scholarly journals COVID-19 Vaccine Hesitancy Among Older Adults: Evidence From the Medicare Current Beneficiary Survey

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 147-147
Author(s):  
Divya Bhagianadh ◽  
Kanika Arora
Keyword(s):  
Older Adults ◽  
Information Sources ◽  
Strong Predictor ◽  
Information Source ◽  
Healthcare Providers ◽  
Community Dwelling ◽  
Vaccine Hesitancy ◽  
Medicare Current Beneficiary Survey ◽  
Logistic Regression Models ◽  
Heterogeneous Effects

Abstract Objective Older adults have been the most enthusiastic cohort about the COVID-19 vaccine since its rollout. However, there is limited evidence on vaccine hesitancy, particularly among community-dwelling older adults. In this study, we examine the prevalence and predictors (especially information sources) of vaccine hesitancy in this group. Methods We use the Medicare Current Beneficiary Survey (MCBS)- Fall 2020 supplement data and employ multivariable logistic regression models to explore this association. We study heterogeneous effects by gender, metro/non-metro residence status, race, and age. Results Depending on healthcare providers (HCP), social media, the internet, and family/friends as the main COVID-19 information source was associated with higher odds of negative vaccine intent when compared to those who rely on regular news. We did not find any association of ‘unsure’ vaccine intent and different information sources. Discussion Recommendation from an HCP is a strong predictor of any vaccine acceptance and higher negative intent for COVID-19 vaccine among those who depend on HCP for information is concerning. This could be due to vaccine hesitancy among HCPs themselves or due to other mechanisms like infrequent interactions with the health system.

COVID-19 Vaccine Hesitancy Among Community-Dwelling Older Adults: The Role of Information Sources

2021 ◽  
pp. 073346482110375
Author(s):  
Divya Bhagianadh ◽  
Kanika Arora
Keyword(s):  
Older Adults ◽  
Health Care Providers ◽  
Information Sources ◽  
Information Source ◽  
Community Dwelling ◽  
Vaccine Hesitancy ◽  
Care Providers ◽  
Logistic Regression Models ◽  
Community Dwelling Older Adults

Despite high enthusiasm surrounding the rollout of the COVID-19 vaccine, some older adults continue to remain hesitant about its receipt. There is limited evidence on vaccine hesitancy among community-dwelling older adults. In this study, we examine the prevalence and predictors (particularly the role played by information sources) of vaccine hesitancy in this group. We use the Medicare Current Beneficiary Survey and employ multivariable logistic regression models to explore this. Relative to those relying on regular news, those depending on health care providers (HCPs), social media, other internet/webpages, and family/friends as the main information source on COVID-19 expressed higher negative vaccine intent. The high negative intent with HCPs as the main information source should be interpreted with caution. This could be reflective of the timing of the survey and changing attitude toward the vaccine among HCPs themselves.

scholarly journals Harnessing Stakeholder Perspectives and Experience to Address Nutrition Risk in Community-Dwelling Older Adults

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 477
Author(s):  
Catherine B. Chan ◽  
Naomi Popeski ◽  
Leah Gramlich ◽  
Marlis Atkins ◽  
Carlota Basualdo-Hammond ◽  
...  
Keyword(s):  
Older Adults ◽  
Design Thinking ◽  
Healthcare Providers ◽  
Community Organizations ◽  
Community Dwelling ◽  
Nutrition Risk ◽  
Intersectoral Cooperation ◽  
Stakeholder Perspectives ◽  
Patient Representatives ◽  
Community Dwelling Older Adults

Community-dwelling, older adults have a high prevalence of nutrition risk but strategies to mitigate this risk are not routinely implemented. Our objective was to identify opportunities for the healthcare system and community organizations to combat nutrition risk in this population in the jurisdiction of Alberta, Canada. An intersectoral stakeholder group that included patient representatives was convened to share perspectives and experiences and to identify problems in need of solutions using a design thinking approach. Results: Two main themes emerged from the workshop: (1) lack of awareness and poor communication of the importance of nutrition risk between healthcare providers and from healthcare providers to patients and (2) the necessity to work in partnerships comprised of patients, community organizations, healthcare providers and the health system. Conclusion: Improving awareness, prevention and treatment of malnutrition in community-dwelling older adults requires intersectoral cooperation between patients, healthcare providers and community-based organizations.

