translational Science Award","award":["1UL1TR003098"],"award-info":[{"award-number":["1UL1TR003098"]}]},{"name":"Baltimore VA Medical Center Geriatric Research"},{"name":"National Institute of Aging","award":["AG028747"],"award-info":[{"award-number":["AG028747"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The COVID-19 pandemic has had a profound impact on older adults, particularly those with existing comorbidities. To inform targeted healthcare strategies for this heterogeneous group, this study seeks to analyze and compare mortality trends among various geriatric age groups within the Veterans Affairs healthcare system, both during the COVID-19 era and the pre-COVID era, while accounting for demographic and clinical factors such as age, gender, race, and comorbidities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this retrospective cohort study using Veterans Affairs Informatics and Computing Infrastructure data, two samples were analyzed: Veterans alive during the pre-COVID era (January 2019\u2014December 2019) and during the COVID era (January 2020\u2014December 2020). Propensity score matching was used to control for age, sex, race, body mass index, and comorbidities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The primary outcome was mortality. Odds ratios (ORs) and 95% confidence intervals were calculated to compare mortality across age groups. Unmatched analyses, adjusted for age, sex, race, body mass index, and comorbidities, showed that mortality significantly increased during the COVID era for age groups 70\u201379 (OR 1.38), 80\u201389 (OR 1.14), and 90\u201399 (OR 1.20), all with p values\u2005&amp;lt;\u20050.0001. No significant increase was observed in centenarians (OR 1.10, 95% confidence interval 0.90\u20131.35, p\u2005=\u2005.345). Matched analysis confirmed these findings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In a large cohort of older Veterans, COVID-19 had a significant impact on mortality in older adults aged 70\u201399, highlighting the need for targeted public health interventions. The lack of significant increase in mortality for centenarians is notable and warrants further study to identify possible protective factors in this unique population.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/gerona\/glaf051","type":"journal-article","created":{"date-parts":[[2025,4,3]],"date-time":"2025-04-03T11:14:35Z","timestamp":1743678875000},"source":"Crossref","is-referenced-by-count":0,"title":["Mortality Trends in Pre-COVID-19 and COVID-19 Eras Among Oldest Veterans"],"prefix":"10.1093","volume":"80","author":[{"given":"Jessica","family":"Palmer","sequence":"first","affiliation":[{"name":"Department of Medicine, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maithri","family":"Kondapaka","sequence":"additional","affiliation":[{"name":"Division of Palliative Medicine, Department of Medicine, MedStar Union Memorial Hospital , Baltimore, Maryland ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brock A","family":"Beamer","sequence":"additional","affiliation":[{"name":"Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]},{"name":"Baltimore Veterans Affairs (VA) Medical Center Geriatrics Research, Education and Clinical Center (GRECC) , Baltimore, Maryland ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tariq","family":"Siddiqui","sequence":"additional","affiliation":[{"name":"Baltimore Veterans Affairs (VA) Medical Center Geriatrics Research, Education and Clinical Center (GRECC) , Baltimore, Maryland ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2496-0965","authenticated-orcid":false,"given":"John D","family":"Sorkin","sequence":"additional","affiliation":[{"name":"Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]},{"name":"Baltimore Veterans Affairs (VA) Medical Center Geriatrics Research, Education and Clinical Center (GRECC) , Baltimore, Maryland ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilbur H","family":"Chen","sequence":"additional","affiliation":[{"name":"Center for Vaccine Development, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0755-1940","authenticated-orcid":false,"given":"Raya Elfadel","family":"Kheirbek","sequence":"additional","affiliation":[{"name":"Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]},{"name":"Baltimore Veterans Affairs (VA) Medical Center Geriatrics Research, Education and Clinical Center (GRECC) , Baltimore, Maryland ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,4,3]]},"reference":[{"volume-title":"Those Who Served: America\u2019s Veterans From World War II to the War on Terror","year":"2020","author":"Vespa","key":"2025060705260538800_CIT0001"},{"key":"2025060705260538800_CIT0002","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1016\/j.annepidem.2020.12.003","article-title":"Coronavirus disease 2019 in veterans receiving care at Veterans Health Administration facilities","volume":"55","author":"Luo","year":"2021","journal-title":"Ann Epidemiol."