The association between loneliness and medication use in older adults

2020 ◽  
Author(s):  
Manav V Vyas ◽  
Jennifer A Watt ◽  
Amy Y X Yu ◽  
Sharon E Straus ◽  
Moira K Kapral
Keyword(s):  
Older Adults ◽  
Odds Ratio ◽  
Regression Models ◽  
Healthy Aging ◽  
Multinomial Logistic Regression ◽  
Medication Use ◽  
Opioid Analgesics ◽  
Adverse Outcomes ◽  
University Of California ◽  
Logistic Regression Models

Abstract Background Loneliness is common in older adults, and it is associated with unhealthy behaviours, including substance use. We evaluated the association between loneliness and self-reported use of opioids and benzodiazepines in older adults. Methods We used data from the Canadian Community Health Survey’s ‘Healthy Aging’ sub-survey and included adults 65 years or older who administered their own medications. We classified individuals as lonely if they scored 6 or more on the three -item University of California, Los Angeles’s Loneliness Scale. We used multinomial logistic regression models, adjusting for demographics and self-reported comorbidities, to describe the association between loneliness and daily or occasional use of opioids, benzodiazepines and non-opioid analgesics. We also explored the association between loneliness and polypharmacy. Results Our cohort included 15,302 older adults, of whom 2,096 (13.7%) were classified as lonely. Daily use of opioids (4.1%) and benzodiazepines (1.7%) were less common than daily use of non-opioid analgesics (33.9%). Lonely older adults had higher daily use of opioids (odds ratio [OR] 1.61, 1.31-1.98) and benzodiazepines (OR 1.66, 1.21-2.28), but not non-opioid analgesics (OR 1.05, 0.92-1.19). Loneliness was not associated with occasional use of opioids, benzodiazepines or non-opioid analgesics in older adults, but was associated with polypharmacy (OR 1.27, 1.06-1.52). Conclusions Loneliness in older adults is associated with increased daily use of opioids and benzodiazepines. Further research should evaluate patient- and physician-level factors that mediate this association, and develop strategies to mitigate loneliness and its attendant adverse outcomes.

Fall Worry Restricts Social Engagement in Older Adults

2019 ◽  
Vol 32 (5-6) ◽  
pp. 422-431 ◽  
Author(s):  
Namkee G. Choi ◽  
Martha L. Bruce ◽  
Diana M. DiNitto ◽  
C. Nathan Marti ◽  
Mark E. Kunik
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Social Engagement ◽  
Regression Models ◽  
Multinomial Logistic Regression ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Health Related ◽  
Reported Health ◽  
Longitudinal Associations

Objective: To examine cross-sectional and longitudinal associations between (a) activity-limiting fall worry (ALW) and (b) self-reported health-related restrictions and social engagement among older adults. Method: The National Health and Aging Trends Study Waves 5 (T1) and 6 (T2) provided data ( n = 6,279). Binary and multinomial logistic regression models were used to examine association of T2 social engagement restrictions with T2 fall worry and association of T1–T2 changes in social engagement restrictions with T1–T2 changes in fall worry. Results: ALW was significantly associated with both informal and formal social engagement restriction at T2. Onset of ALW and continued ALW between T1 and T2 were also significantly associated with newly reported restrictions in both informal and formal social engagement at T2 even controlling for falls incidents and changes in health status and other covariates. Discussion: The findings underscore the importance of reducing fall worry and preventing social disengagement in late life.

Relationships Between Neighborhood Social Capital and The Occurrence of Outdoor Falls in Canadian Older Adults: A Multilevel Analysis

2017 ◽  
Vol 30 (7) ◽  
pp. 1108-1135
Author(s):  
Afshin Vafaei ◽  
William Pickett ◽  
Maria Victoria Zunzunegui ◽  
Beatriz E. Alvarado
Keyword(s):  
Older Adults ◽  
Social Capital ◽  
Odds Ratio ◽  
Regression Models ◽  
Census Data ◽  
Community Dwelling ◽  
Risk Of Falling ◽  
Logistic Regression Models ◽  
Neighborhood Social Capital ◽  
Neighborhood Level

Objective: The aim of this study was to examine whether neighborhood-level social capital is a risk factor for falls outside of the home in older adults. Methods: Health questionnaires were completed by community-dwelling Canadians aged +65 years living in Kingston (Ontario) and St-Hyacinthe (Quebec), supplemented by neighborhood-level census data. Multilevel logistic regression models with random intercepts were fit. Variations in the occurrence of falls across neighborhoods were quantified by median odds ratio and 80% interval odds ratio. Results: Between-neighborhood differences explained 7% of the variance in the occurrence of falls; this variance decreased to 2% after adjustment for neighborhood-level variables. In the fully adjusted models, higher levels of social capital increased the odds of falls by almost 2 times: (odds ratio [OR] = 2.10, 95% confidence interval [CI] = [1.19, 3.71]). Discussion: Living in neighborhoods with higher levels of social capital was associated with higher risk of falling in older adults, possibly through more involvement in social activities.

