scholarly journals Life course socioeconomic conditions, multimorbidity and polypharmacy in older adults

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
K T Jungo ◽  
B Cheval ◽  
S Sieber ◽  
B W A van der Linden ◽  
A Ihle ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Conditions ◽  
Daily Living ◽  
Regression Models ◽  
Smoking Status ◽  
Multiple Chronic Conditions ◽  
Socioeconomic Conditions ◽  
Living Situation ◽  
Lower Odds ◽  
Logistic Regression Models

Abstract Many older adults have multiple chronic conditions (multimorbidity). With multimorbidity often comes the concurrent intake of multiple medications (polypharmacy). Our aims were to assess if childhood socioeconomic conditions (CSC) are associated with multimorbidity and polypharmacy in older adults, and how these associations change when adjusting for adulthood socioeconomic conditions (ASC). We used data from the European longitudinal Survey of Health, Ageing, and Retirement (SHARE), which follows individuals aged 50 years and over in 27 countries since 2004. We analysed data from 35,229 individuals with multimorbidity (mean age: women=64.1, men=65.4) and 20,757 individuals with polypharmacy (mean age: women=69.2, men=70.2). Multimorbidity was defined as 2 or more self-reported chronic conditions and polypharmacy as the intake of 5 or more medications. Confounder-adjusted multilevel logistic regression models were used to analyse associations of CSC (5 categories: most disadvantaged-most advantaged) and ASC with multimorbidity and polypharmacy. All analyses were adjusted for country, age, weight, alcohol consumption, smoking status and physical exercise. In addition, we adjusted the polypharmacy model with the number of chronic conditions, mental health, activities of daily living and living situation. We stratified the analyses by sex. 34% of women had multimorbidity and 26% received polypharmacy. In men, these percentages were 34% and 28%. All categories of CSC (except for disadvantaged CSC in men) were associated with multimorbidity. In both sexes, a higher advantage was associated with lower odds of multimorbidity. In women, advantaged and most advantaged CSC were associated with lower odds of polypharmacy (OR = 0.53, 95% CI 0.31-0.89; OR = 0.48, 95% CI 0.24-0.94). In men, CSC were not associated with polypharmacy. ASC attenuated the association of CSC with multimorbidity among women, but CSC remained associated. In men, CSC were attenuated after adjusting for ASC. Key messages Lower childhood socioeconomic conditions increase the odds of having multiple chronic conditions in older adults. In women, the odds of polypharmacy are marginally linked with CSC. Less disadvantaged socioeconomic conditions in adulthood may allow for compensating a more disadvantaged start in life, particularly in men.

scholarly journals Life Course Socioeconomic Conditions and Frailty at Older Ages

2019 ◽  
Vol 75 (6) ◽  
pp. 1348-1357 ◽  
Author(s):  
Bernadette Wilhelmina Antonia Van der Linden ◽  
Boris Cheval ◽  
Stefan Sieber ◽  
Dan Orsholits ◽  
Idris Guessous ◽  
...  
Keyword(s):  
Life Course ◽  
Old Age ◽  
Chronic Conditions ◽  
Daily Living ◽  
Regression Models ◽  
Longitudinal Survey ◽  
Personal Factors ◽  
Socioeconomic Conditions ◽  
Logistic Regression Models ◽  
Low Activity

Abstract Objectives This article aimed to assess associations of childhood socioeconomic conditions (CSC) with the risk of frailty in old age and whether adulthood socioeconomic conditions (ASC) influence this association. Methods Data from 21,185 individuals aged 50 years and older included in the longitudinal Survey of Health, Ageing, and Retirement in Europe were used. Frailty was operationalized as a sum of presenting weakness, shrinking, exhaustion, slowness, or low activity. Confounder-adjusted multilevel logistic regression models were used to analyze associations of CSC and ASC with frailty. Results While disadvantaged CSC was associated with higher odds of (pre-)frailty in women and men (odds ratio [OR] = 1.73, 95% confidence interval [CI] 1.34, 2.24; OR = 1.84, 95% CI 1.27, 2.66, respectively), this association was mediated by ASC. Personal factors and demographics, such as birth cohort, chronic conditions, and difficulties with activities of daily living, increased the odds of being (pre-)frail. Discussion Findings suggest that CSC are associated with frailty at old age. However, when taking into account ASC, this association no longer persists. The results show the importance of improving socioeconomic conditions over the whole life course in order to reduce health inequalities in old age.

scholarly journals CANCER PREVALENCE AND THE ROLE OF MULTIMORBIDITY AMONG OLDER ADULTS: USING NHANES 2011-2016

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S460-S460
Author(s):  
Fei Tang ◽  
Elizabeth Vasquez
Keyword(s):  
Older Adults ◽  
Cancer Risk ◽  
Cancer Prevention ◽  
Chronic Conditions ◽  
Smoking Status ◽  
Simultaneous Presentation ◽  
Epidemiologic Studies ◽  
Multiple Chronic Conditions ◽  
Cancer Prevalence ◽  
Logistic Regression Models

