Risk factors for social isolation in post-hospitalized older adults

2020 ◽  
Vol 88 ◽  
pp. 104036
Author(s):  
Dharani Nagarajan ◽  
Den-Ching A. Lee ◽  
Lauren M. Robins ◽  
Terry P. Haines
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Social Isolation ◽  
Hospitalized Older Adults

scholarly journals ADVANCING AN INTERDISCIPLINARY SCIENCE OF AGING THROUGH A PRACTICE-BASED DATA SCIENCE APPROACH

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S480-S480
Author(s):  
Robert Lucero ◽  
Ragnhildur Bjarnadottir
Keyword(s):  
Machine Learning ◽  
Risk Factors ◽  
Older Adults ◽  
Text Mining ◽  
Language Processing ◽  
Fall Risk ◽  
Data Science ◽  
Care Quality ◽  
Science Approach ◽  
Hospitalized Older Adults

Abstract Two hundred and fifty thousand older adults die annually in United States hospitals because of iatrogenic conditions (ICs). Clinicians, aging experts, patient advocates and federal policy makers agree that there is a need to enhance the safety of hospitalized older adults through improved identification and prevention of ICs. To this end, we are building a research program with the goal of enhancing the safety of hospitalized older adults by reducing ICs through an effective learning health system. Leveraging unique electronic data and healthcare system and human resources at the University of Florida, we are applying a state-of-the-art practice-based data science approach to identify risk factors of ICs (e.g., falls) from structured (i.e., nursing, clinical, administrative) and unstructured or text (i.e., registered nurse’s progress notes) data. Our interdisciplinary academic-clinical partnership includes scientific and clinical experts in patient safety, care quality, health outcomes, nursing and health informatics, natural language processing, data science, aging, standardized terminology, clinical decision support, statistics, machine learning, and hospital operations. Results to date have uncovered previously unknown fall risk factors within nursing (i.e., physical therapy initiation), clinical (i.e., number of fall risk increasing drugs, hemoglobin level), and administrative (i.e., Charlson Comorbidity Index, nurse skill mix, and registered nurse staffing ratio) structured data as well as patient cognitive, environmental, workflow, and communication factors in text data. The application of data science methods (i.e., machine learning and text-mining) and findings from this research will be used to develop text-mining pipelines to support sustained data-driven interdisciplinary aging studies to reduce ICs.

scholarly journals Prevalence, characteristics and predicting risk factors of adverse drug reactions among hospitalized older adults: A systematic review and meta-analysis

2021 ◽  
Vol 9 ◽  
pp. 205031212110390
Author(s):  
Tadele Mekuriya Yadesa ◽  
Freddy Eric Kitutu ◽  
Serawit Deyno ◽  
Patrick Engeu Ogwang ◽  
Robert Tamukong ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Confidence Interval ◽  
Adverse Drug Reactions ◽  
Potentially Inappropriate Medications ◽  
Drug Reactions ◽  
Related Factors ◽  
Hospitalized Older Adults

Background: Occurrence of adverse drug reactions is a major global health problem mostly affecting older adults. Identifying the magnitude and predictors of adverse drug reactions is crucial to developing strategies to mitigate the burden of adverse drug reactions. This study’s objectives were to estimate and compare the prevalences of adverse drug reactions, to characterize them and to identify the predictors among hospitalized older adults. Methods: A comprehensive systematic literature search including both prevalence and risk factors of adverse drug reactions in hospitalized older adults was conducted using PubMed, Scopus and Google Scholar, involving all articles published in English. Descriptive statistics and comparison of means was performed using SPSS version 20.0 and metaprop command was performed in STATA version 13.0. Heterogeneity was assessed using I2 statistic. Results: A total of 18 studies, involving 80,695 participants with a median age of 77 years, were included in this study. The pooled prevalence of adverse drug reaction was 22% (95% confidence interval: 17%, 28%; I2 = 99.23%). Among high-income countries, the prevalence of adverse drug reactions was 29% (95% confidence interval: 16%, 42%) as compared to 19% (95% confidence interval: 14%–25%) in low and middle-income countries ( p value = 0.176). Of the 620 adverse drug reactions categorized, most were type A (89%), which are generally predictable and preventable. Two-thirds (795, 67%) of the adverse drug reactions were probable and most (1194, 69%) were mild or moderate. The majority (60%) of the categorized adverse drug reactions were preventable and less than one-third (31%) were severe. The most consistently reported predictors of adverse drug reactions in hospitalized older patients were medication-related factors, including polypharmacy and potentially inappropriate medications followed by disease-related factors—renal failure, complex comorbidity, heart failure and liver failure. Conclusion: Almost one-quarter of all hospitalized older adults experienced at least one adverse drug reaction during their hospital stay. The majority of the adverse drug reactions were preventable. Medication-related factors were the most consistently reported predictors of adverse drug reactions followed by disease-related factors.

