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 Body Composition in Community-Dwelling Older Adults Before and After SARS-CoV-2 Infection: A Longitudinal Prospective Study in a Rural Village Struck by the Pandemic

2021 ◽  
Vol 12 ◽  
pp. 215013272110477
Author(s):  
Oscar H. Del Brutto ◽  
Robertino M. Mera ◽  
Denisse A. Rumbea ◽  
Pedro Pérez ◽  
Bettsy Y. Recalde ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Body Composition ◽  
Regression Models ◽  
Community Dwelling ◽  
The Body ◽  
Study Results ◽  
The Impact ◽  
Community Dwelling Older Adults

Background: Information on the body composition of inhabitants of remote communities during the SARS-CoV-2 pandemic is limited. Using a longitudinal population-based study design, we assessed the association between SARS-CoV-2 infection and changes in body composition. Methods: Community-dwelling older adults living in a rural Ecuadorian village received body composition determinations before and 1 year after the pandemic as well as serological tests for detection of SARS-CoV-2 antibodies. The independent association between SARS-CoV-2 infection and abnormalities in body composition at follow-up was assessed by fitting linear mixed models for longitudinal data. Results: Of 327 enrolled individuals, 277 (85%) received baseline and follow-up body composition determinations, and 175 (63%) of them became SARS-CoV-2 seropositive. Overall, diet and physical activity deteriorated during the follow-up. Multivariate random-effects generalized least squares regression models that included the impact of time and seropositivity on follow-up body composition, showed that neither variable contributed to a worsening in body composition. Multivariate logistic regression models disclosed that the serological status at follow-up cannot be predicted by differences in body composition and other baseline covariates. Conclusions: Study results suggest no increased susceptibility to SARS-CoV-2 infection among older adults with abnormal body composition and no significant changes as a result of worse physical activity and dietary habits or seropositivity during the length of the study. Together with a previous study in the same population that showed decrease in hand-grip strength after SARS-CoV-2, results confirm that dynapenia (and not sarcopenia) is associated with SARS-CoV-2 infection in older adults.

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.

scholarly journals Informal and paid care for Brazilian older adults (National Health Survey, 2013)

2017 ◽  
Vol 51 (suppl 1) ◽  
Author(s):  
Maria Fernanda Lima-Costa ◽  
Sérgio Viana Peixoto ◽  
Deborah Carvalho Malta ◽  
Célia Landmann Szwarcwald ◽  
Juliana Vaz de Melo Mambrini
Keyword(s):  
Older Adults ◽  
Informal Care ◽  
National Health ◽  
Health Survey ◽  
Population Aging ◽  
Functional Limitations ◽  
Sociodemographic Factors ◽  
National Health Survey ◽  
Community Dwelling ◽  
Term Care

ABSTRACT OBJECTIVE To describe the prevalence and sociodemographic factors associated with informal and paid care for Brazilian older adults with functional limitations. METHODS Of the 23,815 participants of the National Health Survey aged 60 or older, 5,978 reported needing help to perform activities of daily living and were included in this analysis. The dependent variable was the source of care, categorized as exclusively informal (unpaid), exclusively formal (paid), mixed or none. The socio-demographic variables were age (60-64, 65-74, ≥ 75 years old), gender and number of residents in the household (1, 2, ≥ 3). The multivariate analysis was based on binomial and multinomial logistic regressions. RESULTS Informal care predominated (81.8%), followed by paid (5.8%) or mixed (6.8%) and no care (5.7%). The receipt of care from any source increased gradually with the number of residents in a same household, regardless of age and gender (OR = 4.85 and 9.74 for 2 and ≥ 3, respectively). Age was positively associated with receiving any care while the male gender showed a negative association. The number of residents in the household showed the strongest association with informal care (OR = 10.94 for ≥ 3 residents), compared with paid (OR = 5.48) and mixed (OR = 4.16) care. CONCLUSIONS Informal care is the main source of help for community-dwelling older adults with functional limitations. In a context of rapid population aging and decline in family size, the results reinforce the need for policies to support long-term care for older Brazilians.

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 Older Americans With Disability Are Vulnerable to Economic and Food Insecurity During COVID-19

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 203-203
Author(s):  
Shinae Choi ◽  
Eun Ha Namkung ◽  
Deborah Carr
Keyword(s):  
Older Adults ◽  
Food Insecurity ◽  
Emotional Health ◽  
Functional Limitations ◽  
Personal Characteristics ◽  
Income Loss ◽  
Older Americans ◽  
Logistic Regression Models ◽  
Policies And Procedures ◽  
Medical Bills

Abstract This study investigated whether older Americans with physical disability were vulnerable to three types of economic insecurity (difficulty paying regular bills, difficulty paying medical bills, income loss) and two types of food insecurity (economic obstacles, logistical obstacles) during the early months of the COVID-19 pandemic. We evaluated the extent to which associations are moderated by three personal characteristics (age, sex, race/ethnicity) and two pandemic-specific risk factors (job loss, COVID-19 diagnosis). Data were from a random 25 percent subsample of the Health and Retirement Study participants who completed a COVID-19 module administered in 2020. Our analytic sample included 3,166 adults aged 51 and older. We estimated logistic regression models to document the odds of experiencing each hardship. Persons with three or more functional limitations reported significantly higher odds of both types of food insecurity, and difficulty paying regular and medical bills, relative to those with no limitations. After controlling for health conditions, effects were no longer significant for paying medical bills, and attenuated yet remained statistically significant for other outcomes. Patterns did not differ significantly on the basis of the moderator variables. Older adults with more functional limitations are vulnerable to economic and food insecurity during the pandemic, potentially exacerbating the physical and emotional health threats imposed by the pandemic. Our findings reveal an urgent need to promote policies and procedures to protect older adults with disability from economic and food insecurity. Supports for older adults with disability should focus on logistical as well as financial support for ensuring food security.

