scholarly journals Validation of Self‐Reported Rheumatoid Arthritis Using Medicare Claims: A Nationally Representative Longitudinal Study of Older Adults

2021 ◽  
Vol 3 (4) ◽  
pp. 239-249
Author(s):  
Michael J. Booth ◽  
Daniel Clauw ◽  
Mary R. Janevic ◽  
Lindsay C. Kobayashi ◽  
John D. Piette
Keyword(s):  
Rheumatoid Arthritis ◽  
Older Adults ◽  
Longitudinal Study ◽  
Medicare Claims ◽  
Nationally Representative

scholarly journals Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the English Longitudinal Study of Ageing

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
P. Zaninotto ◽  
Y. T. Huang ◽  
G. Di Gessa ◽  
J. Abell ◽  
C. Lassale ◽  
...  
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Older People ◽  
Hospital Admission ◽  
Prescription Drugs ◽  
Hospital Admissions ◽  
Competing Risk ◽  
Risk Of Falls ◽  
Nationally Representative ◽  
English Longitudinal Study

Abstract Background Falls amongst older people are common; however, around 40% of falls could be preventable. Medications are known to increase the risk of falls in older adults. The debate about reducing the number of prescribed medications remains controversial, and more evidence is needed to understand the relationship between polypharmacy and fall-related hospital admissions. We examined the effect of polypharmacy on hospitalization due to a fall, using a large nationally representative sample of older adults. Methods Data from the English Longitudinal Study of Ageing (ELSA) were used. We included 6220 participants aged 50+ with valid data collected between 2012 and 2018.The main outcome measure was hospital admission due to a fall. Polypharmacy -the number of long-term prescription drugs- was the main exposure coded as: no medications, 1–4 medications, 5–9 medications (polypharmacy) and 10+ medications (heightened polypharmacy). Competing-risk regression analysis was used (with death as a potential competing risk), adjusted for common confounders, including multi-morbidity and fall risk-increasing drugs. Results The prevalence of people admitted to hospital due to a fall increased according to the number of medications taken, from 1.5% of falls for people reporting no medications, to 4.7% of falls among those taking 1–4 medications, 7.9% of falls among those with polypharmacy and 14.8% among those reporting heightened polypharmacy. Fully adjusted SHRs for hospitalization due to a fall among people who reported taking 1–4 medications, polypharmacy and heightened polypharmacy were 1.79 (1.18; 2.71), 1.75 (1.04; 2.95), and 3.19 (1.61; 6.32) respectively, compared with people who were not taking medications. Conclusions The risk of hospitalization due to a fall increased with polypharmacy. It is suggested that prescriptions in older people should be revised on a regular basis, and that the number of medications prescribed be kept to a minimum, in order to reduce the risk of fall-related hospital admissions.

Cognitive Function and the Concordance Between Survey Reports and Medicare Claims in a Nationally Representative Cohort of Older Adults

Medical Care ◽  
2015 ◽  
Vol 53 (5) ◽  
pp. 455-462 ◽  
Author(s):  
Fredric D. Wolinsky ◽  
Michael P. Jones ◽  
Fred Ullrich ◽  
Yiyue Lou ◽  
George L. Wehby
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Medicare Claims ◽  
Nationally Representative ◽  
Representative Cohort

scholarly journals Cost-related Medication Nonadherence in Older Patients with Rheumatoid Arthritis

2013 ◽  
Vol 40 (2) ◽  
pp. 137-143 ◽  
Author(s):  
LESLIE R. HARROLD ◽  
BECKY A. BRIESACHER ◽  
DAN PETERSON ◽  
ASHLEY BEARD ◽  
JEANNE MADDEN ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Older Adults ◽  
Basic Needs ◽  
Fold Increase ◽  
Prescription Drug Coverage ◽  
Medication Nonadherence ◽  
Medicare Current Beneficiary Survey ◽  
High Prevalence ◽  
Nationally Representative ◽  
Weighted Prevalence