Abstract Cancer risk increases as age, understanding the potential risk factors of cancer is essential for cancer prevention. Biological and epidemiologic studies suggest relationships between individual chronic conditions and increased cancer risk. However, limited researches have analyzed the association between multimorbidity (simultaneous presentation of two or more chronic diseases) and cancer. The current study is aimed to evaluate whether having multimorbidity is associated with increased all-site and site-specific cancer prevalence among older adults. Data of 5,200 older adults aged 55 years and older who participated in the 2011-2016 National Health and Nutrition Examination Survey (NHANES) were included in the study. Single and multiple logistic regression models were used to evaluate the associations between multimorbidity and cancer. 3,623 (70%) individuals in our study were identified as having multimorbidity and 992 (19%) individuals were diagnosed with cancer. After adjusting for demographic covariates and smoking status, having multimorbidity was significantly associated with having all-site cancer (AOR: 1.57; 95% CI: 1.25 – 1.98) and lung cancer (AOR: 8.91; 95% CI: 1.51 - 52.73). Multimorbidity was associated with increased odds of having cancers among older adults. Our findings add to the evidence suggesting the potential relationships between multimorbidity and cancer. Future longitudinal studies are needed to examine the biological mechanisms and temporality of the association. If the association between multimorbidity and cancer is affirmed, it could have substantial implications in public health, as management of multiple chronic conditions could also advantage cancer prevention among older adults.

scholarly journals Multimorbidity: Constellations of Conditions across Subgroups of Midlife and Older Individuals, and Related Medicare Expenditures

2017 ◽  
Vol 7 (1) ◽  
pp. 33-43 ◽  
Author(s):  
Siran M. Koroukian ◽  
Nicholas K. Schiltz ◽  
David F. Warner ◽  
Jiayang Sun ◽  
Kurt C. Stange ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Chronic Conditions ◽  
Daily Living ◽  
Functional Limitations ◽  
Upper Body ◽  
Multiple Chronic Conditions ◽  
Fee For Service ◽  
Geriatric Syndromes ◽  
Older Individuals

Introduction: The Department of Health and Human Services’ 2010 Strategic Framework on Multiple Chronic Conditions called for the identification of common constellations of conditions in older adults. Objectives: To analyze patterns of conditions constituting multimorbidity (CCMM) and expenditures in a US representative sample of midlife and older adults (50–64 and ≥65 years of age, respectively). Design: A cross-sectional study of the 2010 Health and Retirement Study (HRS; n=17,912). The following measures were used: (1) count and combinations of CCMM, including (i) chronic conditions (hypertension, arthritis, heart disease, lung disease, stroke, diabetes, cancer, and psychiatric conditions), (ii) functional limitations (upper body limitations, lower body limitations, strength limitations, limitations in activities of daily living, and limitations in instrumental activities of daily living), and (iii) geriatric syndromes (cognitive impairment, depressive symptoms, incontinence, visual impairment, hearing impairment, severe pain, and dizziness); and (2) annualized 2011 Medicare expenditures for HRS participants who were Medicare fee-for-service beneficiaries ( n=5,677). Medicaid beneficiaries were also identified based on their self-reported insurance status. Results: No large representations of participants within specific CCMM categories were observed; however, functional limitations and geriatric syndromes were prominently present with higher CCMM counts. Among fee-for-service Medicare beneficiaries aged 50–64 years, 26.7% of the participants presented with ≥10 CCMM, but incurred 48% of the expenditure. In those aged ≥65 years, these percentages were 16.9% and 34.4%, respectively. Conclusion: Functional limitations and geriatric syndromes considerably add to the MM burden in midlife and older adults. This burden is much higher than previously reported.

scholarly journals Association of Obesity, Multiple Chronic Conditions, and Frailty: the National Health and Aging Trends Survey

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 613-613
Author(s):  
John Batsis ◽  
Christian Haudenschild ◽  
Anna Kahkoska ◽  
Rebecca Crow ◽  
David Lynch ◽  
...  
Keyword(s):  
National Health ◽  
Chronic Conditions ◽  
Regression Models ◽  
Overweight And Obesity ◽  
Multiple Chronic Conditions ◽  
Obesity Epidemic ◽  
Logistic Regression Models ◽  
Adjusted Logistic Regression ◽  
Using Data ◽  
The Relationship

