scholarly journals Social isolation and loneliness as risk factors for hospital admissions for respiratory disease among older adults

Thorax ◽  
2020 ◽  
Vol 75 (7) ◽  
pp. 597-599 ◽  
Author(s):  
Feifei Bu ◽  
Keir Philip ◽  
Daisy Fancourt
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Respiratory Disease ◽  
Hospital Admissions ◽  
Social Contact ◽  
Living Alone ◽  
Social Risk ◽  
Social Risk Factors ◽  
Increased Risk

Rising hospital admissions due to respiratory disease (RD) are a major challenge to hospitals. This study explored modifiable social risk factors among 4478 older adults from the English Longitudinal Study of Ageing. Data were linked with administrative hospital records and mortality registry data (follow-up 9.6 years) and analysed using survival analysis accounting for competing risks. Living alone and social disengagement but not social contact or loneliness were associated with an increased risk of RD admissions, independent of socio-demographic, health and behaviour factors. Providing support for disengaged adults living alone who are at risk of RD admissions should be explored.

scholarly journals Risk factors for depression during the COVID-19 pandemic: a longitudinal study in middle-aged and older adults

BJPsych Open ◽  
2021 ◽  
Vol 7 (5) ◽  
Author(s):  
Jamie Rutland-Lawes ◽  
Anna-Stiina Wallinheimo ◽  
Simon L. Evans
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Longitudinal Study ◽  
Regression Models ◽  
Protective Factor ◽  
Significant Risk ◽  
Living Alone ◽  
Depression Symptoms ◽  
Middle Aged ◽  
Increased Risk

Background The COVID-19 pandemic and resultant social restrictions have had widespread psychological ramifications, including a rise in depression prevalence. However, longitudinal studies on sociodemographic risk factors are lacking. Aims To quantify longitudinal changes in depression symptoms during the pandemic compared with a pre-pandemic baseline, in middle-aged and older adults, and identify the risk factors contributing to this. Method A total of 5331 participants aged ≥50 years were drawn from the English Longitudinal Study of Ageing. Self-reported depression symptoms in June/July 2020 were compared with baseline data from 2–3 years prior. Regression models investigated sociodemographic and lifestyle variables that could explain variance in change in depression. Results Within-participant depression scores increased significantly from pre-pandemic levels: 14% met the criteria for clinical depression at baseline, compared with 26% during the pandemic. Younger age, female gender, higher depression scores at baseline, living alone and having a long-standing illness were significant risk factors. Gender-stratified regression models indicated that older age was protective for women only, whereas urban living increased risk among women only. Being an alcohol consumer was a protective factor among men only. Conclusions Depression in UK adults aged ≥50 years increased significantly during the pandemic. Being female, living alone and having a long-standing illness were prominent risk factors. Younger women living in urban areas were at particularly high risk, suggesting such individuals should be prioritised for support. Findings are also informative for future risk stratification and intervention strategies, particularly if social restrictions are reimposed as the COVID-19 crisis continues to unfold.

scholarly journals Risk Factors for Incident Carotid Artery Revascularization among Older Adults: The Cardiovascular Health Study

2016 ◽  
Vol 6 (3) ◽  
pp. 129-139 ◽  
Author(s):  
Parveen K. Garg ◽  
Willam J.H. Koh ◽  
Joseph A. Delaney ◽  
Ethan A. Halm ◽  
Calvin H. Hirsch ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Carotid Artery ◽  
Cardiovascular Health ◽  
Multivariable Analysis ◽  
Population Based ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Increased Risk

Background: Population-based risk factors for carotid artery revascularization are not known. We investigated the association between demographic and clinical characteristics and incident carotid artery revascularization in a cohort of older adults. Methods: Among Cardiovascular Health Study participants, a population-based cohort of 5,888 adults aged 65 years or older enrolled in two waves (1989-1990 and 1992-1993), 5,107 participants without a prior history of carotid endarterectomy (CEA) or cerebrovascular disease had a carotid ultrasound at baseline and were included in these analyses. Cox proportional hazards multivariable analysis was used to determine independent risk factors for incident carotid artery revascularization. Results: Over a mean follow-up of 13.5 years, 141 participants underwent carotid artery revascularization, 97% were CEA. Baseline degree of stenosis and incident ischemic cerebral events occurring during follow-up were the strongest predictors of incident revascularization. After adjustment for these, factors independently associated with an increased risk of incident revascularization were: hypertension (HR 1.53; 95% CI: 1.05-2.23), peripheral arterial disease (HR 2.57; 95% CI: 1.34-4.93), and low-density lipoprotein cholesterol (HR 1.23 per standard deviation [SD] increment [35.4 mg/dL]; 95% CI: 1.04-1.46). Factors independently associated with a lower risk of incident revascularization were: female gender (HR 0.51; 95% CI: 0.34-0.77) and older age (HR 0.69 per SD increment [5.5 years]; 95% CI: 0.56-0.86). Conclusions: Even after accounting for carotid stenosis and incident cerebral ischemic events, carotid revascularization is related to age, gender, and cardiovascular risk factors. Further study of these demographic disparities and the role of risk factor control is warranted.

