scholarly journals THE EFFECT OF CAREGIVING EXPERIENCE ON CARE RECIPIENT OLDER ADULTS’ MORTALITY: A SURVIVAL ANALYSIS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S217-S217 ◽  
Author(s):  
Teja Pristavec ◽  
Elizabeth A Luth
Keyword(s):  
Older Adults ◽  
Survival Analysis ◽  
Mortality Risk ◽  
Informal Caregiver ◽  
Care Recipient ◽  
National Study ◽  
Dyadic Relationship ◽  
Risk Of Death ◽  
Time Period ◽  
Nationally Representative

Abstract Health and demographic mortality risk factors among older adults are well documented. However, less is known about the dyadic relationship between caregiver characteristics and care recipient mortality outcomes. In a nationally representative sample of older adults, we prospectively explore 1) whether and how having an informal caregiver is associated with care recipient mortality, and 2) among those with caregivers, how caregivers’ experiences of burden and benefits relate to care recipient mortality. We match 6 waves of National Health and Aging Trends Study (2011-2016) with 2011 National Study of Caregivers data. We conduct survival analysis on 7,369 older adults and a subsample of 1,341 older adult-informal caregiver dyads to address our research questions. First, we find that simply having an informal caregiver increases mortality risk by 71% (p<0.001) over the 6-year time period, even when adjusting for key demographic, economic and health factors. Second, we find that older adults whose caregivers perceive burden have a significantly higher mortality risk. This risk is reduced if the caregiver also perceives caregiving benefits. The risk of death is 41% higher for older adults whose caregivers report burden but no benefit compared to those with caregivers who report neither burden nor benefit. Further research should investigate possible reasons why merely having a caregiver increases older adults’ mortality risk. Interventions to increase caregivers’ sense of benefit and reduce their burden may be an effective way of decreasing mortality risk for older adults with declining health and functional ability.

scholarly journals Informal Caregiver Burden, Benefits, and Older Adult Mortality: A Survival Analysis

2020 ◽  
Vol 75 (10) ◽  
pp. 2193-2206
Author(s):  
Teja Pristavec ◽  
Elizabeth A Luth
Keyword(s):  
Older Adults ◽  
Survival Analysis ◽  
Older Adult ◽  
Mortality Risk ◽  
Informal Caregiver ◽  
Adult Mortality ◽  
Care Recipient ◽  
National Study ◽  
Mortality Factors ◽  
Nationally Representative

Abstract Objective Informal caregivers are crucial to maintaining older adults’ health, but few studies examine how caregiving receipt is associated with older person longevity. In a nationally representative sample, we prospectively explore whether and how having an informal caregiver is associated with older adult overall mortality, and how caregivers’ burden and benefits perceptions relate to care recipient mortality. Methods We match six National Health and Aging Trends Study waves (2011–2016) with 2011 National Study of Caregiving data, conducting survival analysis on 7,369 older adults and 1,327 older adult-informal caregiver dyads. Results Having an informal caregiver is associated with 36% (p < .001) higher mortality risk over 6-year follow-up, adjusting for demographic, economic, and health factors. Older adults whose caregivers perceive only burden have 38% higher (p < .05) mortality risk than those with caregivers reporting neither burden nor benefits. This risk is reduced from 38% higher to 5% higher (p < .001) for older adults with caregivers reporting benefits alongside burden, compared to those with caregivers reporting neither perception. Discussion Having a caregiver may signal impending decline beyond known mortality factors. However, interventions to increase caregivers’ benefit perceptions and reduce their burden may decrease mortality risk for older adults with declining health and functional ability.

scholarly journals Trends in the Mortality Risk of Living Alone during Old Age in Sweden, 1992–2011

2020 ◽  
Vol 32 (10) ◽  
pp. 1399-1408
Author(s):  
Benjamin A. Shaw ◽  
Lena Dahlberg ◽  
Charlotta Nilsen ◽  
Neda Agahi
Keyword(s):  
Older Adults ◽  
Old Age ◽  
Mortality Risk ◽  
Psychological Health ◽  
Living Alone ◽  
Service Needs ◽  
Cross Sectional ◽  
Time Period ◽  
The Mean ◽  
Nationally Representative

Objectives: This study investigates the association between living alone and mortality over a recent 19-year period (1992–2011). Method: Data from a repeated cross-sectional, nationally representative (Sweden) study of adults ages 77 and older are analyzed in relation to 3-year mortality. Results: Findings suggest that the mortality risk associated with living alone during old age increased between 1992 and 2011 ( p = .076). A small increase in the mean age of those living alone is partly responsible for the strengthening over time of this association. Throughout this time period, older adults living alone consistently reported poorer mobility and psychological health, less financial security, fewer social contacts, and more loneliness than older adults living with others. Discussion: Older adults living alone are more vulnerable than those living with others, and their mortality risk has increased. They may have unique service needs that should be considered in policies aiming to support aging in place.