Abstract As life expectancy increases, so does the risk of developing multiple chronic conditions (MCC). This is concerning as there is a growing obesity epidemic in older adults which is also associated with developing chronic diseases. Both obesity and MCC also increase the risk of frailty, yet the intersection of the three is not well understood. We evaluated the relationship between obesity, multimorbidity, and frailty using data from adults ≥65 years from the National Health and Aging Trends Survey. Obesity was classified using standard body mass index categories (e.g., ≥30kg/m2) and waist circumference (WC; females≥88cm; males≥102cm). MCC was classified as having ≥2 chronic conditions. Adjusted logistic regression models evaluated the association of BMI or WC categories on MCC (yes/no). An analysis limited to persons with obesity evaluated the relationship between frailty phenotypes (e.g, robust, pre-frail, frail) and MCC. Of the 4,967 participants (59.7% female), 79% resided in a private residence. The 70-79 age category was most prevalent. In those with MCC, there were 1,511 (30.4%) classified as having obesity using BMI, and 3,358 (67.6%) using WC. In those without MCC, there were 287 (17.6%) and 744 (51.7%). Compared to normal BMI, the odds of MCC was 0.71 [0.46,1.09], 1.25 [1.08,1.45] and 2.59 [2.15,3.11] in underweight, overweight and obesity. In pre-frailty and frailty, the odds of MCC were 2.52 [1.77,3.59] and 8.35 [3.7,18.85] in BMI-defined obesity. Using WC, the odds were 2.38 [1.94,2.91], and 5.89 [3.83,9.06]. Obesity using both BMI and WC are both strongly associated with multimorbidity and frailty.

scholarly journals Obstructive Sleep Apnea Treatment and Dementia Risk in Older Adults

SLEEP ◽  
2021 ◽  
Author(s):  
G L Dunietz ◽  
R D Chervin ◽  
J F Burke ◽  
A S Conceicao ◽  
T J Braley
Keyword(s):  
Older Adults ◽  
Statistical Significance ◽  
Fee For Service ◽  
Medicare Beneficiaries ◽  
Lower Odds ◽  
Logistic Regression Models ◽  
Not Otherwise Specified ◽  
Dementia Risk ◽  
Obstructive Sleep ◽  
Study Participants

Abstract Study Objectives To examine associations between PAP therapy, adherence and incident diagnoses of Alzheimer’s disease (AD), mild cognitive impairment (MCI), and dementia not-otherwise-specified (DNOS) in older adults. Methods This retrospective study utilized Medicare 5% fee-for-service claims data of 53,321 beneficiaries, aged 65+, with an OSA diagnosis prior to 2011. Study participants were evaluated using ICD-9 codes for neurocognitive syndromes [AD(n=1,057), DNOS(n=378), and MCI(n=443)] that were newly-identified between 2011-2013. PAP treatment was defined as presence of ≥1 durable medical equipment (HCPCS) code for PAP supplies. PAP adherence was defined as ≥2 HCPCS codes for PAP equipment, separated by≥1 month. Logistic regression models, adjusted for demographic and health characteristics, were used to estimate associations between PAP treatment or adherence and new AD, DNOS, and MCI diagnoses. Results In this sample of Medicare beneficiaries with OSA, 59% were men, 90% were non-Hispanic whites and 62% were younger than 75y. The majority (78%) of beneficiaries with OSA were prescribed PAP (treated), and 74% showed evidence of adherent PAP use. In adjusted models, PAP treatment was associated with lower odds of incident diagnoses of AD and DNOS (OR=0.78, 95% CI:0.69-0.89; and OR=0.69, 95% CI:0.55-0.85). Lower odds of MCI, approaching statistical significance, were also observed among PAP users (OR=0.82, 95% CI:0.66-1.02). PAP adherence was associated with lower odds of incident diagnoses of AD (OR=0.65, 95% CI:0.56-0.76). Conclusions PAP treatment and adherence are independently associated with lower odds of incident AD diagnoses in older adults. Results suggest that treatment of OSA may reduce risk of subsequent dementia.

scholarly journals The Importance of Studying Health Behavior in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 827-827
Author(s):  
Jaime Hughes ◽  
Susan Hughes ◽  
Mina Raj ◽  
Janet Bettger
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Behavior Change ◽  
Chronic Conditions ◽  
Population Level ◽  
Multiple Chronic Conditions ◽  
Prior Work ◽  
Time Changes ◽  
The Impact ◽  
Over Time

Abstract Behavior change is an inherent aspect of routine geriatric care. However, most research and clinical programs emphasis how to initiate behavior change with less emphasis placed on skills and strategies to maintain behaviors over time, including after an intervention has concluded. This presentation will provide an introduction to the symposium, including a review of prior work and our rationale for studying the critical yet overlooked construct of maintenance in older adults. Several key considerations in our work include the impact of multiple chronic conditions, declines in cognitive and functional capacity over time, changes in environmental context and/or social support, and sustainability of community and population-level programs and services.

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