scholarly journals Chronic Diseases and Self-Reported Health Status Among American Indian/Alaska Native Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 627-627
Author(s):  
Ramona Danielson ◽  
Collette Adamsen ◽  
Agnieszka Mason
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Chronic Disease ◽  
Health Status ◽  
American Indian ◽  
Alaska Native ◽  
Chronic Conditions ◽  
Excellent Health ◽  
Reported Health ◽  
Fair Poor

Abstract Background In the 1800s and 1900s, U.S. federal “Indian” policy (e.g., boarding schools, relocation) created historical trauma with impacts that reverberate today, such as the significant health challenges experienced among American Indian/Alaska Native (AI/AN) populations. Our study seeks to better understand the burden of chronic disease, and also resilience, among AI/AN older adults. Methods Data came from Cycle VII (2018-2020) of the National Resource Center on Native American Aging’s “Identifying Our Needs: A Survey of Elders” survey of AI/AN adults ages 55+ from primarily rural tribal survey sites (N=20,642). Analysis explored self-assessed health status (very good/excellent, good, fair/poor) and looked for significant differences in prevalence of chronic conditions a doctor ever told them they had (e.g., high blood pressure, diabetes, depression, arthritis, asthma). Results Self-reported health among AI/AN adults age 55+ was: 26% very good/excellent, 39% good, and 35% fair/poor. 87% of respondents had 1+ chronic illness; 37% had 3+. Among those reporting very good/excellent health, 75% had 1+ chronic illness and 19% had 3+. High blood pressure was the most common chronic disease, at 56% (44% for very good/excellent compared to 67% for fair/poor), followed by diabetes, at 36% (24% for very good/excellent compared to 46% for fair/poor). Conclusions All of the chronic conditions examined showed significantly higher prevalence among AI/AN adults 55+ with fair/poor health. Notably, 1 in 5 respondents with 3 or more chronic conditions indicated very good/excellent health, reinforcing that successful aging can still be experienced by those with chronic health conditions.

Opioid and Other Medication Use and General Health Status in a Cohort of Older Adults

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Paul F. Pinsky ◽  
Danielle Durham ◽  
Scott Strassels
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Chronic Conditions ◽  
Medication Use ◽  
Opioid Use ◽  
Reported Health ◽  
Chronic Opioid Use ◽  
Self Reported Health Status ◽  
Fair Poor

Objective: The aim of this study was to determine whether the use of opioids and other medications in a cohort of older adults was associated with self-reported health status. Methods: Among participants in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Screening Trial linked to Medicare Part D claims data and answering a quality-of-life questionnaire, we examined the relationship between medication use over a 5-year period and various self-reported health status variables assessed several years later, including overall health status (STATUS) and trouble with activities of daily living (TADL). Multivariable logistic regression was used to estimate odds ratios (ORs) for the health status variables and metrics of medication use, including >60-day use, and for opiates, chronic use, with models controlling for demographics (model I), additionally for chronic conditions (model II), and additionally for other medication use (model III). Results: The study cohort included 22,844 PLCO participants (56% women, 90% non-Hispanic whites); 4.2% had chronic opioid use and 12.5% used for >60 days. Fair-poor STATUS was reported in 37.9% of participants with chronic opioid use versus 15.0% of participants without (p < 0.001). ORs for chronic opioid use for fair-poor STATUS (compared to good-excellent) were significantly elevated in all models but decreased from model I (OR = 3.6; 95% CI :3.1–4.1) to model II (OR = 2.7; 95% CI :2.3–3.1) to model III (OR = 2.1; 95% CI :1.8–2.5). ORs for TADL were generally similar to those for STATUS. Other drug classes also had significantly elevated model III ORs for fair-poor versus good-excellent STATUS (range 1.1–1.6). Conclusion: Frequent use of various medication classes correlated with measures of future health status in an elderly population, with opioids having the strongest association. The magnitude of the association decreased after controlling for concurrent chronic conditions but remained elevated. Future research should consider how the use of opioids and other medications impact measures of health-related quality of life.

The Oral Health Status of American Indian/Alaska Native Preschool Children: A Crisis in Indian Country

2001 ◽  
Author(s):  
Candace M. Jones ◽  
Kathy Phipps ◽  
Nancy Reifel ◽  
Betty Skipper ◽  
Patrick Blahut
Keyword(s):  
Preschool Children ◽  
Health Status ◽  
Oral Health ◽  
American Indian ◽  
Alaska Native ◽  
Oral Health Status ◽  
Indian Country

scholarly journals Consistent Honor, Persistent Disadvantage: American Indian and Alaska Native Veteran Health in the National Survey of Veterans

