scholarly journals Outpatient Physical Therapists Should be Competent in Care of Older Adults: A Total Population Register-Based Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 173-173
Author(s):  
Solveig Arnadottir
Keyword(s):  
Older Adults ◽  
General Population ◽  
Total Population ◽  
Physical Therapists ◽  
Population Aging ◽  
Demographic Information ◽  
Continuous Growth ◽  
Time Period ◽  
Icelandic Population ◽  
Old Men

Abstract In Iceland, outpatient physical therapy (OPT) is traditionally not focused on older clients. Yet, the Icelandic population is aging as other populations in the world, and national policies endorse aging in place. The objective of this study was to explore 17 years of demographic information on OPT clients and to identify if this information reflects the total population aging. The research was built on 17 years (1999-2015) of complete data from: the Icelandic Health Insurances register with information on the total population of OPT clients (N=172071), and the Statistics Iceland register with demographic information on the total general population. The results revealed that in 1999, older adults comprised 18.3% of all OPT clients, and in 2015 it had increased to 23.5% Therefore, OPTs were 23% more likely to treat an older adult in 2015, compared to 1999 (Risk Ratio [RR] 1.23; 95% Confidence Interval [CI] 1.19-1.27). In the same time period older people became 15% more prevalent in the general population (RR 1.15; 95%CI 1.10-1.21). Linear modelling revealed a yearly 3.45% (95%CI 3.05-3.85) increase from 1999 to 2015 in the overall proportion of older OPT clients. This yearly trend, however, varied depending on age group and sex with the highest yearly increase in the ≥ 85 years old men (9.1%; 95%CI 7.90-10.35). This case of Iceland presents 17 years of continuous growth in older adults seeking OPT service. These findings reinforce an urgent need to enhance the geriatric competence of OPTs, who in their clinical practice frequently encounter older adults.

scholarly journals Outpatient physical therapy population has been aging faster than the general population: a total population register-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Solveig A. Arnadottir ◽  
Brynjolfur Gauti Jonsson
Keyword(s):  
Older Adults ◽  
Physical Therapy ◽  
General Population ◽  
Health Care Services ◽  
Total Population ◽  
Population Aging ◽  
Population Data ◽  
National Registry ◽  
Future Health ◽  
Icelandic Population

Abstract Background The Icelandic population is aging like other populations in the world, the life expectancy is high, and the national focus is to help people to age in their own homes. The objectives of this research was to describe 17 years of demographic changes among outpatient physical therapy (OPT) clients and to determine if these changes reflect aging in the total population. Methods Data was obtained from a national registry with information on all OPT clients reimbursed by Icelandic Health Insurance from 1999 to 2015, and general population data from the Statistics Iceland registry covering the same 17 years. Simple counts, proportions, Rate Ratios (RR) and 95 % Confidence Intervals (CI) were used to describe and compare the two time-points (1999 and 2015) in both populations, and regression analyses were used to estimate linear changes for each of these 17 years. Results Comparing the endpoints of the 17-year period, the proportion of older adults within the total OPT clientele increased by 23 % (from 18.3 % to 1999 to 23.5 % in 2015; RR 1.23; 95 %CI 1.19–1.27).) while in the general Icelandic population, the proportion of older adults increased by 15 % (from 11.6 % to 1999 to 13.5 % in 2015; RR 1.15; 95 % CI 1.1–1.21). For each of these 17 years, there was an overall 5 % yearly increase in the rate of older adults from the general older Icelandic population who used an OPT (accounting for population aging), and an overall 3.5 % yearly increase in the proportional contribution of older adults to the total OPT clientele. Adjusting for sex and older age group revealed that this increase in rate and proportion was most pronounced among ≥ 85-year-old men. Conclusions This case of Iceland is an example of how health-related and population-based registers may potentially be used to routinely inform and facilitate optimal planning of future health care services for older adults.

scholarly journals The Value of Vaccination in Older Adults: The Why

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 806-807
Author(s):  
Philip Buck
Keyword(s):  
Older Adults ◽  
Time Horizon ◽  
Pneumococcal Disease ◽  
Population Aging ◽  
Indirect Costs ◽  
Health Behavior Change ◽  
Vaccine Preventable Diseases ◽  
Time Period ◽  
The Us ◽  
The Impact

Abstract The incidence of vaccine-preventable diseases remains high among older adults in the US, despite longstanding immunization recommendations, and is projected to increase as the population ages. The impact of US population aging on the burden of four vaccine-preventable diseases (influenza, pneumococcal disease, shingles, and pertussis) was modeled over a 30-year time horizon, with cumulative direct and indirect costs increasing from $378 billion over 10 years to $1.28 trillion over 30 years. Compared to current levels of vaccination coverage, increasing coverage was predicted to avert over 33 million cases of disease and greater than $96 billion in disease-associated costs, with a corresponding increase in vaccination costs of approximately $83 billion over the entire 30-year time period. Specific examples of cost-effectiveness analyses that assess the epidemiologic and economic impact of vaccination against shingles and pertussis in older adults will be discussed. Part of a symposium sponsored by the Health Behavior Change Interest Group.

scholarly journals Declining risk of ischemic heart disease over time in rheumatoid arthritis: 1821 patients from 1972 to 2017.

