scholarly journals Cohort analysis of driving cessation and limitation among older adults

2021 ◽  
Author(s):  
Andrew Schouten ◽  
Martin Wachs ◽  
Evelyn A. Blumenberg ◽  
Hannah R. King
Keyword(s):  
Older Adults ◽  
Longitudinal Data ◽  
Generational Differences ◽  
Cohort Analysis ◽  
The United States ◽  
National Sample ◽  
Health Conditions ◽  
Driving Cessation ◽  
Cross Sectional ◽  
The University

AbstractAutomobiles are central to participation in economic, social, and cultural activities in the United States. The ability to drive as one ages is fundamental to the quality of life among older adults. Driving rates decline significantly with age. Researchers using cross-sectional data have studied the reasons former drivers have stopped driving, but few have followed individuals over time to examine changes in relationships among driving cessation, socio-demographics, and health conditions. We used longitudinal data from a national sample of 20,000 observations from the University of Michigan Health and Retirement Study (HRS) to examine relationships among demographic variables, health conditions, and driving reduction and driving cessation. Longitudinal data allow analysis of generational differences in behavior, a major advantage over cross-sectional data which only allow comparisons of different people at one point in time. We found, like many other studies, that personal decisions to limit and eventually stop driving vary with sex, age, and health conditions. In addition, unlike most previous studies, we also found that those relationships differ by birth cohort with younger cohorts less likely to stop and limit their driving than their older counterparts. The findings indicate an evolution in the association between driving cessation and its causes.

scholarly journals INTERSECTING SELF-REPORTED MOBILITY AND GAIT SPEED TO CREATE A MULTI-DIMENSIONAL MEASURE OF AMBULATION: THE “AMBULATION SPEED-ENDURANCE” (ASE) TYPOLOGY

2015 ◽  
pp. 1-8
Author(s):  
C. SIORDIA
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
The United States ◽  
Community Dwelling ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Cross Sectional ◽  
Dimensional Measure ◽  
Categorization Scheme ◽  
Community Dwelling Older Adults

Background: Assessing mobility through readily available and affordable protocols may help advance public health by providing early detection and implementing intervention therapies aimed at mitigating the progression from physiological vitality to disability at older ages. Until now, little attention has been given to how self-reported mobility (SRM) and gait speed can be combined in a categorization scheme. Objectives: The specific aim of this report is to introduce the Ambulation Speed-Endurance (ASE) Typology to the literature—a classification system that intersects SRM and gait speed to create a multi-dimensional measure of ambulation. Design: Cross-sectional. Setting: Community-dwelling older adults in the United States. Participants: Evidence is provided from the National Health and Aging Trends Study (NHATS) that community-dwelling older adults (n=5,403) may be found in each of the ASE Typologies. The discussion is complimented by investigating the cross-sectional predictors of a “Discrepancy Score” (measure of gap between speed and endurance) amongst those with gait speeds < 0.99 m/sec (n=4,521). Results: Multivariable linear regression results indicate level of severity in speed-endurance discrepancy is higher amongst: non-Latino-Blacks (β=0.48); Latinos (β=0.42); older ages; and lower educated. Models also show that severity in speed-endurance discrepancy is lower amongst: females (β=-0.38); those with higher body mass index; with more chronic health conditions; and poorer self-rated health. Conclusion: Research should continue to investigate how to optimize SRM.

scholarly journals Low Back Pain and Substance Use: Diagnostic and Administrative Coding for Opioid Use and Dependence Increased in U.S. Older Adults with Low Back Pain

Pain Medicine ◽  
2021 ◽  
Author(s):  
Beth B Hogans ◽  
Bernadette C Siaton ◽  
Michelle N Taylor ◽  
Leslie I Katzel ◽  
John D Sorkin
Keyword(s):  
Older Adults ◽  
Substance Use ◽  
Low Back Pain ◽  
Back Pain ◽  
National Sample ◽  
Cross Sectional Study ◽  
Diagnostic Code ◽  
Low Back ◽  
Opioid Use ◽  
Cross Sectional