scholarly journals Examining the association of social risk with heart failure readmission in the Veterans Health Administration

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Charlie M. Wray ◽  
Marzieh Vali ◽  
Louise C. Walter ◽  
Lee Christensen ◽  
Wendy Chapman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Social Support ◽  
Substance Abuse ◽  
Low Income ◽  
Model Performance ◽  
Social Risk ◽  
Veterans Health ◽  
Social Risk Factors ◽  
Increased Risk ◽  
The Impact

Abstract Background Previous research has found that social risk factors are associated with an increased risk of 30-day readmission. We aimed to assess the association of 5 social risk factors (living alone, lack of social support, marginal housing, substance abuse, and low income) with 30-day Heart Failure (HF) hospital readmissions within the Veterans Health Affairs (VA) and the impact of their inclusion on hospital readmission model performance. Methods We performed a retrospective cohort study using chart review and VA and Centers for Medicare and Medicaid Services (CMS) administrative data from a random sample of 1,500 elderly (≥ 65 years) Veterans hospitalized for HF in 2012. Using logistic regression, we examined whether any of the social risk factors were associated with 30-day readmission after adjusting for age alone and clinical variables used by CMS in its 30-day risk stratified readmission model. The impact of these five social risk factors on readmission model performance was assessed by comparing c-statistics, likelihood ratio tests, and the Hosmer-Lemeshow goodness-of-fit statistic. Results The prevalence varied among the 5 risk factors; low income (47 % vs. 47 %), lives alone (18 % vs. 19 %), substance abuse (14 % vs. 16 %), lacks social support (2 % vs. <1 %), and marginal housing (< 1 % vs. 3 %) among readmitted and non-readmitted patients, respectively. Controlling for clinical factors contained in CMS readmission models, a lack of social support was found to be associated with an increased risk of 30-day readmission (OR 4.8, 95 %CI 1.35–17.88), while marginal housing was noted to decrease readmission risk (OR 0.21, 95 %CI 0.03–0.87). Living alone (OR: 0.9, 95 %CI 0.64–1.26), substance abuse (OR 0.91, 95 %CI 0.67–1.22), and having low income (OR 1.01, 95 %CI 0.77–1.31) had no association with HF readmissions. Adding the five social risk factors to a CMS-based model (age and comorbid conditions; c-statistic 0.62) did not improve model performance (c-statistic: 0.62). Conclusions While a lack of social support was associated with 30-day readmission in the VA, its prevalence was low. Moreover, the inclusion of some social risk factors did not improve readmission model performance. In an integrated healthcare system like the VA, social risk factors may have a limited effect on 30-day readmission outcomes.

Abstract P296: Age-related Differences in Risk Factors for Mortality Among Individuals with Chronic Kidney Disease: The REGARDS Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Rikki M Tanner ◽  
Barrett Bowling ◽  
Monika M Safford ◽  
Orlando Gutiérrez ◽  
Lisandro D Colantonio ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Chronic Kidney Disease ◽  
Cardiovascular Risk ◽  
Kidney Disease ◽  
Cardiovascular Risk Factors ◽  
Older Individuals ◽  
Increased Risk ◽  
Regards Study

At younger ages, chronic kidney disease (CKD) is a progressive disorder associated with an increased risk for end-stage renal disease (ESRD). Older individuals with CKD are 10 to 20 times more likely to die than progress to ESRD. We hypothesized that, among individuals with CKD, the association between traditional cardiovascular risk factors with mortality would be weaker and the association between psychosocial risk factors with mortality would be stronger for individuals ≥ 75 years of age compared to those < 75 years of age. We included 5,924 REasons for Geographic And Racial Differences in Stroke (REGARDS) study participants with CKD without ESRD at baseline. CKD was defined as an albumin-to-creatinine ratio ≥ 30 mg/g or an estimated glomerular filtration rate < 60 mL/min/1.73m2. The 12-item Short Form Health Survey (SF-12) was administered and low physical and mental component scores (PCS and MCS) were defined as scores in the lowest quintile. Mortality was assessed through biannual telephone follow-up and contact with proxies provided by the study participant upon recruitment. Date of death was confirmed through death certificates, National Death Index, or Social Security Death Index. Over a median follow-up of 5.0 years, 1,255 deaths occurred. The mortality rate was 30.9 (95% CI: 28.6 - 33.4) and 74.8 (95% CI: 69.2 - 80.8) per 1,000 person-years for individuals < 75 years and ≥ 75 years of age, respectively. Diabetes, history of stroke, and systolic blood pressure were associated with an increased risk for mortality among individuals < 75 years of age but not among those ≥ 75 years of age (Table 1). Low PCS was associated with a higher risk for mortality for both younger and older adults. Symptoms of depression and low MCS were not associated with mortality in either age group. In conclusion, some cardiovascular risk factors are associated with an increased risk for mortality among younger but not older individuals with CKD. These data suggest approaches to reduce mortality risk may differ for younger and older adults with CKD.

