scholarly journals Predicting Symptom Severities in Middle-Aged and Older Adults With Arthritis and Multimorbidity

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 187-187
Author(s):  
Wenhui Zhang
Keyword(s):  
Older Adults ◽  
Sleep Disturbance ◽  
Cognitive Abilities ◽  
Chronic Conditions ◽  
Community Dwelling ◽  
Pain Interference ◽  
National Study ◽  
Chronic Obstructive ◽  
Middle Aged ◽  
Income Adequacy

Abstract Introduction Uncertainties increase with disease guideline-driven decision-making for older adults as their numbers of chronic conditions and functional limitations increase. A national study found that people with arthritis plus ≥ one other chronic condition have reported significantly higher social participation restriction, serious psychological distress, and work limitation than those with ≥two non-arthritis chronic conditions. However, how arthritis comorbidities contribute to the symptoms such as pain, fatigue, sleep, depression, anxiety, and cognitive abilities that chronically impair people’s daily functioning remain unexplored. Purpose To explore how arthritis comorbidities predict the symptom severities of pain interference, fatigue, sleep disturbance, depression, anxiety, and cognitive abilities among community-dwelling middle-aged and older adults. Method: 140 community people aged over 50 with arthritis and multimorbidity were recruited. Stepwise regressions predicted the PROMIS symptoms of pain interference, fatigue, sleep disturbance, depression, anxiety, and cognitive abilities with arthritis type and 18 comorbidities measured by the Functional Comorbidity Index checklist after controlling for demographics. Results Obesity, chronic obstructive pulmonary disease, diabetes, and income significantly predicted pain interference (adjusted R2=35%). Marital status, obesity, and peripheral vascular disease significantly predicted fatigue (adjusted R2=17%). Depression diagnosis and income adequacy significantly predicted depressive symptoms (adjusted R2=23%). Depression, income adequacy, and anxiety diagnosis significantly predicted anxiety (adjusted R2=23%). Age significantly predicted cognitive abilities (adjusted R2=12%). Discussion Comorbidities and socio-demographics, especially income, impact symptom experiences of people aging with arthritis and multimorbidity. Future studies should explore the pathogenesis among arthritis, comorbidities, and symptoms for tailored intervention while disclosing health disparities associated with the arthritis multimorbidity.

scholarly journals Preventing and Managing Chronic Conditions In Older Adults: Lessons Learned From the NHATS and NSOC 2017

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 793-793
Author(s):  
Rose Ann DiMaria-Ghalili ◽  
Cheryl Monturo
Keyword(s):  
Older Adults ◽  
Physical Function ◽  
Chronic Conditions ◽  
Research Policy ◽  
Wound Care ◽  
Medication Management ◽  
Chronic Health Condition ◽  
Lessons Learned ◽  
Community Dwelling ◽  
National Study

Abstract According to the Centers for Disease Control, 85% of older adults have at least one chronic health condition, and 60% percent have at least two chronic conditions. This symposium explores strategies to prevent and manage chronic conditions (nutritional status, medication management, wound care, and physical function) using data from the 2017 National Health and Aging Trends Study (NHATS) and corresponding National Study on Caregiving (NSOC). The datasets include a nationally representative sample of US older adults (NHATS) and their caregivers (NSOC). In addition to survey questions, the 2017 NHATS cohort submitted dried blood samples which include inflammatory biomarkers (hs-C reactive protein [hsCRP] and interleukin-6 [IL-6]). All individual presentations report on weighted data from the analysis to more accurately reflect the US population. In the first paper, DiMaria-Ghalili explores the prevalence of and factors related to malnutrition in community-dwelling and residential living older adults. In the second paper Coates examines the extent to which source of purchased medications impacts the occurrence of self-reported medication mistakes and hospitalizations in community-dwelling participants who managed medications independently. In the third paper, Hathaway compares the socio-demographic, nutrition, and inflammatory profile of older adults with and without wounds. In the fourth paper, Sefcik examines the relationship between the frequency of community-dwelling older adults going outside and physical function. Collectively, findings provide insight into the experiences of vulnerable older adults with chronic conditions informed from the NHATS and NSOC datasets. The symposium will conclude with a discussion by Monturo on implications for research, policy and practice.

scholarly journals Study of potentially preventable hospitalisations (PPH) for chronic conditions: what proportion are preventable and what factors are associated with preventable PPH?

