scholarly journals 223 Prevalence of Depression Among People with Diabetes; Comparative Analysis of Older Adults Across Three Health Systems Using Nationally Representative Data

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Niamh McGrath ◽  
Sheena McHugh ◽  
Elaine Toomey ◽  
Patricia Kearney
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Health Systems ◽  
Diabetes Management ◽  
A Priori ◽  
Global Challenge ◽  
Depression Prevalence ◽  
English Sample ◽  
Diabetes Status ◽  
Nationally Representative

Abstract Background The co-occurrence of depression and diabetes is an emerging global challenge but any association is influenced by variations in prevalence, study design and measure used. We compared depression prevalence in older adults with and without diabetes across three health systems using a validated measure to examine the causal association between diabetes and depression. Methods We used data of adults aged over 49 years, from three nationally representative ageing datasets; The Irish Longitudinal Study on Ageing (TILDA), the English Longitudinal Study on Ageing (ELSA) and the Health and Retirement Study (HRS). Data were collected during 2009–2011 (TILDA), and 2010 (ELSA, HRS). The 8-item CESD scale categorised depression using recommended cut-off scores of < 3 for ELSA and HRS and < 8 for TILDA. Self-reported individual, environmental, behavioural risk, and health system exposure variables were selected a-priori using literature and a directed acyclic graph. Prevalence was presented as a percentage with corresponding 95% confidence intervals. Binomial logistic regression examined the odds of depression by diabetes status. Data were analysed in Stata v15 using the ‘svy’ function. Results Diabetes prevalence (Ireland;8%[(95%CI:7.5–8.6), England;11%(95%CI:10.6–12.0) and USA;19%[(95%CI:18.8-20.1);p<0.001]) and depression prevalence (Ireland;10%(95%CI:9.0–10.6), England;16%(95%CI:15.3-16.9), USA;14%[(95%CI:13.5-14.7);p<0.001] varied across countries. Depression was consistently higher among people with versus without diabetes (Ireland;14%(95%CI:10.9-16.6)vs.9%(95%CI:8.7–10.3),p=0.001], England;25%(95%CI:21.7-27.7)vs.15%[(95%CI:14.2-15.9),p≤0.001] and USA;19%(95%CI:16.9-20.0)vs.13%[(95%CI:12.4-13.8);p≤0.001]. The odds of depression were significantly higher in people with versus without diabetes (Ireland;OR=1.5(95%CI:1.2-1.9);p=0.001, England;OR=1.8(95%CI:1.5–2.2);p<0.000, USA;OR=1.5(95%1.3-1.7);p<0.000), but only remained significant in the English sample after adjustment; (Ireland;OR=1.2(0.8-1.6);p=0.356, England;OR=1.3(1.0–1.6);p=0.045, USA;OR=1.0(0.9-1.1);p=0.898). Conclusion Among older adults in different health systems, depression was consistently higher among people with versus without diabetes. The findings support incorporation of holistic approaches to diabetes management across health systems.

scholarly journals Validation of Self‐Reported Rheumatoid Arthritis Using Medicare Claims: A Nationally Representative Longitudinal Study of Older Adults

2021 ◽  
Vol 3 (4) ◽  
pp. 239-249
Author(s):  
Michael J. Booth ◽  
Daniel Clauw ◽  
Mary R. Janevic ◽  
Lindsay C. Kobayashi ◽  
John D. Piette
Keyword(s):  
Rheumatoid Arthritis ◽  
Older Adults ◽  
Longitudinal Study ◽  
Medicare Claims ◽  
Nationally Representative

scholarly journals Polypharmacy is a risk factor for hospital admission due to a fall: evidence from the English Longitudinal Study of Ageing

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
P. Zaninotto ◽  
Y. T. Huang ◽  
G. Di Gessa ◽  
J. Abell ◽  
C. Lassale ◽  
...  
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Older People ◽  
Hospital Admission ◽  
Prescription Drugs ◽  
Hospital Admissions ◽  
Competing Risk ◽  
Risk Of Falls ◽  
Nationally Representative ◽  
English Longitudinal Study

