Sociodemographic, environmental characteristics and comorbidities of older adults with schizophrenia who access community health service support: A national cross-sectional study

2019 ◽  
Vol 53 (6) ◽  
pp. 570-580
Author(s):  
Cameron Lacey ◽  
Jenni Manuel ◽  
Philip J Schluter ◽  
Richard J Porter ◽  
Suzanne Pitama ◽  
...  
Keyword(s):  
Older Adults ◽  
Environmental Variables ◽  
Total Sample ◽  
Cross Sectional Study ◽  
Social Needs ◽  
Assessment Instrument ◽  
National Database ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Diagnostic Characteristics

Objectives: Schizophrenia is a serious and chronic mental illness known to have broad ranging impacts for individuals across the lifespan, yet research on the disease in older adults is sparse. This study provides a profile of the sociodemographic, environmental and diagnostic characteristics of older community residents with schizophrenia using a national database. Methods: A cross-sectional sample of individuals who underwent community needs assessment using the standardised Home Care International Residential Assessment Instrument between 1 September 2012 and 31 January 2016 was utilised. Sociodemographic, diagnostic, and social and environmental variables were measured for individuals with a diagnosis of schizophrenia and compared to those without a diagnosis of schizophrenia. Statistical investigations employed bivariable and multivariable logistic regression models. Results: A total sample of 71,859 was eligible and 517 (0.7%) had a diagnosis of schizophrenia. The majority of the sociodemographic variables were statistically associated with schizophrenia in the adjusted analysis, except for ethnicity ( p = 0.35). Nearly all the measured social and environmental variables were adversely associated with having a diagnosis of schizophrenia, such as living in squalid conditions (adjusted odds ratio = 2.16; 95% confidence interval = [1.42, 3.28]). Participants with schizophrenia were significantly more likely to be diagnosed with all assessed psychiatric comorbidities ( p < 0.001) and diabetes mellitus ( p  = 0.002), whereas coronary heart disease ( p = 0.001) and other physical comorbidities ( p = 0.001) were found at significantly lower rates. Conclusion: The profile of schizophrenia found here suggests some subtle differences in the demographic profile and distribution of medical comorbidities in the older population with schizophrenia. The results also suggest that this group continues to experience social disadvantage into old age. This requires the attention of policy-makers to ensure that services are tailored to the high social needs of these individuals.

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.

Prevalence and Biological Correlates of Oropharyngeal Dysphagia in Outpatients of a Geriatric Evaluation Clinic: A Brief Report

Gerontology ◽  
2021 ◽  
pp. 1-4
Author(s):  
Abdias Ambrosio-Palma ◽  
Jose Alberto Avila-Funes ◽  
Alberto Mimenza-Alvarado ◽  
Aurora Elizabeth Serralde-Zúñiga ◽  
Mónica Zavala-Solares ◽  
...  
Keyword(s):  
Older Adults ◽  
Assessment Tool ◽  
Oropharyngeal Dysphagia ◽  
Tertiary Hospital ◽  
Cross Sectional Study ◽  
Nutrition Status ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Levels Of Care ◽  
Volume Viscosity

<b><i>Background:</i></b> Oropharyngeal dysphagia (OD) is a relevant disease among older adults and is associated with serious adverse health-related outcomes, such as malnutrition, sarcopenia, or frailty. Increasing its recognition and the related mechanisms will allow us to its prevention and treatment at different levels of care. <b><i>Objectives:</i></b> This study aimed to determine the prevalence and biological correlates of OD in outpatient older adults. <b><i>Method:</i></b> This is a cross-sectional study including 100 adults aged 60 or older from a geriatric clinic of a tertiary hospital in Mexico City. Health variables and geriatric syndromes were recorded. The Eating Assessment Tool-10 detection test and the volume-viscosity swallowing test were used to diagnose OD. Logistic regression models were performed to identify the factors associated with OD. <b><i>Results:</i></b> Mean age was 81.2 (±7.5) years and 21% had OD. The presence of xerostomia (<i>p</i> = 0.05) and a worst nutritional status (<i>p</i> = 0.035) were obtained. <b><i>Conclusions:</i></b> The prevalence of OD among older adults was high. Inadequate nutrition status and the presence of xerostomia are more likely to be present with this swallowing disorder.

scholarly journals Association between dietary antioxidant vitamins intake and homocysteine levels in middle-aged and older adults with hypertension: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e045732
Author(s):  
Xiaolin Peng ◽  
Qin Gao ◽  
Juan Zhou ◽  
Jianping Ma ◽  
Dan Zhao ◽  
...  
Keyword(s):  
Older Adults ◽  
Cross Sectional Study ◽  
Antioxidant Vitamins ◽  
Inverse Association ◽  
Dietary Intakes ◽  
Sectional Study ◽  
Middle Aged ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Dietary Antioxidant