2021 ◽  
Author(s):  
Christian Lillebø Alsing ◽  
Tone Wikene Nystad ◽  
Jannicke Igland ◽  
Clara Gram Gjesdal ◽  
Helga Midtbø ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Heart Disease ◽  
General Population ◽  
Ischemic Heart Disease ◽  
Total Population ◽  
Incidence Rates ◽  
Ischemic Heart ◽  
Time Period ◽  
Annual Decline ◽  
Over Time

Abstract Objectives: To evaluate trends of acute myocardial infarction (AMI) and ischemic heart disease (IHD) in rheumatoid arthritis (RA) patients compared with the general population over time. Methods: We performed a retrospective cohort study of 1821 RA patients diagnosed from 1972 to 2013. The total population of the same county (Hordaland, Norway) and time period was used for comparison. Information on AMI and IHD events was obtained from hospital patient administrative systems or cardiovascular registries. We estimated incidence rates and standardized event ratios (SER) compared with the general population by Poisson regression.Results: There was an average annual decline of 1.6% in age- and sex-adjusted AMI incidence rates from 1972 to 2017 (incidence rate ratio 0.984, 95% CI 0.971–0.998). Excess events in RA patients compared with the general population declined on average 1.3% per year for AMI and 2.3% for IHD from 1972 to 2014. The total RA cohort had 49% (SER 1.49, 95% CI 1.30–1.69) more AMI events and 63% (SER 1.63, 95% CI 1.52–1.74) more IHD events compared with the general population. There were no significant excess AMI and IHD events for RA patients diagnosed after 1998 compared with the general population.Conclusion: Incidence rates and excess events of AMI and IHD in RA patients declined from 1972 to 2017. There were no excess AMI or IHD events in RA patients diagnosed after 1998 compared with the general population.

Psycho-social challenges of elderly

2018 ◽  
Vol 9 (01) ◽  
Author(s):  
Shalini Singh ◽  
Nishat Afroz
Keyword(s):  
Older Adults ◽  
General Population ◽  
Old Age ◽  
Demographic Transition ◽  
Older Persons ◽  
Population Aging ◽  
Demographic Changes ◽  
Social Challenges ◽  
The World ◽  
Care Of Elderly

The world's population is aging and all countries in the world are experiencing growth in the number and proportion of older persons. India is no exception to this demographic transition. With the rapidly increasing number of aged, the care of elderly has emerged as an important issue before the country. This change presents wide-ranging and complex health, social, and economic challenges, both current and future, to which this diverse and heterogeneous country must rapidly adapt. This paper is an attempt to review and discuss the context, scope, and magnitude of India's demographic changes. Further it elaborated the need and concerns of elderly, various psycho-social problems faced by them and impact of population aging on different sphere of country's resources. This paper also discussed the increasing inclination of elderly towards the old age homes and the possible reasons behind it. This chapter also presents an overview of several governmental, recent and ongoing efforts and initiatives, to adapt to population aging and provide support to older adults and their families. It concludes with recommendations that may serve as a productive next step forward, keeping in mind the need for urgent and timely action on the part of government, NGO's, researchers, and general population.

scholarly journals Nurse Practitioner’s Clinical Triggers for Referral to Other 3D Team Members

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 745-745
Author(s):  
Shawn Ladda
Keyword(s):  
Older Adults ◽  
Community Health ◽  
Nurse Practitioners ◽  
Physical Therapists ◽  
Exercise Program ◽  
Health Educator ◽  
Problem Solving Therapy ◽  
Team Members ◽  
Resource Information ◽  
Registered Dietician

Abstract This presentation features how 3D Team nurse practitioners (NP) use results of clinical assessments to determine whether older adults and caregivers enrolled in the study are referred to other Team members; these assessment results are called “clinical triggers”. Other team members who receive referrals based on NP-generated clinical triggers include: Licensed Clinical Social Workers, who deliver Problem Solving Therapy to older adults with significant depressive symptoms; Occupational Therapists, who deliver an evidence-based dementia care intervention; Physical Therapists, who deliver an adapted Otago exercise program; Registered Dietician, who provides nutrition and dietary instruction; and Community Health Educator, who provides community resource information to address social determinants of health. All clinical triggers will be detailed in this presentation, along with a description of each intervention delivered by other team members except the Community Health Educator. Case studies will be presented to illustrate how study participants receive multiple interventions from the 3D Team.