scholarly journals EXPLORING TECHNOLOGY-ENABLED ASSESSMENTS OF SYMPTOMS EXPERIENCE BY INFORMAL CAREGIVERS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S336-S336
Author(s):  
Daniel J Schulman ◽  
Portia Singh ◽  
Mladen Milosevic ◽  
Ali Samadani
Keyword(s):  
Older Adults ◽  
Symptom Management ◽  
Information Source ◽  
Informal Caregivers ◽  
Smartphone Application ◽  
Relevant Information ◽  
Community Dwelling ◽  
Communication And Coordination ◽  
Community Dwelling Older Adults

Abstract For community-dwelling older adults with chronic conditions, effective symptom management is a determinant of quality of life. Providers often have poor knowledge of an individual’s symptoms experience, especially when contact is infrequent, leading to suboptimal symptom management. Many older adults receive frequent care and contact from family, friends, and other informal caregivers (ICGs). Subjective observation by ICGs is an underexplored information source, but faces barriers including ICG burden and lack of ICG knowledge. It is unclear what relevant information might be collected by ICG observations. We conducted a pilot evaluation of Philips CarePartners Mobile (CPM), a prototype smartphone application that provides communication and coordination support to a “circle” of ICGs assisting an older adult. CPM includes features enabling ICGs to share semi-structured observations. 19 caregivers (in 8 circles) used CPM for 12 weeks, contributing 397 observations and participating in interviews and other assessments. We performed a qualitative analysis of the observations, coding for presence of content relevant to dimensions in the UCSF Symptom Management Theory (perception of, evaluation of, and response to symptoms). Relevant content was found in 150 observations, with perception and assessment more common (141) than response (32). Common symptoms included mobility difficulty (31), fatigue (23), dizziness (21), pain (19), and confusion (18). Among observations without symptom-relevant content, many reported on overall mood (92), and reference to social activities was frequent. These results demonstrate that symptoms experience can be assessed using caregiver observations, although further work may be needed to enable caregivers to provide a comprehensive assessment.

scholarly journals Is there an association between ageist attitudes and frailty?

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Douglas Salguero ◽  
Juliana Ferri-Guerra ◽  
Nadeem Y. Mohammed ◽  
Dhanya Baskaran ◽  
Raquel Aparicio-Ugarriza ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Multinomial Logistic Regression ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Outcome Variable ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Frailty Status

Abstract Background Frailty is defined as a state of vulnerability to stressors that is associated with higher morbidity, mortality and healthcare utilization in older adults. Ageism is “a process of systematic stereotyping and discrimination against people because they are old.” Explicit biases involve deliberate or conscious controls, while implicit bias involve unconscious processes. Multiple studies show that self-directed ageism is a risk factor for increased morbidity and mortality. The purpose of this study was to determine whether explicit ageist attitudes are associated with frailty in Veterans. Methods This is a cross-sectional study of Veterans 50 years and older who completed the Kogan’s Attitudes towards Older People Scale (KAOP) scale to assess explicit ageist attitudes and the Implicit Association Test (IAT) to evaluate implicit ageist attitudes from July 2014 through April 2015. We constructed a frailty index (FI) of 44 variables (demographics, comorbidities, number of medications, laboratory tests, and activities of daily living) that was retrospectively applied to the time of completion of the KAOP and IAT. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multinomial logistic regression models with frailty status (robust, prefrail and frail) as the outcome variable, and with KAOP and IAT scores as the independent variables. Age, race, ethnicity, median household income and comorbidities were considered as covariates. Results Patients were 89.76% male, 48.03% White, 87.93% non-Hispanic and the mean age was 60.51 (SD = 7.16) years. The proportion of robust, pre-frail and frail patients was 11.02% (n = 42), 59.58% (n = 227) and 29.40% (n = 112) respectively. The KAOP was completed by 381 and the IAT by 339 participants. In multinomial logistic regression, neither explicit ageist attitudes (KAOP scale score) nor implicit ageist attitudes (IAT) were associated with frailty in community dwelling Veterans after adjusting for covariates: OR = .98 (95% CI = .95–1.01), p = .221, and OR:=.97 (95% CI = .37–2.53), p = .950 respectively. Conclusions This study shows that neither explicit nor implicit ageist attitudes were associated with frailty in community dwelling Veterans. Further longitudinal and larger studies with more diverse samples and measured with other ageism scales should evaluate the independent contribution of ageist attitudes to frailty in older adults.

