Spousal Bereavement and the Cognitive Health of Older Adults in the US: New Insights on Channels, Single Items, and Subjective Evidence

ABSTRACTBackground:National differences in cognitive health of older adults provide an opportunity to shed light on etiological factors. We compared the cognitive health of older adults in New Zealand and the USA, and examined differences in known risk factors.Methods:Two nationally representative samples were derived from the 2010 waves of the New Zealand Longitudinal Study of Ageing (n = 953) and the US Health and Retirement Study (HRS) (n = 3,746). Data from comparable measures of cognitive function, gender, age, income, education, prevalence of cancer, diabetes, heart disease, hypertension and stroke, exercise, alcohol consumption, smoker status, depression, and self-reported health were subjected to hierarchical regression analysis to examine how national differences in cognitive function might be explained by differences in these risk factors.Results:The New Zealand sample scored 4.4 points higher on average than the US sample on the 43 point cognitive scale. Regression analyses of the combined samples showed that poorer cognitive health is more likely in those who are male, older, less educated, have suffered a stroke, consume alcohol less frequently, are more depressed, and report worse overall health. Controlling for age and sex reduced the mean difference to 2.6 and controlling for risk factors further reduced it to 2.3.Conclusions:Older New Zealand adults displayed better cognitive function than those in a US sample. This advantage can be partially explained by age and sex differences and, to some extent, by differences in known risk factors. However, the national advantage remained even when all measured risk factors are statistically controlled.

Download Full-text

A Comparison of Cognitive Function in Pine Study to Health and Retirement Study & CHARLS Study

Innovation in Aging ◽

10.1093/geroni/igaa057.3390 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 924-924

Author(s):

Charu Verma ◽

Mailun Zhang ◽

Mengting Li ◽

Stephanie Bergren ◽

XinQi Dong

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Cognitive Function ◽

Social Engagement ◽

Conditional Logistic Regression ◽

Chinese Americans ◽

Conditional Logistic Regression Model ◽

Cognitive Health ◽

Chinese Older Adults ◽

The Us

Abstract Healthy immigrant theory assumes that immigrants have better health than natives, while it remains unclear whether this theory applies to older Chinese Americans with respect to cognitive health. The objective of this study was to estimate the differences in cognitive function between the US and Chinese older adults. PINE (n=3,157) (2011-2013) with Chinese older adults was compared to HRS study (2010-2011) (n=22,034) and HRS sister CHARLS (n=17,708) (2010-2011). Cognitive function was assessed by episodic memory, working memory, executive function, and MMSE. Cognition impairment was defined by 1.5 standard deviations below mean of z scores. After 1:1 matched samples determined by propensity score and verified by McNemar and Cohen’s Kappa test, conditional logistic regression model with demographic variables controlled was used to assess the differences between the three studies. Multivariable analyses results showed that participants from PINE are 5.667 (OR= 5.667, 95% CI 3.893-8.248, p < .001) times more likely to have cognitive impairment in comparison to HRS’s and 0.166 (OR= 0.166, 95% CI 0.136-0.203, p < .001) times less likely in comparison to CHARLS’s. Result demonstrated that Chinese older adults living in the US have a higher likelihood of cognitive impairment in comparison to the US older adults but less likely than those living in China. Healthy immigrant theory is partially supported in Chinese Americans. Immigrants with better cognitive health are likely to migrate to the US, but limited social engagement in the receiving communities might be a risk factor for cognitive function, leading to worse cognitive health than natives.