ObjectivesPlasma total homocysteine (tHcy) has been implicated in the development of cardiovascular disease. This study aimed to assess the relationship of dietary antioxidant vitamins intake with tHcy levels in middle-aged and older adults with hypertension.DesignA cross-sectional study.SettingThe survey was conducted in the Nanshan district of Shenzhen.ParticipantsA total of 1465 middle-aged and older adults with hypertension were included between July and September of 2013.MeasurementsHyperhomocysteinaemia (HHcy) was defined as tHcy ≥15 µmol/L. Some dietary antioxidant vitamins (vitamin C (VC) and vitamin E (VE), carotenes, retinol, lutein) intake was estimated using the Food Frequency Questionnaire. Sociodemographic and potential covariates were evaluated through questionnaires, anthropometric measurements and blood tests. The association between dietary intakes of antioxidant vitamins and tHcy concentration were evaluated by multiple linear regression analyses after napierian logarithm transformed. Multiple logistic regression models were further used to determine ORs and 95% CIs.ResultsThe β (95% CIs) of VC intake and tHcy was −0.050 (−0.084 to –0.016). Compared with the lowest quartile in the fully adjusted model, the ORs (95% CIs) for HHcy levels across quartiles of dietary VC intake were 0.82 (0.57 to 1.16), 0.49 (0.33 to 0.74) and 0.40 (0.22 to 0.74) (p for trend=0.001). The β (95% CIs) of retinol intake and tHcy was −0.021 (−0.041 to –0.002) and the ORs (95% CIs) in the third quartile of retinol intake was 0.61 (0.42 to 0.86), while the effect for the highest quartile was not significant (p for trend=0.951). No significant association was observed between dietary VE, carotenes and lutein intake and HHcy.ConclusionsA linear inverse association between dietary VC intake and HHcy prevalence, and an L-shaped association between dietary retinol intake and HHcy prevalence were found in Chinese middle-aged and older adults with hypertension.

scholarly journals Sex differences in multimorbidity and polypharmacy trends: A repeated cross-sectional study of older adults in Ontario, Canada

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250567
Author(s):  
Colleen J. Maxwell ◽  
Luke Mondor ◽  
Anna J. Pefoyo Koné ◽  
David B. Hogan ◽  
Walter P. Wodchis
Keyword(s):  
Older Adults ◽  
Sex Differences ◽  
Cross Sectional Study ◽  
Administrative Databases ◽  
Sectional Study ◽  
Cross Sectional ◽  
Absolute Increase ◽  
Logistic Regression Models ◽  
The Impact ◽  
Over Time

Background Multimorbidity is increasing among older adults, but the impact of these recent trends on the extent and complexity of polypharmacy and possible variation by sex remains unknown. We examined sex differences in multimorbidity, polypharmacy (5+ medications) and hyper-polypharmacy (10+ medications) in 2003 vs 2016, and the interactive associations between age, multimorbidity level, and time on polypharmacy measures. Methods and findings We employed a repeated cross-sectional study design with linked health administrative databases for all persons aged ≥66 years eligible for health insurance in Ontario, Canada at the two index dates. Descriptive analyses and multivariable logistic regression models were conducted; models included interaction terms between age, multimorbidity level, and time period to estimate polypharmacy and hyper-polypharmacy probabilities, risk differences and risk ratios for 2016 vs 2003. Multimorbidity, polypharmacy and hyper-polypharmacy increased significantly over the 13 years. At both index dates prevalence estimates for all three were higher in women, but a greater absolute increase in polypharmacy over time was observed in men (6.6% [from 55.7% to 62.3%] vs 0.9% [64.2%-65.1%] for women) though absolute increases in multimorbidity were similar for men and women (6.9% [72.5%-79.4%] vs 6.2% [75.9%-82.1%], respectively). Model findings showed that polypharmacy decreased over time among women aged < 90 years (especially for younger ages and those with fewer conditions), whereas it increased among men at all ages and multimorbidity levels (with larger absolute increases typically at older ages and among those with 4 or fewer conditions). Conclusions There are sex and age differences in the impact of increasing chronic disease burden on changes in measures of multiple medication use among older adults. Though the drivers and health consequences of these trends warrant further investigation, the findings support the heterogeneity and complexity in the evolving association between multimorbidity and polypharmacy measures in older populations.

scholarly journals Association between Physical Frailty and Sleep Quality among Saudi Older Adults: A Community-Based, Cross-Sectional Study

