Treatment of Asthma in Older Adults with Significant Medical Comorbidities

2019 ◽  
pp. 71-78
Author(s):  
Anil Nanda ◽  
Anita N. Wasan
Keyword(s):  
Older Adults ◽  
Medical Comorbidities

Medical and Social Determinants of Brain Health and Dementia in a Multicultural Community Cohort of Older Adults

2021 ◽  
pp. 1-14
Author(s):  
James E. Galvin ◽  
Stephanie Chrisphonte ◽  
Lun-Ching Chang
Keyword(s):  
Older Adults ◽  
Health Disparities ◽  
African Americans ◽  
Health Outcomes ◽  
Sex Education ◽  
Screening Program ◽  
Healthcare Services ◽  
Social Dimension ◽  
Medical Comorbidities ◽  
Race Ethnicity

Background: Socioeconomic status (SES), race, ethnicity, and medical comorbidities may contribute to Alzheimer’s disease and related disorders (ADRD) health disparities. Objective: Analyze effects of social and medical determinants on cognition in 374 multicultural older adults participating in a community-based dementia screening program. Methods: We used the Montreal Cognitive Assessment (MoCA) and AD8 as measures of cognition, and a 3-way race/ethnicity variable (White, African American, Hispanic) and SES (Hollingshead index) as predictors. Potential contributors to health disparities included: age, sex, education, total medical comorbidities, health self-ratings, and depression. We applied K-means cluster analyses to study medical and social dimension effects on cognitive outcomes. Results: African Americans and Hispanics had lower SES status and cognitive performance compared with similarly aged Whites. We defined three clusters based on age and SES. Cluster #1 and #3 differed by SES but not age, while cluster #2 was younger with midlevel. Cluster #1 experienced the worse health outcomes while cluster #3 had the best health outcomes. Within each cluster, White participants had higher SES and better health outcomes, African Americans had the worst physical performance, and Hispanics had the most depressive symptoms. In cross-cluster comparisons, higher SES led to better health outcomes for all participants. Conclusion: SES may contribute to disparities in access to healthcare services, while race and ethnicity may contribute to disparities in the quality and extent of services received. Our study highlights the need to critically address potential interactions between race, ethnicity, and SES which may better explain disparities in ADRD health outcomes.

scholarly journals P3-350: INFLUENCE OF MEDICAL COMORBIDITIES ON BIOMARKER-INFORMED COGNITIVE RESERVE IN OLDER ADULTS

2019 ◽  
Vol 15 ◽  
pp. P1077-P1077
Author(s):  
Shannon L. Risacher ◽  
Matthew Ayers ◽  
Kwangsik Nho ◽  
John D. West ◽  
Timothy J. Hohman ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Reserve ◽  
Medical Comorbidities

scholarly journals Coronavirus Related Mortality in the Geriatrics Ambulatory Practice

2021 ◽  
Vol 12 ◽  
pp. 215013272110253
Author(s):  
Claudene J. George ◽  
Alice Guo
Keyword(s):  
Older Adults ◽  
Retrospective Chart Review ◽  
Black African ◽  
Medical Comorbidities ◽  
The Mean ◽  
Ambulatory Practice ◽  
Outpatient Practice ◽  
Atypical Presentations ◽  
Active Patients ◽  
Related Mortality

Background Older adults often have atypical presentations of common diseases and COVID-19 is no exception. Presentations range from asymptomatic to overwhelming symptoms that result in hospitalization, intubation, or death. The number of COVID-19 related deaths among older adults in the outpatient practice during the peak of the pandemic is unclear. Methods The objective is to describe the COVID-19 status and clinical characteristics of patients in a Geriatrics Ambulatory Practice who died during the peak of the COVID-19 pandemic. Design: Retrospective chart review Participants: 54 adults age 65 years and older. Methods: COVID-19 status defined by positive test result and presumed COVID-19 status based upon clinical presentation. Results Out of 1200 active patients in the Geriatrics Ambulatory Practice, 54 (4.5%) died between January 1st, 2020 and June 30th, 2020. The study sample was 63% female, 33% Hispanic/Latino, 27% Black/African American, and 22% white. The mean (SD) age was 86(8.6) years, range (72-107 years). The most prevalent medical comorbidities in decreasing order of frequency were hypertension (88.9%), diabetes (51.9%), and cognitive impairment (51.9%). Nineteen (35%) were COVID-19 positive and 8 had presumed COVID-19. There were no statistically significant differences in age, gender, race/ethnicity, and medical comorbidities between the COVID-19 or presumed COVID-19 group compared to those with No COVID-19. Conclusion Approximately 35% of Geriatric patients who died during the first 6 months of 2020 had confirmed COVID-19 and an additional 15% had presumed COVID-19. The actual number of COVID-19 related deaths among older adults in the ambulatory practice during the peak of the pandemic is difficult to estimate and likely underestimated.

