scholarly journals Prevalence and Predictors of Mortality for Older Adults Referred to a Hospital Avoidance Program

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 139-139
Author(s):  
Shahzad Gul ◽  
Megan Freund ◽  
Robert Sanson-Fisher ◽  
Matthew Clapham ◽  
Penelope Webster
Keyword(s):  
Older Adults ◽  
Significant Proportion ◽  
Linkage Study ◽  
Demographic Characteristics ◽  
Post Discharge ◽  
Cross Sectional ◽  
Patient Demographic ◽  
Risk Of Mortality ◽  
Complete Health ◽  
Health Characteristic

Abstract A cross sectional retrospective data linkage study of older adults discharged from local hospital avoidance program between January 2017 and January 2018 was undertaken (N=286; mean age 80.5 years). The prevalence of death at 3 months, 6 months, 12 months, 18 months and 33 months was calculated. Patient demographic characteristics associated with participant’s risk of mortality at 33 months after discharge was examined using Cox multivariable regression. Patient demographic and health characteristics associated with participant mortality within 12 months of discharge was examined using multivariable logistic regression for patients with complete health characteristic data (n=195). The mortality prevalence was 17% at six months and the cumulative prevalence at one year, 18 months and 33 months post discharge were 24%, 29% and 36% respectively. Patient demographic characteristics associated with participants’ risk of mortality at 33 months after discharge were gender, age and household arrangements. Health and demographic characteristics associated with mortality within 12 months of discharge were lower cognition, increased burden of comorbidity, decreased physical function, a weight less than 55 kilograms, older age and male gender. These results indicate that a significant proportion of people attending a hospital avoidance program are likely to be entering into the final year of their life. This suggests that hospital avoidance programs should routinely identify patients who are likely nearing end of life, and support advance care planning for this patient group.

scholarly journals Walking for Transportation: What Do U.S. Adults Think Is a Reasonable Distance and Time?

2015 ◽  
Vol 12 (s1) ◽  
pp. S53-S61 ◽  
Author(s):  
Kathleen B. Watson ◽  
Susan A. Carlson ◽  
Tiffany Humbert-Rico ◽  
Dianna D. Carroll ◽  
Janet E. Fulton
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Mail Survey ◽  
Demographic Characteristics ◽  
Health Programs ◽  
Cross Sectional ◽  
Public Health Programs ◽  
Demographic Subgroups ◽  
Public Health Strategies ◽  
Walking For Transportation

Background:Less than one-third of U.S. adults walk for transportation. Public health strategies to increase transportation walking would benefit from knowing what adults think is a reasonable distance to walk. Our purpose was to determine 1) what adults think is a reasonable distance and amount of time to walk and 2) whether there were differences in minutes spent transportation walking by what adults think is reasonable.Methods:Analyses used a cross-sectional nationwide adult sample (n = 3653) participating in the 2010 Summer ConsumerStyles mail survey.Results:Most adults (> 90%) think transportation walking is reasonable. However, less than half (43%) think walking a mile or more or for 20 minutes or more is reasonable. What adults think is reasonable is similar across most demographic subgroups, except for older adults (≥ 65 years) who think shorter distances and times are reasonable. Trend analysis that adjust for demographic characteristics indicates adults who think longer distances and times are reasonable walk more.Conclusions:Walking for short distances is acceptable to most U.S. adults. Public health programs designed to encourage longer distance trips may wish to improve supports for transportation walking to make walking longer distances seem easier and more acceptable to most U.S. adults.

scholarly journals The Psychology of Nutrition with Advancing Age: Focus on Food Neophobia

Nutrients ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 151 ◽  
Author(s):  
Emmy van den Heuvel ◽  
Annie Newbury ◽  
Katherine Appleton
Keyword(s):  
Older Adults ◽  
Eating Behaviour ◽  
Demographic Characteristics ◽  
Living Alone ◽  
Employment Level ◽  
Cross Sectional ◽  
Food Neophobia ◽  
Novel Foods ◽  
Education And Employment ◽  
The Impact

Many factors impact on eating behaviour and nutritional status in older adults. Strategies can be suggested to combat the impact of these factors, including the development of novel food products, but food neophobia (“the reluctance to eat and/or avoidance of novel foods”) may be a barrier to the acceptance of these foods/products. This work aimed to investigate associations between food neophobia, physical disadvantage, and demographic characteristics in adults over 55 years old. Cross-sectional data from 377 older adults was analysed for relationships between food neophobia scores and physical disadvantage (denture wearing, help with food shopping and/or preparing, and risk of sarcopenia), controlling for age group, gender, living status, education, and employment level. Initial analyses demonstrated higher food neophobia scores in association with denture wearing (Beta = 0.186, p = 0.001). However, when demographic characteristics were also considered, food neophobia scores were no longer related to denture wearing (Beta = 0.069, p = 0.226) but instead were related to a higher age, living alone, and a shorter education (smallest Beta = −0.104, p = 0.048). Food neophobia may thus act as a barrier to the consumption of novel foods/products in those who are of higher age, are living alone, and have a shorter education.

