scholarly journals THE ASSOCIATION BETWEEN MULTIPLE CHRONIC CONDITIONS AND DEPRESSIVE SYMPTOMS: DISTINCTIONS BY RACE, GENDER, AND AGE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S314-S314
Author(s):  
Christy L Erving ◽  
Cleothia Frazier
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Lived Experience ◽  
Chronic Conditions ◽  
Mental Health Problems ◽  
White Male ◽  
Psychological Services ◽  
Multiple Chronic Conditions ◽  
Gender And Age ◽  
Nationally Representative

Abstract Multiple chronic conditions (MCC)—the co-occurrence of two or more chronic diseases—is a serious concern due to its high prevalence among middle-age and older-adults, and its association with increased disability, mortality risk, and healthcare costs. A growing body of work has shown that chronic physical conditions are associated with depressive symptoms. While MCC and depression affect a substantial proportion of older adults in general, there are important status variations in disease burden along the dimensions of race, gender, and age. This study employs an intersectional and multi-hierarchical approach to assess how these status characteristics (race, gender, and age) may condition the MCC-depression association. We use data from the 1994-2014 waves of the Health and Retirement Study (HRS), a nationally representative data source providing a longitudinal survey of U.S. adults over the age of 50 biennially. Results revealed that MCC was positively associated with depression in general. However, Black Americans, women, and younger adults were more likely to experience depression relative to their White, male, and older counterparts, respectively. The findings suggest that the lived experience of MCC differs by social status, and is perhaps due (in part) to status differences in access to social resources to counteract the potentially deleterious psychological effects of MCC. This research has also has practical implications: given the strong MCC-depression association, older adults with MCC should be offered psychological services to decrease the likelihood of developing mental health problems due to the stress associated with having multiple chronic conditions.

scholarly journals Cognitive Impairment, Depression, and Cooccurrence of Both among the Elderly in Panama: Differential Associations with Multimorbidity and Functional Limitations

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Alcibiades E. Villarreal ◽  
Shantal Grajales ◽  
Lineth Lopez ◽  
Gabrielle B. Britton ◽  
Panama Aging Research Initiative
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Chronic Conditions ◽  
Mental Health Problems ◽  
Functional Limitations ◽  
Depression Scale ◽  
The Elderly ◽  
Community Dwelling ◽  
Multinomial Regression

Cognitive impairment and depression are common mental health problems among the elderly, although few studies have examined their cooccurrence in older adults in Latin America. The purpose of this study was to examine cognitive impairment, depression, and cooccurrence of the two conditions and associated factors in a sample of older adults in Panama. This study included 304 community-dwelling elderly (≥65 years) individuals. Participants underwent a clinical interview and assessments of cognitive function by the Minimental State Examination and depressive symptoms by the Geriatric Depression Scale. Limitations in basic (BADL) and instrumental (IADL) activities in daily living and the presence of chronic illnesses were recorded. Multinomial regression analysis revealed that cooccurrence of cognitive impairment and depressive symptoms was explained by increasing age (OR: 3.2, 95% CI: 1.20, 8.30), low education (OR: 3.3, 95% CI: 1.33, 8.38), having four or more chronic conditions (OR: 11.5, 95% CI: 2.84, 46.63), and BADL limitations (OR: 5.0, 95% CI: 1.26, 19.68). Less education and limitations in BADL and IADL increased the odds of cognitive impairment alone, while less education and three or more chronic conditions increased the odds of depression alone. These findings underscore the relevance of assessing cognitive impairment in the elderly as part of a long-term approach to managing depression and vice versa.

Associations of multiple (≥5) chronic conditions among a nationally representative sample of older United States adults with self-reported pain

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
David R. Axon ◽  
Daniel Arku
Keyword(s):  
United States ◽  
Older Adults ◽  
Chronic Conditions ◽  
Medical Expenditure Panel Survey ◽  
Functional Limitations ◽  
Medical Expenditure ◽  
Outcome Variable ◽  
Multiple Chronic Conditions ◽  
Work Limitations ◽  
Nationally Representative

Abstract Objectives The association between an individuals’ demographic and health characteristics and the presence of multiple chronic conditions is not well known among older United States (US) adults. This study aimed to identify the prevalence and associations of having multiple chronic conditions among older US adults with self-reported pain. Methods This retrospective, cross-sectional study used data from the 2017 Medical Expenditure Panel Survey. Study subjects were aged ≥50 years and had self-reported pain in the past four weeks. The outcome variable was multiple (≥5) chronic conditions (vs. <5 chronic conditions). Hierarchical logistic regression models were used to identify significant associations between demographic and health characteristics and multiple chronic conditions with significance indicated at an a priori alpha level of 0.05. The complex survey design was accounted for when obtaining nationally-representative estimates. Results The weighted population was 57,074,842 US older adults with pain, of which, 66.1% had ≥5 chronic conditions. In fully-adjusted analyses, significant associations of ≥5 comorbid chronic conditions included: age 50–64 vs. ≥65 years (adjusted odds ratio [AOR]=0.478, 95% confidence interval [CI]=0.391, 0.584); male vs. female gender (AOR=1.271, 95% CI=1.063, 1.519); white vs. other race (AOR=1.220, 95% CI=1.016, 1.465); Hispanic vs. non-Hispanic ethnicity (AOR=0.614, 95% CI=0.475, 0.793); employed vs. unemployed (AOR=0.591, 95% CI=0.476, 0.733); functional limitations vs. no functional limitations (AOR=1.862, 95% CI=1.510, 2.298); work limitations vs. no work limitations (AOR=1.588, 95% CI=1.275, 1.976); little/moderate vs. quite a bit/extreme pain (AOR=0.732, 95% CI=0.599, 0.893); and excellent/very good (AOR=0.375, 95% CI=0.294, 0.480) or good (AOR=0.661, 95% CI=0.540, 0.810) vs. fair/poor physical health. Conclusions Approximately 38 million of the 57 million US older adults with pain in this study had ≥5 chronic conditions in 2017. Several characteristics were associated with multiple chronic conditions, which may be important for health care professionals to consider when working with patients to manage their pain. This study was approved by The University of Arizona Institutional Review Board (2006721124, June 12, 2020).

