Self-rated Health Compared With Objectively Measured Health Status as a Tool for Mortality Risk Screening in Older Adults: 10-Year Follow-up of the Bambui Cohort Study of Aging

Abstract Background Health inequalities are an emerging issue in ageing societies, but inequalities in pre-frailty, which is suffered by almost half of older people, are mostly unknown. Objective This study aimed to determine the association between the socio-economic status (SES) and changes across pre-frailty, frailty, disability and all-cause mortality. Methods We conducted a prospective cohort study across 23 Japanese municipalities between 2010 and 2013. Functionally independent community-dwelling older adults aged ≥65 years (n = 65 952) in 2010 were eligible for the study. The baseline survey was conducted from 2010 to 2012, and the self-reporting questionnaires were mailed to 126 438 community-dwelling older adults [64.8% (81 980/126 438) response rate]. The follow-up survey was conducted in 2013. Overall, 65 952 individuals were followed up [80.4% (65 952/81 980) follow-up rate]. The health status was classified into five groups: robust; pre-frailty; frailty; disability and death. We conducted three multinomial logistic regression models stratified by the initial disability status. Educational attainment and equivalized household income were separately added to the models as exposures after adjusting for covariates. Results Participants with the lowest educational level were less likely to recover from pre-frailty to robust compared with those with the highest level [odds ratio (OR) (95% confidence interval (CI)) = 0.84 (0.76–0.93)]. The participants with the lowest income level were also less likely to recover from pre-frailty to robust compared with those with the highest level [OR (95% CI) = 0.80 (0.69–0.91)]. Conclusions Older individuals with a lower SES were less likely to recover from a pre-frailty status.

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PREDICTORS OF MORTALITY RISK AMONG MEDICARE ADVANTAGE ENROLLEES

Innovation in Aging ◽

10.1093/geroni/igz038.2654 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S724-S724

Author(s):

Soyoung Choun ◽

Lan Doan ◽

Diana J Govier ◽

Karen Hooker ◽

Carolyn Mendez-Luck ◽

...

Keyword(s):

Older Adults ◽

Mortality Risk ◽

Chronic Health Conditions ◽

Health Conditions ◽

Medicare Advantage ◽

Predictors Of Mortality ◽

Self Rated Health ◽

Risk Of Mortality ◽

All Cause Mortality

Abstract Overall all-cause mortality rates have declined significantly in past decades among individuals aged 65 and above in every racial and ethnic group. We explored demographic, overall health, and disability development as predictors of mortality in Medicare beneficiaries enrolled in Medicare Advantage plans. We used data from the 2014-2018 Medicare Health Outcomes Survey, a nationally representative panel survey with a two-year follow-up, administered by the Centers for Medicare and Medicaid Services. Our sample consisted of 1,273,494 community-dwelling adults aged 65 and older (Mage = 74.5 years, age range: 65-109 years) enrolled in Medicare Advantage plans. Mortality was assessed over a 2-year follow-up period. We used Cox proportional hazards regression analysis to predict risk of all-cause mortality by demographics, self-rated health, chronic health conditions, smoking status, and activities of daily living (ADLs). Among all participants, the mortality rate was 7.0% (n = 88,058) at 2-year follow-up. Advanced age and being male were significantly associated with greater risk of mortality, while higher levels of education and income were inversely associated with mortality. Controlling for other factors, white adults had higher mortality risk than black or African American, Hispanic, and Asian older adults. Individuals who were unmarried, had lower self-rated health, had more chronic health conditions, smoked, and had more ADL limitations had higher mortality risk. Our findings suggest that sustained health and better functional capacity are important elements in decreasing the risk of mortality in older adults.

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Effectiveness of Transitional Care from Hospital to Home in Frail Older Adults: A Systematic Review

Innovation in Aging ◽

10.1093/geroni/igab046.2990 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 821-821

Author(s):

Ji Yeon Lee ◽

Yong Sook Yang ◽

Eunhee Cho

Keyword(s):

Quality Of Life ◽

Systematic Review ◽

Older Adults ◽

Health Status ◽

Transitional Care ◽

Frail Older Adults ◽

Self Rated Health ◽

Hospital To Home

Abstract Frail older adults are at high risk of negative consequences from hospitalization and are discharged without completely returning to their pre-existing health status. Transitional care is needed to maintain care continuity from hospital to home. This systematic review aimed to examine transitional care for frail older adults and its effectiveness. The Cochrane guidelines were followed, and search terms were determined by PICO: (P) frail older adults, not disease-specified; (I) transitional care initiated before discharge; (C) usual care; and (O) all health outcomes. Four databases were searched for English-written randomized controlled trials (inception to 2020), and eight trials were ultimately included. Frail older adults in eight trials (1996–2019) totaled 2,785, with a mean sample size of 310. The intervention components varied from hospital care (e.g., geriatric assessment, discharge planning, rehabilitation) to follow-up care after discharge (e.g., home visit, phone follow-up, community service). Most measured outcomes were readmission (n = 7), function (n = 4), quality of life (n = 4), self-rated health (n = 3), and mortality (n = 3). Statistical significance was reported in the following number of trials: readmission (n = 2), function (n = 2), quality of life (n = 1), self-rated health (n = 3), and mortality (n = 0). The effectiveness of the intervention on each outcome was inconsistent across the trials. Varied transitional care between hospital and home was implemented to improve health status; however, its effectiveness was controversial. A novel, yet evidence-based approach is needed to develop transitional care interventions for these vulnerable populations.

