scholarly journals Kinlessness at the End of Life in the United States: Implications for Place of Death, and Quality of Life Among Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 604-604
Author(s):  
Katherine Ornstein ◽  
Natalie Plick ◽  
Claire Ankuda
Keyword(s):  
Older Adults ◽  
The United States ◽  
Community Dwelling ◽  
Hospital Death ◽  
Representative Study ◽  
National Estimates ◽  
Nationally Representative ◽  
Assess Quality ◽  
Eol Care

Abstract We used the Health and Retirement Study, a large nationally representative study of U.S. older adults from 2002-2015, to identify decedents and assess quality of EOL care by availability of kin. 7.9% of participants were kinless at EOL (no adult children or spouses), reflecting national estimates of 1,027,600 older adults. Those who were kinless at EOL were more likely to be female (61.2% vs 51.5%), from the lowest wealth quartile (53.6% vs 35.6%), and less likely to be white and non-Hispanic (75.6% vs 81.8%). Among the community-dwelling population, individuals with kin received 2.4 times as much hours of help from informal caregivers per month, compared to those without kin. We did not observe differences in rates of hospital death by kin status in adjusted models. More work is needed to assess any unmet needs in the EOL period for kinless older adults, especially as healthcare moves towards increased in-home supports.

scholarly journals Driving Status and Transportation Disadvantage Among Medicare Beneficiaries

2018 ◽  
Vol 39 (9) ◽  
pp. 935-943 ◽  
Author(s):  
Miriam Ryvicker ◽  
Evan Bollens-Lund ◽  
Katherine A. Ornstein
Keyword(s):  
United States ◽  
Older Adults ◽  
Well Being ◽  
The United States ◽  
Community Dwelling ◽  
Medicare Beneficiaries ◽  
Coordination Strategies ◽  
Representative Study ◽  
Nationally Representative ◽  
Community Dwelling Older Adults

Transportation disadvantage may have important implications for the health, well-being, and quality of life of older adults. This study used the 2015 National Health Aging Trends Study, a nationally representative study of Medicare beneficiaries aged 65 and over ( N = 7,498), to generate national estimates of transportation modalities and transportation disadvantage among community-dwelling older adults in the United States. An estimated 10.8 million community-dwelling older adults in the United States rarely or never drive. Among nondrivers, 25% were classified as transportation disadvantaged, representing 2.3 million individuals. Individuals with more chronic medical conditions and those reliant on assistive devices were more likely to report having a transportation disadvantage ( p < .05). Being married resulted in a 50% decreased odds of having a transportation disadvantage ( p < .01). Some individuals may be at higher risk for transportation-related barriers to engaging in valued activities and accessing care, calling for tailored interventions such as ride-share services combined with care coordination strategies.

Association of Systolic and Diastolic Blood Pressure With All-Cause Mortality Among Community-Dwelling Older Adults: A Prospective Observational Study

2021 ◽  
pp. 089826432110552
Author(s):  
Qian Lian ◽  
Tazeen H. Jafar ◽  
John C. Allen ◽  
Stefan Ma ◽  
Rahul Malhotra
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Diastolic Blood Pressure ◽  
Mortality Risk ◽  
Cox Regression ◽  
Community Dwelling ◽  
Representative Study ◽  
Hazard Ratios ◽  
Nationally Representative ◽  
Community Dwelling Older Adults

Objectives To assess the association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with mortality among older adults in Singapore. Methods Association of SBP and DBP measured in 2009 for 4443 older adults (69.5±7.4 years; 60–97 years) participating in a nationally representative study with mortality risk through end-December 2015 was assessed using Cox regression. Results Higher mortality risk was observed at the lower and upper extremes of SBP and DBP. With SBP of 100–119 mmHg as the reference, multivariable mortality hazard ratios [HRs (95% confidence interval)] were SBP <100 mmHg: 2.41 (1.23–4.72); SBP 160–179 mmHg: 1.51 (1.02–2.22); and SBP ≥180 mmHg: 1.78 (1.12–2.81). With DBP of 70–79 mmHg as the reference, HRs were DBP <50 mmHg: 2.41 (1.28–4.54) and DBP ≥110 mmHg: 2.16 (1.09–4.31). Discussion Management of high blood pressure among older adults will likely reduce their mortality risk. However, the association of excessively low SBP and DBP values with mortality risk needs further evaluation.