scholarly journals ASSOCIATION BETWEEN GERIATRIC HOME VISIT AND EMERGENCY ROOM OR HOSPITAL UTILIZATION: A RETROSPECTIVE STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S958-S958
Author(s):  
Xin Zhang ◽  
Paul Takahashi
Keyword(s):  
Older Adults ◽  
Retrospective Study ◽  
Healthcare Utilization ◽  
Advance Care Planning ◽  
Home Visit ◽  
Community Dwelling ◽  
Hospital Utilization ◽  
Care Planning ◽  
Medical Comorbidities ◽  
Advance Care

Abstract Homebound older adults tend to have more medical comorbidities, higher risk of mortality, and higher healthcare utilization compared to non-homebound, community dwelling older adults in the U.S. Preventative primary care home visit have been shown to reduce hospitalizations and total healthcare costs in this population. Through a retrospective study, we aim to explore characteristics associated with ED and hospital utilization in patients who have received a home visit. A total 608 subjects, 70% female and median age of 86 years, were involved. A 184 (30%) of homebound subjects were hospitalized or visited the ED in 90 days. Comparing those with hospitalization or ED and those without, there was no significant difference in sex, age, race, marital status, or advance care planning. A 74% of those with 90 day ED/hospitalization had prior ED visit within 1 year of home visit compared to 59% of those without (p=0.0004). In addition, 58% of those with 90 day ED/hospitalization had prior hospitalization within 1 year of home visit compared to 44% of those without (p=0.0015). They also had significantly higher number of total medical comorbidities (median 4.5 vs 4, p=0.02). Our study suggests that prior healthcare utilization and medical comorbidity burden may be better predictors of 90 day hospitalization or ED use in geriatric patients who have received a home visit. Advance care planning and age did not significantly differ between the two groups in our study. Further studies should be performed to validate our findings in a prospective manner.

Cognitive control constrains memory attributions

2019 ◽  
Vol 42 ◽  
Author(s):  
Colleen M. Kelley ◽  
Larry L. Jacoby
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Control

Abstract Cognitive control constrains retrieval processing and so restricts what comes to mind as input to the attribution system. We review evidence that older adults, patients with Alzheimer's disease, and people with traumatic brain injury exert less cognitive control during retrieval, and so are susceptible to memory misattributions in the form of dramatic levels of false remembering.

Cognitive Load Affects Speech Motor Performance Differently in Older and Younger Adults

2019 ◽  
Vol 62 (5) ◽  
pp. 1258-1277 ◽  
Author(s):  
Megan K. MacPherson
Keyword(s):  
Older Adults ◽  
Cognitive Load ◽  
Motor Performance ◽  
Age Groups ◽  
Incongruent Condition ◽  
Sentence Production ◽  
Movement Duration ◽  
Production Task ◽  
Younger Adults ◽  
Speech Motor

PurposeThe aim of this study was to determine the impact of cognitive load imposed by a speech production task on the speech motor performance of healthy older and younger adults. Response inhibition, selective attention, and working memory were the primary cognitive processes of interest.MethodTwelve healthy older and 12 healthy younger adults produced multiple repetitions of 4 sentences containing an embedded Stroop task in 2 cognitive load conditions: congruent and incongruent. The incongruent condition, which required participants to suppress orthographic information to say the font colors in which color words were written, represented an increase in cognitive load relative to the congruent condition in which word text and font color matched. Kinematic measures of articulatory coordination variability and movement duration as well as a behavioral measure of sentence production accuracy were compared between groups and conditions and across 3 sentence segments (pre-, during-, and post-Stroop).ResultsIncreased cognitive load in the incongruent condition was associated with increased articulatory coordination variability and movement duration, compared to the congruent Stroop condition, for both age groups. Overall, the effect of increased cognitive load was greater for older adults than younger adults and was greatest in the portion of the sentence in which cognitive load was manipulated (during-Stroop), followed by the pre-Stroop segment. Sentence production accuracy was reduced for older adults in the incongruent condition.ConclusionsIncreased cognitive load involving response inhibition, selective attention, and working memory processes within a speech production task disrupted both the stability and timing with which speech was produced by both age groups. Older adults' speech motor performance may have been more affected due to age-related changes in cognitive and motoric functions that result in altered motor cognition.

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