},{"issue":"21","key":"2025060705260538800_CIT0003","doi-asserted-by":"publisher","first-page":"3252","DOI":"10.1001\/archinte.160.21.3252","article-title":"Are patients at veterans affairs medical centers sicker? A comparative analysis of health status and medical resource use","volume":"160","author":"Agha","year":"2000","journal-title":"Arch Intern Med."},{"issue":"446","key":"2025060705260538800_CIT0004","first-page":"1","article-title":"COVID-19 mortality in adults aged 65 and over: United States, 2020","author":"Tejada-Vera","year":"2022","journal-title":"NCHS Data Brief"},{"key":"2025060705260538800_CIT0005","doi-asserted-by":"publisher","first-page":"101494","DOI":"10.1016\/j.arr.2021.101494","article-title":"Triple jeopardy in ageing: COVID-19, co-morbidities and inflamm-ageing","volume":"73","author":"Rea","year":"2022","journal-title":"Ageing Res Rev."},{"issue":"8","key":"2025060705260538800_CIT0006","doi-asserted-by":"publisher","first-page":"e24750","DOI":"10.1097\/MD.0000000000024750","article-title":"Clinical characteristics and outcome of patients aged over 80 years with Covid-19","volume":"100","author":"Capdevila-Reniu","year":"2021","journal-title":"Medicine (Baltim)."},{"issue":"17","key":"2025060705260538800_CIT0007","doi-asserted-by":"publisher","first-page":"5180","DOI":"10.3390\/jcm11175180","article-title":"Risk factors and mortality in elderly ARDS COVID-19 compared to patients without COVID-19","volume":"11","author":"Chiumello","year":"2022","journal-title":"J Clin Med"},{"issue":"12","key":"2025060705260538800_CIT0008","doi-asserted-by":"publisher","first-page":"2735","DOI":"10.1111\/jgs.16894","article-title":"COVID-19 in older adults: a series of 76 patients aged 85 years and older with COVID-19","volume":"68","author":"Vrillon","year":"2020","journal-title":"J Am Geriatr Soc."},{"issue":"22","key":"2025060705260538800_CIT0009","doi-asserted-by":"publisher","first-page":"6803","DOI":"10.3390\/jcm11226803","article-title":"COVID-19 clinical features and outcomes in elderly patients during six pandemic waves","volume":"11","author":"Fericean","year":"2022","journal-title":"J Clin Med"},{"issue":"1","key":"2025060705260538800_CIT0010","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1111\/ggi.14102","article-title":"COVID-19 in older adults: what are the differences with younger patients","volume":"21","author":"G\u00f3mez-Belda","year":"2021","journal-title":"Geriatr Gerontol Int"},{"issue":"5","key":"2025060705260538800_CIT0011","doi-asserted-by":"publisher","first-page":"e2312140","DOI":"10.1001\/jamanetworkopen.2023.12140","article-title":"Excess mortality among patients in the veterans affairs health system compared with the overall US population during the first year of the COVID-19 pandemic","volume":"6","author":"Weinberger","year":"2023","journal-title":"JAMA Netw Open"},{"key":"2025060705260538800_CIT0012","doi-asserted-by":"publisher","first-page":"100093","DOI":"10.1016\/j.lana.2021.100093","article-title":"County-level impact of the COVID-19 Pandemic on excess mortality among U.S. veterans: A population-based study","volume":"5","author":"Feyman","year":"2021","journal-title":"Lancet Reg. Health - Am"},{"article-title":"incident-specific annex to the VHA high consequence infection (HCI) base plan","year":"2020","author":"COVID-19 response plan","key":"2025060705260538800_CIT0013"},{"issue":"21","key":"2025060705260538800_CIT0014","doi-asserted-by":"publisher","first-page":"651","DOI":"10.15585\/mmwr.mm6921e1","article-title":"Universal and serial laboratory testing for SARS-CoV-2 at a long-term care skilled nursing facility for veterans\u2014Los Angeles, California, 2020","volume":"69","author":"Dora","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep."},{"issue":"1","key":"2025060705260538800_CIT0015","doi-asserted-by":"publisher","first-page":"115","DOI":"10.1016\/j.ajic.2020.10.022","article-title":"Halting a SARS-CoV-2 outbreak in a US veterans affairs nursing home","volume":"49","author":"Psevdos","year":"2021","journal-title":"Am J Infect Control."