Prisoner and Creator of Space and Place: An Interpretive Descriptive QGIS Study to Understand Exercise Experiences of Community-Dwelling Older Adults in a Low-Income Neighborhood

ObjectiveTo systematically review the research conducted on prevalence of frailty and prefrailty among community-dwelling older adults in low-income and middle-income countries (LMICs) and to estimate the pooled prevalence of frailty and prefrailty in community-dwelling older adults in LMICs.DesignSystematic review and meta-analysis. PROSPERO registration number is CRD42016036083.Data sourcesMEDLINE, EMBASE, AMED, Web of Science, CINAHL and WHO Global Health Library were searched from their inception to 12 September 2017.SettingLow-income and middle-income countries.ParticipantsCommunity-dwelling older adults aged ≥60 years.ResultsWe screened 7057 citations and 56 studies were included. Forty-seven and 42 studies were included in the frailty and prefrailty meta-analysis, respectively. The majority of studies were from upper middle-income countries. One study was available from low-income countries. The prevalence of frailty varied from 3.9% (China) to 51.4% (Cuba) and prevalence of prefrailty ranged from 13.4% (Tanzania) to 71.6% (Brazil). The pooled prevalence of frailty was 17.4% (95% CI 14.4% to 20.7%, I2=99.2%) and prefrailty was 49.3% (95% CI 46.4% to 52.2%, I2=97.5%). The wide variation in prevalence rates across studies was largely explained by differences in frailty assessment method and the geographic region. These findings are for the studies with a minimum recruitment age 60, 65 and 70 years.ConclusionThe prevalence of frailty and prefrailty appears higher in community-dwelling older adults in upper middle-income countries compared with high-income countries, which has important implications for healthcare planning. There is limited evidence on frailty prevalence in lower middle-income and low-income countries.PROSPERO registration numberCRD42016036083.

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Engagement in Enriching Early-Life Activities Is Associated With Larger Hippocampal and Amygdala Volumes in Community-Dwelling Older Adults

The Journals of Gerontology Series B ◽

10.1093/geronb/gby150 ◽

2018 ◽

Vol 75 (8) ◽

pp. 1637-1647 ◽

Cited By ~ 2

Author(s):

Kyle D Moored ◽

Thomas Chan ◽

Vijay R Varma ◽

Yi-Fang Chuang ◽

Jeanine M Parisi ◽

...

Keyword(s):

Older Adults ◽

Low Income ◽

Early Life ◽

Underserved Populations ◽

Hippocampal Volume ◽

Community Dwelling ◽

Magnetic Resonance Imaging Scan ◽

Modifiable Factor ◽

Lifestyle Activities ◽

Community Dwelling Older Adults

AbstractObjectivesNumerous studies show benefits of mid- and late-life activity on neurocognitive health. Yet, few studies have examined how engagement in enriching activities during childhood, when the brain is most plastic, may confer long-term neurocognitive benefits that may be especially important to individuals raised in low-income settings. We examined associations between enriching early-life activities (EELAs) and hippocampal and amygdala volumes in a sample of predominantly African-American, community-dwelling older adults. We further assessed whether these associations were independent of current activity engagement.MethodsNinety participants from the baseline Brain Health Substudy of the Baltimore Experience Corps Trial (mean age: 67.4) completed retrospective activity inventories and an magnetic resonance imaging scan. Volumes were segmented using FreeSurfer.ResultsEach additional EELA was associated with a 2.3% (66.6 mm3) greater amygdala volume after adjusting for covariates. For men, each additional EELA was associated with a 4.1% (278.9 mm3) greater hippocampal volume. Associations were specific to these regions when compared with the thalamus, used as a control region.DiscussionEnriching lifestyle activities during an important window of childhood brain development may be a modifiable factor that impacts lifelong brain reserve, and results highlight the importance of providing access to such activities in historically underserved populations.