scholarly journals Care trajectories of chronically ill older adult patients discharged from hospital: a quantitative cross-sectional study using health insurance claims data

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yvonne de Man ◽  
Femke Atsma ◽  
Wilma Jonkers ◽  
Sophia E. J. A. de Rooij ◽  
Gert P. Westert ◽  
...  
Keyword(s):  
Older Adults ◽  
Hip Fracture ◽  
Cross Sectional Study ◽  
Community Nursing ◽  
Sectional Study ◽  
Post Discharge ◽  
Cross Sectional ◽  
Term Care ◽  
First 90 Days

Abstract Background For older adults, a good transition from hospital to the primary or long-term care setting can decrease readmissions. This paper presents the 6-month post-discharge healthcare utilization of older adults and describes the numbers of readmissions and deaths for the most frequently occurring aftercare arrangements as a starting point in optimizing the post-discharge healthcare organization. Methods This cross-sectional study included older adults insured with the largest Dutch insurance company. We described the utilization of healthcare within 180 days after discharge from their first hospital admission of 2015 and the most frequently occurring combinations of aftercare in the form of geriatric rehabilitation, community nursing, long-term care, and short stay during the first 90 days after discharge. We calculated the proportion of older adults that was readmitted or had died in the 90–180 days after discharge for the six most frequent combinations. We performed all analyses in the total group of older adults and in a sub-group of older adults who had been hospitalized due to a hip fracture. Results A total of 31.7% of all older adults and 11.4% of the older adults with a hip fracture did not receive aftercare. Almost half of all older adults received care of a community nurse, whereas less than 5% received long-term home care. Up to 18% received care in a nursing home during the 6 months after discharge. Readmissions were lowest for older adults with a short stay and highest in the group geriatric rehabilitation + community nursing. Mortality was lowest in the total group of older aldults and subgroup with hip fracture without aftercare. Conclusions The organization of post-discharge healthcare for older adults may not be organized sufficiently to guarantee appropriate care to restore functional activity. Although receiving aftercare is not a clear predictor of readmissions in our study, the results do seem to indicate that older adults receiving community nursing in the first 90 days less often die compared to older adults with other types of aftercare or no aftercare. Future research is necessary to examine predictors of readmissions and mortality in both older adult patients discharged from hospital.

Hospitalization for Primary Care-Sensitive Conditions in Adults and Its Impact on Hospital Care in São Paulo City, Brazil

2020 ◽  
pp. 0272684X2097641
Author(s):  
Ricardo da Silva Targueta ◽  
Caio Vinicius Da Fonseca Silva ◽  
Jane de Eston Armond ◽  
Carolina Nunes França ◽  
Gustavo Bernardes de Figueiredo Oliveira ◽  
...  
Keyword(s):  
Primary Care ◽  
Diagnosis Related Groups ◽  
Significant Proportion ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Primary Care Level ◽  
Risk Of Mortality ◽  
Duration Of Hospitalization ◽  
Clinical Conditions ◽  
Sensitive Conditions

Introduction Identifying conditions among all cause hospitalizations that could be prevented at the primary care level would allow the development of strategies to reduce the range of diseases treated in hospital and promote a more efficient utilization of resources. Objective We sought to evaluate hospitalizations for clinical conditions that are sensitive to primary care in adults. Methods Cross-sectional study with data captured in hospital electronic health records using the diagnosis related groups classification system. Results Primary care-sensitive conditions were associated with longer duration of hospitalization, older age, higher prevalence of female patients, higher complexity at admission and during hospitalization, and a higher risk of mortality as compared with other conditions not sensitive to primary care. Conclusion A significant proportion of hospitalizations are due to causes sensitive to primary care. Hospitalizations due to primary care-sensitive conditions are associated with longer hospital stay, greater complexity and severity, and a higher risk of mortality.