Disadvantaged Adolescents in Psychiatric Treatment

1988 ◽  
Vol 16 (3) ◽  
pp. 167-171 ◽  
Author(s):  
Fredrik Almqvist
Keyword(s):  
Risk Factors ◽  
Preventive Measures ◽  
Psychiatric Treatment ◽  
Social Risk ◽  
Children And Families ◽  
Social Risk Factors ◽  
Biological Parents ◽  
Death Of A Parent ◽  
Prospective Epidemiological Study

In a prospective epidemiological study, a cohort of all children born in 1955 in Helsinki have so far been surveyed into their youth. On the basis of the present seven-year follow-up in adolescence, it was observed that the cumulative incidence of public psychiatric treatment is 9.1%. Marital status of the biological parents deviating from normal or the death of a parent as well as a low social status of the father are factors connected with an elevated risk of required psychiatric treatment during youth. The combined effects of such social risk factors are additive. The risk of necessary treatment was observed to be three times greater in young people who exhibited both risk factors during childhood. The results of the study indicate how preventive measures might be directed. At the same time, the need for more detailed studies in the future to allow preventive measures to be directed more accurately than hitherto, at children and families requiring them, is emphasized.

scholarly journals The association between socioeconomic status and pandemic influenza: Systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0244346
Author(s):  
Svenn-Erik Mamelund ◽  
Clare Shelley-Egan ◽  
Ole Rogeberg
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Pandemic Influenza ◽  
Seasonal Influenza ◽  
Hospital Admissions ◽  
Meta Analysis ◽  
Random Effect ◽  
Low Ses ◽  
Social Risk ◽  
Social Risk Factors

Background The objective of this study is to document whether and to what extent there is an association between socioeconomic status (SES) and disease outcomes in the last five influenza pandemics. Methods/principle findings The review included studies published in English, Danish, Norwegian and Swedish. Records were identified through systematic literature searches in six databases. We summarized results narratively and through meta-analytic strategies. Only studies for the 1918 and 2009 pandemics were identified. Of 14 studies on the 2009 pandemic including data on both medical and social risk factors, after controlling for medical risk factors 8 demonstrated independent impact of SES. In the random effect analysis of 46 estimates from 35 studies we found a pooled mean odds ratio of 1.4 (95% CI: 1.2–1.7, p < 0.001), comparing the lowest to the highest SES, but with substantial effect heterogeneity across studies,–reflecting differences in outcome measures and definitions of case and control samples. Analyses by pandemic period (1918 or 2009) and by level of SES measure (individual or ecological) indicated no differences along these dimensions. Studies using healthy controls tended to document that low SES was associated with worse influenza outcome, and studies using infected controls find low SES associated with more severe outcomes. A few studies compared severe outcomes (ICU or death) to hospital admissions but these did not find significant SES associations in any direction. Studies with more unusual comparisons (e.g., pandemic vs seasonal influenza, seasonal influenza vs other patient groups) reported no or negative non-significant associations. Conclusions/significance We found that SES was significantly associated with pandemic influenza outcomes with people of lower SES having the highest disease burden in both 1918 and 2009. To prepare for future pandemics, we must consider social vulnerability. The protocol for this study has been registered in PROSPERO (ref. no 87922) and has been published Mamelund et al. (2019).

scholarly journals Sporadic and recurrent non-suicidal self-injury before age 14 and incident onset of psychiatric disorders by 17 years: prospective cohort study

2018 ◽  
Vol 212 (4) ◽  
pp. 222-226 ◽  
Author(s):  
Paul O. Wilkinson ◽  
Tianyou Qiu ◽  
Sharon Neufeld ◽  
Peter B. Jones ◽  
Ian M. Goodyer
Keyword(s):  
Risk Factors ◽  
Psychiatric Symptoms ◽  
Mental Illnesses ◽  
Social Risk ◽  
Social Risk Factors ◽  
Vulnerable Group ◽  
Self Injury ◽  
Increased Risk ◽  
History Of ◽  
New Onset

