scholarly journals 149 Falls in the United States: Magnitude, Risk, Disparities, and Solutions

2019 ◽  
Vol 48 (Supplement_4) ◽  
pp. iv34-iv39
Author(s):  
Matthew Lee Smith ◽  
Edgar Vieira ◽  
Angelica Herrera-Venson ◽  
Kathleen Cameron
Keyword(s):  
United States ◽  
Older Adults ◽  
Older Adult ◽  
Fall Prevention ◽  
Prevention Programs ◽  
The United States ◽  
Incidence Rates ◽  
Gis Mapping ◽  
Isolated Populations ◽  
National Network

Abstract In the United States, falls incidence rates remain steady among older adults (those age 65 years and older), which highlights the need for effective interventions to prevent falls and manage fall-related risks. Falls are the leading cause of unintentional injury and injury-related disability and deaths among older adults (29,668 deaths, 61.6/100,000, in the US in 2016), and the rate of fall-related deaths among older adults increased 31% from 2007 to 2016. In the United States, an older adult goes to an emergency room due to a fall every 11 seconds (3 million visits per year), and an older adult dies from a fall-related injury every 19 minutes. In response to this issue, the Administration for Community Living (ACL) and other governmental agencies have dedicated large sums of funding to initiate and support fall prevention and management efforts in clinical and community settings. As part of the solution, ACL supported 40 grantees to deliver eight evidence-based fall prevention programs (e.g., A Matter of Balance, Stepping On, Tai Chi, Otago Exercise Program) from 2010-2016. During that time, this ongoing initiative has reached 45,812 participants in 22 states by delivering 3,755 workshops. The majority of workshops were delivered in senior centers (26%), residential facilities (20%), healthcare organizations (13%), and faith-based organizations (9%). This presentation will use geographic information system (GIS) mapping to geospatially depict the dissemination of these programs as well as highlights their impact on fall-related outcomes. Additionally, models of clinical and community collaboration for fall prevention will be described, which shows the importance of leveraged resources, seamless referral systems, and timely feedback channels. Further, policy initiatives and a national network of state-based fall prevention coalitions will be described to coordinate and integrate efforts across clinical, community, corporate, and academic settings. Lastly, strategies will be shared to diversify the delivery infrastructure for fall prevention programs and incorporate technological options for isolated populations and those without access to preventive services.

scholarly journals Delivery of Fall Prevention Interventions for At-Risk Older Adults in Rural Areas: Findings from a National Dissemination

2018 ◽  
Vol 15 (12) ◽  
pp. 2798 ◽  
Author(s):  
Matthew Smith ◽  
Samuel Towne ◽  
Angelica Herrera-Venson ◽  
Kathleen Cameron ◽  
Scott Horel ◽  
...  
Keyword(s):  
Older Adults ◽  
Fall Prevention ◽  
Rural Areas ◽  
Prevention Program ◽  
Technical Assistance ◽  
Prevention Programs ◽  
The United States ◽  
Incidence Rates ◽  
Retention Rates ◽  
Fall Prevention Program

Falls incidence rates and associated injuries are projected to increase among rural-dwelling older adults, which highlights the need for effective interventions to prevent falls and manage fall-related risks. The purpose of this descriptive study was to identify the geospatial dissemination of eight evidence-based fall prevention programs (e.g., A Matter of Balance, Stepping On, Tai Chi, Otago Exercise Program) across the United States (U.S.) in terms of participants enrolled, workshops delivered, and geospatial reach. These dissemination characteristics were compared across three rurality designations (i.e., metro areas; non-metro areas adjacent to metro areas; and, non-metro areas not adjacent to metro areas). Data were analyzed from a national repository of 39 Administration for Community Living (ACL) grantees from 2014–2017 (spanning 22 states). Descriptive statistics were used to assess program reach, delivery-site type, and completion rate by rurality. Geographic information systems (GIS) geospatially represented the collective reach of the eight interventions. Of the 45,812 participants who attended a fall prevention program, 12.7% attended workshops in non-metro adjacent areas and 6.6% attended workshops in non-metro non-adjacent areas. Of the 3755 workshops delivered (in over 550 unique counties), most were delivered in senior centers (26%), residential facilities (20%), healthcare organizations (13%), and faith-based organizations (9%). On average, the workshop attendance/retention rates were consistent across rurality (~70%). Findings highlight the need to diversify the delivery infrastructure for fall prevention programs to adequately serve older adults in rural areas. Ongoing efforts are needed to offer sustainable technical assistance and to develop scalable clinical-community referral systems to increase fall prevention program participation among rural-dwelling older adults.