2021 ◽  
Vol 33 (7-8_suppl) ◽  
pp. 68S-81S
Author(s):  
Kimberly R. Huyser ◽  
Sofia Locklear ◽  
Connor Sheehan ◽  
Brenda L. Moore ◽  
John S. Butler
Keyword(s):  
Socioeconomic Status ◽  
American Indian ◽  
National Survey ◽  
Alaska Native ◽  
Daily Living ◽  
Disadvantaged Population ◽  
Additional Support ◽  
Fair Poor ◽  
National Survey Of Veterans ◽  
Hispanic White

Objective: To examine self-rated health and activities of daily living (ADLs) limitations among American Indian and Alaska Native (AI/AN) veterans relative to white veterans. Methods: We use the 2010 National Survey of Veterans and limit the sample to veterans who identify as AI/AN or non-Hispanic white. We calculated descriptive statistics, confidence intervals, and used logistic regression. Results: AI/AN veterans are younger, have lower levels of income, and have higher levels of exposure to combat and environmental hazards compared to white veterans. We found that AI/AN veterans are significantly more likely to report fair/poor health controlling for socioeconomic status and experience an ADL controlling for age, health behaviors, socioeconomic status, and military factors. Discussion: The results indicate that AI/AN veterans are a disadvantaged population in terms of their health and disability compared to white veterans. AI/AN veterans may require additional support from family members and/or Veteran Affairs to address ADLs.

Home Blood Pressure Monitoring Devices: Device Performance in an Alaska Native and American Indian Population

2021 ◽  
Vol 33 (7-8_suppl) ◽  
pp. 40S-50S
Author(s):  
Krista R. Schaefer ◽  
Amber L. Fyfe-Johnson ◽  
Carolyn J. Noonan ◽  
Michael R. Todd ◽  
Jason G. Umans ◽  
...  
Keyword(s):  
Blood Pressure ◽  
American Indian ◽  
Alaska Native ◽  
Blood Pressure Monitoring ◽  
Intraclass Correlation ◽  
Home Blood Pressure ◽  
Home Blood Pressure Monitoring ◽  
Pressure Monitoring ◽  
Calibration Models ◽  
American Indian People

Objectives: Home blood pressure monitoring (HBPM) is an important component of blood pressure (BP) management. We assessed performance of two HBPM devices among Alaska Native and American Indian people (ANAIs). Methods: We measured BP using Omron BP786 arm cuff, Omron BP654 wrist cuff, and Baum aneroid sphygmomanometer in 100 ANAIs. Performance was assessed with intraclass correlation, paired t-tests, and calibration models. Results: Compared to sphygmomanometer, average BP was higher for wrist cuff (systolic = 4.8 mmHg and diastolic = 3.6 mmHg) and varied for arm cuff (systolic = −1.5 mmHg and diastolic = 2.5 mmHg). Calibration increased performance from grade B to A for arm cuff and from D to B for wrist cuff. Calibration increased false negatives and decreased false positives. Discussion: The arm HBPM device is more accurate than the wrist cuff among ANAIs with hypertension. Most patients are willing to use the arm cuff when accuracy is discussed.

scholarly journals Effectiveness of an eHealth self-management tool for older adults with multimorbidity (KeepWell): protocol for a hybrid effectiveness–implementation randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e048350
Author(s):  
Monika Kastner ◽  
Julie Makarski ◽  
Leigh Hayden ◽  
Jemila S Hamid ◽  
Jayna Holroyd-Leduc ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Randomised Controlled Trial ◽  
Disease Management ◽  
Chronic Conditions ◽  
Controlled Trial ◽  
Management Tool ◽  
Self Management ◽  
Plain Language ◽  
Randomised Controlled

IntroductionIn response to the burden of chronic disease among older adults, different chronic disease self-management tools have been created to optimise disease management. However, these seldom consider all aspects of disease management are not usually developed specifically for seniors or created for sustained use and are primarily focused on a single disease. We created an eHealth self-management application called ‘KeepWell’ that supports seniors with complex care needs in their homes. It incorporates the care for two or more chronic conditions from among the most prevalent high-burden chronic diseases.Methods and analysisWe will evaluate the effectiveness, cost and uptake of KeepWell in a 6-month, pragmatic, hybrid effectiveness–implementation randomised controlled trial. Older adults age ≥65 years with one or more chronic conditions who are English speaking are able to consent and have access to a computer or tablet device, internet and an email address will be eligible. All consenting participants will be randomly assigned to KeepWell or control. The allocation sequence will be determined using a random number generator.Primary outcome is perceived self-efficacy at 6 months. Secondary outcomes include quality of life, health background/status, lifestyle (nutrition, physical activity, caffeine, alcohol, smoking and bladder health), social engagement and connections, eHealth literacy; all collected via a Health Risk Questionnaire embedded within KeepWell (intervention) or a survey platform (control). Implementation outcomes will include reach, effectiveness, adoption, fidelity, implementation cost and sustainability.Ethics and disseminationEthics approval has been received from the North York General Hospital Research and Ethics Board. The study is funded by the Canadian Institutes of Health Research and the Ontario Ministry of Health. We will work with our team to develop a dissemination strategy which will include publications, presentations, plain language summaries and an end-of-grant meeting.Trial registration numberNCT04437238.