Abstract Background Falls amongst older people are common; however, around 40% of falls could be preventable. Medications are known to increase the risk of falls in older adults. The debate about reducing the number of prescribed medications remains controversial, and more evidence is needed to understand the relationship between polypharmacy and fall-related hospital admissions. We examined the effect of polypharmacy on hospitalization due to a fall, using a large nationally representative sample of older adults. Methods Data from the English Longitudinal Study of Ageing (ELSA) were used. We included 6220 participants aged 50+ with valid data collected between 2012 and 2018.The main outcome measure was hospital admission due to a fall. Polypharmacy -the number of long-term prescription drugs- was the main exposure coded as: no medications, 1–4 medications, 5–9 medications (polypharmacy) and 10+ medications (heightened polypharmacy). Competing-risk regression analysis was used (with death as a potential competing risk), adjusted for common confounders, including multi-morbidity and fall risk-increasing drugs. Results The prevalence of people admitted to hospital due to a fall increased according to the number of medications taken, from 1.5% of falls for people reporting no medications, to 4.7% of falls among those taking 1–4 medications, 7.9% of falls among those with polypharmacy and 14.8% among those reporting heightened polypharmacy. Fully adjusted SHRs for hospitalization due to a fall among people who reported taking 1–4 medications, polypharmacy and heightened polypharmacy were 1.79 (1.18; 2.71), 1.75 (1.04; 2.95), and 3.19 (1.61; 6.32) respectively, compared with people who were not taking medications. Conclusions The risk of hospitalization due to a fall increased with polypharmacy. It is suggested that prescriptions in older people should be revised on a regular basis, and that the number of medications prescribed be kept to a minimum, in order to reduce the risk of fall-related hospital admissions.

scholarly journals Epidemiology of undiagnosed depression in people with diabetes mellitus: a comparative analysis of Ireland, England and the USA

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e049155
Author(s):  
Niamh McGrath ◽  
Kate O Neill ◽  
Sheena M McHugh ◽  
Elaine Toomey ◽  
Patricia M Kearney
Keyword(s):  
Longitudinal Study ◽  
Health Systems ◽  
Community Dwelling ◽  
Secondary Outcome ◽  
Depression Symptoms ◽  
Depression Diagnosis ◽  
Diabetes Status ◽  
Depression Detection ◽  
Prevalence Of Depression ◽  
The Usa

ObjectivesImproving detection of depression in people with diabetes is recommended. However, little is known about how different health systems compare in depression detection. We estimated and compared the (1) prevalence of depression detection in people with and without diabetes, and (2) association between diabetes and undiagnosed depression across three health systems.DesignCross-sectional analysis of three nationally representative studies: The Irish Longitudinal Study on Ageing, the English Longitudinal Study on Ageing and the Health and Retirement Study.SettingCommunity-dwelling adults in Ireland, England and the USA.ParticipantsAdults aged ≥50 years.Primary and secondary outcome measuresThe primary outcome was depression diagnosis. The secondary outcome was any depression. Any depression was defined by the presence of self-reported doctor-diagnosed depression or current depression symptoms on the Centre for Epidemiological Studies-Depression scale. Depression diagnosis was categorised as: undiagnosed, symptomatic and diagnosed, and asymptomatic and diagnosed. We estimated age-standardised prevalence of depression diagnosis by country and diabetes status. Anyone who self-reported having ever received a doctor diagnosis of diabetes was classified as having diabetes. Among respondents with depression, we estimated the association between diabetes and undiagnosed depression by country using multivariable logistic regression.ResultsThe prevalence of depression (diagnosed and undiagnosed) was higher in people with diabetes in each country with absolute rates varying by country; undiagnosed prevalence (Ireland: diabetes 10.1% (95% CI 7.5% to 12.8%) vs no diabetes 7.5% (95% CI 6.8% to 8.2%), England: diabetes 19.3% (95% CI 16.5% to 22.2%) vs no diabetes 11.8% (95% CI 11.0% to 12.6%), USA: diabetes 7.4% (95% CI 6.4% to 8.4%) vs no diabetes 6.1% (95% CI 5.7% to 6.6%)). In the fully adjusted model, there was no clear pattern of association between diabetes status and undiagnosed depression; Ireland: OR=0.82 (95% CI 0.5 to 1.3), England: OR=1.47 (95% CI 1.0 to 2.1), USA: OR=0.80 (95% CI 0.7 to 1.0).ConclusionsAlthough undiagnosed depression was more prevalent among people with diabetes, the relationship between diabetes and undiagnosed depression differed by country. Targeted efforts are needed to improve depression detection among community-dwelling older adults, particularly those with diabetes.