},{"journal-title":"COVID-19 Screening Tool. U.S Department of Veterans Affairs","year":"2021","key":"2025060705260538800_CIT0016"},{"issue":"10","key":"2025060705260538800_CIT0017","doi-asserted-by":"publisher","first-page":"e2128391","DOI":"10.1001\/jamanetworkopen.2021.28391","article-title":"Coverage and estimated effectiveness of mRNA COVID-19 vaccines among US veterans","volume":"4","author":"Young-Xu","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"3","key":"2025060705260538800_CIT0018","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1093\/jamia\/ocaa284","article-title":"Virtual care expansion in the veterans health administration during the COVID-19 pandemic: clinical services and patient characteristics associated with utilization","volume":"28","author":"Ferguson","year":"2021","journal-title":"J Am Med Inform Assoc."},{"issue":"1","key":"2025060705260538800_CIT0019","doi-asserted-by":"publisher","first-page":"e24502","DOI":"10.2196\/24502","article-title":"COVID-19-related hospitalization rates and severe outcomes among veterans from 5 veterans affairs medical centers: hospital-based surveillance study","volume":"7","author":"Cardemil","year":"2021","journal-title":"JMIR Public Health Surveill"},{"issue":"6","key":"2025060705260538800_CIT0020","doi-asserted-by":"publisher","first-page":"1448","DOI":"10.1111\/jgs.17127","article-title":"Trends in 30-day mortality from COVID-19 among older adults in the Veterans Affairs system","volume":"69","author":"Seligman","year":"2021","journal-title":"J Am Geriatr Soc"},{"key":"2025060705260538800_CIT0021","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1016\/j.annepidem.2022.04.003","article-title":"Hospitalization, mechanical ventilation, and case-fatality outcomes in US veterans with COVID-19 disease between years 2020\u20132021","volume":"70","author":"Luo","year":"2022","journal-title":"Ann Epidemiol"},{"issue":"5","key":"2025060705260538800_CIT0022","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1111\/ggi.14574","article-title":"The number of centenarians continues to increase during the COVID-19 pandemic in Japan","volume":"23","author":"Aoki","year":"2023","journal-title":"Geriatr Gerontol Int"},{"issue":"1","key":"2025060705260538800_CIT0023","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1007\/s40520-022-02287-6","article-title":"Centenarians born before 1919 are resistant to COVID-19","volume":"35","author":"Caruso","year":"2023","journal-title":"Aging Clin Exp Res."},{"issue":"5","key":"2025060705260538800_CIT0024","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1159\/000518905","article-title":"Centenarians and COVID-19: is there a link between longevity and better immune defense","volume":"68","author":"Kordowitzki","year":"2022","journal-title":"Gerontology."},{"issue":"18","key":"2025060705260538800_CIT0025","doi-asserted-by":"publisher","first-page":"21855","DOI":"10.18632\/aging.203577","article-title":"Centenarians exposed to the Spanish flu in their early life better survived to COVID-19","volume":"13","author":"Poulain","year":"2021","journal-title":"Aging (Albany NY)"},{"issue":"1","key":"2025060705260538800_CIT0026","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1186\/s12979-024-00450-3","article-title":"Centenarians, semi and supercentenarians, COVID-19 and Spanish flu: a serological assessment to gain insight into the resilience of older centenarians to COVID-19","volume":"21","author":"Trombetta","year":"2024","journal-title":"Immun Ageing"},{"issue":"1","key":"2025060705260538800_CIT0027","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1093\/epirev\/mxs013","article-title":"The epidemiology of longevity and exceptional survival","volume":"35","author":"Newman","year":"2013","journal-title":"Epidemiol Rev."},{"volume-title":"U.S. Department of Veterans Affairs","author":"VINCI Objectives","key":"2025060705260538800_CIT0028"},{"issue":"1","key":"2025060705260538800_CIT0029","doi-asserted-by":"publisher","first-page":"157","DOI":"10.23750\/abm.v91i1.9397","article-title":"WHO declares COVID-19 a pandemic","volume":"91","author":"Cucinotta","year":"2020","journal-title":"Acta Biomed."},{"issue":"1","key":"2025060705260538800_CIT0030","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1097\/00005650-199801000-00004","article-title":"Comorbidity measures for use with administrative data","volume":"36","author":"Elixhauser","year":"1998","journal-title":"Med Care."