Predictors of Emergency Preparedness Among Older Adults in the United States

2020 ◽  
pp. 1-7 ◽  
Author(s):  
Sue Anne Bell ◽  
Dianne Singer ◽  
Erica Solway ◽  
Mattias Kirch ◽  
Jeffrey Kullgren ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
Emergency Preparedness ◽  
The United States ◽  
Community Dwelling ◽  
Power Outage ◽  
Evacuation Plans ◽  
Nationally Representative ◽  
Community Dwelling Older Adults ◽  
Hispanic White

ABSTRACT Objectives: Emergency preparedness becomes more important with increased age, as older adults are at heightened risk for harm from disasters. In this study, predictors of preparedness actions and confidence in preparedness among older adults in the United States were assessed. Methods: This nationally representative survey polled community-dwelling older adults ages 50-80 y (n = 2256) about emergency preparedness and confidence in addressing different types of emergencies. Logistic regression was used to identify predictors of reported emergency preparedness actions and confidence in addressing emergencies. Results: Participants’ mean age was 62.4 y (SD = 8); 52% were female, and 71% were non-Hispanic white. Living alone was associated with lower odds of having a 7-d supply of food and water (adjusted odds ratio [aOR] = 0.74; 95% confidence interval [CI]: 0.56-0.96), a stocked emergency kit (aOR = 0.64; 95% CI: 0.47-0.86), and having had conversations with family or friends about evacuation plans (aOR = 0.59; 95% CI: 0.44-0.78). Use of equipment requiring electricity was associated with less confidence in addressing a power outage lasting more than 24 h (aOR = 0.66; 95% CI: 0.47-0.94), as was use of mobility aids (OR = 0.65; 95% CI: 0.45-0.93). Conclusions: These results point to the need for tailored interventions to support emergency preparedness for older adults, particularly among those who live alone and use medical equipment requiring electricity.

scholarly journals Achieving Healthcare Equity: Disparities in Diagnosis, Quality of Care, and Outcomes Among People With Dementia

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 665-666
Author(s):  
Maricruz Rivera-Hernandez ◽  
Amit Kumar ◽  
Amit Kumar
Keyword(s):  
Older Adults ◽  
Quality Of Care ◽  
Ethnic Groups ◽  
Racial Differences ◽  
Ethnic Disparities ◽  
Public Health Problem ◽  
The United States ◽  
Community Dwelling ◽  
Racial And Ethnic Disparities

Abstract Alzheimer’s disease and Related Dementia (ADRD) is a significant public health problem and improving the quality and efficiency of care for older adults with ADRD is a national priority. Approximately five million older adults in the United States, including 50% of nursing home residents and 20% of community-dwelling elderly, have ADRD or probable dementia. Although, the number of minorities affected by ADRD growing at an alarming rate, the diagnosis of ADRD and supportive care for this condition are more likely to be delayed among racial/ethnic minority groups. Given the need to ensure equity of care among racial and ethnic groups, there is a pressing need to understand disparities in diagnosis, access and quality of care among racial and ethnic groups with ADRD, specifically using nationally representative data. This symposium will feature four presentations that provide novel insight regarding racial disparities among people with ADRD in the community-, institution-based post-acute, and long-term settings. Individual presentations will describe 1) racial and ethnic differences in risk and protective factors of dementia and cognitive impairment without dementia; 2) racial and ethnic disparities in high-quality home health use among persons with dementia; 3) Within- and between-nursing homes racial and ethnic disparities in resident’s outcomes for people with ADRD; and 4) racial differences in transition to post-acute care and rehab utilization following hip fracture related hospitalization in patients with ADRD. Finally, there will be a discussion regarding policy and clinical implications, as well directions for future research.

scholarly journals Association Between Sleep Medications and Falls and Fall-related Worries in Community-Dwelling Older Adults in the United States

2019 ◽  
Vol 66 (3) ◽  
pp. 23-32
Author(s):  
Kathy Nguyen ◽  
Jonathan Watanabe
Keyword(s):  
United States ◽  
Older Adults ◽  
Medication Use ◽  
Community Setting ◽  
The United States ◽  
Community Dwelling ◽  
Sleep Medication ◽  
Medication Reviews ◽  
Falls In Older Adults ◽  
Nationally Representative