scholarly journals TECHNOLOGICAL AND FINANCIAL PREDICTORS OF FEAR OF FINANCIAL ABUSE AMONG OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S478-S478
Author(s):  
Shaina Alves ◽  
Erin Grinshteyn
Keyword(s):  
Older Adults ◽  
Financial Institutions ◽  
Credit Card ◽  
Elder Abuse ◽  
Financial System ◽  
Community Dwelling ◽  
Logistic Regression Models ◽  
Financial Abuse ◽  
Asset Protection ◽  
Technological Competence

Abstract Much research has focused on elder abuse. Less research focuses on fear of abuse. This analysis examines the associations between feelings of technological competence and variables assessing financial confidence with fear of financial victimization. Data were collected among community dwelling older adults in Nevada (n=467). Questions were asked regarding technological competence, confidence in navigating the financial system, asset protection, trust in financial institutions, and previous financial abuse victimization. The outcome was assessed by asking how afraid the respondent was of becoming a victim of financial abuse. Multivariate logistic regression models were run controlling for confounding. Controlling for all covariates, those who reported feeling unconfident in their technological competence had 2.5 times the odds of being afraid of financial abuse compared with those who felt confident (p<0.02). Those who reported feeling like their assets were at risk had 4.12 times the odds of being afraid of financial abuse (p<0.0001). Older adults who reported feeling vulnerable to financial victimization had 9.4 times the odds of being afraid of financial abuse compared with those who felt invulnerable (p<0.0001). Those who were previously victims of financial abuse had 4.33 times odds of being afraid of financial abuse compared with those who had no history of financial abuse (p<0.0001). Feeling confident in the financial system, asset protection, fear of credit card use, and trust in financial institutions were not associated with fear of financial abuse. These data provide a better understanding of fear of financial abuse, which will allow for better prevention of this issue.

scholarly journals Disrupted Rest-Activity Rhythms and Cerebral Small Vessel Disease Pathology in Older Adults

Stroke ◽  
2021 ◽  
Author(s):  
Rosa Sommer ◽  
Lei Yu ◽  
Julie A. Schneider ◽  
David A. Bennett ◽  
Aron S. Buchman ◽  
...  
Keyword(s):  
Older Adults ◽  
Small Vessel Disease ◽  
Cerebral Small Vessel Disease ◽  
Community Dwelling ◽  
Small Vessel ◽  
Activity Rhythms ◽  
Logistic Regression Models ◽  
Vessel Disease ◽  
Lower Amplitude ◽  
Rest Activity

Background and Purpose: The pathogenesis of cerebral small vessel disease remains incompletely understood. The relationship between circadian rhythm disturbances and histopathologic measures of cerebral small vessel disease has not been studied. We hypothesized that disrupted circadian rest-activity rhythms would be associated with a higher burden of cerebral small vessel disease pathology. Methods: We studied 561 community-dwelling older adults (mean age at death, 91.2, 27.4% male) from the Rush Memory and Aging Project. We used actigraphy to quantify several measures of 24-hour rest-activity rhythmicity, including interdaily stability, intradaily variability, and amplitude, and used ordinal logistic regression models to relate these measures to the severity of cerebral arteriolosclerosis, atherosclerosis, macroinfarcts, and microinfarcts, assessed at autopsy. Results: Lower interdaily stability was associated with a higher burden of arteriolosclerosis, higher intradaily variability was associated with a higher burden of atherosclerosis and subcortical infarcts, and lower amplitude was associated with a higher burden of arteriosclerosis, atherosclerosis and subcortical macroinfarcts. Moreover, the associations between interdaily stability and arteriolosclerosis and intradaily variability and subcortical infarcts were independent of cardiovascular risk factors, sleep fragmentation, and medical comorbidities. Conclusions: Disrupted rest-activity rhythms are associated with a greater burden of cerebral small vessel disease in older adults.

