scholarly journals Intersectional Discrimination Attributions and Health Outcome among American Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 871-871
Author(s):  
Peiyi Lu ◽  
Dexia Kong ◽  
Mack Shelley ◽  
Joan Davitt
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Latent Class ◽  
Physical Appearance ◽  
Later Life ◽  
National Origin ◽  
Financial Status ◽  
Adverse Health Outcomes ◽  
Class 1 ◽  
Everyday Discrimination

Abstract Discrimination has been consistently documented to relate to adverse health outcomes. However, most existing research focused on a single discrimination attribution (e.g. ageism). Few studies considered multifaceted discrimination attributions. Guided by an intersectionality framework, this study examined intersectional discrimination attributions and their associations with health outcomes. Older respondents (aged >50) from the Health and Retirement Study in 2014-2015 were included in the analysis (n=6,286). Their experiences and self-perceived reasons (age, gender, sexual orientation, race, national origin, religion, financial status, weight, physical appearance, disability, and others) for everyday discrimination were examined. Latent class analysis was employed to ascertain the profiles of subgroups characterized by their intersectional discrimination attributions. Regression models examined the correlates of the class memberships and the associations with health outcomes. Six classes were identified: class 1 (54.52% of the sample) had no/minimal discrimination experience; Class 2 (21.89%) experienced primarily ageism; class 3 (8.81%) reported discrimination based on age/gender/national origin/race; class 4 (7.99%) attributed discrimination to financial/other reasons; class 5 (5.87%) experienced discrimination based on age/weight/physical appearance/disability; and class 6 (0.92%) perceived discrimination from almost every aspect. Intersectional discrimination attributions were associated with poorer self-rated health, and greater levels of depressive symptoms and loneliness. The associations between intersectional discrimination and cognition were not statistically significant. This study found multiple marginalized identities co-occur and compound to contribute to perceived everyday discrimination among American older adults. Those experiencing discrimination due to multiple reasons warrant particular attention. Results underscore the utility of an intersectional approach in understanding discrimination in later life.

Intersectional Discrimination Attributions and Health Outcomes Among American Older Adults: A Latent Class Analysis

2021 ◽  
pp. 009141502110665
Author(s):  
Peiyi Lu ◽  
Dexia Kong ◽  
Mack Shelley ◽  
Joan K. Davitt
Keyword(s):  
Health Outcomes ◽  
Latent Class Analysis ◽  
Latent Class ◽  
Physical Appearance ◽  
Later Life ◽  
National Origin ◽  
Class Analysis ◽  
Discrimination Group ◽  
Class 1 ◽  
High Discrimination

Guided by an intersectionality framework, this study examined intersectional discrimination attributions and their associations with health outcomes. Older respondents (aged ≥50) from the Health and Retirement Study in 2014-2015 were included ( N = 6286). Their reasons for discrimination (age, gender, sexual orientation, race, national origin, religion, financial status, weight, physical appearance, disability, and others) were examined. Latent class analysis examined the subgroup profiles. Six classes were identified: class 1 (54.52% of the sample) had no/minimal discrimination; Class 2 (21.89%) experienced primarily ageism; class 3 (8.81%) reported discrimination based on age/gender/national origin/race; class 4 (7.99%) attributed discrimination to financial/other reasons; class 5 (5.87%) experienced discrimination based on age/weight/physical appearance/disability; and class 6 (0.92%) perceived high discrimination. Intersectional discrimination was associated with poorer self-rated health and higher depressive symptoms compared to the no/minimal discrimination group. Multiple marginalized identities co-occur and contribute to discrimination. An intersectional approach is recommended to understand discrimination in later life.