2021 ◽  
Vol 18 (23) ◽  
pp. 12741
Author(s):  
Bader A. Alqahtani
Keyword(s):  
Older Adults ◽  
Sleep Quality ◽  
Frailty Index ◽  
Cross Sectional Study ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Community Based ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Frailty Status

(1) Background: Prevalence of poor sleep quality and its association with frailty status among the aging population of Saudi Arabia has not been studied. Therefore, the main objective of the current study was to estimate the prevalence of poor sleep quality and investigate the association between poor sleep quality and frailty in Saudi older adults; (2) Methods: A total of 270 (mean age 69.9 ± 6.2) older adults from the Riyadh region were involved in the study. To measure sleep quality, the Arabic version of the Pittsburgh Sleep Quality Index (PSQI) was used. The Fried’s frailty index was utilized to assess frailty. Using multiple logistic regression models, the association between sleep quality and frailty status was evaluated using the Odds Ratio and confidence intervals (CI 95%); (3) Results: The pre-frailty and frailty status were prevalent among older adults who had poor sleep quality, 37% and 37.6% (p < 0.001), retrospectively. Poor sleep quality (PSQI > 5) was independently associated with both frailty (OR = 2.13) and prefrailty groups (OR = 1.67); (4) Conclusions: our study demonstrated a significant association between frailty and poor sleep quality. However, a longitudinal future study needs to be established to confirm this association and establish the causality relationship.

scholarly journals Neighborhood Environments and Utilitarian Walking Among Older vs. Younger Rural Adults

2021 ◽  
Vol 9 ◽  
Author(s):  
Chanam Lee ◽  
Chunkeun Lee ◽  
Orion T. Stewart ◽  
Heather A. Carlos ◽  
Anna Adachi-Mejia ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Communities ◽  
Public Transportation ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Neighborhood Environment ◽  
Cross Sectional ◽  
Younger Adults ◽  
Logistic Regression Models ◽  
Telephone Interviews

Introduction: Walking has the potential to promote health across the life span, but age-specific features of the neighborhood environment (NE), especially in rural communities, linked with walking have not been adequately characterized. This study examines the relationships between NE and utilitarian walking among older vs. younger adults living in US rural towns.Methods: Data for this cross-sectional study came from telephone interviews in 2011–2012 with 2,140 randomly sampled younger (18–64 years, n = 1,398) and older (65+ years, n = 742) adults, collecting personal and NE perception variables. NE around each participant's home was also measured objectively using geographic information system techniques. Separate mixed-effects logistic regression models were estimated for the two age groups, predicting the odds of utilitarian walking at least once a week.Results: Perceived presence of crosswalks and pedestrian signals was significantly related to utilitarian walking in both age groups. Among older adults, unattended dogs, lighting at night, and religious institutions were positively while steep slope was negatively associated with their walking. For younger adults, traffic speed (negative, –), public transportation (positive, +), malls (–), cultural/recreational destinations (+), schools (+), and resource production land uses such as farms and mines (–) were significant correlates of utilitarian walking.Conclusion: Different characteristics of NE are associated with utilitarian walking among younger vs. older adults in US rural towns. Optimal modifications of NE to promote walking may need to reflect these age differences.

scholarly journals SERUM 25(OH)D SIGNIFICANTLY IMPACTS ALZHEIMER’S DISEASE IN OLDER ADULTS LIVING IN LONG-TERM CARE COMMUNITIES.

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S863-S863
Author(s):  
Robert A Churchill ◽  
Ronna Robbins ◽  
Nalini Ranjit ◽  
Sara Sweitzer ◽  
Margaret Briley
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Serum Levels ◽  
Cross Sectional Study ◽  
Vitamin D Supplementation ◽  
Cross Sectional ◽  
Term Care ◽  
Logistic Regression Models ◽  
Hydroxyvitamin D

Abstract 6.08 million Americans suffer from Alzheimer’s Disease (AD), with some estimating diagnoses will reach 15.0 million by 2060. Age is the strongest risk factor for AD, and the prevalence of AD among older adults necessitates investigation into preventable risk factors. 25-hydroxyvitamin D [25(OH)D] deficiency is more prevalent in older adults than other age demographics. Research shows a strong correlation between deficient 25(OH)D serum levels (≤20ng/ml) and AD diagnosis. The association with insufficient (≤30 ng/ml) levels remains unclear. Older adults (age &gt; 65 yo) of five LTC communities in Texas participated in the cross-sectional study. One-year medical history and demographics were abstracted from medical records using double-blinded data abstraction and entry. Blood draws measured 25(OH)D serum levels. Adjusted logistic regression models examined if insufficient 25(OH)D serum levels (≤30 ng/ml) are associated with AD diagnosis. Confounders were total daily vitamin D supplementation, BMI, race, gender, age, years in community, and diagnosis of liver and renal disease. Participants (n=174, mean age: 83 yo) consisted of 63% female and 89% Caucasian. Fifty five percent had insufficient serum 25(OH)D levels (mean level: 32.6 ng/ml; mean supplementation rate: 1,138 IU per/d), and 20% had diagnosis of AD. 25% had both insufficient serum levels and AD, while 12.6% had adequate serum levels and AD. Those with insufficient 25(OH)D serum levels had elevated odds (OR=2.8; CL: 1.14, 7.02; p=0.024) of having AD after adjusting for confounders. Insufficient serum 25(OH)D levels (≤30 ng/ml) are associated with increased diagnoses of AD, indicating the importance of adequate levels among LTC residents.