Download Full-text

A Qualitative Study of the Aging Experience among Korean Older Adults Residing in Urban, Rural, and the US Immigrant Context

Korea Gerontological Society ◽

10.31888/jkgs.2019.39.3.589 ◽

2019 ◽

Vol 39 (3) ◽

pp. 589-612

Author(s):

Jun-woo Lee ◽

Jenny H Pak ◽

Hyuna Lee

Keyword(s):

Older Adults ◽

Qualitative Study ◽

The Us ◽

Urban Rural

Download Full-text

The Value of Vaccination in Older Adults: The Why

Innovation in Aging ◽

10.1093/geroni/igaa057.2929 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 806-807

Author(s):

Philip Buck

Keyword(s):

Older Adults ◽

Time Horizon ◽

Pneumococcal Disease ◽

Population Aging ◽

Indirect Costs ◽

Health Behavior Change ◽

Vaccine Preventable Diseases ◽

Time Period ◽

The Us ◽

The Impact

Abstract The incidence of vaccine-preventable diseases remains high among older adults in the US, despite longstanding immunization recommendations, and is projected to increase as the population ages. The impact of US population aging on the burden of four vaccine-preventable diseases (influenza, pneumococcal disease, shingles, and pertussis) was modeled over a 30-year time horizon, with cumulative direct and indirect costs increasing from $378 billion over 10 years to $1.28 trillion over 30 years. Compared to current levels of vaccination coverage, increasing coverage was predicted to avert over 33 million cases of disease and greater than $96 billion in disease-associated costs, with a corresponding increase in vaccination costs of approximately $83 billion over the entire 30-year time period. Specific examples of cost-effectiveness analyses that assess the epidemiologic and economic impact of vaccination against shingles and pertussis in older adults will be discussed. Part of a symposium sponsored by the Health Behavior Change Interest Group.

Download Full-text

Engaging and Educating Older Adults and Caregivers in Age-Friendly Healthcare

Innovation in Aging ◽

10.1093/geroni/igaa057.2397 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 686-686

Author(s):

Erin Emery-Tiburcio ◽

Rani Snyder

Keyword(s):

Older Adults ◽

New York ◽

Health System ◽

Medical Center ◽

Health Resources ◽

Primary Care Providers ◽

Care Providers ◽

New York University ◽

The Us ◽

Treatment Plans

Abstract As the Age-Friendly Health System initiative moves across the US and around the world, not only do health system staff require education about the 4Ms, but older adults, caregivers, and families need education. Engaging and empowering the community about the 4Ms can improve communication, clarify and improve adherence to treatment plans, and improve patient satisfaction. Many methods for engaging the community in age-friendly care are currently in development. Initiated by Health Resources and Services Administration (HRSA)-funded Geriatric Workforce Enhancement Programs (GWEPs), Community Catalyst is leading the co-design of Age-Friendly Health System materials with older adults and caregivers. Testing these materials across the country in diverse populations of older adults and caregivers will yield open-source documents for local adaptation. Rush University Medical Center is testing a method for identifying, engaging, educating, and providing health services for family caregivers of older adults. This unique program integrates with the Age-Friendly Health System efforts in addressing all 4Ms for caregivers. The Bronx Health Corps (BHC) was created by the New York University Hartford Institute of Geriatric Nursing to educate older adults in the community about health and health behaviors. BHC developed a method for engaging and educating older adults that is replicable in other communities. Baylor College of Medicine adapted and tested the Patient Priorities Care model to educate primary care providers about how to engage older adults in conversations about What Matters to them. Central to the Age-Friendly movement, John A. Hartford Foundation leadership will discuss the implications of this important work.

Download Full-text

Sex in Late Life: Assessing Adults’ Expectations and the Role of Healthcare Professionals

Innovation in Aging ◽

10.1093/geroni/igaa057.1003 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 313-313

Author(s):

Jill Naar ◽

Raven Weaver ◽

Shelbie Turner

Keyword(s):