scholarly journals Associations of the COVID-19 pandemic with older individuals’ healthcare utilization and self-reported health status: a longitudinal analysis from Singapore

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
SangNam Ahn ◽  
Seonghoon Kim ◽  
Kanghyock Koh
Keyword(s):  
Health Status ◽  
Healthcare Utilization ◽  
Chronic Conditions ◽  
Health Effect ◽  
Healthcare Spending ◽  
Older Individuals ◽  
Middle Aged ◽  
Peak Period ◽  
Reported Health ◽  
Self Reported Health Status

Abstract Background The COVID–19 pandemic has challenged the capacity of healthcare systems around the world and can potentially compromise healthcare utilization and health outcomes among non-COVID–19 patients. Objectives To examine the associations of the COVID-19 pandemic with healthcare utilization, out-of-pocket medical costs, and perceived health among middle-aged and older individuals in Singapore. Method Utilizing data collected from a monthly panel survey, a difference-in-differences approach was used to characterize monthly changes of healthcare use and spending and estimate the probability of being diagnosed with a chronic condition and self-reported health status before and during the COVID-19 outbreak in 2020. Subjects Data were analyzed from 7569 nationally representative individuals from 2019 January and 2020 December. Measures Healthcare utilization and healthcare spending by medical service categories as well as self-reported health status. Results Between January and April 2020 (the first peak period of COVID-19 in Singapore), doctor visits decreased by 30%, and out-of-pocket medical spending decreased by 23%, mostly driven by reductions in inpatient and outpatient care. As a result, the probability of any diagnosis of chronic conditions decreased by 19% in April 2020. The decreased healthcare utilization and spending recovered after lifting the national lockdown in June, 2020 and remained similar to the pre-pandemic level through the rest of 2020. Conclusions Middle-aged and older Singaporeans’ healthcare utilization and the diagnosis of chronic conditions substantially decreased during the first peak period of the COVID-19 outbreak. Further studies to track the longer-term health effect of the pandemic among non-COVID-19 patients are warranted.

Light-Intensity Physical Activity and Cardiometabolic Risk Among Older Adults With Multiple Chronic Conditions

2018 ◽  
Vol 33 (4) ◽  
pp. 507-515 ◽  
Author(s):  
Yueyao Li ◽  
Kellee White ◽  
Katherine R. O’Shields ◽  
Alexander C. McLain ◽  
Anwar T. Merchant
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Older Adults ◽  
Light Intensity ◽  
Total Cholesterol ◽  
Chronic Conditions ◽  
Cardiometabolic Risk ◽  
Multiple Chronic Conditions ◽  
Intensity Physical Activity

Purpose: To assess the relationship between light-intensity physical activity (LIPA) and cardiometabolic risk factors among middle-aged and older adults with multiple chronic conditions. Design: Cross-sectional design utilizing data from the Health and Retirement Study (2010, 2012). Setting: Laboratory- and survey-based testing of a nationally representative sample of community-dwelling middle aged and older adults. Participants: Adults aged 50 years and older (N = 14 996). Measures: Weighted metabolic equivalent of tasks was calculated using self-reported frequency of light, moderate, and vigorous physical activity. Cardiometabolic risk factors (systolic and diastolic blood pressure, glycosylated hemoglobin [HbA1c], high-density lipoprotein cholesterol [HDL-C], total cholesterol, and non-HDL-C) were objectively measured. A multiple chronic condition index was based on 8 self-reported chronic conditions. Analysis: Weighted multivariate linear regression models. Results: Light-intensity physical activity was independently associated with favorable HDL-C (β = 1.25; 95% confidence interval [CI]: 0.46-2.05) and total cholesterol (β = 2.72; 95% CI: 0.53-4.90) after adjusting for relevant confounders. The HDL-C health benefit was apparent when stratified by number of chronic conditions, for individuals with 2 to 3 conditions (β = 1.73; 95% CI: 0.58-2.89). No significant associations were observed between LIPA and blood pressure, HbA1c, or non-HDL-C. Conclusions: Engaging in LIPA may be an important health promotion activity to manage HDL-C and total cholesterol. Additional longitudinal research is needed to determine the causal association between LIPA and cardiometabolic risk which can potentially inform physical activity guidelines targeting older adults with multiple chronic conditions.

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