scholarly journals The change and correlates of healthy ageing among Chinese older adults: findings from the China health and retirement longitudinal study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Peng Nie ◽  
Yan Li ◽  
Nan Zhang ◽  
Xiaomin Sun ◽  
Bao Xin ◽  
...  
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Chronic Diseases ◽  
Ordinary Least Squares ◽  
Cognitive Status ◽  
Healthy Ageing ◽  
Random Effects Models ◽  
Pressure Peak ◽  
Nationally Representative ◽  
The Ideal

Abstract Background This study tentatively constructs a composite measure of Chinese Healthy Ageing Index (CHAI) among older adults aged 60+ and investigates change of CHAI during 2011–2015 and its association with sociodemographic characteristics. Methods Data collected from 8182 old adults aged 60+ in the 2011 and 2015 China Health and Retirement Longitudinal Study (CHARLS, a nationally representative sample) were used. Six medical measures of blood pressure, peak expiratory flow, cognitive status score, fasting glucose, kidney function and C-reactive function were used to construct CHAI (range 0–12, 0–2 = healthiest, 7–12 = unhealthiest). Ordinary least squares, logistic and random effects models examined social and spatial determinants of CHAI score and the prevalence of the ideal CHAI. Unconditional quantile regression tested heterogeneous impacts of sociodemographic determinants of CHAI score. Results Mean CHAI score declined from 5.7 to 5.2, and the proportion of the ideal CHAI (CHAI score = 0–2) increased from 5.6 to 9.4% during 2011–2015, indicating an improvement in healthy ageing over time. During 2011–2015, the highest rates of the ideal CHAI were in Southeast and East of China. Older adults, male, living in the Center and West, smoking, obesity/overweight and having chronic diseases were positively associated with total CHAI score and negatively with a higher prevalence of the ideal CHAI. Being married, having high education and regular social activities were associated with a higher rate of the ideal CHAI. The positive predictors for total CHAI were stronger in those with worse CHAI status. Conclusions In China healthy ageing has improved during 2011–2015, but substantial geographical and sociodemographic heterogeneities exist in the improvements, suggesting health equality remains a challenge in China. Future policies and interventions should especially focus on men, those in Central and West China, and combat health problems like obesity, chronic diseases and unhealthy behaviors.

scholarly journals Associations between social and intellectual activities with cognitive trajectories in Chinese middle-aged and older adults: a nationally representative cohort study

2020 ◽  
Author(s):  
Haibin Li ◽  
Changwei Li ◽  
Anxin Wang ◽  
Yanling Qi ◽  
Wei Feng ◽  
...  
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Aging ◽  
Multinomial Logistic Regression ◽  
Middle Aged ◽  
Cognitive Assessments ◽  
Visuospatial Skills ◽  
Nationally Representative ◽  
Intellectual Activities ◽  
Representative Cohort