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e038415
Author(s):  
Jennifer Johnston ◽  
Jo Longman ◽  
Dan Ewald ◽  
Jonathan King ◽  
Sumon Das ◽  
...  
Keyword(s):  
Chronic Conditions ◽  
Hospital Admissions ◽  
Medication Management ◽  
Community Dwelling ◽  
Living Alone ◽  
Chronic Obstructive ◽  
Discharge Diagnosis ◽  
Obstructive Pulmonary Disease ◽  
Factors Associated ◽  
Study Sites

IntroductionThe proportion of potentially preventable hospitalisations (PPH) which are actually preventable is unknown, and little is understood about the factors associated with individual preventable PPH. The Diagnosing Potentially Preventable Hospitalisations (DaPPHne) Study aimed to determine the proportion of PPH for chronic conditions which are preventable and identify factors associated with chronic PPH classified as preventable.SettingThree hospitals in NSW, Australia.ParticipantsCommunity-dwelling patients with unplanned hospital admissions between November 2014 and June 2017 for congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes complications or angina pectoris. Data were collected from patients, their general practitioners (GPs) and hospital records.Outcome measuresAssessments of the preventability of each admission by an Expert Panel.Results323 admissions were assessed for preventability: 46% (148/323) were assessed as preventable, 30% (98/323) as not preventable and 24% (77/323) as unclassifiable. Statistically significant differences in proportions preventable were found between the three study sites (29%; 47%; 58%; p≤0.001) and by primary discharge diagnosis (p≤0.001).Significant predictors of an admission being classified as preventable were: study site; final principal diagnosis of CHF; fewer diagnoses on discharge; shorter hospital stay; GP diagnosis of COPD; GP consultation in the last 12 months; not having had a doctor help make the decision to go to hospital; not arriving by ambulance; patient living alone; having someone help with medications and requiring help with daily tasks.ConclusionsThat less than half the chronic PPH were assessed as preventable, and the range of factors associated with preventability, including site and discharge diagnosis, are important considerations in the validity of PPH as an indicator. Opportunities for interventions to reduce chronic PPH include targeting patients with CHF and COPD, and the provision of social welfare and support services for patients living alone and those requiring help with daily tasks and medication management.

scholarly journals Disease-related disability burden: a comparison of seven chronic conditions in middle-aged and older adults

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chieh-Ying Chou ◽  
Ching-Ju Chiu ◽  
Chia-Ming Chang ◽  
Chih-Hsing Wu ◽  
Feng-Hwa Lu ◽  
...  
Keyword(s):  
Older Adults ◽  
Physical Disability ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Disease Diagnosis ◽  
Rate Of Change ◽  
Middle Aged ◽  
Rates Of Change ◽  
Depression Status ◽  
Stage Disease

Abstract Background Although previous studies have explored the effect of chronic conditions on physical disability, little is known about the levels and rates of change in physical disability after a chronic condition diagnosis in middle-aged and older adults in the Asian population. The aim of this study is to ascertain the average levels and rates of change in the development of disability after disease diagnosis, as well as to determine the influences of sociodemographic and health-related correlates in the development of disability. Methods This is a retrospective cohort study analyzing data of nationally representative participants aged 50 and over with a chronic condition or having developed one during follow-ups based on data from the 1996–2011 Taiwan Longitudinal Study on Aging (TLSA) (n = 5131). Seven chronic conditions were examined. Covariates included age at initial diagnosis, gender, education level, number of comorbidities, and depression status. Physical disability was measured by combining self-reported ADL, IADL, and strength and mobility activities with 17 total possible points, further analyzed with multilevel modeling. Results The results showed that (1) physical disability was highest for stroke, followed by cancer and diabetes at the time of the initial disease diagnosis. (2) The linear rate of change was highest for stroke, followed by lung disease and heart disease, indicating that these diseases led to higher steady increases in physical disability after the disease diagnosis. (3) The quadratic rate of change was highest in diabetes, followed by cancer and hypertension, indicating that these diseases had led to higher increments of physical disability in later stage disease. After controlling for sociodemographic and comorbidity, depression status accounted for 39.9–73.6% and 37.9–100% of the variances in the physical disability intercept and change over time, respectively. Conclusions Despite the fact that a comparison across conditions was not statistically tested, an accelerated increase in physical disabilities was found as chronic conditions progressed. While stroke and cancer lead to disability immediately, conditions such as diabetes, cancer, and hypertension give rise to higher increments of physical disability in later stage disease. Mitigating depressive symptoms may be beneficial in terms of preventing disability development in this population.

