The Impact of Socioeconomic Status on Coronary Disease Status and Lipid Lowering in the Setting of Secondary Prevention: A Population-based Study of Older Adults

Abstract Adherence to a healthy lifestyle –characterized by abstaining from smoking, being physically and cognitively active, having a high-quality diet, and limiting alcohol use– is associated with slower cognitive decline in older adults, but whether this relationship extends to individuals with a genetic predisposition (e.g., ApoE4 carriers) remains uncertain. From the population-based study, the Chicago Health and Aging Project, we followed 3,886 individuals with regular clinical and cognitive assessments from 1993 to 2012. Of 3,886 older adults, 1,269 (32.7%) were ApoE4 carriers. Compared to non-carries, ApoE4 carriers had a faster cognitive decline by -0.027 (95%CI -0.032, -0.023) units per year. In contrast, individuals with 2-3 and 4-5 healthy lifestyle factors had a slower cognitive decline by 0.008 (95%CI 0.002, 0.014) and 0.019 (95%CI 0.011, 0.026) units per year, compared to those with 0-1 factor. In analyses stratified by ApoE4 status, adherence to a healthy lifestyle (e.g., 4-5 vs. 0-1 factors) was associated with a slower rate of cognitive decline in both ApoE4 carriers ($\beta$=0.029 units/year; 95%CI 0.013, 0.045) and non-carriers ($\beta$=0.013, 95%CI 0.005, 0.022). These results underscore the impact of a healthy lifestyle on cognition, particularly among individuals with a genetic predisposition who are more vulnerable to cognitive decline as they age.

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The Impact of Socioeconomic Status, Surgical Resection and Type of Hospital on Survival in Patients with Pancreatic Cancer. A Population-Based Study in The Netherlands

PLoS ONE ◽

10.1371/journal.pone.0166449 ◽

2016 ◽

Vol 11 (11) ◽

pp. e0166449 ◽

Cited By ~ 19

Author(s):

Margijske H. G. van Roest ◽

Maaike A. van der Aa ◽

Lydia G. M. van der Geest ◽

Koert P. de Jong

Keyword(s):

Pancreatic Cancer ◽

Socioeconomic Status ◽

The Netherlands ◽

Surgical Resection ◽

Population Based ◽

Population Based Study ◽

The Impact

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Prevalence of Disability According to Multimorbidity and Disease Clustering: A Population-Based Study

Journal of Comorbidity ◽

10.15256/joc.2011.1.3 ◽

2011 ◽

Vol 1 (1) ◽

pp. 11-18 ◽

Cited By ~ 22

Author(s):

Alessandra Marengoni ◽

Sara Angleman ◽

Laura Fratiglioni

Keyword(s):

Older Adults ◽

Hip Fracture ◽

Chronic Diseases ◽

Functional Disability ◽

Disease Status ◽

Population Based ◽

Swedish Population ◽

Population Based Study ◽

Logistic Regression Models ◽

Organ Systems

Background The prevalence of chronic diseases has increased with population ageing, and research has attempted to elucidate the correlation between chronic diseases and disability. However, most studies in older populations have focused on the effect of single disabling conditions, even though most older adults have more than one chronic disease (multimorbidity). Objective The aims of this study were to evaluate the association of disability with disease, in terms of multimorbidity and specified pairs of diseases, in a population-based study of older adults. Materials and Methods Using the Kungsholmen Project, we estimated the prevalence of disability by the number of chronic diseases, disease status by organ systems, and in specific pairs of chronic conditions, in a Swedish population ( n=1,099; ≥77 years). Disability was defined as need of assistance in at least one activity of daily living (Katz index). Results Functional disability was seen in 17.9% of participants. It increased as the number of chronic diseases increased. The prevalence of disability varied greatly amongst specific pairs of diseases: from 6.7% in persons affected by hypertension and atrial fibrillation to 82.4% in persons affected by dementia and hip fracture. In multivariate logistic regression models, the disease pairs that were significantly associated with the highest increased relative odds of disability contained dementia (dementia–hip fracture, dementia–CVD, and dementia–depression). Conclusions Our findings suggest specific pairs of diseases are much more highly associated with disability than others, particularly diseases coupled with dementia. This knowledge may improve prevention of disablement and planning of resource distribution.

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An Innovative Individual-Level Socioeconomic Measure Predicts Critical Care Outcomes in Older Adults: A Population-Based Study

Journal of Intensive Care Medicine ◽

10.1177/0885066620931020 ◽

2020 ◽

pp. 088506662093102

Author(s):

Amelia Barwise ◽

Chung-Il Wi ◽

Ryan Frank ◽

Bojana Milekic ◽

Nicole Andrijasevic ◽

...

Keyword(s):

Older Adults ◽

Socioeconomic Status ◽

Critical Care ◽

Intensive Care ◽

Population Based ◽

Adult Patients ◽

Critical Care Outcomes ◽

Individual Level ◽

Care Outcomes ◽

The Impact

Background: Little is known about the impact of socioeconomic status (SES) as a key element of social determinants of health on intensive care unit (ICU) outcomes for adults. Objective: We assessed whether a validated individual SES index termed HOUSES (HOUsing-based SocioEconomic status index) derived from housing features was associated with short-term outcomes of critical illness including ICU mortality, ICU-free days, hospital-free days, and ICU readmission. Methods: We performed a population-based cohort study of adult patients living in Olmsted County, Minnesota, admitted to 7 intensive care units at Mayo Clinic from 2011 to 2014. We compared outcomes between the lowest SES group (HOUSES quartile 1 [Q1]) and the higher SES group (HOUSES Q2-4). We stratified the cohort based on age (<50 years old and ≥50 years old). Results: Among 4134 eligible patients, 3378 (82%) patients had SES successfully measured by the HOUSES index. Baseline characteristics, severity of illness, and reason for ICU admission were similar among the different SES groups as measured by HOUSES except for larger number of intoxications and overdoses in younger patients from the lowest SES. In all adult patients, there were no overall differences in mortality, ICU-free days, hospital-free days, or ICU readmissions in patients with higher SES compared to lower SES. Among older patients (>50 years), those with higher SES (HOUSES Q2-4) compared to those with lower SES (HOUSES Q1) had lower mortality rates (hazard ratio = 0.72; 95% CI: 0.56-0.93; adjusted P = .01), increased ICU-free days (mean 1.08 days; 95% CI: 0.34-1.84; adjusted P = .004), and increased hospital-free days (mean 1.20 days; 95% CI: 0.45-1.96; adjusted P = .002). There were no differences in ICU readmission rates (OR = 0.74; 95% CI: 0.55-1.00; P = .051). Conclusion: Individual-level SES may be an important determinant or predictor of critical care outcomes in older adults. Housing-based socioeconomic status may be a useful tool for enhancing critical care research and practice.

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