Engaging Vital Older Adults in Intergenerational Service-Learning

2018 ◽  
pp. 266-287
Author(s):  
Reneé A. Zucchero
Keyword(s):  
United States ◽  
Older Adults ◽  
Service Learning ◽  
Older Adult ◽  
Undergraduate Students ◽  
The United States ◽  
Life Review ◽  
Future Research ◽  
Negative Stereotypes ◽  
Adult Volunteers

The population of older adults within the United States is growing rapidly, which calls for increased understanding of that population. However, ageism is pervasive and one of the most engrained forms of prejudice. Intergenerational service-learning may be one way to reduce negative stereotypes and ageism. The Co-Mentoring Project is an intergenerational service-learning project that matches undergraduate students and vital older adult volunteers. Students meet with their partners at least four times over the course of the semester to conduct a life review and gather information to begin the older adults' memoirs. This chapter provides a rationale for intergenerational service-learning and information about its theoretical underpinnings. The chapter also offers information about service-learning best practices, including structured reflection, and how the Project's methodology is consistent with them. The multi-modal assessment conducted for the Project and its outcomes are discussed. Finally, directions for future research are described.

scholarly journals 1470. Epidemiology of Invasive Pneumococcal Disease (IPD) Following 18 years of Pneumococcal Conjugate Vaccine (PCV) Use in the United States

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S736-S737
Author(s):  
Tamara Pilishvili ◽  
Ryan Gierke ◽  
Monica M Farley ◽  
William Schaffner ◽  
Ann Thomas ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
Genome Sequencing ◽  
Invasive Pneumococcal Disease ◽  
Pneumococcal Disease ◽  
The United States ◽  
Census Bureau ◽  
Incidence Rates ◽  
Whole Genome ◽  
Vaccine Type

Abstract Background PCVs have been recommended for U.S. children since 2000. A 7-valent vaccine (PCV7) was introduced in 2000. This was replaced by a 13-valent vaccine (PCV13) in 2010. PCV13 was also recommended for adults aged ≥ 65 years in August 2014. We evaluated PCV impact on IPD. Methods IPD cases (isolation of pneumococcus from sterile sites) were identified through CDC’s Active Bacterial Core surveillance during 1998-2018. Isolates were serotyped by Quellung or whole genome sequencing and classified as PCV13-type and non-vaccine-type (NVT). Incidence rates (cases/100,000) were calculated using U.S. Census Bureau population denominators. Results From 1998 through 2018, overall IPD rates among children aged < 5 years decreased by 93% (from 95 to 7 cases/100,000). PCV13-type IPD decreased by 98% (from 88 to 2 cases/100,000). Among adults aged ≥ 65 years, overall IPD rates decreased by 60% (from 61 to 25 cases/100,000). PCV13-type IPD rates declined 86% (from 46 to 7 cases/100,000). Declines were most dramatic in the years following PCV7 introduction, with additional declines after PCV13 introduction in children (Figures 1 and 2). Serotypes 3, 19A, and 19F caused most of the remaining PCV13-type IPD. NVT IPD rates did not change significantly among children. Among adults aged 50-64 years, NVT IPD increased by 83% (from 6 to 12 cases/100,000) (p< 0.01). Among adults aged ≥ 65 years, NVT IPD increased by 22% (from 15 to 18 cases/100,000) (p< 0.01). The most common NVTs in 2018 were 22F (10% of all IPD), 9N (7%) and 15A (5%). Among children, the proportion of cases with meningitis increased from 5% to 14% (p< 0.01), and the proportion with pneumonia/empyema increased from 17% to 31% (p< 0.01). Among adults, the proportion of cases with meningitis did not change (3%), while the proportion with pneumonia/empyema increased from 72% to 76% (p=0.01). Figure 1: Incidence of invasive pneumococcal disease among children aged < 5 years, 1998-2018 Figure 2: Incidence of invasive pneumococcal disease among adults aged ≥ 65 years, 1998-2018 Conclusion Overall IPD incidence among children and adults decreased following PCV introduction for children, driven primarily by reductions in PCV-type IPD. NVT IPD increased in older adults, but these increases did not eliminate reductions from PCV13-type IPD. Disclosures Lee Harrison, MD, GSK (Consultant)Merck (Consultant)Pfizer (Consultant)Sanofi Pasteur (Consultant)