scholarly journals Effects of Weight Gain after 20 Years of Age and Incidence of Hyper-Low-Density Lipoprotein Cholesterolemia: The Iki Epidemiological Study of Atherosclerosis and Chronic Kidney Disease (ISSA-CKD)

2021 ◽  
Vol 10 (14) ◽  
pp. 3098
Author(s):  
Shota Okutsu ◽  
Yoshifumi Kato ◽  
Shunsuke Funakoshi ◽  
Toshiki Maeda ◽  
Chikara Yoshimura ◽  
...  
Keyword(s):  
Weight Gain ◽  
General Population ◽  
Ldl Cholesterol ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Population Based ◽  
Lipid Lowering ◽  
Low Density ◽  
Obesity Hypertension ◽  
Old Men

The aim of this study was to investigate the effects of long-term weight gain from the age of 20 on incidence of hyper-low-density-lipoprotein (LDL) cholesterolemia in the general population of Japanese people. Methods: We conducted a population-based retrospective cohort study using annual health checkup data for residents of Iki City, Nagasaki Prefecture, Japan. A total of 3179 adult (≥30 years old) men and women without hyper-LDL cholesterolemia at baseline, who underwent two or more health checkups were included in the analysis. Information on weight gain (≥10 kg) after 20 years of age was obtained using questionnaire. The outcome of this study was development of hyper-LDL cholesterolemia defined as LDL-cholesterol level ≥3.62 mmol/L and/or initiation of lipid-lowering medications. Results: During a mean follow-up period of 4.53 years, 665 of the 3179 participants developed hyper-LDL cholesterolemia (46.5/1000 person-years). The incidence of hyper-LDL cholesterolemia was higher in participants with a weight gain of ≥10 kg (55.3/1000 person-years) than among those with a weight gain of <10 kg (41.8/1000 person-years). This association remained statistically significant even after adjustment for age, sex, smoking, daily drinking, exercise, obesity, hypertension, and diabetes (multivariable hazard ratio 1.31, 95% confidence interval 1.08–1.58, p = 0.006). Conclusion: A weight gain of ≥10 after 20 years of age affected the development of hyper-LDL cholesterol regardless of age, sex, and obesity in a general population of Japanese.

scholarly journals Changing Educational Gradients in Life Expectancy With and Without Disease Among U.S. Older Adults From 2000 to 2010

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 505-505
Author(s):  
Matthew Farina ◽  
Phillip Cantu ◽  
Mark Hayward
Keyword(s):  
Older Adults ◽  
Life Expectancy ◽  
Chronic Diseases ◽  
Population Aging ◽  
Good Health ◽  
Vital Statistics ◽  
Healthy Life Expectancy ◽  
Healthy Life ◽  
Education Group ◽  
Education Groups

Abstract Recent research has documented increasing education inequality in life expectancy among U.S. adults; however, much is unknown about other health status changes. The objective of study is to assess how healthy and unhealthy life expectancies, as classified by common chronic diseases, has changed for older adults across education groups. Data come from the Health and Retirement Study and National Vital Statistics. We created prevalence-based life tables using the Sullivan method to assess sex-specific life expectancies for stroke, heart disease, cancer, and arthritis by education group. In general, unhealthy life expectancy increased with each condition across education groups. However, the increases in unhealthy life expectancy varied greatly. While stroke increased by half a year across education groups, life expectancy with diabetes increased by 3 to 4 years. In contrast, the evidence for healthy life expectancy provides mixed results. Across chronic diseases, healthy life expectancy decreased by 1 to 3 years for respondents without a 4-year degree. Conversely, healthy life expectancy increased for the college educated by .5 to 3 years. While previous research shows increases in life expectancy for the most educated, trends in life expectancy with chronic conditions is less positive: not all additional years are in lived in good health. In addition to documenting life expectancy changes across education groups, research assessing health of older adults should consider the changing inequality across a variety of health conditions, which will have broad implications for population aging and policy intervention.