scholarly journals Social Isolation and Hospitalization Risk Factors Among Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 95-95
Author(s):  
J Mary Louise Pomeroy ◽  
Gilbert Gimm
Keyword(s):  
United States ◽  
Risk Factors ◽  
Older Adults ◽  
Social Isolation ◽  
The United States ◽  
Community Dwelling ◽  
Psychosocial Risk ◽  
Depression And Anxiety ◽  
Socially Isolated ◽  
Community Dwelling Older Adults

Abstract PURPOSE: This study examines psychosocial risk factors associated with hospitalization among community-dwelling older adults in the United States. METHODS: Using two waves of the National Health and Aging Trends Study from 2011 and 2015, we conducted descriptive and multivariate analyses of individual-level data from a nationally representative sample of 8,003 Medicare beneficiaries ages 65 and older. Associations between hospitalization and risk factors including social isolation, depression, and anxiety were assessed. Covariates included gender, race/ethnicity, age, region, insurance type, falls, and comorbidities. RESULTS: Overall, about 20.9% of older adults reported a hospitalization within the past year and 22.2% were socially isolated. The odds of hospitalization were higher for socially isolated adults (OR 1.17; p = .02), for depressed adults (OR 1.25; p = .01), and for individuals with anxiety (OR 1.25; p = .02). Individuals living in the Western region had lower odds of hospitalization (OR 0.71; p = .001), whereas men (OR 1.13; p = .03), those requiring assistance with activities of daily living (OR 1.48; p < .001), and those having one (OR 1.41; p = .03) or more (OR 3.05; p < .001) chronic health conditions had higher odds of hospitalization. CONCLUSION: Social isolation, depression, and anxiety represent significant psychosocial risk factors for hospitalization among community-dwelling older adults in the United States. Efforts to reduce health care costs and improve health outcomes for older adults should explore ways to strengthen social integration and improve mental health.

scholarly journals COVID-19-Related Changes in Potential Risk Factors for Elder Mistreatment Reported by Caregivers of Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 940-940
Author(s):  
Lena Makaroun ◽  
Scott Beach ◽  
Tony Rosen ◽  
Ann-Marie Rosland
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Older Adults ◽  
Social Isolation ◽  
Service Providers ◽  
Community Sample ◽  
Poor Mental Health ◽  
Elder Mistreatment ◽  
Care Recipients ◽  
Increased Risk

Abstract In previous studies, caregiver (CG) stress, substance use, poor physical health, poor mental health, financial problems, and social isolation have been associated with increased risk of elder mistreatment (EM) for older care recipients (CR). This study aimed to assess how the COVID-19 pandemic has impacted these CG-related risk factors for EM in a community sample of CGs. A non-probability sample of 433 CGs caring for adult CRs age ≥60 years with physical (76%), cognitive (34%) and mental health (14%) conditions completed a survey on COVID-19 impacts in April-May 2020. CGs had mean age 61 (range 21 – 91), were 75% female and 92% non-Hispanic White. Over 40% of CGs reported doing worse financially since COVID-19. Compared to before COVID-19, 15% reported drinking more alcohol and 64% reported somewhat or greatly increased feelings of social isolation and loneliness. CGs reported that COVID-19 had made caregiving more physically (18.7%), emotionally (48.5%) and financially (14.5%) difficult, interfered with their own healthcare (19%), and led to family conflict over caring for CR (13.2%). Younger CGs (age <65) and those with annual income <$50,000 were more likely to report negative COVID-19 impacts. This study suggests CGs of older adults may be experiencing increased stress, alcohol use, social isolation and negative impacts on their own health and financial situation. Healthcare and social service providers should assess for these EM risk-factors in caregivers and connect them and their care recipients with resources and services to address these stressors to reduce risk of EM during the COVID-19 pandemic.

scholarly journals A Virtual Companionship Intervention Reduces Loneliness During the COVID-19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 966-966
Author(s):  
Ellen Rudy ◽  
Kelsey McNamara ◽  
Rajiv Patel ◽  
Corey Sturm
Keyword(s):  
Risk Factors ◽  
Social Support ◽  
Older Adults ◽  
Social Isolation ◽  
Free Access ◽  
National Service ◽  
Medicare Advantage ◽  
Virtual Visits ◽  
Clinical Conditions ◽  
The Impact