Association of Systolic and Diastolic Blood Pressure With All-Cause Mortality Among Community-Dwelling Older Adults: A Prospective Observational Study

2021 ◽  
pp. 089826432110552
Author(s):  
Qian Lian ◽  
Tazeen H. Jafar ◽  
John C. Allen ◽  
Stefan Ma ◽  
Rahul Malhotra
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Diastolic Blood Pressure ◽  
Mortality Risk ◽  
Cox Regression ◽  
Community Dwelling ◽  
Representative Study ◽  
Hazard Ratios ◽  
Nationally Representative ◽  
Community Dwelling Older Adults

Objectives To assess the association of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with mortality among older adults in Singapore. Methods Association of SBP and DBP measured in 2009 for 4443 older adults (69.5±7.4 years; 60–97 years) participating in a nationally representative study with mortality risk through end-December 2015 was assessed using Cox regression. Results Higher mortality risk was observed at the lower and upper extremes of SBP and DBP. With SBP of 100–119 mmHg as the reference, multivariable mortality hazard ratios [HRs (95% confidence interval)] were SBP <100 mmHg: 2.41 (1.23–4.72); SBP 160–179 mmHg: 1.51 (1.02–2.22); and SBP ≥180 mmHg: 1.78 (1.12–2.81). With DBP of 70–79 mmHg as the reference, HRs were DBP <50 mmHg: 2.41 (1.28–4.54) and DBP ≥110 mmHg: 2.16 (1.09–4.31). Discussion Management of high blood pressure among older adults will likely reduce their mortality risk. However, the association of excessively low SBP and DBP values with mortality risk needs further evaluation.

scholarly journals IDENTIFYING UNMET NEED IN INFORMAL CAREGIVING: DISPARITIES BY GENDER, EMPLOYMENT STATUS, AND RACE-ETHNICITY

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S219-S220
Author(s):  
Steven A Cohen ◽  
Furong Xu ◽  
Marissa R Meucci ◽  
Symone Woodham ◽  
Mary L Greaney
Keyword(s):  
Older Adults ◽  
Employment Status ◽  
Informal Caregivers ◽  
Unmet Need ◽  
Informal Caregiving ◽  
Care Recipient ◽  
National Study ◽  
Caregiver Health ◽  
White Caregivers ◽  
Race Ethnicity

Abstract Older adults, including those with dementia and other types of cognitive decline, often report a desire to remain in their homes. Over 50 million informal caregivers in the US provide needed in-home assistance to those in need, and there are well-documented disparities in informal caregiving responsibilities by sociodemographic factors , yet little is known about “unmet need” in informal caregiving. Therefore, the study’s objective is to examine discrepancies in unmet caregiving-related need by race/ethnicity, gender, and employment status. We abstracted data about caregivers from the 2017 National Study of Caregiving and linked these data to participants in the National Health and Aging Trends Study on caregivers of older adults (n=993). Generalized linear models were used to model the discrepancies between the number of activities of daily living for which the care recipient required assistance and the number of tasks caregivers provide, by race/ethnicity, gender, and employment status, accounting for confounders and complex sampling. Care recipients whose primary informal caregivers were employed were 69% more likely than those whose informal caregivers were not employed to experience unmet caregiving need (OR 1.69, 95%CI 1.19-2.41). A similar association between employment and unmet caregiving was observed among White caregivers (OR=1.79, 95% CI 1.16-2.69), while the association was not significant among Black caregivers (p=0.228). These findings suggest potentially addressable disparities in informal caregiving duties between Black and White caregivers, and can be used to inform and develop of policies and programs designed to improve caregiver health and reduce undue strain on caregiver health and wellbeing.

Which treatment options impact outcomes in elderly chronic lymphocytic leukemia patients with high prevalence of comorbidity?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 7016-7016
Author(s):  
Sacha Satram-Hoang ◽  
Carolina M. Reyes ◽  
Khang Hoang ◽  
Fayez Momin ◽  
Sridhar Guduru ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Chronic Lymphocytic Leukemia ◽  
Risk Reduction ◽  
Mortality Risk ◽  
Cox Regression ◽  
Lymphocytic Leukemia ◽  
Medicare Part ◽  
Time Period ◽  
High Prevalence ◽  
Significant Mortality