Objective.Economic access to costly medications including biologic agents can be challenging. Our objective was to examine whether patients with rheumatoid arthritis (RA) are at particular risk for cost-related medication nonadherence (CRN) and spending less on basic needs.Methods.We identified a nationally representative sample of older adults with RA (n = 1100) in the Medicare Current Beneficiary Survey (2004–2008) and compared them to older adults with other morbidities categorized by chronic disease count: 0 (n = 5898), 1–2 (n = 30,538), and ≥ 3 (n = 34,837). We compared annual rates of self-reported CRN (skipping or reducing medication doses or not obtaining prescriptions because of cost) as well as spending less on basic needs to afford medications and tested for differences using survey-weighted logistic regression analyses adjusted for demographic characteristics, health status, and prescription drug coverage.Results.In the RA sample, the unadjusted weighted prevalence of CRN ranged from 20.7% in 2004 to 18.4% in 2008 as compared to 18.5% and 11.9%, respectively, in patients with 3 or more non-RA conditions. In adjusted analyses, having RA was associated with a 3.5-fold increase in the risk of CRN (OR 3.52, 95% CI 2.63–4.71) and almost a 2.5-fold risk of spending less on basic needs (OR 2.41, 95% CI 1.78–3.25) as compared to those without a chronic condition.Conclusion.Patients with RA experience a high prevalence of CRN and forgoing of basic needs, more than do older adults with multiple other chronic conditions. The situation did not improve during a period of policy change aimed at alleviating high drug costs.

The Concordance of Survey Reports and Medicare Claims in a Nationally Representative Longitudinal Cohort of Older Adults

Medical Care ◽  
2014 ◽  
Vol 52 (5) ◽  
pp. 462-468 ◽  
Author(s):  
Fredric D. Wolinsky ◽  
Michael P. Jones ◽  
Fred Ullrich ◽  
Yiyue Lou ◽  
George L. Wehby
Keyword(s):  
Older Adults ◽  
Longitudinal Cohort ◽  
Medicare Claims ◽  
Nationally Representative

scholarly journals 223 Prevalence of Depression Among People with Diabetes; Comparative Analysis of Older Adults Across Three Health Systems Using Nationally Representative Data

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Niamh McGrath ◽  
Sheena McHugh ◽  
Elaine Toomey ◽  
Patricia Kearney
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Health Systems ◽  
Diabetes Management ◽  
A Priori ◽  
Global Challenge ◽  
Depression Prevalence ◽  
English Sample ◽  
Diabetes Status ◽  
Nationally Representative

Abstract Background The co-occurrence of depression and diabetes is an emerging global challenge but any association is influenced by variations in prevalence, study design and measure used. We compared depression prevalence in older adults with and without diabetes across three health systems using a validated measure to examine the causal association between diabetes and depression. Methods We used data of adults aged over 49 years, from three nationally representative ageing datasets; The Irish Longitudinal Study on Ageing (TILDA), the English Longitudinal Study on Ageing (ELSA) and the Health and Retirement Study (HRS). Data were collected during 2009–2011 (TILDA), and 2010 (ELSA, HRS). The 8-item CESD scale categorised depression using recommended cut-off scores of < 3 for ELSA and HRS and < 8 for TILDA. Self-reported individual, environmental, behavioural risk, and health system exposure variables were selected a-priori using literature and a directed acyclic graph. Prevalence was presented as a percentage with corresponding 95% confidence intervals. Binomial logistic regression examined the odds of depression by diabetes status. Data were analysed in Stata v15 using the ‘svy’ function. Results Diabetes prevalence (Ireland;8%[(95%CI:7.5–8.6), England;11%(95%CI:10.6–12.0) and USA;19%[(95%CI:18.8-20.1);p<0.001]) and depression prevalence (Ireland;10%(95%CI:9.0–10.6), England;16%(95%CI:15.3-16.9), USA;14%[(95%CI:13.5-14.7);p<0.001] varied across countries. Depression was consistently higher among people with versus without diabetes (Ireland;14%(95%CI:10.9-16.6)vs.9%(95%CI:8.7–10.3),p=0.001], England;25%(95%CI:21.7-27.7)vs.15%[(95%CI:14.2-15.9),p≤0.001] and USA;19%(95%CI:16.9-20.0)vs.13%[(95%CI:12.4-13.8);p≤0.001]. The odds of depression were significantly higher in people with versus without diabetes (Ireland;OR=1.5(95%CI:1.2-1.9);p=0.001, England;OR=1.8(95%CI:1.5–2.2);p<0.000, USA;OR=1.5(95%1.3-1.7);p<0.000), but only remained significant in the English sample after adjustment; (Ireland;OR=1.2(0.8-1.6);p=0.356, England;OR=1.3(1.0–1.6);p=0.045, USA;OR=1.0(0.9-1.1);p=0.898). Conclusion Among older adults in different health systems, depression was consistently higher among people with versus without diabetes. The findings support incorporation of holistic approaches to diabetes management across health systems.