Self-efficacy, Neighborhood Walking, and Fall History in Older Adults

2015 ◽  
Vol 23 (1) ◽  
pp. 64-71 ◽  
Author(s):  
N.A. Gallaghe ◽  
P.J. Clarke ◽  
C. Loveland-Cherry ◽  
D.L. Ronis ◽  
K.A. Gretebeck
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Self Efficacy ◽  
Cross Sectional Study ◽  
Demographic Characteristics ◽  
Full Model ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hierarchical Multiple Regression ◽  
The Relationship

This cross-sectional study examined the association of self-efficacy with neighborhood walking in older adult (mean age = 76.1, SD = 8.34) fallers (n = 108) and nonfallers (n = 217) while controlling for demographic characteristics and mobility. Hierarchical multiple regression indicated that the full model explained 39% of the variance in neighborhood walking in fallers (P < .001) and 24% in nonfallers (P < .001). Self-efficacy explained 23% of the variance in fallers (P < .001) and 11% in nonfallers (P < .001). Neighborhood walking was significantly associated with self-efficacy for individual barriers in both groups. Self-efficacy for neighborhood barriers trended toward significance in fallers (β = .18, P = .06). Fall history did not moderate the relationship between self-efficacy and neighborhood walking. Walking interventions for older adults should address self-efficacy in overcoming individual walking barriers. Those targeting fallers should consider addressing self-efficacy for overcoming neighborhood barriers.

scholarly journals Socio-demographic characteristics and co-occurrence of depressive symptoms with chronic diseases among older adults in China: the China Longitudinal Ageing Social Survey

2019 ◽  
Author(s):  
Zhenjie Wang ◽  
Hanmo Yang ◽  
Zhanyuan Guo ◽  
Bei Liu ◽  
Shen Geng
Keyword(s):  
Older Adults ◽  
Chronic Diseases ◽  
Odds Ratio ◽  
Depression Scale ◽  
Epidemiological Studies ◽  
Demographic Characteristics ◽  
Education Attainment ◽  
Cross Sectional ◽  
Social Survey ◽  
Depression Status

Abstract Background The aim of the current study is to assess the cross-sectional association of chronic non-communicable diseases (hypertension, diabetes mellitus, arthritis, and cerebrovascular) with depression among older adults in China. Methods Data was obtained from the China Longitudinal Ageing Social Survey (CLASS) conducted in 2014. A total of 7505 participants were included. Depression status was assessed by 9-item Center for Epidemiological Studies Depression Scale (CES-D) Associations between depression and chronic diseases, adjusting for so, demographics and chronic diseases risk factors were assessed. Results We found negative associations between depression and several socioeconomic factors, including education attainment and economic level. Widowed/divorced/ unmarried individuals are more likely to suffer from depression. Hypertension (Odds ratio:1.29 [95%CI:1.16, 1.42]), diabetes (1.41 [95%CI:1.19,1.67]), arthritis (1.72 [1.52, 1.96]), and cerebrovascular disease (1.69 [1.41, 2.02]) were found to be associated with depression. Conclusions Most depression cases were found to be strongly associated with chronic diseases. Our findings has provided empirical evidence for clinicians to view co-morbid depression with chronic diseases, which could help them to evaluate, diagnose and manage depression promptly.

Perceived Voice Disorders in Older Adults and Impact on Social Interactions

2021 ◽  
pp. 1-8
Author(s):  
Connie K. Porcaro ◽  
Clare Singer ◽  
Boris Djokic ◽  
Ali A. Danesh ◽  
Ruth Tappen ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Interactions ◽  
Social Engagement ◽  
Leisure Activities ◽  
Treatment Strategies ◽  
Voice Disorders ◽  
Community Dwelling ◽  
Vocal Performance ◽  
Older Individuals ◽  
Cross Sectional

Purpose Many aging individuals, even those who are healthy, report voice changes that can impact their ability to communicate as they once did. While this is commonly reported, most do not seek evaluation or management for this issue. The purpose of this study was to investigate the prevalence and differences in voice disorders in older adults, along with the effect of fatigue on their social interactions. Method This is a cross-sectional investigation of a community-dwelling sample of individuals aged 60 years or older. Participants completed the Questionnaire on Vocal Performance, the Social Engagement Index subset “Engagement in Social or Leisure Activities,” and the Fatigue Severity Scale. Results Results indicated 32.5% of the 332 participants reported symptoms of voice problems with no difference found between male and female respondents. A slight increase in report of voice problems was noted with each year of age. Participants who self-reported voice problems indicated less interaction in social activities involving communication than those who did not. Finally, as severity of self-reported voice problems increased, an increase was reported by the same individuals for signs of fatigue. Conclusions Voice problems and resulting decreased social interaction are commonly experienced by older individuals. Voice symptoms in older adults have been found to benefit from evidence-based treatment strategies. It is critical to provide education to encourage older individuals to seek appropriate evaluation and management for voice issues through a speech-language pathologist or medical professional.

What Determines The Migration Intentions Of University Students?