Background Falls are the leading cause of unintentional fatal and nonfatal injuries in seniors. Sleep medications are associated with adverse events risk in older adults. The objective of this study is to quantify the relationship between different levels of sleep medication use with falls and fall-related worries in United States adults aged 65 years and older using a nationally representative sample. Methods Using the 2011 National Health and Aging Trends Study, survey-weighted multiple logistic regression was used to determine the association between participants who reported sleep medication use and the outcomes: falls in the last month, falls in the last year, multiple falls in the last year, fall-related worries, and limitation of activities due to fall-related worries. Results In adjusted analyses, older adults who used sleep medications every night compared to non-users of sleep medications were at increased odds of falls in the last year with an odds ratio (OR) of 1.51 (95% confidence limit [CL] 1.27, 1.78) and of multiple falls with an OR = 1.67 (95% CL 1.35, 2.06). For those who used sleep medications less than every night compared to non-users, there were no statistically significant increased odds of fall outcomes. Older adults who used sleep medication most nights (5–6 nights per week) and every night compared to non-users had increased odds of having fall-related worries with an OR = 1.61 (95% CL 1.06, 2.45) and an OR = 1.32 (95% CL 1.11, 1.58), respectively. Conclusion Older adults who use sleep medication every night are at greater odds of experiencing falls and having fall-related worries. Increased involvement by pharmacists in the community setting and pharmacist-led comprehensive medication reviews are efforts that may reduce sleep medication use and result in fewer falls in older adults.

scholarly journals Sarcopenic Obesity in Older Adults: Findings From the National Health and Aging Trends Study

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 617-618
Author(s):  
Kathleen Dondero ◽  
Jason Falvey ◽  
Brock Beamer ◽  
Odessa Addison
Keyword(s):  
Older Adults ◽  
National Health ◽  
The United States ◽  
Community Dwelling ◽  
Sarcopenic Obesity ◽  
European Working ◽  
National Burden ◽  
Nationally Representative ◽  
Socially Isolated ◽  
Community Dwelling Older Adults

Abstract Sarcopenic obesity increases risk for dysmobility and loss of independence, (Gandham et al., 2021). However, the national burden of sarcopenic obesity and the resultant impacts for older adults has yet to be described. Within a nationally representative sample from the National Health and Aging Trends Study (NHATS), 2066 community-dwelling older adults were obese, representing 12,136,374 individuals in the United States, or 31.8% of all community dwelling older adults. Based on the European Working Group definition, 18% of the obese older adults were sarcopenic. Sarcopenic obese older adults were more likely to have fallen in the last month and been hospitalized over the prior year. After adjusting for age and sex, sarcopenic obese older adults were 3.7 times more likely (95% CI 2.2-5.0) to have 2 or more comorbid conditions and frailty was 6.4 times more likely (95% CI 4.4-9.5) compared to nonsarcopenic obese older adults. Sarcopenic obese older adults were also more likely to have 1+ ADL disabilities (OR 3.7; 95% CI 2.5-5.4). Further, they were more likely to be socially isolated (OR 2.1; 95% CI 1.3-3.2) and report food insecurity (OR 1.5; 95% CI 0.8-2.9). These findings suggest older adults with obesity and sarcopenia have higher rates of geriatric vulnerabilities, which might indicate a need for caution when recommending weight loss alone as an intervention. A more comprehensive intervention may be necessary to address social and physiological risks. Future studies should examine whether early intervention in sarcopenic obese older adults can reduce chronic health risk and preserve independence.

scholarly journals Oral health-related quality of life in Colombian Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 593-594
Author(s):  
Piedad Suarez ◽  
Jennifer Ailshire ◽  
Margarita Osuna
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Oral Health ◽  
Health Assessment ◽  
Community Dwelling ◽  
Assessment Index ◽  
Related Quality ◽  
Health Related ◽  
Nationally Representative

Abstract Despite its importance for health and wellbeing, oral health quality of life (OHQoL) has received little attention in lower-income countries, such as Colombia. This study describes the prevalence of older adults’ OHQoL and variability by socioeconomic status. We use data from the 2015 SABE-Colombia (N=18,700), a nationally representative survey of community-dwelling Colombians ages 60 and older. We used the Simple Count Geriatric Oral Health Assessment Index (SC-GOHAI), a self-reported measure of frequent oral health problems such as chewing, swallowing, and speaking designed to assess OHQoL. The scale ranges from 0-12; higher scores indicate worse OHQoL. About 69% of older Colombians reported at least one OHQoL problem. The most common issues were difficulty chewing hard food and speaking. High education and income were associated with better OHQoL and smoking were associated with worse OHQoL. Oral health may therefore reflect another dimension of social and health inequality for older Colombians.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

2018 ◽  
pp. 220-236
Author(s):  
Elliot Friedman ◽  
Beth LeBreton ◽  
Lindsay Fuzzell ◽  
Elizabeth Wehrpsann
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Outcomes ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Quality Of Life Research ◽  
Increased Risk ◽  
Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

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