},{"issue":"7","key":"2025060705260538800_CIT0031","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1097\/MLR.0000000000000735","article-title":"Identifying increased risk of readmission and in-hospital mortality using hospital administrative data: the AHRQ Elixhauser Comorbidity Index","volume":"55","author":"Moore","year":"2017","journal-title":"Med Care."},{"issue":"6","key":"2025060705260538800_CIT0032","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1097\/MLR.0b013e31819432e5","article-title":"A modification of the Elixhauser comorbidity measures into a point system for hospital death using administrative data","volume":"47","author":"van Walraven","year":"2009","journal-title":"Med Care."},{"issue":"4","key":"2025060705260538800_CIT0033","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.2307\/2531734","article-title":"Models for longitudinal data: a generalized estimating equation approach [published correction appears in Biometrics 1989 Mar;45(1):347]","volume":"44","author":"Zeger","year":"1988","journal-title":"Biometrics."},{"issue":"14\u201315","key":"2025060705260538800_CIT0034","doi-asserted-by":"publisher","first-page":"1825","DOI":"10.1002\/sim.4780111406","article-title":"An overview of methods for the analysis of longitudinal data","volume":"11","author":"Zeger","year":"1992","journal-title":"Stat Med."},{"issue":"3","key":"2025060705260538800_CIT0035","doi-asserted-by":"publisher","first-page":"232","DOI":"10.1093\/gerona\/58.3.m232","article-title":"Morbidity profiles of centenarians: survivors, delayers, and escapers","volume":"58","author":"Evert","year":"2003","journal-title":"J Gerontol A Biol Sci Med Sci."},{"issue":"16","key":"2025060705260538800_CIT0036","doi-asserted-by":"publisher","first-page":"1584","DOI":"10.1016\/s0264-410x(99)00490-9","article-title":"Compression of morbidity in the elderly","volume":"18","author":"Fries","year":"2000","journal-title":"Vaccine."},{"issue":"8","key":"2025060705260538800_CIT0037","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1111\/jgs.14222","article-title":"Compression of morbidity is observed across cohorts with exceptional longevity","volume":"64","author":"Ismail","year":"2016","journal-title":"J Am Geriatr Soc."},{"key":"2025060705260538800_CIT0038","doi-asserted-by":"publisher","first-page":"100975","DOI":"10.1016\/j.eclinm.2021.100975","article-title":"Centenarians and extremely old people living with frailty can elicit durable SARS-CoV-2 spike specific IgG antibodies with virus neutralization functions following virus infection as determined by serological study","volume":"37","author":"Foley","year":"2021","journal-title":"EClinicalMed"},{"issue":"2","key":"2025060705260538800_CIT0039","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1111\/cei.13606","article-title":"Analysis of T and NK cell subsets in the Sicilian population from young to supercentenarian: the role of age and gender","volume":"205","author":"Ligotti","year":"2021","journal-title":"Clin Exp Immunol."},{"issue":"36","key":"2025060705260538800_CIT0040","doi-asserted-by":"publisher","first-page":"1250","DOI":"10.15585\/mmwr.mm6936a4","article-title":"Delay or avoidance of medical care because of COVID-19-related concerns\u2014United States, June 2020","volume":"69","author":"Czeisler","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep."}],"container-title":["The Journals of Gerontology, Series A: Biological Sciences and Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/biomedgerontology\/advance-article-pdf\/doi\/10.1093\/gerona\/glaf051\/62852755\/glaf051.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/biomedgerontology\/article-pdf\/80\/6\/glaf051\/63448652\/glaf051.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/biomedgerontology\/article-pdf\/80\/6\/glaf051\/63448652\/glaf051.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,7]],"date-time":"2025-06-07T09:26:16Z","timestamp":1749288376000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/biomedgerontology\/article\/doi\/10.1093\/gerona\/glaf051\/8104845"}},"subtitle":[],"editor":[{"given":"Lewis A","family":"Lipsitz","sequence":"additional","affiliation":[{"name":"(Medical Sciences Section)"}],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,4,3]]},"references-count":40,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,5,5]]}},"URL":"https:\/\/doi.org\/10.1093\/gerona\/glaf051","relation":{},"ISSN":["1079-5006","1758-535X"],"issn-type":[{"type":"print","value":"1079-5006"},{"type":"electronic","value":"1758-535X"}],"subject":[],"published-other":{"date-parts":[[2025,6]]},"published":{"date-parts":[[2025,4,3]]},"article-number":"glaf051"}}