Mild parkinsonian signs, energy decline, and striatal volume in community-dwelling older adults

2021 ◽  
Author(s):  
Qu Tian ◽  
Rebecca Ehrenkranz ◽  
Andrea L Rosso ◽  
Nancy W Glynn ◽  
Lana M Chahine ◽  
...  
Keyword(s):  
Older Adults ◽  
Regression Models ◽  
Rating Scale ◽  
Gray Matter Volume ◽  
Energy Levels ◽  
Community Dwelling ◽  
Linear Regression Models ◽  
Logistic Regression Models ◽  
Body Composition Study ◽  
Using Data

Abstract Background Mild Parkinsonian Signs (MPS), highly prevalent in older adults, predict disability. It is unknown whether energy decline, a predictor of mobility disability, is also associated with MPS. We hypothesized that those with MPS had greater decline in self-reported energy levels (SEL) than those without MPS, and that SEL decline and MPS share neural substrates. Methods Using data from the Health, Aging and Body Composition Study, we analyzed 293 Parkinson’s Disease-free participants (83±3 years old, 39% Black, 58% women) with neuroimaging data, MPS evaluation by Unified Parkinson Disease Rating Scale in 2006-2008, and ≥ 3 measures of SEL since 1999-2000. Individual SEL slopes were computed via linear mixed models. Associations of SEL slopes with MPS were tested using logistic regression models. Association of SEL slope with volume of striatum, sensorimotor, and cognitive regions were examined using linear regression models adjusted for normalized total gray matter volume. Models were adjusted for baseline SEL, mobility, demographics, and comorbidities. Results Compared to those without MPS (n=165), those with MPS (n=128) had 37% greater SEL decline in the prior eight years (p=0.001). Greater SEL decline was associated with smaller right striatal volume (adjusted standardized β=0.126, p=0.029). SEL decline was not associated with volumes in other regions. The association of SEL decline with MPS remained similar after adjustment for right striatal volume (adjusted OR=2.03, 95% CI: 1.16 - 3.54). Conclusion SEL decline may be faster in those with MPS. Striatal atrophy may be important for declining energy but does not explain the association with MPS.

Relationship Between Frailty and Depression Among Community-Dwelling Older Adults: The Mediating and Moderating Role of Social Support

2020 ◽  
Vol 60 (8) ◽  
pp. 1466-1475 ◽  
Author(s):  
Yaru Jin ◽  
Huaxin Si ◽  
Xiaoxia Qiao ◽  
Xiaoyu Tian ◽  
Xinyi Liu ◽  
...  
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Rating Scale ◽  
Depression Scale ◽  
Community Dwelling ◽  
Linear Regression Models ◽  
Frailty Phenotype ◽  
Community Dwelling Older Adults ◽  
The Relationship

Abstract Background and Objectives Frailty is associated with depression in older adults and reduces their social support. However, the mechanism underlying such relationship remains unclear. We aim to examine whether social support acts as a mediator or moderator in the relationship between frailty and depression. Research Design and Methods This cross-sectional study was conducted among 1,779 community-dwelling older adults aged 60 and older. Frailty, social support, and depressive symptoms were measured by the Physical Frailty Phenotype, Social Support Rating Scale, and five-item Geriatric Depression Scale, respectively. Data were also collected on age, gender, years of schooling, monthly income, cognitive function, number of chronic diseases, physical function, and pain. Results Linear regression models showed that subjective support and support utilization, but not objective support, mediated and moderated the relationship between frailty and depressive symptoms. The Johnson–Neyman technique determined a threshold of 30 for subjective support, but not for support utilization, beyond which the detrimental effect of frailty on depressive symptoms was offset. Discussion and Implications Social support underlies the association of frailty with depression, and its protective role varies by type. Interventions on depression should address improving perceptions and utilization of social support among frail older adults rather than simply providing them with objective support.

scholarly journals NEIGHBORHOOD AGE COMPOSITION AND SELF-RATED HEALTH: FINDINGS FROM A NATIONALLY REPRESENTATIVE STUDY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S64-S64
Author(s):  
Amanda Lehning ◽  
Amanda J Lehning ◽  
Nicole Mattocks ◽  
Kyeongmo Kim ◽  
Richard J Smith
Keyword(s):  
Older Adults ◽  
Regression Models ◽  
Neighborhood Change ◽  
Age Composition ◽  
Logistic Regression Models ◽  
Self Rated Health ◽  
Representative Study ◽  
Nationally Representative ◽  
Using Data ◽  
Conceptual Work