BackgroundNon-suicidal self-injury (NSSI) is highly prevalent in adolescents and may be a behavioural marker for emergent mental illnesses.AimsTo determine whether sporadic or recurrent NSSI up to the age of 14 years predicted increased risk of new onset of psychiatric disorder in the subsequent 3 years, independent of psychiatric symptoms and social risk factors.MethodIn total, 945 individuals aged 14 years with no past/present history of mental illness completed a clinical interview and completed a questionnaire about NSSI at the ages of 14 and 17 years.ResultsRecurrent NSSI at baseline predicted total disorders, depression and eating disorders. Sporadic baseline NSSI predicted new onset of anxiety disorders only.ConclusionsNSSI (especially recurrent NSSI) in the early-adolescent years is a behavioural marker of newly emerging mental illnesses. Professionals should treat both recurrent and sporadic NSSI as important risk factors, and prevention strategies could be targeted at this vulnerable group.Declaration of interestNone.

scholarly journals The association between socioeconomic status and pandemic influenza: systematic review and meta-analysis

2020 ◽  
Author(s):  
Svenn-Erik Mamelund ◽  
Clare Shelley-Egan ◽  
Ole Rogeberg
Keyword(s):  
Risk Factors ◽  
Socioeconomic Status ◽  
Seasonal Influenza ◽  
Hospital Admissions ◽  
Association Studies ◽  
Low Ses ◽  
Social Risk ◽  
Social Risk Factors ◽  
Medical Risk ◽  
Medical Risk Factors

AbstractBackgroundThe objective was to document whether and to what extent there was an association between socioeconomic status (SES) and disease outcomes in the last five influenza pandemics.Methods/Principle FindingsThe review included studies published in English, Danish, Norwegian and Swedish. Records were identified through systematic literature searches in six databases. Results are summarized narratively and using meta-analytic strategies. We found studies only for the 1918 and 2009 pandemics. Of 14 studies on the 2009 pandemic including data on both medical and social risk factors, after controlling for medical risk factors 8 demonstrated independent impact of SES. A random effect analysis of 46 estimates from 35 studies found a pooled mean odds ratio of 1.4 (95% CI: 1.2 – 1.7), comparing the lowest to the highest SES, but with substantial effect heterogeneity across studies –reflecting differences in outcome measures and definitions of case and control samples. Analyses by pandemic period (1918 or 2009) and by level of SES measure (individual or ecological) indicate no differences along these dimensions. Studies using healthy controls tend to find low SES associated with worse influenza outcome, and studies using infected controls find low SES associated with more severe outcomes. Studies comparing severe outcomes (ICU or death) to hospital admissions are few but indicate no clear association. Studies with more unusual comparisons (e.g., pandemic vs seasonal influenza, seasonal influenza vs other patient groups) report no or negative associations.Conclusions/SignificanceResults show that social risk factors help to explain pandemic outcomes in 1918 and in 2009 although the mechanisms and types of social vulnerabilities leading to disparities in outcomes may differ over time. Studies of the 2009 pandemic also showed that social vulnerability could not always be explained by medical risk factors. To prepare for future pandemics, we must consider social along with medical vulnerability.The protocol for this study has been registered in PROSPERO (ref. no 87922) and has been published (1).

scholarly journals A Screening and Referral Intervention for Food Insecurity Among Older Emergency Department Patients

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 37-37
Author(s):  
Aileen Aylward ◽  
Timothy Platts-Mills ◽  
Liane Wardlow ◽  
Conor Sullivan ◽  
Jessa Engelberg Anderson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Emergency Department ◽  
Food Insecurity ◽  
Local Area ◽  
Social Risk ◽  
Social Risk Factors ◽  
Community Based ◽  
Community Based Services ◽  
Satisfaction With Services

Abstract Food insecurity is prevalent among older adults, negatively impacts health, and may increase healthcare utilization. Risk factors include poverty, lack of transportation, and social isolation. Community-based services may mitigate food insecurity and other social risk factors. However, identifying those at risk and connecting them to services can be challenging. We implemented a screening and referral program in an Emergency Department (ED) to identify older adults facing food insecurity and connect them to a local Area Agency on Aging (AAA), which arranged and tracked delivery of community-based services. ED nursing assistants used the Hunger Vital Sign screener to assess food insecurity in patients aged 60 years and older. ED Care Managers (CMs) saw all who screened positive and made referrals to the AAA. The AAA conducted an intake assessment and arranged services. Patients were contacted three months after their ED visit to evaluate health, quality of life, and satisfaction with services. Of 423 patients screened over 7 months, 45 (11%) reported food insecurity. Of those, 25 were referred to the AAA. Patients were not referred to the AAA due to CM inability to make a referral (7), declining services (4), or other reasons (11). The AAA reached 21 patients and 9 received at least one service. Of those, 5 were reached for follow-up and reported satisfaction with services. The most frequently requested service was Meals on Wheels (10). Food insecurity is common among older ED patients. An ED-AAA partnership is feasible and connects older adults to beneficial services in their communities.

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