scholarly journals Home Care Resiliency during the COVID-19 Pandemic: Older Adult-Home Care Aide Dyads’ Perspectives

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 721-721
Author(s):  
Naoko Muramatsu ◽  
Lijuan Yin ◽  
Maria Caceres ◽  
Jordan Skowronski
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Healthcare Providers ◽  
Community Dwelling ◽  
Care Recipient ◽  
Work Related ◽  
Care Recipients ◽  
Acute And Chronic Stress ◽  
Home Based ◽  
Related Stress

Abstract Homecare has increased its value as an alternative to nursing homes and adapted to evolving COVID-19 challenges. However, little is known about how COVID-19 has impacted community-dwelling older adults who need assistance with daily activities, including dressing, cooking, and shopping. Guided by the stress process framework, this mixed-method study examined how older homecare recipients experienced the acute and chronic stress during the first eight months of the pandemic, focusing on the role of home care aides (HCAs) in the context of Medicaid-funded in-home services. Thirty-five dyads of care recipients and HCAs participated in a COVID telephone survey as part of a larger study. Care recipients were typically older minority (40% African American, 31% Latinx) women (77%). Their COVID-related anxiety level, assessed by a 6-item Spielberger State Anxiety Inventory (1 “not at all” to 4 “very much”), was 2.2 (SD=0.9). While COVID-19 drastically reduced contacts with family members and healthcare providers, HCAs continued to provide care in person. One care recipient said, “Fortunately, I still have my HCA come and that keeps me sane.” HCAs showed resilience while facing their own family- and work-related stress: “I have followed the rules and just adapted. (COVID) did not affect the activities for my client.” Some dyads, however, experienced care disruptions because of COVID infection or fear in one or both parties. COVID-19 has demonstrated homecare resilience at the person-, dyad-, and organization-levels, calling for equitable, sustainable home-based care for a growing number of older adults who desire to stay in the home.

scholarly journals 400Overactive bladder with/without urinary incontinence and falls in the community-dwelling elderly

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Kenji Omae ◽  
Noriaki Kurita ◽  
Taro Takeshima ◽  
Toru Naganuma ◽  
Sei Takahashi ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Fall Risk ◽  
Community Dwelling ◽  
Important Predictor ◽  
Multivariable Logistic Regression Analysis ◽  
Logistic Regression Models ◽  
Falls In Older Adults ◽  
Tree Approach

Abstract Background Little is known about the fall risk of older adults with overactive bladder (OAB), especially in the absence of urgency incontinence (UI). Methods This prospective cohort study included 630 community-dwelling, independent older adults 75 years old or older who attended a health check-up in 2017 with a 1-year follow-up. The associations of OAB with and without UI (OAB-wet and OAB-dry) with a fall history, and future fall risk compared to no OAB were assessed using logistic regression models. The contribution of OAB as a predictor of falls was examined using a random forest and decision tree approach. Results Of the 577 analyzed participants (median age 79 years), 273 were men. The prevalence of OAB-dry and OAB-wet at baseline was 15% and 14%, respectively. Multivariable logistic regression analysis revealed that both OAB-dry and OAB-wet were associated with a higher likelihood of prior falls (adjusted ORs vs no OAB 2.03 and 2.21, respectively; 95% CI 1.23–3.37 and 1.29–3.78, respectively). Among the 363 participants without a fall history, the adjusted ORs (95% CIs) of OAB-dry and OAB-wet for the occurrence of falls during the 1-year follow-up were 2.74 (1.19–6.29) and 1.35 (0.47–3.87), respectively. The tree-based approach used for all participants showed that OAB was an important predictor of falls in adults without a fall history. Conclusions OAB, even in the absence of UI, is an important predictor of falls in older adults with a low absolute fall risk. Key messages Our findings suggest that OAB is a risk factor for falls in the community-dwelling elderly irrespective of the presence of UI.