2014 ◽  
Vol 1 (1) ◽  
pp. 193-198
Author(s):  
Heiko Haase ◽  
Arndt Lautenschläger
Keyword(s):  
University Students ◽  
Career Choice ◽  
Cross Sectional Study ◽  
Demographic Characteristics ◽  
Migration Decision ◽  
Considerable Proportion ◽  
Sectional Study ◽  
Intention To Stay ◽  
Cross Sectional ◽  
The University

AbstractThe paper aims at exploring determinants of the university students' intentions to stay within their university region. At this, we presume that students' career choice motivations are related to their professional intentions, which again, along with demographic characteristics, affect their migration decision. Our analysis is based on a cross-sectional study of 2,353 students from three different higher education institutions, two of them located in Germany and one in Namibia. Results indicate that in Germany migration matters because a considerable proportion of students intend to leave the university region after graduation. At this, we found that the students' geographical provenance exerts the most significant effect on the intention to stay. Moreover, certain professional intentions were directly and some career choice motivations were indirectly linked with the intention to remain at the university location. We present several conclusions and implications.

Spontaneous self-affirmation before and during COVID-19: Associations with information-seeking, worry and adherence

2020 ◽  
Author(s):  
Tracy Epton ◽  
Chris Keyworth ◽  
Chris Armitage
Keyword(s):  
Older Adults ◽  
Opposite Direction ◽  
Information Seeking ◽  
Demographic Characteristics ◽  
Brief Interventions ◽  
Adaptive Behaviors ◽  
Uk Government ◽  
Nationally Representative

Objective: To assess the extent of spontaneous self-affirmation pre COVID-19 and during COVID-19 pandemic to identify for whom self-affirmation interventions might be helpful; and the extent to which spontaneous self-affirmation is associated with increased information-seeking, worry and adherence to UK government instructions. Methods: Two large nationally-representative surveys of UK adults were conducted via YouGov in March 2019 (pre COVID-19; N = 10421) and April 2020 (during COVID-19; N = 2252); both surveys measured demographic characteristics and spontaneous self-affirmation. The latter survey included measures of time spent accessing COVID-19 related news, worry about COVID-19 related news and degree of adherence to UK government instructions. Results: Spontaneous self-affirmation was lower before COVID-19 (44%) than it was during the pandemic (57%), although the pattern was in the opposite direction among older adults. Older adults were more likely to spontaneously self-affirm during COVID-19 than pre COVID-19. Greater spontaneous self-affirmation was associated with more time spent accessing news, and greater adherence to UK government instructions, but not media-related worry. Conclusions: The threat of COVID-19 may have triggered greater levels of spontaneous self-affirmation, which could give people the resources they needed to allow them to seek COVID-19-related news and adhere to UK government instructions. Groups lower in spontaneous self-affirmation, such as younger people could be targeted with brief interventions to promote self-affirmation and encourage performance of adaptive behaviors.

Health Concerns of Older Adults: Observations from a Survey and Public Education Programme in Bhubaneswar, India

2019 ◽  
Vol 15 (1) ◽  
pp. 10-16
Author(s):  
Shreyan Kar ◽  
Tushar Kanti Das ◽  
Prasanta Kumar Mohapatra ◽  
Brajaballav Kar ◽  
Anupama Senapati ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cardiovascular Risk ◽  
Mood State ◽  
Physical Symptoms ◽  
Considerable Proportion ◽  
Cardiovascular Risks ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Health Concerns

Background: While it is apparent that old age is associated with multiple health concerns, the extent of its multiplicity and burden is often not clear. It was intended to find out self-reported health concerns for one month and cardiovascular risk factors in middle and older adults. Methods: In the cross-sectional survey, attendees of a Healthy Ageing Conference were approached with a semi-structured questionnaire about their health concerns and cardiovascular risks. Risk of a cardiovascular event in 10 years based on QRISK3 was calculated. Results: A considerable proportion of older adults had a range of physical symptoms, depressive mood state and memory problems. Mean number of health problems reported were 4.8±3.3 (male 4.4±3.1 and female 5.0±4.3). Cardiovascular risk was high, mean QRISK3 score for males were 22.2% (±14.4), and for females 10.3% (±6.6) (p<0.05). On average, the heart age was increased by 7.9±6.2 years (8.6±6.6 years for males and 5.0±3.3 for females). The relative risk of participants was 2.1 for males and 1.5 for females for heart attack or stroke within the ten years, compared to healthy persons. The symptoms and risk factors were elicited easily, and the process probably facilitated improving the awareness about the health concerns holistically. The survey also identified issues related to the engagement of older adults in the existing health care systems. Conclusions: The results suggested that questionnaire-based health screening in a community can identify a range of health concerns and identify multi-morbidity in general and cardiovascular risks in particular. This process may help to focus on the appropriate public health awareness and intervention programmes required in the community.

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