Leisure Activities and the Subjective Well-Being of Older Adults in Croatia

GeroPsych ◽  
2018 ◽  
Vol 31 (1) ◽  
pp. 31-39 ◽  
Author(s):  
Ljiljana Kaliterna Lipovčan ◽  
Tihana Brkljačić ◽  
Zvjezdana Prizmić Larsen ◽  
Andreja Brajša-Žganec ◽  
Renata Franc
Keyword(s):  
Older Adults ◽  
Leisure Activities ◽  
Leisure Activity ◽  
Later Life ◽  
Perceived Health ◽  
Well Being ◽  
Hierarchical Regression ◽  
Subjective Well Being ◽  
Convenience Sample ◽  
Financial Status

Abstract. Research shows that engagement in leisure activities promotes well-being among older adults. The objective of the current study was to examine the relationship between subjective well-being (flourishing) and leisure activities (total number of different activities in the previous year) in a sample of older adults in Croatia, thereby considering the variables of sex, marital status, financial status, and self-perceived health. The differences in the examined variables between the groups of older adults who reported to be engaged in new activities with those who did not were also examined. The sample of N = 169 older adults aged 60 years and above was drawn from a convenience sample of adult internet users in Croatia. Participants reported their self-perceived health and the number of leisure activities they engaged in over the previous year as well as completing the Flourishing Scale. Hierarchical regression analyses indicated that older adults who were engaged in more various leisure activities, who perceived better financial status, and who were married reported higher levels of flourishing. A comparison of the two groups of older adults with and without engagement in leisure activities showed that those engaged in at least one leisure activity were more likely to be women, reported higher levels of flourishing, and perceived their own financial status as better. This study indicated that engaging in leisure activities in later life might provide beneficial effects for the well-being of older adults.

scholarly journals Profile Groups Based on Lifestyle and Differences in Mental Health and Cognition

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 404-404
Author(s):  
Joseph Kim ◽  
Kyuree Kim
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Latent Class ◽  
Mail Survey ◽  
Later Life ◽  
Self Rated Health ◽  
Final Sample ◽  
Group 2 ◽  
Mean Differences

Abstract The purpose of this study was to identify the profiles of older adults according to lifestyle. Data for the study were from the 2017 Consumption and Activities Mail Survey (CAMS). CAMS 2017 is a questionnaire mailed to a sub-sample of respondents from the Health and Retirement Study. Participants were limited to older adults 65 and older, and the final sample consisted of 1136 older adults. The sample included 443 men and 693 women. Caucasians comprised 82.0% of the participants. Lifestyle was measured through items assessing the amount of time spent on activities. Due to high skewness, the items were dichotomized, 0=no time spent on activity and 1=time spent on the activity. Latent class analysis (LCA) was performed to identify groups based on lifestyle. LCA is a person-centered approach for identifying unobserved subgroups based on similarity in responses to items. Three lifestyle groups were identified. Group 1 was “Outgoing” with 471 individuals. Group 2 was “Adequate” with 229 individuals. Group 3 was “Inactive” with 436 individuals. An ANOVA was then conducted to assess mean differences in self-rated health, cognition, depressive symptoms, and loneliness for the three lifestyle groups. The “Outgoing” and “Adequate” groups had significantly higher scores on self-rated health and cognition, and in addition, significantly lower scores on depressive symptoms and loneliness compared to the “Inactive” group. No significant differences were observed between the “Outgoing” and “Adequate” groups. An implication from this study is the importance of maintaining an active lifestyle in later life for better mental health and cognition.

scholarly journals Multimorbidity patterns and memory trajectories in older adults: Evidence from the English Longitudinal Study of Ageing

2021 ◽  
Author(s):  
Rebecca Bendayan ◽  
Yajing Zhu ◽  
A D Federman ◽  
R J B Dobson
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Latent Class ◽  
Health Behaviours ◽  
Health Conditions ◽  
Delayed Recall ◽  
Class 1 ◽  
English Longitudinal Study ◽  
Psychiatric Problems