Abstract Objective Low back pain (LBP) is a leading cause of pain and disability. Substance use complicates the management of LBP, and potential risks increase with aging. Despite implications for an aging, diverse U.S. population, substance use and LBP comorbidity remain poorly defined. The objective of this study was to characterize LBP and substance use diagnoses in older U.S. adults by age, gender, and race. Design Cross-sectional study of a random national sample. Subjects Older adults including 1,477,594 U.S. Medicare Part B beneficiaries. Methods Bayesian analysis of 37,634,210 claims, with 10,775,869 administrative and 92,903,649 diagnostic code assignments. Results LBP was diagnosed in 14.8±0.06% of those more than 65 years of age, more in females than in males (15.8±0.08% vs. 13.4±0.09%), and slightly less in those more than 85 years of age (13.3±0.2%). Substance use diagnosis varied by substance: nicotine, 9.6±0.02%; opioid, 2.8±0.01%; and alcohol, 1.3±0.01%. Substance use diagnosis declined with advancing age cohort. Opioid use diagnosis was markedly higher for those in whom LBP was diagnosed (10.5%) than for those not diagnosed with LBP (1.5%). Most older adults (54.9%) with an opioid diagnosis were diagnosed with LBP. Gender differences were modest. Relative rates of substance use diagnoses in LBP were modest for nicotine and alcohol. Conclusions Older adults with LBP have high relative rates of opioid diagnoses, irrespective of gender or age. Most older adults with opioid-related diagnoses have LBP, compared with a minority of those not opioid diagnosed. In caring for older adults with LBP or opioid-related diagnoses, health systems must anticipate complexity and support clinicians, patients, and caregivers in managing pain comorbidities. Older adults may benefit from proactive incorporation of non-opioid pain treatments. Further study is needed.

scholarly journals Visual Acuity’s Association With Levels of Leisure-Time Physical Activity in Community-Dwelling Older Adults

2012 ◽  
Vol 20 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Mark W. Swanson ◽  
Eric Bodner ◽  
Patricia Sawyer ◽  
Richard M. Allman
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Visual Acuity ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
University Of Alabama ◽  
Cross Sectional ◽  
The University

Little is known about the effect of reduced vision on physical activity in older adults. This study evaluates the association of visual acuity level, self-reported vision, and ocular disease conditions with leisure-time physical activity and calculated caloric expenditure. A cross-sectional study of 911 subjects 65 yr and older from the University of Alabama at Birmingham Study of Aging (SOA) cohort was conducted evaluating the association of vision-related variables to weekly kilocalorie expenditure calculated from the 17-item Leisure Time Physical Activity Questionnaire. Ordinal logistic regression was used to evaluate possible associations while controlling for potential confounders. In multivariate analyses, each lower step in visual acuity below 20/50 was significantly associated with reduced odds of having a higher level of physical activity, OR 0.81, 95% CI 0.67, 0.97. Reduced visual acuity appears to be independently associated with lower levels of physical activity among community-dwelling adults.

scholarly journals Retirement Without God: Activism and Community Among Secular People Over 60

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 441-441
Author(s):  
Joseph Blankholm
Keyword(s):  
United States ◽  
Older Adults ◽  
Social Movement ◽  
Generational Differences ◽  
Crucial Role ◽  
National Level ◽  
The United States ◽  
Ethnographic Research ◽  
Vast Literature

Abstract There are more than 1,400 nonbeliever communities in the United States and well over a dozen organizations that advocate for secular people on the national level. Together, these local and national groups comprise a social movement that includes atheists, agnostics, humanists, freethinkers, and other kinds of nonbelievers. Despite the fact that retired people over 60 dedicate most of the money and energy needed to run these groups, the increasingly vast literature on secular people and secularism has paid them almost no attention. Relying on more than one hundred interviews (including dozens with people over 60), several years of ethnographic research, and a survey of organized nonbelievers, this paper demonstrates the crucial role that people over 60 play in the American secular movement today. It also considers the reasons older adults are so important to these groups, the challenges they face in trying to recruit younger members and combat stereotypes about aging leadership, and generational differences that structure how various types of nonbeliever groups look and feel. This paper reframes scholarly understandings of very secular Americans by focusing on people over 60 and charts a new path in secular studies.

Abstract 88: Increasing False Positive Diagnoses May Lead to Overestimation of Stroke Incidence, Particularly in the Young

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Abhinav J Appukutty ◽  
Lesli E Skolarus ◽  
Mellanie V Springer ◽  
William J Meurer ◽  
James F Burke
Keyword(s):  
Older Adults ◽  
False Positive ◽  
Age Groups ◽  
Vascular Risk Factor ◽  
The United States ◽  
Cross Sectional ◽  
Stroke Incidence ◽  
Ed Visits ◽  
Over Time