Abstract Neighborhood age composition is an understudied area. Furthermore, existing empirical and conceptual work is conflicting, with some indicating neighborhoods with more older adults are beneficial and other scholarship suggesting it can be detrimental. Using data from 7,197 older adults from the first wave (2011) of the National Health & Aging Trends Study combined with census tract data from the National Neighborhood Change Database, we examined the association between neighborhood age composition and self-rated health. Findings from logistic regression models indicate those living in neighborhoods with a growing concentration of older residents are significantly more likely to report lower self-rated health compared to those living in a neighborhood in which older adults overall are declining (β=1.51, p < .05) or are becoming diluted by younger residents (β=.66, p < .05). Results have implications for interventions promoting aging in place, particularly for those who may be stuck in place in age-concentrated neighborhoods.

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.

scholarly journals Eldercare services for people with and without a dementia diagnosis: an analysis of Swedish registry data

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Atiqur sm-Rahman ◽  
Lars-Christer Hydén ◽  
Susanne Kelfve
Keyword(s):  
Older Adults ◽  
Regression Models ◽  
Strong Predictor ◽  
Older Age ◽  
Policy Implications ◽  
Substantial Part ◽  
Linear Regression Models ◽  
Dementia Diagnosis ◽  
Logistic Regression Models ◽  
To Receive

Abstract Background The growing number of people living with dementia (PlwD) implies an increase in the demand for eldercare services in Sweden like in many other countries. Few studies have analyzed the use of eldercare services for PlwD. The aim of the present study is to investigate the association between demographic factors (age, sex, cohabiting status) and the use of municipal eldercare services (including both home care and residential care) for older adults with dementia compared to older adults without dementia in Sweden. Methods This study used several nationwide Swedish registers targeting all individuals aged 65 and above living in Sweden in 2014 and still alive 31st of March 2015 (n = 2,004,409). The primary outcomes variables were different types of eldercare service, and all participants were clustered based on age, sex, cohabiting status, and dementia diagnosis. In addition to descriptive statistics, we performed multivariate logistic regression models for binary outcomes and linear regression models for continuous outcomes. Results Results showed that (1) older age is a significantly strong predictor for the use of eldercare services, although PlwD start using eldercare at an earlier age compared with people without dementia; (2) women tend to receive more eldercare services than men, especially in older age, although men with dementia who live alone are more likely than women living alone to receive eldercare; (3) having a dementia diagnosis is a strong predictor for receiving eldercare. However, it was also found that a substantial proportion of men and women with dementia did not receive any eldercare services. Conclusions We found that people with a dementia diagnosis use more as well as start to use eldercare services at an earlier age than people without dementia. However, further research is needed to investigate why a substantial part of people with a dementia diagnosis does not have any eldercare at all and what the policy implications of this might be.

Pain as a Risk Factor for Loneliness Among Older Adults

2017 ◽  
Vol 30 (9) ◽  
pp. 1450-1461 ◽  
Author(s):  
Kerstin Emerson ◽  
Ian Boggero ◽  
Glenn Ostir ◽  
Jayani Jayawardhana
Keyword(s):  
Older Adults ◽  
Regression Models ◽  
Functional Decline ◽  
Premature Mortality ◽  
Community Dwelling ◽  
Logistic Regression Models ◽  
Community Dwelling Older Adults ◽  
Retirement Study ◽  
Time Point

Objective: The objective of this is to examine whether pain is associated with the onset of loneliness in a sample of community-dwelling older adults. Methods: We used data from the 2008 and 2012 Health and Retirement Study. We limited the sample to community-dwelling persons aged 60 years and over who were not lonely in 2008 in order to predict the risk of onset of loneliness (incidence) in 2012. Our analytic sample included 1,563 observations. Results: Approximately 31.7% of participants reported loneliness at follow-up (2012). Logistic regression models showed that the odds of loneliness onset was 1.58 higher for those with pain at both time points, compared with those who had pain at neither time point, even after controlling for other covariates. Discussion: The results indicate that pain may increase the risk of loneliness in older adults. This suggests that appropriate pain interventions could prevent future loneliness, which in turn could prevent functional decline, disability, and premature mortality.

scholarly journals Assessment of Neck Grasp as a Screening Tool for Identifying Obstructive Sleep Apnea in Community-Dwelling Older Adults