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Mitochondrial DNA haplogroups affect physical performances in Han older adults: an 8‐year follow‐up prospective cohort study

Geriatrics and Gerontology International ◽

10.1111/ggi.14105 ◽

2020 ◽

Author(s):

Chuan‐Wei Yang ◽

Chia‐Ing Li ◽

Jan‐Gowth Chang ◽

Chiu‐Shong Liu ◽

Chih‐Hsueh Lin ◽

...

Keyword(s):

Older Adults ◽

Mitochondrial Dna ◽

Cohort Study ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Physical Performances

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Cohort study of ageing from Bagé (SIGa-Bagé), Brazil: profile and methodology

BMC Public Health ◽

10.1186/s12889-021-11078-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Elaine Thumé ◽

Marciane Kessler ◽

Karla P. Machado ◽

Bruno P. Nunes ◽

Pamela M. Volz ◽

...

Keyword(s):

Older Adults ◽

Health Care ◽

Cohort Study ◽

Primary Health Care ◽

Rio Grande ◽

Cognitive Testing ◽

Rio Grande Do Sul ◽

Primary Health ◽

The Impact

Abstract Background The Bagé Cohort Study of Ageing is a population-based cohort study that has recently completed the first follow-up of a representative sample of older adults from Bagé, a city with more than 100,000 inhabitants located in the state of Rio Grande do Sul, Brazil. This is one of the first longitudinal studies to assess the impact of primary health care coverage on health conditions and inequalities. Our aim is to investigate the prevalence, incidence and trends of risk factors, health behaviours, social relationships, non-communicable diseases, geriatric diseases and disorders, hospitalisation, self-perceived health, and all-cause and specific-cause mortality. In addition, we aim to evaluate socioeconomic and health inequalities and the impact of primary health care on the outcomes under study. Methods/design The study covers participants aged 60 or over, selected by probabilistic (representative) sampling of the urban area of the city of Bagé, which is covered by Primary Health Care Services. The baseline examination included 1593 older adults and was conducted from July 2008 to November 2008. After eight to nine years (2016/2017), the first follow-up was conducted from September 2016 to August 2017. All participants underwent an extensive core assessment programme including structured interviews, questionnaires, cognitive testing (baseline and follow-up), physical examinations and anthropometric measurements (follow-up). Results Of the original participants, 1395 (87.6%) were located for follow-up: 757 elderly individuals (47.5%) were re-interviewed, but losses in data transfer occurred for 22. The remaining 638 (40.1%) had died. In addition, we had 81 (5.1%) refusals and 117 (7.3%) losses. Among the 1373 older adults who were followed down, there was a higher proportion of female interviewees (p=0.042) and a higher proportion of male deaths (p=0.001) in 2016/2017. There were no differences in losses and refusals according to gender (p=0.102). There was a difference in average age between the interviewees (68.8 years; SD ±6.5) and non-interviewees (73.2 years; SD ±9.0) (p<0.001). Data are available at the Department of Social Medicine in Federal University of Pelotas, Rio Grande do Sul, Brazil, for any collaboration.

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Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study

Physical Therapy ◽

10.1093/ptj/pzab059 ◽

2021 ◽

Author(s):

K Makino ◽

S Lee ◽

S Bae ◽

I Chiba ◽

K Harada ◽

...

Keyword(s):

Older Adults ◽

Cohort Study ◽

Fear Of Falling ◽

Community Dwelling ◽

Cardiovascular Health Study ◽

Physical Frailty ◽

Frailty Status ◽

Community Dwelling Older Adults ◽

The Relationship

Abstract Objective The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. Methods A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48±2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to “Are you afraid of falling?”) at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. Results Multivariate logistic regression showed that pre-frailty or frailty increase the risk of not only future falls (OR: 1.57; 95%CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95%CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95%CI = 1.04-1.68). Conclusions Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. Impact Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high-risk not only for falls but also for FOF.

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Challenging the “jolly fat” hypothesis among older adults: High body mass index predicts increases in depressive symptoms over a 5-year period

Journal of Health Psychology ◽

10.1177/1359105316675209 ◽

2016 ◽

Vol 23 (1) ◽

pp. 48-58 ◽

Cited By ~ 9

Author(s):

Peter Joseph Dearborn ◽

Michael A Robbins ◽

Merrill F Elias

Keyword(s):

Older Adults ◽

Body Mass Index ◽

Depressive Symptoms ◽

Body Mass ◽

Functional Limitations ◽

High Body Mass Index ◽

Obesity Prevalence ◽

Community Based ◽

Objectively Measured

Several investigators have observed lowered risk of depression among obese older adults, coining the “jolly fat” hypothesis. We examined this hypothesis using baseline and a 5-year follow-up body mass index, depressive symptoms, and covariates from 638 community-based older adults. High objectively measured body mass index and functional limitations predicted increased future depressive symptoms. However, symptoms did not predict future body mass index. Self-reported body mass index showed similar associations despite underestimating obesity prevalence. Results did not differ on the basis of gender. Results for this study, the first longitudinal reciprocal risk analysis between objectively measured body mass index and depressive symptoms among older adults, do not support the “jolly fat” hypothesis.

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