Older Adults ◽

Sexual Health ◽

Health Behaviors ◽

Healthcare Professionals ◽

Late Life ◽

Sexual History ◽

Growth Curve Models ◽

The Us ◽

Sexual Health Behaviors ◽

The Life Course

Abstract Sexual activity contributes to quality of life throughout the lifespan. However, stigma about sex in late life influences older adults’ perceptions and healthcare professionals’ perceptions of older adults’ sexual health/behaviors. Using a multi-methods approach, we examined attitudes and knowledge about sexual health/behaviors in late life. Using longitudinal data from the Midlife in the US Study (Wave 1-3; N=7049), we ran age-based growth curve models to analyze changes in levels of optimism about sex in their future. We also piloted a survey with healthcare professionals assessing attitudes, knowledge, and awareness of policy about sexual health/behaviors among older adults. Adults’ expectations became less optimistic with increased age (β = -0.1, SE = 0.003, p < .0001). Men were more optimistic than women at age 20 (p = 0.016), but men’s optimism decreased over the life course at a faster rate than did women’s (p < .0001), so that from ages 40-93, men were less optimistic than women. Among healthcare professionals (N=21), the majority indicated never or rarely asking their clients about sexual history or health/behaviors; however, they indicated some knowledge about issues relevant to older adults (e.g., safe-sex practices, sexual dysfunction). Few indicated awareness about policies related to sexual behavior among residents (i.e., issues of consent, STIs). Among adults, there is a need to address declining optimism for expectations about sex in late life. Health professionals are well-situated to raise awareness and normalize discussions about sexual health, thus countering negative stigma and contributing to increasing optimism for expectations to remain sexually active.

Download Full-text

1381. Rotavirus Gastroenteritis among older adults: discussion based on a systematic literature review

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1563 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S700-S701

Author(s):

Cristina Carias ◽

Susanne Hartwig ◽

M Nabi Kanibir ◽

Ya-Ting Chen

Keyword(s):

Older Adults ◽

High Risk ◽

Acute Gastroenteritis ◽

Rate Ratio ◽

Rotavirus Gastroenteritis ◽

Incident Rate Ratio ◽

The Us ◽

Incident Rate ◽

The Uk ◽

Retrospective Database

Abstract Background While the burden of Rotavirus Gastroenteritis (RGE) is well recognized in young children, it is less so in older adults. However, older adults are also at high-risk of Acute Gastroenteritis (AGE) severe outcomes. In this review, we thus aimed to comprehensively assess RGE burden and vaccination impact in older individuals. Methods We performed a systematic literature review with PubMed and Scopus, from 2000 to 2019, using MESH and free-range terms. We included only studies that reported the incidence, and/or RV vaccination impact, in adults aged 60 and above and using regional specific data-sources. Results We analyzed 11 manuscripts for individuals aged 60 and above (Figure 1). Studies spanned Australia, Sweden, Netherlands, Canada (2), Germany (2), UK (2), and the US (2). Yearly inpatient RV incidence varied between 1.6 per 100,000 in Australia for those 65+ (retrospective database analyses, pre-vaccine); and 26 per 100,000 for those 85+ in Canada (modeling estimates for 2006-10, pre-vaccine). The incidence rate ratio for inpatient RGE between the post and pre-vaccine periods for those 65+ was 0.57 [95% CI: 0.10 – 3.15] in Canada, but 2.24 [95%CI: 1.78-2.83] in Australia, which may be due to increased testing for RV in the elderly post-vaccine. Reductions in the post-vaccination burden of RV and AGE among 60+ were reported in the UK (2 studies), and the US (2 studies) via retrospective database analyses In the UK, post-vaccine reductions in AGE health care-utilization were reported in the Emergency Department (21%), and outpatient centers (walk-in centers: 47%; general practice consultations: 36%). Retrospective database analyses documenting the incident rate ratio (IRR) of Rotavirus Gastroenteritis (RGE) and Acute Gastroenteritis (AGE) in older adults between the pre and post-vaccine period. Retrospective database analyses documenting the incident rate ratio (IRR) of Rotavirus Gastroenteritis (RGE) and Acute Gastroenteritis (AGE) in older adults between the pre and post-vaccine period. Conclusion While the burden of RGE mainly falls on young children, it also affects older adults. Retrospective database analyses reveal that, likely due to indirect vaccination benefits, increases in RV vaccination coverage have had an impact on lowering RGE, and AGE cases and healthcare utilization in older adults, a group at high-risk of severe outcomes for AGE. Disclosures Cristina Carias, PhD, Merck (Employee, Shareholder) Susanne Hartwig, n/a, MSD Vaccins (Employee) M.Nabi Kanibir, MD, Merck/MSD (Employee, Shareholder) Ya-Ting Chen, PhD, Merck & Co., Inc. (Employee, Shareholder)