2020 ◽  
Vol 11 ◽  
pp. 215013272098442
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera ◽  
Bettsy Y. Recalde ◽  
Pablo R. Castillo
Keyword(s):  
Older Adults ◽  
Obstructive Sleep Apnea ◽  
Logistic Regression ◽  
Sleep Apnea ◽  
Predictive Value ◽  
Regression Models ◽  
Community Dwelling ◽  
Logistic Regression Models ◽  
Obstructive Sleep ◽  
Community Dwelling Older Adults

Background Inability to encircle the neck by hands (neck grasp) has been proposed as an indicator of obstructive sleep apnea (OSA) that would be useful for recognition of candidates for polysomnography (PSG). We assessed the value of neck grasp for predicting OSA in community-dwelling older adults of Amerindian ancestry. Methods Neck grasp was evaluated in individuals aged ≥60 years undergoing PSG. The association between neck grasp and OSA was assessed by logistic regression models adjusted for relevant covariates. Mediation analysis was used to establish the proportion of the effect of the association between neck grasp and OSA, which is mediated by the neck circumference (a well-known OSA biomarker). Receiver operator characteristics curve analysis was used to estimate diagnostic accuracy of neck grasp for predicting OSA. Results Of 201 individuals undergoing PSG, 167 (83%) had the neck grasp test. The remaining 34 could not perform the test because of different factors. Neck grasp was positive in 127 (76%) cases, and 114 (68%) individuals had OSA (apnea-hypopnea index ≥5). Multivariate logistic regression models disclosed a significant association between neck grasp and OSA. The neck circumference was the single covariate remaining independently significant in these models. Neck grasp was not efficient at predicting OSA (sensitivity: 83.3%, specificity: 39.6%, positive predictive value: 0.75 and negative predictive value: 0.53). The area under the curve disclosed only a moderate predictive capability (61.5%) of neck grasp. Conclusion Results do not support the use of neck grasp as an independent predictor of OSA in the study population.

scholarly journals Longitudinal Relationships Between Favorite Activities and Homebound Status in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 496-496
Author(s):  
Xiaocao Sun ◽  
Minhui Liu ◽  
Christina Miyawaki ◽  
Yuxiao Li ◽  
Tianxue Hou ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Regression Models ◽  
Community Dwelling ◽  
Logistic Regression Models ◽  
New Information ◽  
Homebound Older Adults ◽  
Watching Tv ◽  
Community Dwelling Older Adults ◽  
Longitudinal Relationships

Abstract Favorite activities are usually meaningful to older adults and may influence their homebound status and vice versa. Using Round 1 (R1, in 2011) and Round 5 (R5, in 2015) data from the National Health and Aging Trends Study, we examined the patterns of favorite activity by homebound status and investigated their relationship among community-dwelling older adults (N=3,332). Homebound status (non-homebound, semi-homebound, and homebound) was determined by the frequency, difficulty, and needing help of outdoor mobility. Favorite activities were named by participants verbatim and then were classified into two categories (active and non-active) based on the estimated energy needed to perform the activity. Logistic regression models were used to determine whether homebound status at R1 predicted the types of favorite activity in R5, and ordinal logistic regression models for predictions from the types of favorite activity at R1 to homebound status at R5, adjusting for demographics and health conditions. The sample was, on average, 76±7.23 years old, non-Hispanic White (72.9%), and female (59.7%). Regardless of the homebound status, reading and walking are the top two favorite activities. Homebound older adults enjoyed “non-active” activities (e.g., watching TV), while non-homebound counterparts preferred “active” outdoor maintenance. Being homebound at R1 predicted non-active favorite activity in R5 (OR=.257, p<0.001), and R1 non-active favorite activity also predicted homebound status in R5 (OR=1.219, p =0.039). These findings provide new information on the activity preferences of older adults with different homebound status and how their preferences may influence their future homebound status.

scholarly journals Conceptualizing Food Insecurity Among Older Adults: Development of a Summary Indicator in the National Health and Aging Trends Study

2020 ◽  
Author(s):  
Emma L Tucher ◽  
Tamra Keeney ◽  
Alicia J Cohen ◽  
Kali S Thomas
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Food Insecurity ◽  
National Health ◽  
Regression Models ◽  
Functional Limitations ◽  
Community Dwelling ◽  
Financial Barriers ◽  
Logistic Regression Models ◽  
The Impact