Future of Cancer Incidence in the United States: Burdens Upon an Aging, Changing Nation

2009 ◽  
Vol 27 (17) ◽  
pp. 2758-2765 ◽  
Author(s):  
Benjamin D. Smith ◽  
Grace L. Smith ◽  
Arti Hurria ◽  
Gabriel N. Hortobagyi ◽  
Thomas A. Buchholz
Keyword(s):  
United States ◽  
Older Adults ◽  
Cancer Incidence ◽  
The United States ◽  
Census Bureau ◽  
Incidence Rates ◽  
Population Projections ◽  
Demographic Changes ◽  
Younger Adults ◽  
The Impact

Purpose By 2030, the United States' population will increase to approximately 365 million, including 72 million older adults (age ≥ 65 years) and 157 million minority individuals. Although cancer incidence varies by age and race, the impact of demographic changes on cancer incidence has not been fully characterized. We sought to estimate the number of cancer patients diagnosed in the United States through 2030 by age and race. Methods Current demographic-specific cancer incidence rates were calculated using the Surveillance Epidemiology and End Results database. Population projections from the Census Bureau were used to project future cancer incidence through 2030. Results From 2010 to 2030, the total projected cancer incidence will increase by approximately 45%, from 1.6 million in 2010 to 2.3 million in 2030. This increase is driven by cancer diagnosed in older adults and minorities. A 67% increase in cancer incidence is anticipated for older adults, compared with an 11% increase for younger adults. A 99% increase is anticipated for minorities, compared with a 31% increase for whites. From 2010 to 2030, the percentage of all cancers diagnosed in older adults will increase from 61% to 70%, and the percentage of all cancers diagnosed in minorities will increase from 21% to 28%. Conclusion Demographic changes in the United States will result in a marked increase in the number of cancer diagnoses over the next 20 years. Continued efforts are needed to improve cancer care for older adults and minorities.

scholarly journals Social Isolation and COVID-19 Mitigation: Perspectives of Key Informants in the United States and Japan

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 441-441
Author(s):  
Emily Ihara ◽  
Megumi Inoue ◽  
Cortney Hughes Rinker ◽  
Naoru Koizumi
Keyword(s):  
United States ◽  
Older Adults ◽  
Social Isolation ◽  
Older Adult ◽  
Adult Population ◽  
The United States ◽  
Mitigation Measures ◽  
Adult Care ◽  
Key Informant ◽  
The Many

Abstract The deleterious health effects of social isolation and loneliness among older adults have been well-established and were exacerbated by the forced separation for those at health risk of contracting the COVID-19 virus. Both the United States and Japan are experiencing phenomenal growth of the older adult population; Japan is considered a “super-aged” society, with the highest proportion of people aged 65 and older in the world. This study examined how COVID-19 and mitigation measures may have affected services for older adults. We conducted key informant interviews with specialists in aging and older adult care in both Japan (n=5) and the United States (n=14). All interviews were conducted over Zoom and lasted 30-60 minutes. The research team transcribed and checked the interviews for accuracy and conducted multiple coding sessions to identify, sort, and consolidate the codes using Atlas.ti. Key themes in both countries that emerged included the many cracks in the system of programs and services for older adults, the inaccessibility to technology and the internet, and the particular difficulties of socioeconomic inequities, especially for those living alone. Older adults were motivated to become more technologically proficient and local communities came forward to help provide support. One key informant from the U.S. noted that their organization experienced a 600% increase in interest among volunteers as a result of the pandemic. Despite the many challenges of the pandemic, many silver linings emerged. One participant poetically stated, “I think that's human nature – when you have no other choice, you find a way.”