Download Full-text

The Impact of Function Focused Care From Acute Care to Home Care and Nursing Homes

Innovation in Aging ◽

10.1093/geroni/igaa057.2148 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 629-629

Author(s):

Silke Metzelthin ◽

Sandra Zwakhalen ◽

Barbara Resnick

Keyword(s):

Older Adults ◽

The Netherlands ◽

Home Care ◽

Acute Care ◽

Long Term Care ◽

Functional Decline ◽

Term Care ◽

The Us ◽

The Impact

Abstract Functional decline in older adults often lead towards acute or long-term care. In practice, caregivers often focus on completion of care tasks and of prevention of injuries from falls. This task based, safety approach inadvertently results in fewer opportunities for older adults to be actively involved in activities. Further deconditioning and functional decline are common consequences of this inactivity. To prevent or postpone these consequences Function Focused Care (FFC) was developed meaning that caregivers adapt their level of assistance to the capabilities of older adults and stimulate them to do as much as possible by themselves. FFC was first implemented in institutionalized long-term care in the US, but has spread rapidly to other settings (e.g. acute care), target groups (e.g. people with dementia) and countries (e.g. the Netherlands). During this symposium, four presenters from the US and the Netherlands talk about the impact of FFC. The first presentation is about the results of a stepped wedge cluster trial showing a tendency to improve activities of daily living and mobility. The second presentation is about a FFC training program. FFC was feasible to implement in home care and professionals experienced positive changes in knowledge, attitude, skills and support. The next presenter reports about significant improvements regarding time spent in physical activity and a decrease in resistiveness to care in a cluster randomized controlled trial among nursing home residents with dementia. The fourth speaker presents the content and first results of a training program to implement FFC in nursing homes. Nursing Care of Older Adults Interest Group Sponsored Symposium

Download Full-text

A Scoping Review of Interventions for Spousal Bereavement in Older Adults

American Journal of Geriatric Psychiatry ◽

10.1016/j.jagp.2021.08.002 ◽

2021 ◽

Author(s):

Jennie B. Davidow ◽

Benjamin S. Zide ◽

Leonard L Levin ◽

Kelsey D Biddle ◽

Juan Carlos Urizar ◽

...

Keyword(s):

Older Adults ◽

Scoping Review ◽

Spousal Bereavement

Download Full-text

Driving Cessation and Social Participation in Late Life: A Systematic Review

Innovation in Aging ◽

10.1093/geroni/igaa057.1504 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 464-464

Author(s):

Weidi Qin

Keyword(s):

Older Adults ◽

Social Participation ◽

Social Engagement ◽

Social Life ◽

Late Life ◽

Cochrane Library ◽

Inclusion Criteria ◽

Driving Cessation ◽

The Us

Abstract Driving cessation is a major life transition in late life, and can affect the quality of social life in older adults. The present study aims to systematically review the literature on how driving cessation affects social participation among older adults in the US. The study selection followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Extant literature published from 1990 to 2019 that examined driving cessation and social participation or social engagement among older adults in the US was searched using eight search engines: PsycINFO, CINAHL, SocIndex, AgeLine, MedLine, Scopus, Transportation Research Board Publication Index, and Cochrane Library. Quantitative studies that met the inclusion criteria were reviewed. The assessment of methodological quality was also conducted for included studies. In total, seven studies met the inclusion criteria. Six of the included studies found significant relationships between driving cessation and at least one domain of social participation, such as volunteering, employment, leisure-time activities, and the frequency of contacts. However, the measures of social participation were inconsistent across studies, which might explain that no effects of driving cessation were found on the structure of social network, such as contacts with friends and extended family. There is a need to assist older adults in successfully transitioning to driving cessation and maintaining the social participation. The overall quality of included studies is moderate based on the assessment of risk of bias and confounding.

Download Full-text