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PATTERNS OF PSYCHOACTIVE MEDICATION USE IN COMMUNITY-DWELLING OLDER ADULTS IN THE UNITED STATES IN 2015

Innovation in Aging ◽

10.1093/geroni/igz038.2608 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S710-S710

Author(s):

Rashmita Bajracharya ◽

Danya Qato

Keyword(s):

Older Adults ◽

Low Income ◽

Medical Expenditure Panel Survey ◽

The United States ◽

Community Dwelling ◽

Medical Expenditure ◽

Cross Sectional ◽

Psychoactive Medication ◽

Community Dwelling Older Adults ◽

Psychoactive Medications

Abstract Per the 2015 Beer’s Criteria, most psychoactive medications are identified as potentially inappropriate for use in older adults as this population is especially vulnerable to the potential adverse effects associated with psychoactive medications, including sedation, anticholinergic effects, and falls. Past studies found increasing use of psychoactive medications in community-dwelling older adults; however, patterns of use by other sociodemographic, socioeconomic, and clinical subgroups have not been explored. This is a cross-sectional analysis of 2015 Medical Expenditure Panel Survey in a sample of 6122 older adults (60-85 years). We utilized Andersen’s Behavioral Model of Health Services Utilization to guide logistic regression model development and estimated odds ratios (OR) with 95% confidence intervals (CI) to quantify the association between psychoactive use and predisposing(sex and race); enabling(marital status, education, poverty, insurance); and need-based[multi-morbidity and activities of daily living (ADL) limitations] factors. Over 30% of older adults in the U.S. reported taking a psychoactive medication in 2015. Prevalence of use was significantly higher in women (35.9%), the unmarried(34.1%), low-income(35.7%), white(34.0%), multimorbid (32.0%), and ADL limitation groups (45.9%) compared to men, married, high-income, other races, not multimorbid, and no ADL limitations groups, respectively. Female sex [OR=1.62(1.38-1.91)], low-income [OR=1.30(1.04-1.6)], multimorbidity [OR=3.2(2.6-3.9)], and ADL limitations [OR=2.2(1.7-2.8)] were identified as independent predictors of psychoactive use. There is differential use of psychoactive medications by sociodemographic, socioeconomic, and clinical factors. Given the increased complexity of pharmacotherapy regimens, especially in those with multimorbidity and ADL limitations, improved efforts aimed at prudent use of psychoactive medications should be intensified.

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AN ACTING AND IMPROV CLASS: WELL-BEING AND COMMUNITY BELONGING FOR OLDER AFRICAN AMERICANS IN LOW-INCOME HOUSING

Innovation in Aging ◽

10.1093/geroni/igz038.520 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S144-S144

Author(s):

Laura Sutherland ◽

Ruth E Dunkle ◽

Garrett T Pace ◽

Ariel Kennedy ◽

Pat Baldwin

Keyword(s):

Older Adults ◽

Low Income ◽

Participant Observation ◽

Well Being ◽

Community Dwelling ◽

Structured Interviews ◽

Public Performance ◽

Community Belonging ◽

Community Dwelling Older Adults ◽

Low Income Housing

Abstract Arts-based interventions can enhance the quality of life of older adults, but community-dwelling older adults may have reduced access to such interventions. The purpose of this study was to examine whether a creative arts program can improve the overall health and well-being of older adults in low-income housing. A university social work department and community agency collaborated in establishing a professionally run theater group of older adults in two low-income housing buildings in an urban area. All residents were encouraged to participate. The study consisted of three twelve-week acting and improvisation courses, focusing on either staged reading of monologues and dialogues, co-writing a script, or staged reading of a complete play. Each class culminated in a public performance for the building. Fourteen participants enrolled, all African American (11 women, 3 men; mean age 66 years; mean ADL = 1.4 (range of 1-2.5)). Attendance on average was 8 classes. Data were collected through pre- and post-test questionnaires, participant observation of class sessions, semi-structured interviews with building managers, and post-session participant reflections. Thematic analysis was performed, and revealed key themes of increased community belonging, increased confidence, and increased daily coping abilities. Additional themes included the gaining of new artistic skills and interest in continuing classes. Barriers to participation included difficulty in recruitment and absence due to ongoing health conditions and caregiving responsibilities. This project has implications for the potential of arts-based programming to increase well-being for underrepresented community-dwelling older adults.

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Psychometric Testing of the Korean Version of the Attitudes toward the Advance Directives in Low-Income Chronically Ill Older Adults

Healthcare ◽

10.3390/healthcare8010062 ◽

2020 ◽

Vol 8 (1) ◽

pp. 62

Author(s):

JinShil Kim ◽

Seongkum Heo ◽

Sun Woo Hong ◽

HeeRyang Kim ◽

Ahrang Jung ◽

...