Chronic conditions and major depression in community-dwelling older adults

2011 ◽  
Vol 131 (1-3) ◽  
pp. 172-178 ◽  
Author(s):  
Kirsten M. Fiest ◽  
Shawn R. Currie ◽  
Jeanne V.A. Williams ◽  
JianLi Wang
Keyword(s):  
Older Adults ◽  
Major Depression ◽  
Chronic Conditions ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

scholarly journals Can Virtual Assistants Perform Cognitive Assessment in Older Adults? A Review

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1310
Author(s):  
Carmen Moret-Tatay ◽  
Isabel Iborra-Marmolejo ◽  
María José Jorques-Infante ◽  
José Vicente Esteve-Rodrigo ◽  
Carla H. A. Schwanke ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Language Processing ◽  
Cognitive Assessment ◽  
Chronic Conditions ◽  
Community Dwelling ◽  
Screening Process ◽  
Digital Devices ◽  
The Given ◽  
Community Dwelling Older Adults

Community-dwelling older adults have raised the scientific community’s interest during the COVID-19 era as their chronic conditions might be aggravated by the consequences of confinement. Digital devices in this field to monitor cognitive impairment are an emerging reality of an innovative nature. However, some groups may not have benefited from these developments as much as, for example, younger people. The aim of this manuscript is to carry out a review on the development of digital devices, and specifically virtual assistants, for the detection of cognitive impairment in older adults. After a screening process, eight studies were found under the given criteria, and this number was even smaller for those using virtual assistants. Given the opportunities offered by virtual assistants through techniques such as natural language processing, it seems imperative to take advantage of this opportunity for groups such as older adults.

scholarly journals Associations of objective versus subjective social isolation with sleep disturbance, depression, and fatigue in community-dwelling older adults

2018 ◽  
Vol 23 (9) ◽  
pp. 1130-1138 ◽  
Author(s):  
Joshua Hyong-Jin Cho ◽  
Richard Olmstead ◽  
Hanbyul Choi ◽  
Carmen Carrillo ◽  
Teresa E. Seeman ◽  
...  
Keyword(s):  
Older Adults ◽  
Sleep Disturbance ◽  
Social Isolation ◽  
Community Dwelling ◽  
Community Dwelling Older Adults

scholarly journals Positive Effects of Openness on Cognitive Aging in Middle-Aged and Older Adults: A 13-Year Longitudinal Study

2019 ◽  
Vol 16 (12) ◽  
pp. 2072 ◽  
Author(s):  
Yukiko Nishita ◽  
Chikako Tange ◽  
Makiko Tomida ◽  
Rei Otsuka ◽  
Fujiko Ando ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Abilities ◽  
Cognitive Aging ◽  
Fixed Effects ◽  
Short Form ◽  
Cognitive Change ◽  
Middle Aged ◽  
Adult Intelligence Scale ◽  
Positive Effects ◽  
Picture Completion

The relationship between openness (a psychological trait of curiosity) and a cognitive change was examined in middle-aged and older adults. Participants were 2214 men and women (baseline age range: 40 to 81 years). They were tested up to seven times over approximately 13 years. Openness at the baseline was assessed by the NEO Five-Factor Inventory. Cognitive abilities were assessed at each examination using the Wechsler adult intelligence scale-revised short form, which includes information, similarities, picture completion, and digit symbol subscales. General linear mixed models comprised fixed effects of openness, age at the baseline, follow-up time, their interactions, and the covariates. The results indicated that the main effects of openness were significant for all scores. Moreover, the interaction term openness × age × time was significant for the information and similarities test scores, indicating that changes in the information and similarities scores differed depending on the level of openness and baseline age. The estimated trajectory indicated that the differences in slopes between participants with high and low openness were significant after 60 years of age for the information, and after 65 years of age for the similarities scores. It is concluded that openness has a protective effect on the decline in general knowledge and logical abstract thinking in old age.