Abstract Objectives Measurement of food insecurity in older adults is focused on financial barriers to food access. Given that older adults are particularly susceptible to additional access-related barriers including functional limitations and lack of social support, the objective of this study was to construct a summary indicator of food insecurity incorporating these domains. Methods We used nationally representative survey data from Round 5 of the National Health and Aging Trends Study (NHATS; n = 7,070). We constructed a summary indicator of food insecurity using factors within the following three domains: functional, social support, and financial limitations. First, we identified the prevalence of food insecurity among the sample as defined by the new summary indicator. Then, we estimated unadjusted and adjusted logistic regression models to assess the association between the expanded measure of food insecurity and biopsychosocial factors. Results In 2015, 4.3% (95% confidence interval [CI] 3.75–4.94) of community-dwelling older adults, approximately 1,673,775 million people, were characterized as having food insecurity. Multivariable-adjusted regression models identified that being homebound (odds ratio [OR] 3.49, 95% CI 2.03, 6.00), frail (OR 9.50, 95% CI 4.92–18.37), and experiencing community disability (OR 5.19, 95% CI 3.90–6.90) was associated with food insecurity. Discussion Food insecurity among older adults is broader than lacking adequate financial resources to obtain food; it is also associated with social and functional limitations. A more comprehensive conceptualization will aid future study on the impact of food insecurity on health status, utilization, and outcomes to inform senior nutrition program targeting and services.

scholarly journals Correlates of Depressive Symptoms in Older Adults with Diabetes

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
LaRita C. Jones ◽  
Olivio J. Clay ◽  
Fernando Ovalle ◽  
Andrea Cherrington ◽  
Michael Crowe
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
Regression Models ◽  
Community Dwelling ◽  
Diabetes Distress ◽  
Health Issues ◽  
Linear Regression Models ◽  
Health Complications ◽  
Specific Health

Investigators examined correlates of depressive symptoms within a sample of older adults with diabetes. Participants completed a structured telephone interview with measures including depressive symptoms, health conditions, cognitive function, and diabetes distress. Correlations and hierarchical linear regression models were utilized to examine bivariate and covariate-adjusted correlates of depressive symptoms. The sample included 246 community-dwelling adults with diabetes (≥65 years old). In bivariate analyses, African Americans, individuals with specific health issues (neuropathy, stroke, respiratory issues, arthritis, and cardiac issues), and those with higher levels of diabetes distress reported more depressive symptoms. Older age, higher education, more income, and better cognitive function were inversely associated with depressive symptoms. In the final covariate-adjusted regression model, stroke (B= .22,p<.001), cognitive function (B= −.14,p<.01), and higher levels of diabetes-related distress (B= .49,p<.001) each were uniquely associated with more depressive symptoms. Diabetes distress partially mediated the associations between cardiac issues and depressive symptoms and between cognitive function and depressive symptoms. Findings suggest that interventions targeted at helping older adults manage their diabetes-related distress and reducing the likelihood of experiencing additional health complications may reduce depressive symptoms within this population.

scholarly journals Energy Decline May Predict Mild Parkinsonian Signs in Community-Dwelling Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 185-186
Author(s):  
Rebecca Ehrenkranz ◽  
Qu Tian ◽  
Andrea Rosso ◽  
Nancy W Glynn ◽  
Lana Chahine ◽  
...  
Keyword(s):  
Older Adults ◽  
Risk Factor ◽  
Rating Scale ◽  
Community Dwelling ◽  
Mobility Impairment ◽  
Body Composition Study ◽  
Health Aging ◽  
Motor Component ◽  
Disease Rating ◽  
Community Dwelling Older Adults

Abstract Mild Parkinsonian Signs (MPS) are common in older adults without overt neurological disease. MPS are often progressive and predict disability and dementia, yet little is known about predictors for MPS. Low self-reported energy is associated with mobility impairment, which is a hallmark of MPS. Yet whether self-reported energy relates to MPS is unknown. We explored the association of changes in self-reported energy with MPS in 293 participants (aged 83 ± 2.8 years, 58% women, 61% White) free of dementia and Parkinson’s Disease in the Health, Aging and Body Composition Study. Self-reported energy was assessed on a 0-10 scale annually between Year 2 and Year 10 (mean follow-up: 8 years) and its slope was estimated via linear mixed effects models. MPS were evaluated at Year 10 based on the Unified Parkinson Disease Rating Scale motor component. On average, self-reported energy declined 0.06 points per year. In a linear regression model adjusted for age, fatigue, and comorbidities, those with MPS had steeper SEL decline (β [Standard Error] = -0.358 [0.119]) in the prior eight years than those without MPS. Thus, declining self-reported energy may be a risk factor for MPS. Self-reported energy is easily evaluated in routine clinic visits, and may be a modifiable risk factor that can be targeted to reduce the incidence of MPS.

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