scholarly journals Rural America’s Hospitals are Not Prepared to Protect Older Adults From a Surge in COVID-19 Cases

2020 ◽  
Vol 6 ◽  
pp. 233372142093616 ◽  
Author(s):  
Natalie M. Davoodi ◽  
Margaret Healy ◽  
Elizabeth M. Goldberg
Keyword(s):  
United States ◽  
Older Adults ◽  
Rural Communities ◽  
Older Adult ◽  
The United States ◽  
Rural America ◽  
Health News ◽  
Medical Supplies ◽  
Poor Outcomes ◽  
The U.S

Rural communities with predominantly older adult populations could be especially vulnerable to poor outcomes from COVID-19 due to lacking intensive care unit (ICU) capacity. Our objective is to describe the scope of the problem by summarizing population totals of older adults in rural America and their community’s ICU bed availability. We performed a review of peer-reviewed literature, in addition to hand searching non–peer-reviewed and governmental/non-governmental agency reports, using the Kaiser Health News data report to assess the number of ICU beds in 10 predominantly rural states with the highest older adult populations. We found that while 19% of the U.S. population lives in rural counties, these counties contain only 1% of the ICU beds in the United States. Counties particularly at risk for inadequate ICU capacity include Crittenden, Arkansas; Cass, Minnesota; and Sagadahoc, Maine. Solutions include building new delivery systems, reopening previously closed rural hospitals, and calling on local businesses to create medical supplies. In summary, the 10 million older adults in rural communities in the United States may face challenges with obtaining critical care treatment due to the increased need of ICU beds during the COVID-19 pandemic.

scholarly journals Awareness and Use of Nutrition Information Predict Measured and Self-Rated Diet Quality of Older Adults in the United States (P18-046-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Anna Vaudin ◽  
Edwina Wambogo ◽  
Alanna Moshfegh ◽  
Nadine Sahyoun
Keyword(s):  
United States ◽  
Older Adults ◽  
Socioeconomic Status ◽  
Older Adult ◽  
Diet Quality ◽  
The United States ◽  
Healthy Eating Index ◽  
Nutrition Information ◽  
Ratio Method

Abstract Objectives This study aimed to investigate: 1) the diet quality of older adults, using the Healthy Eating Index 2015 (HEI-2015) and self-rated diet quality, 2) characteristics associated with reported awareness and use of nutrition information, 3) factors associated with HEI-2015 score and self-rated diet quality, including the relationship with awareness and use of nutrition information. Methods A cross-sectional analysis of 24-hour recall and questionnaire data from the National Health and Nutrition Examination Survey 2009–2014, including 4493 subjects, aged 60 years and older. The population ratio method was used in SAS 9.4 to calculate mean HEI scores. Data was stratified by gender, then t-tests and ANOVA were used to compare means and chi-squares were used to compare proportions. Logistic and linear regression were used to test for associations with diet quality, controlling for potential covariates. Results The mean total HEI score for men was significantly lower than for women (63.7 ± 0.8 vs. 66.6 ± 0.8 respectively, P < 0.0001). Compared to men, more women reported nutrition awareness (53.7% vs. 41.1%, P < 0.0001), and use of nutrition information (19.3% vs. 9.2%, P < 0.0001). Nutrition awareness was also associated with race, age, education, socioeconomic status, and food security. In bivariate analyses, nutrition awareness and use of nutrition information were significantly associated with both HEI score and self-rated diet quality in both men and women. In multivariate analyses, nutrition awareness remained a significant predictor of HEI for women but not men, and remained a significant predictor of self-reported diet quality in men but not women. Conclusions Nutrition awareness and use of nutrition information are significantly related to diet quality in older adults, even when controlling for other factors. There are differences in these relationships for older adult men versus women. Gaps in awareness, indicating need for nutrition education, exist in men, non-whites, those participating in nutrition assistance programs, and those with lower education and socioeconomic status. Closing these gaps may lead to improved diet quality in segments of the older adult population. Funding Sources Agricultural Research Service, United States Department of Agriculture.