Abstract Background: Associations between the frequency of social and intellectual activities and cognitive trajectories are understudied in Chinese middle-aged and older adults. We aimed to examine this association in a nationally representative longitudinal study. Methods: The China Health and Retirement Longitudinal Study (CHARLS) is a nationally representative sample of Chinese middle-aged and older participants. The frequency of social and intellectual activities was measured at baseline. Interview-based cognitive assessments of orientation and attention, episodic memory, and visuospatial skills and the calculation of combined global scores were assessed every 2 year. Cognitive trajectories over the study period were analyzed using group-based trajectory model , and the associations of the trajectory memberships with social and intellectual activities were analyzed using multinomial logistic regression. Odd ratios (OR) and 95% confidence intervals (CI) were reported. Results: Among 8204 participants aged 50-75 years, trajectory analysis identified three longitudinal patterns of cognitive function based on the global cognitive scores: “ persistently low ” (n = 1550, 18.9%); “persistently moderate” (n = 3194, 38.9%); and “persistently high” (n = 3460, 42.2%). After adjustment for sociodemographic variables, lifestyles, geriatric symptoms and health conditions, more frequent intellectual activities (OR: 0.54, 95% CI: 0.38-0.77) and social activities (OR: 0.79, 95% CI: 0.65-0.95) were both associated with a lower likelihood of being in the “persistently low” global cognitive trajectory group. Conclusions: More frequent social and intellectual activities were associated with more favorable cognitive aging trajectories.

scholarly journals Social Participation Patterns and Well-Being Among Older Adults: Findings From the United States, the UK, and China

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 293-294
Author(s):  
Yun Zhou ◽  
Bei Wu ◽  
Chenxin Tan
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Social Participation ◽  
Latent Class ◽  
Well Being ◽  
The United States ◽  
Chinese Older Adults ◽  
The Us ◽  
Nationally Representative ◽  
The Uk

Abstract This study used Latent Class Analysis to examine patterns of social participation among older adults in the US, the UK, and China, from the three nationally representative surveys conducted in 2018-2019: The Health and Retirement Study, the English Longitudinal Study of Ageing, and the China Health and Retirement Longitudinal Study. Although the profiles of social participation were distinctively different, several common patterns were found: Comprehensive Participants, Occasional Participants, and Deficient Participants. It was estimated that less than 10% of older adults from these countries were extensively engaged in social participation. Seventy-seven percent of Chinese older adults were shown being “Deficient Participants”, and the percentages were 29% and 20% in the US and the UK, respectively. The findings showed positive associations of levels of participation with socioeconomic status and health. The magnitudes of these associations varied across the nations. Actions are needed to promote levels of participation for Chinese older adults.

scholarly journals Associations between social and intellectual activities with cognitive trajectories in Chinese middle-aged and older adults: a nationally representative cohort study

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Haibin Li ◽  
Changwei Li ◽  
Anxin Wang ◽  
Yanling Qi ◽  
Wei Feng ◽  
...  
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Cognitive Function ◽  
Cognitive Aging ◽  
Multinomial Logistic Regression ◽  
Middle Aged ◽  
Cognitive Assessments ◽  
Visuospatial Skills ◽  
Nationally Representative ◽  
Intellectual Activities

Abstract Background Associations between the frequency of social and intellectual activities and cognitive trajectories are understudied in Chinese middle-aged and older adults. We aimed to examine this association in a nationally representative longitudinal study. Methods The China Health and Retirement Longitudinal Study (CHARLS) is a nationally representative sample of Chinese middle-aged and older participants. The frequency of social and intellectual activities was measured at baseline. Interview-based cognitive assessments of orientation and attention, episodic memory, and visuospatial skills and the calculation of combined global scores were assessed every 2 years from 2011 to 2016. Cognitive aging trajectories over time were analyzed using group-based trajectory modeling, and the associations of the trajectory memberships with social and intellectual activities were analyzed using multinomial logistic regression. Odds ratios (OR) and 95% confidence intervals (CI) were reported. Results Among 8204 participants aged 50–75 years at baseline, trajectory analysis identified three longitudinal patterns of cognitive function based on the global cognitive scores: “persistently low trajectory” (n = 1550, 18.9%), “persistently moderate trajectory” (n = 3194, 38.9%), and “persistently high trajectory” (n = 3460, 42.2%). After adjustment for sociodemographic variables, lifestyles, geriatric symptoms, and health conditions, more frequent intellectual activities (OR 0.54, 95% CI 0.38–0.77) and social activities (OR 0.79, 95% CI 0.65–0.95) were both associated with a lower likelihood of being in the “persistently low trajectory” for global cognitive function. Conclusions These findings suggested that more frequent social and intellectual activities were associated with more favorable cognitive aging trajectories.

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