scholarly journals Unwelcome Companions: Loneliness Associates with the Cluster of Pain, Fatigue, and Depression in Older Adults

2021 ◽  
Vol 7 ◽  
pp. 233372142199762
Author(s):  
Victoria D. Powell ◽  
Nauzley C. Abedini ◽  
Andrzej T. Galecki ◽  
Mohammed Kabeto ◽  
Navasuja Kumar ◽  
...  
Keyword(s):  
Older Adults ◽  
Total Sample ◽  
Study Data ◽  
Demographic Variables ◽  
Symptom Cluster ◽  
Psychosocial Stressors ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Severe Fatigue ◽  
Retirement Study

Objective: Pain, fatigue, and depression commonly co-occur as a symptom cluster in pathological inflammatory states. Psychosocial stressors such as loneliness may lead to similar states through shared mechanisms. We investigated the association of loneliness with pain, fatigue, and depression in older adults. Methods: Using Health and Retirement Study data ( N = 11,766), we measured cross-sectional prevalence of frequent, moderate to severe pain; severe fatigue; depressive symptoms; and co-occurrence of symptoms surpassing threshold levels (i.e., symptom cluster). Logistic regression models evaluated associations with loneliness. Results: Pain, fatigue, and depression were reported in 19.2%, 20.0%, and 15.3% of the total sample, respectively. The symptom cluster was seen in 4.9% overall; prevalence in lonely individuals was significantly increased (11.6% vs. 2.3%, p < .0001). After adjusting for demographic variables, loneliness associated with the symptom cluster (adjusted OR = 3.39, 95% CI = 2.91, 3.95) and each symptom (pain adjusted OR = 1.61, 95% CI = 1.48, 1.76; fatigue adjusted OR = 2.02, 95% CI = 1.85, 2.20; depression adjusted OR = 4.34, 95% CI = 3.93, 4.79). Discussion: Loneliness strongly associates with the symptom cluster of pain, fatigue, and depression. Further research should examine causal relationships and investigate whether interventions targeting loneliness mitigate pain, fatigue, and depression.

scholarly journals Association of sedentary behavior with overweight and abdominal obesity in older adults

2019 ◽  
Vol 24 ◽  
pp. 1-7
Author(s):  
Talita Inácio Martins Resende ◽  
Joilson Meneguci ◽  
Jeffer Eidi Sasaki ◽  
Álvaro da Silva Santos ◽  
Renata Damião
Keyword(s):  
Older Adults ◽  
Waist Circumference ◽  
Sedentary Behavior ◽  
Body Mass ◽  
Abdominal Obesity ◽  
The Elderly ◽  
Total Sample ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Behavioral Variables

The aim of this study was to examine the association of sedentary behavior with overweight and abdominal obesity in older adults. This was a cross-sectional study with older men and women residing in the municipalities of the Regional Health Superintendency of Uberaba, Minas Gerais. Sedentary behavior was assessed according to the time spent sitting on a weekday and a weekend day. Body mass, height and waist circumference were measured. Excess weight was determined by means of body mass index, while abdominal obesity by waist circumference. Poisson regression analyzes with robust variance were used to examine the association of sedentary behavior with overweight and abdominal obesity. The total sample consisted of 3223 older people (61.3% women), with a mean age of 70 ± 7.26 years. There was no association between quartiles of sedentary behavior and overweight (2nd quartile: PR = 0.99; 95%CI: 0.94–1.05; 3rd quartile: PR = 0.99; 95%CI: 0.93–1.07; 4th quartile: PR = 1.07; 95%CI: 1.00–1.13) and abdominal obesity (2nd quartile: PR = 1.04; 95%CI: 1.00–1.08; 3rd quartile: PR = 1.03; 95%CI: 0.98–1.08; 4th quartile: PR = 0.98; 95%CI: 0.94–1.03) when analyses were adjusted for sociodemographic, health perception and behavioral variables. The sedentary behavior was not associated with overweight and abdominal obesity in the elderly.

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