Introduction: Stroke incidence is reportedly increasing in younger adults. While increasing vascular risk factor prevalence has been suggested as a cause, the reasons for rising stroke incidence in the young are not clear. We explored several alternate explanations: trends in neurologically-focused emergency department (ED) visits, differential diagnostic classification of stroke and TIA over time, and changes in the use of advanced imaging in young and older adults. Methods: We performed a retrospective, serial, cross-sectional study on a nationally representative sample of all ED visits in the United States to quantify changes in patterns of neurologically-focused ED visits, stroke and TIA diagnoses, and rates of MRI utilization for young (18 – 44 years) and older (65+ years) adults over a 17-year period (1995 – 2000; 2005 – 2015) using National Hospital Ambulatory Medical Care Survey (NHAMCS) data. Results: In young adults, 0.4% (95% CI 0.3% – 0.5%) of neurologically-focused ED visits resulted in a primary diagnosis of stroke vs. 6.8% (95% CI 6.2% – 7.5%) for older adults. In both populations, the incidence of neurologically-focused ED visits has increased over time (+111/100,000 population/year, 95% CI +94 – +130 in the young vs. +70/100,000 population/year, 95% CI +34 – +108 in older adults). There was no evidence of differential classification of TIA to stroke over time (OR 1.001 per year, 95% CI 0.926 – 1.083 in the young; OR 1.003 per year, 95% CI 0.982 – 1.026 in older adults) and no evidence of disproportionate rise in MRI utilization for neurologically-focused ED visits in the young (OR 1.057 per year, 95% CI 1.028 – 1.086 in the young; OR 1.095 per year, 95% CI 1.066 – 1.125 in older adults). Conclusions: If the specificity of stroke diagnosis amongst ED visits is similar amongst young and older populations, then the combination of data observed here, including (1) a lower prior probability of stroke diagnoses in the young and (2) an increasing trend in neurologically-focused ED visits in both age groups, suggests that false positive diagnoses will increase over time, with a faster rise in the young compared to older adults. These data suggest a potential explanation that may contribute to higher stroke incidence in the young and merits further scrutiny.

scholarly journals WHAT IS THE ROLE BODY SWAY DEVIATION AND BODY SWAY VELOCITY PLAY IN POSTURAL STABILITY IN OLDER ADULTS?

2013 ◽  
Vol 56 (3) ◽  
pp. 117-123 ◽  
Author(s):  
Jitka Jančová Všetečková ◽  
Nicholas Drey
Keyword(s):  
Older Adults ◽  
Postural Stability ◽  
Care Home ◽  
Cross Sectional Study ◽  
Body Sway ◽  
Centre Of Pressure ◽  
Cross Sectional ◽  
Physically Active ◽  
Surface Test ◽  
The University

This cross sectional study focused on how Postural Stability (PS) indicators: body sway deviation (BSD) and body sway velocity (BSV), change with age and their association with levels of social and physical activity. Observational study: 80 older adults (aged: 60–96) were purposefully recruited from two sources: the University of the Third Age (TAU) (n = 35) and a residential care home (CH) (n = 45). Differences in the indicators of PS, approximated through Centre of Pressure (COP) measurements, were assessed by the Romberg Stance Test (Test A) subsequently repeated on 10 cm foam surface (Test B), using a Kistler® Dynamometric Platform. The RCH Group was older, had higher BMI and was less socially and physically active, showed more body sway in all indicators compared to TAU group. For all participants body sway velocity (BSV) was significantly correlated with age. The strength of correlation of body sway deviation (BSD) with age was also significant but not as strong. The findings indicate in line with previous studies that deterioration in BSV is associated with poor PS more than deterioration in BSD.

scholarly journals Urban-rural differences in the prevalence of muscle weakness and slow gait speed: A cross-sectional analysis from the NHANES (2001-2002 and 2011-2014)

2021 ◽  
pp. 1-7
Author(s):  
J.J. Aziz ◽  
K.F. Reid ◽  
J.A. Batsis ◽  
R.A. Fielding
Keyword(s):  
United States ◽  
Older Adults ◽  
Grip Strength ◽  
Muscle Weakness ◽  
Rural Areas ◽  
Gait Speed ◽  
The United States ◽  
Cross Sectional ◽  
Comorbidity Burden ◽  
Urban Rural

Background: Older adults living in rural areas suffer from health inequities compared to their urban counterparts. These include comorbidity burden, poor diet, and physical inactivity, which are also risk factors for sarcopenia, for which muscle weakness and slow gait speed are domains. To date, no study has examined urban-rural differences in the prevalence of muscle weakness and slow gait speed in older adults living in the United States. Objective: To compare the prevalence of grip strength weakness and slow gait speed between urban and rural older adults living in the United States. Design: A cross-sectional, secondary data analysis of two cohorts from the National Health and Nutrition Examination Survey (NHANES), using gait speed or grip strength data, and urban-rural residency, dietary, examination, questionnaire and demographic data. Participants: 2,923 adults (≥ 60 yrs.). Measures: Grip weakness was defined as either, an absolute grip strength of <35 kg. and <20 kg. or grip strength divided by body mass index (GripBMI) of <1.05 and <0.79 for men and women, respectively. Slow gait speed was defined as a usual gait speed of ≤0.8m/s. Results: The prevalence of GripBMI weakness was significantly higher in urban compared to rural participants (27.4% vs. 19.2%; p=0.001), whereas their absolute grip strength was lower (31.75(±0.45) vs. 33.73(±0.48)). No urban-rural differences in gait speed were observed. Conclusions: Older adults residing in urban regions of the United States were weaker compared to their rural counterparts. This report is the first to describe urban-rural differences in handgrip strength and slow gait speed in older adults living in the United States.