Abstract Background We aimed to examine the multimorbidity patterns within a representative sample of UK older adults and their association with concurrent and subsequent memory. Methods Our sample consisted of 11,449 respondents (mean age at baseline was 65.02) from the English Longitudinal Study of Ageing (ELSA). We used fourteen health conditions and immediate and delayed recall scores (IMRC and DLRC) over 7 waves (14 years of follow up). Latent class analyses were performed to identify the multimorbidity patterns and linear mixed models were estimated to explore their association with their memory trajectories. Models were adjusted by socio-demographics, BMI and health behaviors. Results Results showed 8 classes: Class 1:Heart Disease/Stroke (26%), Class 2:Asthma/Lung Disease (16%), Class 3:Arthritis/Hypertension (13%), Class 4:Depression/Arthritis (12%), Class 5:Hypertension/Cataracts/Diabetes (10%), Class 6:Psychiatric Problems/Depression (10%), Class 7:Cancer (7%) and Class 8:Arthritis/Cataracts (6%). At baseline, Class 4 was found to have lower IMRC and DLRC scores and Class 5 in DLRC, compared to the no multimorbidity group (n=6380, 55.72% of total cohort). For both tasks, in unadjusted models, we found an accelerated decline in Classes 1, 3 and 8; and, for DLRC, also in Classes 2 and 5. However, it was fully attenuated after adjustments. Conclusions These findings suggest that individuals with certain combinations of health conditions are more likely to have lower levels of memory compared those with no multimorbidity and their memory scores tend to differ between combinations. Socio-demographics and health behaviours have a key role to understand who is more likely to be at risk of an accelerated decline.

scholarly journals Self-Reported Energy Trajectories Predict Adverse Health Outcomes in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 794-795
Author(s):  
Briana Sprague ◽  
Xiaonan Zhu ◽  
Rebecca Ehrenkranz ◽  
Qu Tian ◽  
Theresa Gmelin ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Mixed Models ◽  
Single Item ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Observational Cohort ◽  
Outcome Performance ◽  
Future Work ◽  
Mortality Hazard Ratio

Abstract Declining energy may indicate homeostatic dysregulation and predict adverse health outcomes. We hypothesized that declining energy would predict greater frailty (1-10), greater mortality, and faster mood (CES-D) and cognition (3MS) decline over time. This observational cohort studies included 2,443 older adults (mean age=74.6, 62.5% White, 47.8% men) from the Health ABC Study with up to eight years of data. Energy was assessed using a single-item question about prior month’s energy (baseline mean=6.7, SD=1.7, range=0–10, lower=less energy). We used linear mixed models to create energy change scores (mean=-.07 points/year, SD=.05, range=-0.32-0.21, negative=decreased energy). In regression models adjusting for baseline outcome performance and energy and demographics, declining energy predicted greater frailty (β=-2.72, 95%CI = -3.39,-2.06), greater mortality (hazard ratio=.07, p<.001), and faster CES-D (β=-.93, 95%CI=-1.10,-0.75) but not 3MS decline. Energy changes are easy to assess and predict clinically-relevant outcomes. Future work should consider mechanisms of declining energy on disability-related outcomes. Part of a symposium sponsored by Brain Interest Group.

Understanding Variations in the Health Consequences of Sedentary Behavior: A Taxonomy of Social Interaction, Novelty, Choice, and Cognition

2021 ◽  
pp. 1-9
Author(s):  
Wendell C. Taylor
Keyword(s):  
Older Adults ◽  
Social Interaction ◽  
Health Outcomes ◽  
Sedentary Behavior ◽  
Age Groups ◽  
Sedentary Behaviors ◽  
Positive Health ◽  
Adverse Health Outcomes ◽  
Important Challenge ◽  
Positive Health Outcomes

The study of sedentary behaviors requires taxonomies (classification schemes) to standardize data collection, measurements, and outcomes. Three taxonomies of sedentary behaviors have been identified, but none address an important challenge in sedentary behavior research, which is to distinguish between beneficial and detrimental health effects of various sedentary behaviors. Some sedentary behaviors (e.g., reading) are associated with positive health outcomes, whereas other sedentary behaviors (e.g., television viewing) are associated with adverse health outcomes. To address directly this complexity and present a different conception and understanding of discrepant findings related to health outcomes, a new taxonomy is needed. The development of the new taxonomy is guided by analysis of literature and selection of a relevant and informative behavioral sciences theoretical framework (i.e., self-determination theory). Because older adults are an increasing percentage of the population and report a high prevalence of sedentary behaviors, the new taxonomy was designed for older adults with potential application to all age groups. Taylor’s taxonomy of sedentary behaviors is parsimonious with four domains: social interaction (i.e., not solitary, companionship, interacting, and connecting with others); novelty (i.e., refreshingly new, unusual, or different); choice (i.e., volition, preferred option or alternative, the power, freedom, or decision to choose); and cognition (i.e., mentally stimulating and engaging).