THE INFLUENCE OF LIFESTYLE BEHAVIORS ON THE INCIDENCE OF FRAILTY

2019 ◽  
pp. 1-6
Author(s):  
M.G. BORDA ◽  
M.U. PÉREZ-ZEPEDA ◽  
R. SAMPER-TERNENT ◽  
R.C. GÓMEZ ◽  
J.A. AVILA-FUNES ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Frailty Index ◽  
Population Based ◽  
Community Dwelling ◽  
Clinical State ◽  
Physically Active ◽  
Logistic Regression Models ◽  
Healthy Behaviors ◽  
Health Related

Background: Frailty is a clinical state defined as an increase in an individual’s vulnerability to developing adverse health-related outcomes. Objectives: We propose that healthy behaviors could lower the incidence of frailty. The aim is to describe the association between healthy behaviors (physical activity, vaccination, tobacco use, and cancer screening) and the incidence of frailty. Design: This is a secondary longitudinal analysis of the Mexican Health and Aging Study (MHAS) cohort. Setting: MHAS is a population-based cohort, of community-dwelling Mexican older adults. With five assessments currently available, for purposes of this work, 2012 and 2015 waves were used. Participants: A total of 6,087 individuals 50-year or older were included. Measurements: Frailty was defined using a 39-item frailty index. Healthy behaviors were assessed with questions available in MHAS. Individuals without frailty in 2012 were followed-up three years in order to determine their frailty incidence, and its association with healthy behaviors. Multivariate logistic regression models were used to assess the odds of frailty occurring according to the four health-related behaviors mentioned above. Results: At baseline (2012), 55.2% of the subjects were male, the mean age was 62.2 (SD ± 8.5) years old. The overall incidence (2015) of frailty was 37.8%. Older adults physically active had a lower incidence of frailty (48.9% vs. 42.2%, p< 0.0001). Of the activities assessed in the adjusted multivariate models, physical activity was the only variable that was independently associated with a lower risk of frailty (odds ratio: 0.79, 95% confidence interval 0.71-0.88, p< 0.001). Conclusions: Physically active older adults had a lower 3-year incidence of frailty even after adjusting for confounding variables. Increasing physical activity could therefore represent a strategy for reducing the incidence of frailty. Other so-called healthy behaviors were not associated with incident frailty, however there is still uncertainty on the interpretation of those results.

Mild parkinsonian signs, energy decline, and striatal volume in community-dwelling older adults

2021 ◽  
Author(s):  
Qu Tian ◽  
Rebecca Ehrenkranz ◽  
Andrea L Rosso ◽  
Nancy W Glynn ◽  
Lana M Chahine ◽  
...  
Keyword(s):  
Older Adults ◽  
Regression Models ◽  
Rating Scale ◽  
Gray Matter Volume ◽  
Energy Levels ◽  
Community Dwelling ◽  
Linear Regression Models ◽  
Logistic Regression Models ◽  
Body Composition Study ◽  
Using Data

Abstract Background Mild Parkinsonian Signs (MPS), highly prevalent in older adults, predict disability. It is unknown whether energy decline, a predictor of mobility disability, is also associated with MPS. We hypothesized that those with MPS had greater decline in self-reported energy levels (SEL) than those without MPS, and that SEL decline and MPS share neural substrates. Methods Using data from the Health, Aging and Body Composition Study, we analyzed 293 Parkinson’s Disease-free participants (83±3 years old, 39% Black, 58% women) with neuroimaging data, MPS evaluation by Unified Parkinson Disease Rating Scale in 2006-2008, and ≥ 3 measures of SEL since 1999-2000. Individual SEL slopes were computed via linear mixed models. Associations of SEL slopes with MPS were tested using logistic regression models. Association of SEL slope with volume of striatum, sensorimotor, and cognitive regions were examined using linear regression models adjusted for normalized total gray matter volume. Models were adjusted for baseline SEL, mobility, demographics, and comorbidities. Results Compared to those without MPS (n=165), those with MPS (n=128) had 37% greater SEL decline in the prior eight years (p=0.001). Greater SEL decline was associated with smaller right striatal volume (adjusted standardized β=0.126, p=0.029). SEL decline was not associated with volumes in other regions. The association of SEL decline with MPS remained similar after adjustment for right striatal volume (adjusted OR=2.03, 95% CI: 1.16 - 3.54). Conclusion SEL decline may be faster in those with MPS. Striatal atrophy may be important for declining energy but does not explain the association with MPS.

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