7016 Background: Therapy selection in chronic lymphocytic leukemia (CLL) patients is based on disease severity as well as patient characteristics such as age and comorbidity. While treatment outcomes are mostly available from clinical trial data in younger patients, less is known about the effect of comorbidities on outcomes in elderly CLL patients in the real-world setting. Methods: The linked Surveillance, Epidemiology, and End Results (SEER)-Medicare database was utilized in this retrospective cohort analysis of 3,366 first primary CLL patients. Patients were diagnosed between 1/1/1998-12/31/2007, were >66 years, continuously enrolled in Medicare Part A and B with no HMO coverage in the year prior to diagnosis and received first-line treatment with any oral or infused therapy. CLB is covered by Medicare Part D and data for its use were only available from 2007-2009 in the dataset. Cox regression with backward elimination and propensity score weighted Cox regression estimated the relative risk of death. Date of last follow-up was 12/31/2009. Results: There were 153 CLB, 606 R-mono, 702 R+IV Chemo, and 1,905 IV Chemo-only patients. CLB and R-mono patients were older at diagnosis with mean age of 77 compared to R+IV Chemo (73 years) and IV Chemo-only (76 years; p<.0001). Patients administered R-mono had a higher comorbidity burden and more advanced disease compared with other treatment groups. In the survival analysis we compared CLB to R-mono during the time period 2007-2009 and R+IV Chemo to IV Chemo-only during the time period 1998-2009. The adjusted multivariate survival analysis revealed a significant mortality risk reduction with R+IV Chemo compared with IV Chemo-only patients (HR, 0.72; 95% CI, 0.62-0.84) while a non-significant mortality risk reduction was noted with R-mono compared to CLB patients (HR, 0.47; 95% CI, 0.21-1.05). Older age and increasing comorbidity score were significantly associated with higher mortality. Conclusions: These findings suggest that chemo-immunotherapy is more effective than chemotherapy in an elderly population with a high prevalence of comorbidity. This extends the conclusions from clinical trials in younger, medically fit patients.

scholarly journals The Impact of Obesity and Adiposity on Mortality Risk in Older Adults: A Ten-year Survival Analysis

2021 ◽  
Author(s):  
Letícia Almeida Nogueira Moura ◽  
Valéria Pagotto ◽  
Cristina Camargo Pereira ◽  
Rômulo Roosevelt da Silva Filho ◽  
César de Oliveira ◽  
...  
Keyword(s):  
Older Adults ◽  
Survival Analysis ◽  
Mortality Risk ◽  
Cancer Mortality ◽  
Cox Regression ◽  
Clinical History ◽  
The Body ◽  
Increased Risk ◽  
Multifrequency Bioimpedance ◽  
The Impact

Abstract There are not much information about the impact of obesity on all-cause, cardiovascular and cancer mortality in older adults. We have investigated the impact of obesity and adiposity on all-cause, cardiovascular and cancer mortality, in older adults after a 10-year follow-up. Prospective cohort study has been carried out with individuals ≥ 60 years. Sociodemographic characteristics, lifestyle, clinical history, laboratory tests and anthropometric data were collected. Adiposity was defined as tertiles of the percentage of body fat assessed by multifrequency bioimpedance. For obesity, three classifications were considered using the body mass index (BMI) as follows: ≥ 25.0 kg/m² in men and ≥ 26.6 kg/m² in women, ≥ 27.0 kg/m² and ≥ 30.0 kg/m². The BMI ≥ 30.0 kg/m² was associated a reduction in the all-cause mortality risk in non-ajusted Cox regression (HR: 0.65; 95% CI: 0.43 - 0.97) and in the Kaplan-Meier curves (p = 0.032). However, in multivariate Cox regression none of the diagnostic criteria for obesity and adiposity were significantly associated with all-cause, cardiovascular or cancer mortality. This 10-year survival analysis has showed that obesity and adiposity were not associated with an increased risk of all-cause, cardiovascular or cancer mortality in the older adults.

Abstract MP96: Dysglycemia and Mortality in Older Adults With and Without Diabetes

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Priya Palta ◽  
Elbert S Huang ◽  
Rita R Kalyani ◽  
Sherita H Golden ◽  
Frederick L Brancati ◽  
...  
Keyword(s):  
Older Adults ◽  
Mortality Risk ◽  
Survey Design ◽  
Smoking Status ◽  
Hdl Cholesterol ◽  
Mortality Data ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Nationally Representative ◽  
Diagnosed Diabetes