scholarly journals Serious Fall Injury History and Adverse Health Outcomes After Initiating Hemodialysis Among Older U.S. Adults

2018 ◽  
Vol 73 (9) ◽  
pp. 1216-1221 ◽  
Author(s):  
C Barrett Bowling ◽  
Rasheeda K Hall ◽  
Anjali Khakharia ◽  
Harold A Franch ◽  
Laura C Plantinga
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Skilled Nursing Facility ◽  
Prognostic Significance ◽  
Dialysis Initiation ◽  
First Year ◽  
Prognostic Information ◽  
Fall Injury ◽  
Adverse Health ◽  
Adverse Health Outcomes

Abstract Background Although older adults with predialysis chronic kidney disease are at higher risk for falls, the prognostic significance of a serious fall injury prior to dialysis initiation has not been well described in the end-stage renal disease population. Methods We examined the association between a serious fall injury in the year prior to starting hemodialysis and adverse health outcomes in the year following dialysis initiation using a retrospective cohort study of U.S. Medicare beneficiaries ≥ 67 years old who initiated dialysis in 2010–2012. Serious fall injuries were defined using diagnostic codes for falls plus an injury (fracture, joint dislocation, or head injury). Health outcomes, defined as time-to-event variables within the first year of dialysis, included four outcomes: a subsequent serious fall injury, hospital admission, post-acute skilled nursing facility (SNF) utilization, and mortality. Results Among this cohort of 81,653 initiating hemodialysis, 2,958 (3.6%) patients had a serious fall injury in the year prior to hemodialysis initiation. In the first year of dialysis, 7.6% had a subsequent serious fall injury, 67.6% a hospitalization, 30.7% a SNF claim, and 26.1% died. Those with versus without a serious fall injury in the year prior to hemodialysis initiation were at higher risk (hazard ratio, 95% confidence interval) for a subsequent serious fall injury (2.65, 2.41–2.91), hospitalization (1.11, 1.06–1.16), SNF claim (1.40, 1.30–1.50), and death (1.14, 1.06–1.22). Conclusions For older adults initiating dialysis, a history of a serious fall injury may provide prognostic information to support decision making and establish expectations for life after dialysis initiation.

scholarly journals Underlying Vulnerabilities to the Cytokine Storm and Adverse COVID-19 Outcomes in the Aging Immune System

2020 ◽  
Author(s):  
Lolita S Nidadavolu ◽  
Jeremy D Walston
Keyword(s):  
Older Adults ◽  
Immune System ◽  
Chronic Disease ◽  
Health Outcomes ◽  
Innate Immune System ◽  
Innate Immune ◽  
Cytokine Storm ◽  
Adverse Health ◽  
Disease States ◽  
Adverse Health Outcomes

Abstract Older adults are far more vulnerable to adverse health outcomes and mortality after contracting COVID-19. There are likely multiple age-related biological, clinical, and environmental reasons for this increased risk, all of which are exacerbated by underlying age-associated changes to the immune system as well as increased prevalence of chronic disease states in older adults. Innate immune system overactivity, termed the cytokine storm, appears to be critical in the development of the worst consequences of COVID-19 infection. Pathophysiology suggests that viral stimulation of the innate immune system, augmented by inflammatory signals sent from dying cells, ramps up into a poorly controlled outpouring of inflammatory mediators. Other aging-related changes in cells such as senescence as well as higher prevalence of chronic disease states also likely ramp up inflammatory signaling. This in turn drives downstream pathophysiological changes to pulmonary, cardiovascular, skeletal muscle, and brain tissues that drive many of the adverse health outcomes observed in older adults. This article provides an overview of the underlying etiologies of innate immune system activation and adaptive immune system dysregulation in older adults and how they potentiate the consequences of the COVID-19-related cytokine storm, and possible uses of this knowledge to develop better risk assessment and treatment monitoring strategies.

Sign in / Sign up

Export Citation Format

Share Document