scholarly journals Neighborhood age structure and cognitive function in a nationally-representative sample of older adults in the U.S.

2017 ◽  
Vol 174 ◽  
pp. 149-158 ◽  
Author(s):  
Esther M. Friedman ◽  
Regina A. Shih ◽  
Mary E. Slaughter ◽  
Margaret M. Weden ◽  
Kathleen A. Cagney
Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Madeline B Zipperer ◽  
James R Churilla ◽  
Michael R Richardson

Introduction: There is limited evidence examining the combined effects of cognitive function and C-reactive protein (CRP) on mortality risk using a large nationally representative sample of U.S. adults. Hypothesis: We assessed the hypothesis that cognitive function and CRP produce a combined effect in predicting all-cause mortality risk. Objective: Examine the combined effects of cognitive function and CRP in predicting all-cause mortality in a large nationally representative sample of U.S. adults. Methods: The study sample (n=2,111) included older adults (≥ 60 years of age) who participated in the 1999-2002 National Health and Nutrition Examination Survey. A four-level variable was created based on CRP concentration and cognitive function (high cognitive function and low to average CRP; high cognitive function and high CRP; low cognitive function and low to average CRP; low cognitive function and high CRP). Results: Compared to a referent group with low to average CRP and high cognitive function, analysis revealed a statistically significant increase in risk of all-cause mortality in adults with high CRP and low cognitive function (Hazards Ratio [HR] 1.97; 95% Confidence Interval [CI], 1.52-2.55, p<0.0001) and in adults with low to average CRP and low cognitive function (HR 1.76; 95% CI, 1.44-2.15, p<0.0001). Similar relationships were not revealed in adults with high cognitive function, regardless of CRP concentration. Conclusions: In a large nationally representative sample of older U.S. adults, low cognitive function was associated with increased all-cause mortality risk independent of CRP concentration.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S806-S806
Author(s):  
Alicia Riley

Abstract This study examines regional disparities in later life health from a life course perspective. To sort out when and how region influences health over the life course, I focus on the sharp contrast between the South and the rest of the U.S. in health and mortality. I draw on data from the National Life Health and Aging Project (NSHAP), a nationally representative sample of community-dwelling older adults in the U.S., to estimate the differential risk of multiple health outcomes and mortality by regional trajectory. I find that older adults who leave the South are worse off in multiple outcomes than those who stay. I also find evidence of a protective health effect of community cohesion and dense social networks for the Southerners who stay in the South. My results suggest that regional trajectory influences health in later life through its associations with socioeconomic status, access to healthcare, and social rootedness.


2020 ◽  
pp. 1-8
Author(s):  
A. Rotstein ◽  
S. Z. Levine

ABSTRACT Background: Cumulative evidence suggests that health-related risk factors during midlife and old-age are associated with cognitive impairment. However, studies are needed to clarify the association between early-life risk factors and impaired cognitive functioning to increment existing knowledge. Objective: To examine the association between childhood infectious diseases and late-life cognitive functioning in a nationally representative sample of older adults. Participants: Eligible respondents were 2994 community-dwelling individuals aged 65–85. Measurements: Cognitive functioning was assessed using the Mini-Mental State Examination (MMSE). Childhood infectious diseases (i.e. chicken pox, measles, and mumps) were self-reported. The study covariates were age, sex, highest educational level achieved, smoking status, body mass index, and depression. The primary statistical analysis examined the association between the number of childhood infectious diseases and total MMSE scores, accounting for all study covariates. Regression models of progressive complexity were examined for parsimony. The robustness of the primary results was tested in 17 sensitivity analyses. Results: The most parsimonious model was a linear adjusted model (Bayesian Information Criterion = 12646.09). Late-life cognitive functioning significantly improved as the number of childhood infectious diseases increased (β = 0.18; 95% CI = 0.11, 0.26; p < 0.001). This effect was not significantly attenuated in all sensitivity analyses. Conclusion: The current study results are consistent with prior ecological findings indicating that some childhood infectious diseases are associated with better cognitive functioning in old-age. This points to an early-life modifiable risk factor associated with older-life cognitive functioning. Our results may reflect selective mortality and/or beneficial effects via hormetic processes.


Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 341
Author(s):  
David R. Axon ◽  
Shannon Vaffis ◽  
Srujitha Marupuru

The prevalence of older adults with pain and comorbid cardiovascular conditions is increasing in the United States (U.S.). This retrospective, cross-sectional database study used 2017 Medical Expenditure Panel Survey data and hierarchical logistic regression models to identify predictive characteristics of opioid use among a nationally representative sample of older U.S. adults (aged ≥50 years) with pain in the past four weeks and comorbid hypertension (pain–hypertension group) or hypercholesterolemia (pain–hypercholesterolemia group). The pain–hypertension group included 2733 subjects (n = 803 opioid users) and the pain–hypercholesterolemia group included 2796 subjects (n = 795 opioid users). In both groups, predictors of opioid use included: White race versus others, Hispanic versus non-Hispanic ethnicity, 1 versus ≥5 chronic conditions, little/moderate versus quite a bit/extreme pain, good versus fair/poor perceived mental health, functional limitation versus no functional limitation, smoker versus non-smoker, and Northeast versus West census region. In addition, Midwest versus West census region was a predictor in the pain–hypertension group, and 4 versus ≥5 chronic conditions was a predictor in the pain–hypercholesterolemia group. In conclusion, several characteristics of older U.S. adults with pain and comorbid hypertension or hypercholesterolemia were predictive of opioid use. These characteristics could be addressed to optimize individuals’ pain management and help address the opioid overdose epidemic.


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