Keyword(s):

Older Adults ◽

Factor Structure ◽

Advance Directives ◽

Low Income ◽

Psychometric Testing ◽

Chronically Ill ◽

Community Dwelling ◽

Model Fit ◽

Advance Care ◽

Community Dwelling Older Adults

The purpose of this study was to examine the psychometric properties of the Advance Directive Attitude Survey in Korean (K-ADAS), a measure of attitudes toward advance directives (ADs). A total of 118 low-income, community-dwelling older adults (mean age, 75.09 years) participated. An exploratory factor analysis (EFA) was conducted to determine the factor structure of the K-ADAS. Validity was further assessed by known associations of the K-ADAS with perceived susceptibility and severity using part of the Advance Care Planning surveys. Its reliability was examined by calculating alpha coefficients. EFA determined a three-factor structure model with good model fit. Validity was further supported with significant correlations between the K-ADAS and susceptibility and severity. Reliability was supported by adequate level of Cronbach’s alpha. The K-ADAS was a valid and reliable measure for assessment of AD attitudes with a sound model fit. Thus, the K-ADAS can be used to assess AD attitudes among community-dwelling elders.

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ROBBING PETER TO PAY PAUL: HANDLING FINANCIAL CHALLENGES AMONG LOW-INCOME OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.017 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S6-S6

Author(s):

Laura Samuel ◽

Rebecca Wright ◽

Melissa Spahr ◽

Laken C Roberts ◽

Sarah L Szanton

Keyword(s):

Older Adults ◽

Low Income ◽

Community Dwelling ◽

Community Resources ◽

Snowball Sampling ◽

Community Programs ◽

Public Benefits ◽

The Social ◽

Financial Challenges ◽

Community Dwelling Older Adults

Abstract Low income older adults often face financial challenges which increase their risk for earlier disability and mortality. This study explored the social norms, beliefs and practices relevant to handling financial challenges among low-income community-dwelling older adults residing near Baltimore, MD whom we recruited using convenience and snowball sampling. Four vignette-based focus group sessions included 28 participants. Using hierarchical thematic analysis, three key themes emerged. First, the theme “Rob Peter to pay Paul” describes the consensus that individuals must prioritize financial needs, which required individuals to “work with a budget”, apply for aid, “cry for [aid]” and, when needed, “work something out” with landlords and lenders. One participant described the amount of work by saying “We’re retired but we’re working for ourselves.” Secondly, the theme “Your rent should be first” describes how low income older adults prioritize housing over food and other needs because “resources for housing is a problem” and because homelessness is both more permanent and socially stigmatizing than hunger - “Don’t nobody know you’re hungry unless you tell them, but everybody know when you outdoors.” Finally, the theme “We need to put the word out” describes the consensus that public benefits and community resources should be made more visible and accessible. Many individuals only know about resources because they seek information (“you go and you find out”), but “ it’s hard to ask for help. ” These results can inform the development and improvement of financial and community programs and policies for low-income older adults addressing financial challenges.

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Functional Goals and Predictors of Their Attainment in Low-Income Community-Dwelling Older Adults

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2016.11.017 ◽

2017 ◽

Vol 98 (5) ◽

pp. 896-903 ◽

Cited By ~ 8

Author(s):

Brian W. Waldersen ◽

Jennifer L. Wolff ◽

Laken Roberts ◽

Allysin E. Bridges ◽

Laura N. Gitlin ◽

...

Keyword(s):

Older Adults ◽

Low Income ◽

Community Dwelling ◽

Community Dwelling Older Adults

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CAPABLE Program Improves Disability in Research and Implementation Settings

Innovation in Aging ◽

10.1093/geroni/igab046.449 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 118-118

Author(s):

Sarah Szanton ◽

Qiwei Li ◽

Laura Gitlin

Keyword(s):

Older Adults ◽

Low Income ◽

Cost Savings ◽

Community Dwelling ◽

Community Based ◽

Adults With Disabilities ◽

Community Based Organizations ◽

Cognitively Intact ◽

Community Dwelling Older Adults ◽

Multiple Health

Abstract Interventions to reduce disability are crucial for older adults with disabilities to avert unnecessary hospitalizations or nursing home placements and improve daily life. Developed and tested at one research site, multiple health systems and community based organizations have since implemented CAPABLE. All published or peer reviewed tests of CAPABLE were reviewed (six studies, 11 sites) with a total of 1087 low-income community-dwelling older adults with disabilities. Participants were an average age of 74-79, cognitively intact, and self-reported difficulty with one or more activities of daily living (ADL). These trials were reviewed by extracting the participants’ scores on main outcomes, ADLs and IADLs, and when available, fall efficacy, depression, pain and cost savings. All studies yielded improvements in ADL and IADL limitations, with small to strong effect sizes. Studies with the complete dose of CAPABLE showed more improvement in ADLs and cost savings than the studies that implemented a decreased dose.

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