scholarly journals The change and correlates of healthy ageing among Chinese older adults: findings from the China health and retirement longitudinal study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Peng Nie ◽  
Yan Li ◽  
Nan Zhang ◽  
Xiaomin Sun ◽  
Bao Xin ◽  
...  
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Chronic Diseases ◽  
Ordinary Least Squares ◽  
Cognitive Status ◽  
Healthy Ageing ◽  
Random Effects Models ◽  
Pressure Peak ◽  
Nationally Representative ◽  
The Ideal

Abstract Background This study tentatively constructs a composite measure of Chinese Healthy Ageing Index (CHAI) among older adults aged 60+ and investigates change of CHAI during 2011–2015 and its association with sociodemographic characteristics. Methods Data collected from 8182 old adults aged 60+ in the 2011 and 2015 China Health and Retirement Longitudinal Study (CHARLS, a nationally representative sample) were used. Six medical measures of blood pressure, peak expiratory flow, cognitive status score, fasting glucose, kidney function and C-reactive function were used to construct CHAI (range 0–12, 0–2 = healthiest, 7–12 = unhealthiest). Ordinary least squares, logistic and random effects models examined social and spatial determinants of CHAI score and the prevalence of the ideal CHAI. Unconditional quantile regression tested heterogeneous impacts of sociodemographic determinants of CHAI score. Results Mean CHAI score declined from 5.7 to 5.2, and the proportion of the ideal CHAI (CHAI score = 0–2) increased from 5.6 to 9.4% during 2011–2015, indicating an improvement in healthy ageing over time. During 2011–2015, the highest rates of the ideal CHAI were in Southeast and East of China. Older adults, male, living in the Center and West, smoking, obesity/overweight and having chronic diseases were positively associated with total CHAI score and negatively with a higher prevalence of the ideal CHAI. Being married, having high education and regular social activities were associated with a higher rate of the ideal CHAI. The positive predictors for total CHAI were stronger in those with worse CHAI status. Conclusions In China healthy ageing has improved during 2011–2015, but substantial geographical and sociodemographic heterogeneities exist in the improvements, suggesting health equality remains a challenge in China. Future policies and interventions should especially focus on men, those in Central and West China, and combat health problems like obesity, chronic diseases and unhealthy behaviors.

scholarly journals Associations between social and intellectual activities with cognitive trajectories in Chinese middle-aged and older adults: a nationally representative cohort study

2020 ◽  
Author(s):  
Haibin Li ◽  
Changwei Li ◽  
Anxin Wang ◽  
Yanling Qi ◽  
Wei Feng ◽  
...  
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Aging ◽  
Multinomial Logistic Regression ◽  
Middle Aged ◽  
Cognitive Assessments ◽  
Visuospatial Skills ◽  
Nationally Representative ◽  
Intellectual Activities ◽  
Representative Cohort

Abstract Background: Associations between the frequency of social and intellectual activities and cognitive trajectories are understudied in Chinese middle-aged and older adults. We aimed to examine this association in a nationally representative longitudinal study. Methods: The China Health and Retirement Longitudinal Study (CHARLS) is a nationally representative sample of Chinese middle-aged and older participants. The frequency of social and intellectual activities was measured at baseline. Interview-based cognitive assessments of orientation and attention, episodic memory, and visuospatial skills and the calculation of combined global scores were assessed every 2 year. Cognitive trajectories over the study period were analyzed using group-based trajectory model , and the associations of the trajectory memberships with social and intellectual activities were analyzed using multinomial logistic regression. Odd ratios (OR) and 95% confidence intervals (CI) were reported. Results: Among 8204 participants aged 50-75 years, trajectory analysis identified three longitudinal patterns of cognitive function based on the global cognitive scores: “ persistently low ” (n = 1550, 18.9%); “persistently moderate” (n = 3194, 38.9%); and “persistently high” (n = 3460, 42.2%). After adjustment for sociodemographic variables, lifestyles, geriatric symptoms and health conditions, more frequent intellectual activities (OR: 0.54, 95% CI: 0.38-0.77) and social activities (OR: 0.79, 95% CI: 0.65-0.95) were both associated with a lower likelihood of being in the “persistently low” global cognitive trajectory group. Conclusions: More frequent social and intellectual activities were associated with more favorable cognitive aging trajectories.

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