Abstract 15730: Ankle-Brachial Index and Physical Function in Community-Based Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kunihiro Matsushita ◽  
Shoshana Ballew ◽  
Yingying Sang ◽  
Corey Kalbaugh ◽  
Laura Loehr ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Independent Living ◽  
Ankle Brachial Index ◽  
Poor Performance ◽  
Community Dwelling ◽  
Atherosclerosis Risk In Communities ◽  
Logistic Regression Models ◽  
History Of ◽  
The Impact

Background: Lower extremity peripheral artery disease (PAD), commonly defined by an ankle-brachial index (ABI) <0.9, increases mortality risk and also reduces physical function. All prior studies of the impact of PAD on objectively measured physical function have been in restricted populations with known PAD or physical inactivity, leaving uncertainty regarding its impact in the community. Methods: We studied 5,351 ARIC participants (age 71-90 years during 2011-2013) who underwent the assessment of ABI and the Short Physical Performance Battery (SPPB, 0-12 scale), a summary measure of physical function based on three domains (4-meter walk velocity, timed chair stands, and standing balance). Logistic regression models examined the association of ABI with poor physical function (SPPB score <6), adjusting for potential confounders including a history of other cardiovascular diseases. Results: There were 463 participants (8.2%) with ABI <0.9 and 506 participants (9.0%) with ABI ≥1.3, a potential manifestation of PAD reflecting noncompressible pedal arteries. Both ABI <0.9 and ≥1.3 were significantly and independently associated with higher odds of having poor physical function compared to those with a normal ABI (1.1-1.2). The 469 participants (8.8%) with a “borderline” low ABI (0.9-1.0) also demonstrated significantly poor physical function. Low ABI was significantly associated with poor performance in every SPPB domain, whereas none were statistically significant for high ABI. The results were largely consistent among those without a history of stroke or heart failure. Conclusion: In our population of community-dwelling older adults, ~25% had low, borderline low, or high ABI suggestive of PAD and demonstrated poorer physical function compared to those with normal ABI. Since physical function is a key element for independent living in older adults and several therapeutic options for PAD exist, our findings may have broad and important implications.

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 COVID-19 Pandemic Restrictions Affecting Older Adults' Social Interactions and Communication

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 247-247
Author(s):  
Mackinsey Shahan ◽  
Seung Eun Jung ◽  
Frankie Palmer ◽  
Amy Ellis
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Online Survey ◽  
Community Dwelling ◽  
Individual Interviews ◽  
Funding Sources ◽  
Phone Calls ◽  
Use Of Technology ◽  
Increased Risk ◽  
The Impact

Abstract Objectives Due to increased risk of social isolation caused by COVID-19, this study was conducted to understand changes in health behaviors among older adults, particularly concerning means of social interaction. Methods Community dwelling adults ages 60 and older completed qualitative individual interviews via Zoom and a 24 item online survey, the Questionnaire for Assessing the Impact of the COVID-19 Pandemic in Older Adults. Data were analyzed using directed content analysis and descriptive statistics. Results A total of 23 participants completed interviews and 25 completed online surveys. Participants were mainly female (72%), white (96%), with a mean age of 71.96 years. Nineteen (76%) participants were very concerned by the pandemic, and only one participant was not at all concerned. Participants frequently reported more interactions with their immediate family. Only five (20%) reported communicating with close friends and family less often than before the pandemic began. Seven (28%) reported communicating with friends and family more often than before and about half (52%) reported that their frequency of communication was “about the same” as pre-pandemic. Twenty-one (84%) participants communicated with others daily or at least several times per week. However, participants reported less face-to-face interaction and increased use of technology, such as virtual happy hours. All participants stayed in touch with others by phone calls (100%). Other often used means of communication were texting (92%), video calls (68%), email (68%), social media (52%), and postal mail (48%). Participants also reported some social gatherings with individuals bringing their own food and social distancing maintained. Despite this, 16 participants (64%) reported feeling isolated from others sometimes or often. Conclusions Although many older adults have adjusted their usual behaviors to stay in contact with others during the pandemic, this study found that most still felt isolated. Long-term feelings of isolation and lack of social support may compromise nutrition for this population. Therefore, it is crucial that nutrition professionals incorporate aspects of social support when working with these individuals. Funding Sources Julie O'Sullivan Maillet Research Grant Award funded by the Academy of Nutrition and Dietetics Foundation (ANDF).

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