Abstract Loneliness and social isolation are established risk factors for many clinical conditions yet few scalable interventions exist. Papa Inc. is a national service that pairs older adults with “Papa Pals” (empathetic, laypeople) who provide companionship and assistance with everyday tasks. Participants have free access if their Medicare Advantage plan offers it. During the COVID-19 pandemic, Papa provided virtual companionship visits via telephone or video. This study evaluated the impact of virtual companionship visits on loneliness status (UCLA 3-item Loneliness Scale) during the COVID-19 pandemic. The sample (N=894) included adults ages 65+ who identified as lonely at baseline and who completed at least one virtual visit between March 18, 2020 and December 31, 2020. Virtual visits were classified into four categories based on participants’ total number of visit minutes: Low (124 ave min), Medium Low (ML) (305 ave min), Medium High (MH) (567 ave min), and High (1360 ave min). Lonely and severely lonely participants engaged a mean of 573 and 673 minutes in the program, respectively. Improvement in loneliness status was associated with greater use of minutes for the ML and MH participants compared to Low participants (ML OR: 1.46 95CI: 1.00 - 2.11, MH OR 1.65 95CI: 1.13 - 2.40). These findings indicate that a virtual companionship intervention can be an impactful and scalable tool for older adults who want to age at home and have limited social support, especially during the uncertain COVID landscape. Further research is warranted to understand persistent loneliness.

scholarly journals Changes in Elder Mistreatment Risk Factors Reported by Caregivers of Older Adults During the COVID-19 Pandemic

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 73-74
Author(s):  
Lena Makaroun ◽  
Scott Beach ◽  
Tony Rosen ◽  
Ann-Marie Rosland
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Social Isolation ◽  
Social Service ◽  
Service Providers ◽  
Community Sample ◽  
Elder Mistreatment ◽  
Financial Situation ◽  
Care Recipients ◽  
Related Risk

Abstract This study aimed to assess how the COVID-19 pandemic has impacted caregiver (CG)-related risk factors for elder mistreatment (EM) in a community sample of CGs. A non-probability sample of 433 CGs caring for care recipients (CRs) age ≥60 years completed a survey on COVID-19 impacts in April-May 2020. Compared to before COVID-19, over 40% of caregivers reported doing worse financially, 16% were experiencing new financial hardship, 19.4% were a lot more worried about their financial situation, 15% reported drinking more alcohol, and 64% had somewhat or greatly increased feelings of social isolation and loneliness. CGs reported that COVID-19 had made caregiving more physically (18.7%), emotionally (48.5%) and financially (14.5%) difficult and interfered with their own healthcare (19%). Differences found between younger and older caregivers will be presented and implications of these increased CG-related EM risk factors for healthcare and social service providers discussed.

scholarly journals Risk Factors for Social Isolation Among Older Adults in Long Term Care: A Scoping Review

2020 ◽  
Author(s):  
Sheila A. Boamah ◽  
Rachel Weldrick ◽  
Tin-Suet Joan Lee ◽  
Nicole Taylor
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Social Isolation ◽  
Scoping Review ◽  
Long Term Care ◽  
Community Dwelling ◽  
Structural Factors ◽  
Term Care ◽  
Online Databases

Objectives: A wealth of literature has established risk factors for social isolation among older people, however much of this research has focused on community-dwelling populations. Relatively little is known about how risk of social isolation is experienced among those living in long-term care (LTC) homes. We conducted a scoping review to identify possible risk factors for social isolation among older adults living in LTC homes. Methods: A systematic search of five online databases retrieved 1535 unique articles. Eight studies met the inclusion criteria. Results: Thematic analyses revealed that possible risk factors exist at three levels: individual (e.g., communication barriers), systems (e.g., location of LTC facility), and structural factors (e.g., discrimination). Discussion: Our review identified several risk factors for social isolation that have been previously documented in literature, in addition to several risks that may be unique to those living in LTC homes. Results highlight several scholarly and practical implications.

Association between emergency department modifiable risk factors and subsequent delirium among hospitalized older adults

2021 ◽  
Author(s):  
Lucas Oliveira J. e Silva ◽  
Jessica A. Stanich ◽  
Molly M. Jeffery ◽  
Heidi L. Lindroth ◽  
Donna M. Miller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Emergency Department ◽  
Modifiable Risk Factors ◽  
Hospitalized Older Adults
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