scholarly journals Comparing Estimates of Fall-Related Mortality Incidence Among Older Adults in the United States

2018 ◽  
Vol 74 (9) ◽  
pp. 1468-1474 ◽  
Author(s):  
Matthew C Lohman ◽  
Amanda J Sonnega ◽  
Emily J Nicklett ◽  
Lillian Estenson ◽  
Amanda N Leggett
Keyword(s):  
United States ◽  
Risk Factors ◽  
Older Adults ◽  
Confidence Interval ◽  
Incidence Rate ◽  
The United States ◽  
Incidence Rates ◽  
Mortality Incidence ◽  
Representative Cohort ◽  
Related Mortality

AbstractBackgroundFalls are the leading cause of injury-related mortality among older adults in the United States, but incidence and risk factors for fall-related mortality remain poorly understood. This study compared fall-related mortality incidence rate estimates from a nationally representative cohort with those from a national vital record database and identified correlates of fall-related mortality.MethodsCause-of-death data from the National Death Index (NDI; 1999–2011) were linked with eight waves from the Health and Retirement Study (HRS), a representative cohort of U.S. older adults (N = 20,639). Weighted fall-related mortality incidence rates were calculated and compared with estimates from the Centers for Disease Control and Prevention (CDC) vital record data. Fall-related deaths were identified using International Classification of Diseases (Version 10) codes. Person-time at risk was calculated from HRS entry until death or censoring. Cox proportional hazards models were used to identify individual-level factors associated with fall-related deaths.ResultsThe overall incidence rate of fall-related mortality was greater in HRS–NDI data (51.6 deaths per 100,000; 95% confidence interval: 42.04, 63.37) compared with CDC data (42.00 deaths per 100,000; 95% confidence interval: 41.80, 42.19). Estimated differences between the two data sources were greater for men and adults aged 85 years and older. Greater age, male gender, and self-reported fall history were identified as independent risk factors for fall-related mortality.ConclusionIncidence rates based on aggregate vital records may substantially underestimate the occurrence of and risk for fall-related mortality differentially in men, minorities, and relatively younger adults. Cohort-based estimates of individual fall-related mortality risk are important supplements to vital record estimates.

Effectiveness of Programs for the Prevention of Child Sexual Abuse

2020 ◽  
Vol 25 (1) ◽  
pp. 1-15 ◽  
Author(s):  
Amaia Del Campo ◽  
Marisalva Fávero
Keyword(s):  
United States ◽  
Sexual Abuse ◽  
New Zealand ◽  
Critical Analysis ◽  
Prevention Programs ◽  
The United States ◽  
Sexual Abuse Prevention ◽  
Negative Effects ◽  
The United Kingdom ◽  
Methodological Considerations

Abstract. During the last decades, several studies have been conducted on the effectiveness of sexual abuse prevention programs implemented in different countries. In this article, we present a review of 70 studies (1981–2017) evaluating prevention programs, conducted mostly in the United States and Canada, although with a considerable presence also in other countries, such as New Zealand and the United Kingdom. The results of these studies, in general, are very promising and encourage us to continue this type of intervention, almost unanimously confirming its effectiveness. Prevention programs encourage children and adolescents to report the abuse experienced and they may help to reduce the trauma of sexual abuse if there are victims among the participants. We also found that some evaluations have not considered the possible negative effects of this type of programs in the event that they are applied inappropriately. Finally, we present some methodological considerations as critical analysis to this type of evaluations.

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