scholarly journals Barriers and Motivators of Bicycling by Gender Among Older Adult Bicyclists in the Midwest

2019 ◽  
Vol 47 (1) ◽  
pp. 67-77 ◽  
Author(s):  
Amanda Grimes ◽  
Matthew Chrisman ◽  
Joseph Lightner
Keyword(s):  
Older Adults ◽  
Environmental Factors ◽  
Online Survey ◽  
Ecological Model ◽  
The United States ◽  
Environmental Barriers ◽  
Cross Sectional ◽  
The Social ◽  
Personal Level ◽  
Barriers And Motivators

Introduction. Physical activity (PA), particularly low-impact activities like bicycling, can improve health in older adults. However, bicycling rates are lower in the Midwest than other regions in the United States. Therefore, it is important to identify unique social, personal, and environmental factors that inhibit or promote bicycling, and how these are associated with PA. The influences of these factors were explored using the social ecological model. Method. A cross-sectional online survey was developed using previously validated local and national bicycling questionnaires, then distributed to Midwestern bicyclists 50 years and older. Exploratory factor analysis was conducted to understand the influences of social, personal, and environmental barriers and promoters on bicycling patterns. All models were conducted separately by gender, and accounted for age, race, education, marital status, income, and employment. Results. Social promoters (B = 0.386, p = .002), such as having friends/family that bicycle were associated with greater PA. Personal promoters (B = −0.311, p = .006) such as needing to lose weight were associated with reduced PA. Environmental factors had no associations with PA. However, individual environmental components, such as number of vehicles on the roads, were significantly associated with PA for both males and females. Females reported more barriers than males. The overall model accounted for 16.1% of the total variance in PA levels. Conclusion. Interventions to promote PA via bicycling in older adults should focus on social factors, while also reducing personal-level factors for males. Interventions for females could focus on reducing specific personal, social, and environmental barriers.

scholarly journals Education-Related Inequalities in Dental Services Use among Older Adults in 23 Countries

2020 ◽  
Vol 99 (12) ◽  
pp. 1341-1347
Author(s):  
F. Bof de Andrade ◽  
J.L.F. Antunes ◽  
F.C.D. Andrade ◽  
M.F.F. Lima-Costa ◽  
J. Macinko
Keyword(s):  
United States ◽  
Older Adults ◽  
South Korea ◽  
The United States ◽  
Self Report ◽  
Absolute Difference ◽  
Dental Services ◽  
Cross Sectional ◽  
Relative Index ◽  
Index Of Inequality

This study aimed to measure the magnitude of education-related inequalities in the use of dental services among older adults (aged 50 y or older) from a sizable multicountry sample of 23 upper-middle- and high-income countries. This study used cross-sectional data from nationally representative surveys of people aged 50 y and over. Countries included in the Health and Retirement Study surveys were the following: Brazil, China, South Korea, Mexico, United States, Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, France, Germany, Greece, Italy, Israel, Luxembourg, Poland, Portugal, Slovenia, Spain, Sweden, and Switzerland. The dependent variable was the use of dental services, based on the self-report of having had a dental visit within the previous year, except for the United States and South Korea, which used 2-y recall periods. Educational level was used as the measure of socioeconomic position and was standardized across countries. Multivariate logistic regression modeling was used to evaluate the factors associated with the use of dental services, and the magnitude of education inequalities in the use of dental services was assessed using the slope index of inequality (SII) to measure absolute inequalities and the relative index of inequality for relative inequalities. The pooled prevalence of the use of dental services was 31.7% and ranged from 18.7% in China to 81.2% in Sweden. In the overall sample, the absolute difference in the prevalence of use between the lowest and highest educational groups was 20 percentage points. SII was significant for all countries except Portugal. Relative educational inequalities were significant for all countries and ranged from 3.2 in Poland to 1.2 in Sweden. There were significant education-related inequalities in the use of dental care by older adults in all countries. Monitoring these inequalities is critical to the planning and delivery of dental services.

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