Exploring a Hidden Epidemic: Drowning Among Adults Aged 65 Years and Older

2021 ◽  
pp. 089826432110147
Author(s):  
Tessa Clemens ◽  
Amy E. Peden ◽  
Richard C. Franklin
Keyword(s):  
Older Adults ◽  
New Zealand ◽  
Retrospective Analysis ◽  
Older Adult ◽  
Total Population ◽  
Downward Trend ◽  
Population Projections ◽  
Prevention Strategies ◽  
Drowning Prevention

Objectives: To explore trends in unintentional fatal drowning among older adults (65 years and older). Methods: Total population retrospective analysis of unintentional fatal drowning among people aged 65 years and older in Australia, Canada and New Zealand (2005–2014) was conducted. Results: 1459 older adults died. Rates ranged from 1.69 (Canada) to 2.20 (New Zealand) per 100,000. Trends in crude drowning rates were variable from year to year. A downward trend was observed in New Zealand (y = −.507ln(x) + 2.9918), with upward trends in Australia (y = .1056ln(x) + 1.5948) and Canada (y = .1489ln(x) + 1.4571). Population projections suggest high annual drowning deaths by 2050 in Australia (range: 120–190; 1.69–2.76/100,000) and Canada (range: 209–430; 1.78–3.66/100,000). Significant locations and activities associated with older adult drowning differed by country and age band. Conclusions: Drowning among older adults is a hidden epidemic claiming increasing lives as the population ages. Targeted drowning prevention strategies are urgently needed in Australia, Canada, New Zealand and other similar countries.

scholarly journals Family Solidarity, Social Support, Loneliness, and Well-Being Among Older Adults in Rural China

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 319-320
Author(s):  
Xiaoyan Zhang ◽  
Merril Silverstein
Keyword(s):  
Older Adults ◽  
Life Satisfaction ◽  
Adult Children ◽  
Child Support ◽  
Structural Equation ◽  
Total Population ◽  
Well Being ◽  
Equation Modeling ◽  
National Bureau ◽  
Subjective Well Being

Abstract China is experiencing a large increase in elderly population. In 2019, China’s population aged 60 and above had reached 253 million, accounting for 18.1% of the total population (National Bureau of Statistics of China, 2020). By 2050, the number of adults aged 60+ would be up to 430 million, reaching one third of the total population (Du, Zhai & Chen, 2005). Considering such a rapid aging process and the existing large number of older adults in China, it becomes imperative to investigate how psychosocial factors affect this group’s subjective well-being. This study proposed that, among older adults, higher support received from each of the three relational sources (adult children, family and friends) were associated with reduced loneliness and improved well-being. Structural equation modeling was conducted using a sample of rural adults aged 60 and older (N= 1142) from the 2018 wave of data from the Longitudinal Study of Older Adults in Anhui Province, China. Findings indicated that support from adult children directly and indirectly decreased older adults’ depression and improved their life satisfaction through loneliness; while support from family members directly decreased depression but did not directly improve life satisfaction or indirectly improve well-being through loneliness. Although support from friends did not have a significant impact on older adults’ well-being, it indirectly improved well-being through reduced loneliness. Findings have implications for programs or interventions targeting both parent -adult-child support and friends support and reducing rural older adults’ loneliness.

scholarly journals Comorbid disease burden among MS patients 1968–2012: A Swedish register–based cohort study

2020 ◽  
pp. 135245852091049 ◽  
Author(s):  
Kelsi A Smith ◽  
Sarah Burkill ◽  
Ayako Hiyoshi ◽  
Tomas Olsson ◽  
Shahram Bahmanyar ◽  
...  
Keyword(s):  
General Population ◽  
Age Groups ◽  
Comorbid Disease ◽  
Hazard Ratios ◽  
Time Period ◽  
Younger Age ◽  
Cardiovascular Depression ◽  
Prevalence Prevalence ◽  
Time Periods ◽  
Prevalence Ratios

Background: People with multiple sclerosis (pwMS) have increased comorbid disease (CMD) risk. Most previous studies have not considered overall CMD burden. Objective: To describe lifetime CMD burden among pwMS. Methods: PwMS identified using Swedish registers between 1968 and 2012 ( n = 25,476) were matched by sex, age, and county of residence with general-population comparators ( n = 251,170). Prevalence, prevalence ratios (PRs), survival functions, and hazard ratios by MS status, age, and time period compared seven CMD: autoimmune, cardiovascular, depression, diabetes, respiratory, renal, and seizures. Results: The magnitude of the PRs for each CMD and age group decreased across time, with higher PRs in earlier time periods. Before 1990, younger age groups had higher PRs, and after 1990, older age groups had higher PRs. Male pwMS had higher burden compared with females. Overall, renal, respiratory, and seizures had the highest PRs. Before 2001, 50% of pwMS received a first/additional CMD diagnosis 20 years prior to people without MS, which reduced to 4 years after 2001. PwMS had four times higher rates of first/additional diagnoses in earlier time periods, which reduced to less than two times higher in recent time periods compared to people without MS. Conclusion: Swedish pwMS have increased CMD burden compared with the general population, but this has reduced over time.

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