Demographic factors associated with missed follow-up among solid tumor patients treated at a large multi-site academic institution

2020 ◽  
Vol 16 (32) ◽  
pp. 2635-2643
Author(s):  
Samantha L Freije ◽  
Jordan A Holmes ◽  
Saleh Rachidi ◽  
Susannah G Ellsworth ◽  
Richard C Zellars ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Odds Ratio ◽  
Regression Models ◽  
Tumor Patients ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Follow Up Care ◽  
Risk Patients ◽  
African American Race

Aim: To identify demographic predictors of patients who miss oncology follow-up, considering that missed follow-up has not been well studies in cancer patients. Methods: Patients with solid tumors diagnosed from 2007 to 2016 were analyzed (n = 16,080). Univariate and multivariable logistic regression models were constructed to examine predictors of missed follow-up. Results: Our study revealed that 21.2% of patients missed ≥1 follow-up appointment. African–American race (odds ratio [OR] 1.33; 95% CI: 1.17–1.51), Medicaid insurance (OR 1.59; 1.36–1.87), no insurance (OR 1.66; 1.32–2.10) and rural residence (OR 1.78; 1.49–2.13) were associated with missed follow-up. Conclusion: Many cancer patients miss follow-up, and inadequate follow-up may influence cancer outcomes. Further research is needed on how to address disparities in follow-up care in high-risk patients.

scholarly journals Sex Differences in the Association between Internet Usage and Overweight/Obesity: Evidence from a Nationally Representative Survey in Nepal

Sexes ◽  
2021 ◽  
Vol 2 (1) ◽  
pp. 132-143
Author(s):  
Juwel Rana ◽  
Md. Momin Islam ◽  
John Oldroyd ◽  
Nandeeta Samad ◽  
Rakibul Islam
Keyword(s):  
Odds Ratio ◽  
Regression Models ◽  
Internet Use ◽  
Adjusted Odds Ratio ◽  
Internet Usage ◽  
The Internet ◽  
Logistic Regression Models ◽  
Biological Sex ◽  
Obesity Interventions ◽  
Nationally Representative

Objective: To examine the associations between internet use and overweight/obesity in people aged 15–49 years in Nepal and the extent to which these associations differ by biological sex. Materials and methods: The study analyzed the nationally representative Nepal Demographic and Health Survey (NDHS) 2016 data. Multivariable ordinal logistic regression models were fitted to estimate the total effects of internet use (IU) in the last 12 months and frequency of internet use (FIU) in the last month on overweight/obesity adjusted for potential confounders. Results: Of the 10,380 participants, the prevalence of overweight/obesity by IU was 38% (95% confidence interval (CI): 35.9%, 40.1%) for males and 44.1% (95% CI: 41.6%, 46.6%) for female. The likelihood of overweight/obesity was significantly higher (adjusted odds ratio (aOR): 1.55; 95% CI: 1.40, 1.73; p < 0.001) among those participants who used the internet compared to the participants who did not use the internet in the last 12 months. Similar associations were observed when using the augmented measure of exposure-FIU in the last month. We observed the modification effect of sex in the associations of IU (p-difference < 0.001) and FIU (p-difference < 0.002) with overweight/obesity in Nepal. Conclusions: Our findings suggest that future overweight/obesity interventions in Nepal discourage unnecessary internet use, particularly among males.

scholarly journals Use of potentially inappropriate medications among ambulatory home-dwelling elderly patients with dementia: A review of the literature

2017 ◽  
Vol 150 (3) ◽  
pp. 169-183 ◽  
Author(s):  
Tejal Patel ◽  
Karen Slonim ◽  
Linda Lee
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Adverse Events ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Adverse Outcomes ◽  
Potentially Inappropriate Medication ◽  
Potentially Inappropriate Medications ◽  
Inappropriate Medication Use ◽  
Inappropriate Medications