scholarly journals CHRONIC PAIN CONTRIBUTES TO INJURIOUS FALLS IN COMMUNITY-DWELLING OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S622-S622
Author(s):  
Yurun Cai ◽  
Suzanne Leveille ◽  
Ling Shi ◽  
Tongjian You ◽  
Ping Chen
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Community Dwelling ◽  
Pain Severity ◽  
Pain Interference ◽  
Fall Injuries ◽  
Injurious Falls ◽  
Multisite Pain ◽  
Community Dwelling Older Adults ◽  
Pain Distribution

Abstract Fall injuries are a leading cause of death among older adults, and chronic pain has been identified as a fall risk factor. However, the potential impact of chronic pain on injurious falls is unknown. This prospective study examined the relation between chronic pain and injurious falls in a 4-year follow-up of community-dwelling older adults. The MOBILIZE Boston study recruited 765 older adults aged ≥70y living in the Boston area. Pain characteristics, including pain severity, pain interference, and pain location, were measured at baseline using the Brief Pain Inventory subscales and a joint pain questionnaire. Musculoskeletal pain distribution was categorized as “no pain”, “single site pain”, or “multisite pain”. Injurious falls were ascertained in telephone interviews following reports of falls on the monthly fall calendar postcards. The overall rate of injurious falls was 35/100 person-years. Negative binomial models, adjusting for sociodemographics, BMI, chronic conditions, mobility difficulty, analgesic and psychiatric medications, and depression, showed that pain interference and pain distribution, but not pain severity, independently predicted injurious falls. Participants in the highest third of pain interference scores had a 53% greater risk of injurious falls compared to those in the lowest pain interference group (adj.IRR=1.53, 95% CI: 1.15, 2.05). Older adults with multisite pain had a 50% higher risk of injurious falls than those without pain (adj.IRR=1.50, 95% CI: 1.16, 1.93). Risk of injurious falls related to pain was stronger among women than men. Research is needed to determine effective strategies to prevent fall injuries among older adults with chronic pain.

scholarly journals SLEEP IN LATE LIFE: RECENT RESEARCH ON PSYCHIATRIC CORRELATES AND TREATMENT

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S44-S44
Author(s):  
Mary E Dozier
Keyword(s):  
Older Adults ◽  
Sleep Disturbance ◽  
Behavioral Interventions ◽  
Slow Wave Sleep ◽  
Well Being ◽  
Community Dwelling ◽  
Depression Symptoms ◽  
Services And Supports ◽  
Sleep And Cognition ◽  
The Impact

Abstract Sleep is an often overlooked health factor, particularly in older adults. Sleep disturbance is associated with increased functional impairment as well as poorer cognitive, mental, and physical health trajectories. Understanding the clinical impact of disturbed sleep, and the optimal targets for intervention, is critical for the promotion of health and well-being in older adults. This symposium will highlight recent findings that advance the extant knowledge on the interplay of sleep disturbance and physical and psychiatric co-morbidities in older adults across a variety of settings. Darina V. Petrovsky will discuss the impact of medical, demographic, and contextual factors on excessive daytime sleepiness in older adults receiving long-term services and supports. Kathi L. Heffner will present data on a recent study examining change in slow wave sleep, and subsequent change in osteoarthritis pain, following insomnia treatment. Courtney Bolstad will discuss the differential impact of onset, maintenance, and terminal insomnia on anxiety and depression symptoms in community-dwelling older adults. Eliza Davidson will present research on the association between sleep disturbance and hoarding symptoms in older adults engaged in behavioral interventions for hoarding disorder. Finally, Christina McCrae will discuss the relationship between sleep and cognition in older adults with insomnia.

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