Studies in middle-aged adults report higher levels of glycated hemoglobin are associated with increased risk of mortality in non-diabetic individuals. Few studies have sufficient data to assess this association in older adults. We analyzed data from the Third National Health and Nutrition Examination Survey (1988-1994), Continuous NHANES (1999-2004), and their linked mortality data (through December 2006) to determine the risk of mortality by levels of HbA1c in older adults with and without diabetes. All analyses are weighted to represent the US population and to account for the complex survey design. Cox proportional hazard models examining the relationship between HbA1c and mortality were adjusted for age, sex, race, education, body mass index, smoking status, HDL cholesterol and hypertension. At baseline, in 7,405 adults, age ≥65 with HbA1c data (42.9% men; 7.5% black; 2.4% Mexican; mean age 73.5 (0.13)), 22.8% had clinically diagnosed diabetes (defined as self-reported physician diagnosis of diabetes and/or use of insulin or hypoglycemic medications). Over a median follow-up of 7.8 years, 4,625 participants (41.9%; 68.1 per 1000 person-years) died due to cardiovascular disease (CVD; n=1520) or non-CVD (n=3105). Non-diabetic older adults with a HbA1c between 5.7-6.4% (defined as “at risk for diabetes” by the American Diabetes Association) had a significantly greater risk of all-cause (HR: 1.39; 95% CI: 1.03-1.89) and non-CVD (HR: 1.55; 95% CI: 1.13-2.13) mortality compared to those with HbA1c<5.0% (referent). In older diabetic adults, there was a graded increase in mortality risk with significant associations found between HbA1c and all-cause (HR: 1.90; 95% CI: 1.13-3.28) and CVD (HR: 2.67; 95% CI: 1.17-6.09) mortality, in analyses comparing participants with a HbA1c between 8.0-8.9% to those with HbA1c <6.5% (referent). These data from a large, nationally representative sample of older adults indicate that dysglycemia is associated with increased mortality risk in older adults with and without diabetes.

scholarly journals Mobility Difficulties, Physical Activity, and All-cause Mortality Risk in a Nationally representative Sample of Older Adults

2017 ◽  
Vol 73 (9) ◽  
pp. 1272-1279 ◽  
Author(s):  
Beatriz Olaya ◽  
Maria Victoria Moneta ◽  
Joan Doménech-Abella ◽  
Marta Miret ◽  
Ivet Bayes ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Mortality Risk ◽  
Representative Sample ◽  
All Cause Mortality ◽  
Nationally Representative

scholarly journals The positive effects of caring for family carers of older adults: a scoping review

2020 ◽  
Vol 4 (3) ◽  
pp. 349-375
Author(s):  
Alex Pysklywec ◽  
Michelle Plante ◽  
Claudine Auger ◽  
William B. Mortenson ◽  
Jacquie Eales ◽  
...  
Keyword(s):  
Older Adults ◽  
Environmental Factors ◽  
Scoping Review ◽  
Personal Growth ◽  
Care Recipient ◽  
Assistive Device ◽  
Family Carers ◽  
Negative Effects ◽  
Dyadic Relationship ◽  
Positive Effects

The negative effects of caring are well documented; however, positive effects have received less attention. A scoping review of 22 studies published between 2000 and 2018 was conducted regarding the positive effects of family caring for older adults. Our analysis revealed that positive effects are embedded in relationships, summarised in three themes: in relationship with one’s self (the carer), for example, personal growth; in relationship with the care recipient, for example, a deepened dyadic relationship; and in relationship with others, for example, new care-related relationships. Seeing the positive effects of caring relationally may shape environmental factors, such as assistive device, social policy or health services development.

scholarly journals Low serum klotho associated with all-cause mortality among a nationally representative sample of American adults

2021 ◽  
Author(s):  
Jacob K Kresovich ◽  
Catherine M Bulka
Keyword(s):  
Physical Activity ◽  
Mortality Risk ◽  
Representative Sample ◽  
Cox Regression ◽  
The United States ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Nationally Representative ◽  
Low Serum

Abstract α-Klotho (klotho) is a protein involved in suppressing oxidative stress and inflammation. In animal models, it is reported to underlie numerous aging phenotypes and longevity. Among a nationally representative sample of adults aged 40 to 79 in the United States, we investigated whether circulating concentrations of klotho is a marker of mortality risk. Serum klotho was measured by ELISA on 10,069 individuals enrolled in the National Health and Nutrition Examination Survey between 2007-2014. Mortality follow-up data based on the National Death Index were available through December 31, 2015. After a mean follow-up of 58 months (range: 1-108), 616 incident deaths occurred. Using survey-weighted Cox regression models adjusted for age, sex and survey cycle, low serum klotho concentration (&lt; 666 pg/mL) was associated with a 31% higher risk of death (compared to klotho concentration &gt; 985 pg/mL, HR: 1.31, 95% CI: 1.00, 1.71, P= 0.05). Associations were consistent for mortality caused by heart disease or cancer. Associations of klotho with all-cause mortality did not appear to differ by most participant characteristics. However, we observed effect modification by physical activity, such that low levels of serum klotho were more strongly associated with mortality among individuals who did not meet recommendation-based physical activity guidelines. Our findings suggest that, among the general population of American adults, circulating levels of klotho may serve as a marker of mortality risk.

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