scholarly journals Private Insurance and Mental Health among Older Adults with Multiple Chronic Conditions: A Longitudinal Analysis by Race and Ethnicity

2021 ◽  
Vol 18 (5) ◽  
pp. 2615
Author(s):  
Hankyung Jun ◽  
Emma Aguila
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Race And Ethnicity ◽  
Chronic Conditions ◽  
Private Insurance ◽  
The United States ◽  
Mental Illnesses ◽  
Multiple Chronic Conditions

Older adults with multiple chronic conditions have a higher risk than those without multiple conditions of developing a mental health condition. Individuals with both physical and mental conditions face many substantial burdens. Many such individuals also belong to racial and ethnic minority groups. Private insurance coverage can reduce the risks of developing mental illnesses by increasing healthcare utilization and reducing psychological stress related to financial hardship. This study examines the association between private insurance and mental health (i.e., depressive symptoms and cognitive impairment) among older adults in the United States with multiple chronic conditions by race and ethnicity. We apply a multivariate logistic model with individual fixed-effects to 12 waves of the Health and Retirement Study. Among adults with multiple chronic conditions in late middle age nearing entry to Medicare and of all racial and ethnic groups, those without private insurance have a stronger probability of having depressive symptoms. Private insurance and Medicare can mediate the risk of cognitive impairment among non-Hispanic Whites with multiple chronic conditions and among Blacks regardless of the number of chronic conditions. Our study has implications for policies aiming to reduce disparities among individuals coping with multiple chronic conditions.

scholarly journals Longitudinal relationship of diabetes and depressive symptoms in older adults from Mexico: a secondary data analysis

2020 ◽  
Vol 8 (2) ◽  
pp. e001789
Author(s):  
Teresa Alvarez-Cisneros ◽  
Paloma Roa-Rojas ◽  
Carmen Garcia-Peña
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Secondary Data ◽  
Random Effects Models ◽  
Health Factors ◽  
Longitudinal Association ◽  
Common Risk Factors ◽  
Nationally Representative ◽  
Relationship Of

IntroductionSeveral studies have argued a causal relationship between diabetes and depression, while others have highlighted that their association is a result of common risk factors. Because Mexico is a country with a high prevalence of diabetes, and diabetes and depression are a frequent comorbidity, we chose this country to investigate the longitudinal relationship of these two conditions, focusing on the influence of demographic, health, and socioeconomic factors which could act as common risk factors for both conditions.Research design and methodsUsing the harmonized Mexican Health and Aging Study, a nationally representative sample of adults older than 50 with a response rate of 93%, we analyzed the longitudinal relationship of diabetes and depressive symptoms using ‘between-within’ random-effects models, focusing on the effect of demographic, socioeconomic and health factors.ResultsWhile older adults with diabetes reported a higher prevalence of depressive symptoms in the four waves of the study, there was no causal longitudinal association between them once controlling for demographic, socioeconomic and health factors (between-effect OR=0.88, 95% CI 0.77 to 1.01; within-effect OR=0.87, 95% CI 0.69 to 1.11).ConclusionsThere is no causal longitudinal association between diabetes and depression; the higher prevalence of depression among older adults with diabetes seems a result of socioeconomic and health factors that are not exclusive to respondents with diabetes but are more frequent in this group. Our results highlight the importance of prevention and control of chronic conditions as well as the role of socioeconomic inequalities in mental health.

scholarly journals The Importance of Studying Health Behavior in Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 827-827
Author(s):  
Jaime Hughes ◽  
Susan Hughes ◽  
Mina Raj ◽  
Janet Bettger
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Behavior Change ◽  
Chronic Conditions ◽  
Population Level ◽  
Multiple Chronic Conditions ◽  
Prior Work ◽  
Time Changes ◽  
The Impact ◽  
Over Time

Abstract Behavior change is an inherent aspect of routine geriatric care. However, most research and clinical programs emphasis how to initiate behavior change with less emphasis placed on skills and strategies to maintain behaviors over time, including after an intervention has concluded. This presentation will provide an introduction to the symposium, including a review of prior work and our rationale for studying the critical yet overlooked construct of maintenance in older adults. Several key considerations in our work include the impact of multiple chronic conditions, declines in cognitive and functional capacity over time, changes in environmental context and/or social support, and sustainability of community and population-level programs and services.

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