Background: Older adults with dementia are at high risk for drug-related adverse outcomes. While much is known about potentially inappropriate medication use in older adults, its prevalence and characteristics among those with dementia are not as well elucidated. We conducted a literature review to examine the prevalence of potentially inappropriate medication use among home-dwelling older adults with dementia. Our secondary aim was to determine the most frequently implicated medications and factors associated with potentially inappropriate medication use. Methods: MEDLINE, EMBASE, CINAHL, and International Pharmaceutical Abstracts were searched between 1946 and 2014 for articles that referenced potentially inappropriate medication use and types of dementia. One reviewer screened all titles and abstracts from the initial search and full-text articles after the initial screen for eligibility, then 2 reviewers independently abstracted data from included studies. Results: Searches yielded 81 articles, of which 7 met inclusion criteria. Prevalence of potentially inappropriate medication use varied from 15% to 46.8%. No single drug or drug class was reported consistently across all studies as the most frequent potentially inappropriate medication, but anticholinergics and benzodiazepines, drugs that affect cognition, were among the most common medications or pharmacological classes listed. Discussion: Older adults with dementia may be particularly vulnerable to potentially inappropriate medications because of cognitive impairment from their condition and the greater likelihood of experiencing adverse events from medications. Given this population’s greater susceptibility to adverse events, more intense medication and patient monitoring may be warranted, especially among those taking anticholinergics and benzodiazepines, as these drugs can contribute to cognitive impairment.

Poisoning deaths among late-middle aged and older adults: comparison between suicides and deaths of undetermined intent

2018 ◽  
Vol 31 (08) ◽  
pp. 1159-1169 ◽  
Author(s):  
Namkee G. Choi ◽  
Diana M. DiNitto ◽  
C. Nathan Marti ◽  
Bryan Y. Choi
Keyword(s):  
Substance Use ◽  
Regression Models ◽  
Mental Health Problems ◽  
Multinomial Logistic Regression ◽  
Accurate Determination ◽  
Health Problems ◽  
Life Stressors ◽  
Manner Of Death ◽  
Logistic Regression Models ◽  
Poisoning Deaths

ABSTRACTBackground:Given the rapid increase in prescription and illicit drug poisoning deaths in the 50+ age group, we examined precipitating/risk factors and toxicology results associated with poisoning deaths classified as suicides compared to intent-undetermined death (UnD) among decedents aged 50+.Methods:Data were from the 2005–2015 US National Violent Death Reporting System (N = 15,453). χ2 tests and multinomial logistic regression models were used to compare three groups of decedents: suicide decedent who left a suicide note, suicide decedent who did not leave a note, and UnD cases.Results:Compared to suicide decedents without a note (37.7% of the sample), those with a note (29.4%) were more likely to have been depressed and had physical health problems and other life stressors, while UnD cases (32.9%) were less likely to have had mental health problems and other life stressors but more likely to have had substance use and health problems. UnD cases were also more likely to be opioid (RRR = 2.65, 95% CI = 2.42–2.90) and cocaine (RRR = 2.59, 95% CI = 2.09–3.21) positive but less likely to be antidepressant positive. Blacks were more than twice as likely as non-Hispanic Whites to be UnDs. Results from separate regression models in the highest UnD states (Maryland and Utah) and in states other than Maryland/Utah were similar.Conclusions:Many UnDs may be more correctly classified as unintentional overdose deaths. Along with more accurate determination processes for intent/manner of death, substance use treatment and approaches to curbing opioid and other drug use problems are needed to prevent intentional and unintentional poisoning deaths.

scholarly journals Alcohol consumption and pregnancy in the Mexican national addiction survey

1997 ◽  
Vol 13 (2) ◽  
pp. 205-211 ◽  
Author(s):  
Guilherme Borges ◽  
Roberto Tapia-Conyer ◽  
Malaquías López-Cervantes ◽  
María Elena Medina-Mora ◽  
Blanca Pelcastre ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Spontaneous Abortion ◽  
Regression Models ◽  
Congenital Abnormalities ◽  
Adverse Outcomes ◽  
Multiple Logistic Regression ◽  
National Data ◽  
Logistic Regression Models ◽  
Important Relationship

In 1988, the General Directorate of Epidemiology and the Mexican Institute of Psychiatry conducted the first National Addiction Survey (ENA), providing regional and national data on alcohol, tobacco, and drug use. The ENA providing a subsample of women who have been pregnant at some time in their lives. There were 5,234 affirmative responses. Women were asked if they had suffered any of three adverse outcomes during their last pregnancy: spontaneous abortion, stillbirth, and congenital abnormalities. Prevalence of spontaneous abortion was 3.8%, stillbirth 1.2%, and congenital abnormalities 1.1 %. Multiple logistic-regression models were used to analyze the effect of alcohol consumption on these problems. Consumption during pregnancy was related only with the prevalence of congenital abnormalities, with prevalence odds of 3.4. Among habitual users during the last 12 months, oniy women in the highest use category showed an important relationship with the three problems mentioned. Follow-up studies on the Mexican population are recommended in order to obtain more conclusive findings.

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