Prevalence of Tympanic Membrane Perforations Among Adolescents, Adults, and Older Adults in the United States

2021 ◽  
pp. 019459982110621
Author(s):  
Alexander S. Kim ◽  
Joshua F. Betz ◽  
Nicholas S. Reed ◽  
Bryan K. Ward ◽  
Carrie L. Nieman
Keyword(s):  
United States ◽  
Older Adults ◽  
Life Course ◽  
Tympanic Membrane ◽  
Population Level ◽  
The United States ◽  
Population Estimates ◽  
Cross Sectional ◽  
Tympanic Membrane Perforations ◽  
The Life Course

Tympanic membrane (TM) perforations can occur at any age, but limited population-level data are available. Using data from the National Health and Nutrition Examination Survey, we performed a cross-sectional analysis of the prevalence and population estimates for TM perforations among individuals ≥12 years old in the United States. Overall, TM perforations have a prevalence of 2.1% (95% CI, 1.7%-2.6%), corresponding to 5.8 million Americans. Across the life course, older adults have the highest prevalence of TM perforations at 6.1% (95% CI, 4.7%-7.6%), corresponding to nearly 3 million Americans, as opposed to a prevalence of 0.6% (95% CI, 0.3%-0.9%) in adolescents, which equates to 0.2 million Americans. Males and females have a similar prevalence at 2.3% (95% CI, 1.6%-3.0%) among males and 2.0% (95% CI, 1.4%-2.6%) among females. These prevalence and population estimates provide the first US-based population estimates of the burden of TM perforations over the life course.

scholarly journals Further decoding the mystery of American pain: The importance of work

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0261891
Author(s):  
David G. Blanchflower ◽  
Alex Bryson
Keyword(s):  
United States ◽  
Life Course ◽  
The Elderly ◽  
The United States ◽  
Cross Sectional ◽  
Wear And Tear ◽  
Educational Groups ◽  
Employment Rates ◽  
The Life Course ◽  
What Matters

A recent paper showed that, whereas we expect pain to rise with age due to accumulated injury, physical wear and tear, and disease, the elderly in America report less pain than those in midlife. Further exploration revealed this pattern was confined to the less educated. The authors called this the ‘mystery of American pain’ since pain appears to rise with age in other countries irrespective of education. Revisiting this issue with the same cross-sectional data we show that what matters in explaining pain through to age 65 is whether one is working or not. The incidence of pain across the life-course is nearly identical for workers in America and elsewhere, but it is greater for non-working Americans than it is for non-workers elsewhere. As in other countries, pain is hump-shaped in age among those Americans out of work but rises a little over the life-course for those in work. Furthermore, these patterns are apparent within educational groups. We show that, if one ascribes age-specific employment rates from other OECD countries to Americans, the age profile of pain in the United States is more similar to that found elsewhere in the OECD. This is because employment rates are lower in the United States than elsewhere between ages 30 and 60: the simulation reduces the pain contribution of these non-workers to overall pain in America, so it looks somewhat similar to pain elsewhere. We conclude that what matters in explaining pain over the life-course is whether one is working or not and once that is accounted for, the patterns are consistent across the United States and the rest of the OECD.

scholarly journals Midlife as a pivotal period in the life course

2014 ◽  
Vol 39 (1) ◽  
pp. 20-31 ◽  
Author(s):  
Margie E. Lachman ◽  
Salom Teshale ◽  
Stefan Agrigoroaei
Keyword(s):  
United States ◽  
Life Course ◽  
Middle Age ◽  
Well Being ◽  
The United States ◽  
Cross Sectional ◽  
Cross Sectional Studies ◽  
The Life Course ◽  
Health And Well Being

We provide evidence for multidirectionality, variability, and plasticity in the nature and direction of change in physical health, cognitive functioning, and well-being during the middle years of the life course. The picture of well-being in midlife based on longitudinal data from the Midlife in the United States (MIDUS) study is a more positive one than portrayed in previous cross-sectional studies. We present middle age as a pivotal period in the life course in terms of balancing growth and decline, linking earlier and later periods of life, and bridging younger and older generations. We highlight the role of protective factors and multisystem resilience in mitigating declines. Those in middle age play a central role in the lives of those who are younger and older at home, in the workplace, and in society at large. Thus, a focus on promoting health and well-being in middle age can have a far-reaching impact.

scholarly journals A Confluence of Policy Inequality: Health Disparities in Old Age Among American Indian and Alaska Native Populations

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 37-37
Author(s):  
Sadie Giles
Keyword(s):  
United States ◽  
Health Disparities ◽  
Life Course ◽  
American Indian ◽  
Old Age ◽  
Alaska Native ◽  
Political History ◽  
The United States ◽  
The Political ◽  
The Life Course

Abstract Racial health disparities in old age are well established, and new conceptualizations and methodologies continue to advance our understanding of health inequality across the life course. One group that is overlooked in many of these analyses, however, is the aging American Indian/Native Alaskan (AI/NA) population. While scholars have attended to the unique health inequities faced by the AI/NA population as a whole due to its discordant political history with the US government, little attention has been paid to unique patterns of disparity that might exist in old age. I propose to draw critical gerontology into the conversation in order to establish a framework through which we can uncover barriers to health, both from the political context of the AI/NA people as well as the political history of old age policy in the United States. Health disparities in old age are often described through a cumulative (dis)advantage framework that offers the benefit of appreciating that different groups enter old age with different resources and health statuses as a result of cumulative inequalities across the life course. Adding a framework of age relations, appreciating age as a system of inequality where people also gain or lose access to resources and status upon entering old age offers a path for understanding the intersection of race and old age. This paper will show how policy history for this group in particular as well as old age policy in the United States all create a unique and unequal circumstance for the aging AI/NA population.

scholarly journals Urban-rural differences in the prevalence of muscle weakness and slow gait speed: A cross-sectional analysis from the NHANES (2001-2002 and 2011-2014)

2021 ◽  
pp. 1-7
Author(s):  
J.J. Aziz ◽  
K.F. Reid ◽  
J.A. Batsis ◽  
R.A. Fielding
Keyword(s):  
United States ◽  
Older Adults ◽  
Grip Strength ◽  
Muscle Weakness ◽  
Rural Areas ◽  
Gait Speed ◽  
The United States ◽  
Cross Sectional ◽  
Comorbidity Burden ◽  
Urban Rural

Background: Older adults living in rural areas suffer from health inequities compared to their urban counterparts. These include comorbidity burden, poor diet, and physical inactivity, which are also risk factors for sarcopenia, for which muscle weakness and slow gait speed are domains. To date, no study has examined urban-rural differences in the prevalence of muscle weakness and slow gait speed in older adults living in the United States. Objective: To compare the prevalence of grip strength weakness and slow gait speed between urban and rural older adults living in the United States. Design: A cross-sectional, secondary data analysis of two cohorts from the National Health and Nutrition Examination Survey (NHANES), using gait speed or grip strength data, and urban-rural residency, dietary, examination, questionnaire and demographic data. Participants: 2,923 adults (≥ 60 yrs.). Measures: Grip weakness was defined as either, an absolute grip strength of <35 kg. and <20 kg. or grip strength divided by body mass index (GripBMI) of <1.05 and <0.79 for men and women, respectively. Slow gait speed was defined as a usual gait speed of ≤0.8m/s. Results: The prevalence of GripBMI weakness was significantly higher in urban compared to rural participants (27.4% vs. 19.2%; p=0.001), whereas their absolute grip strength was lower (31.75(±0.45) vs. 33.73(±0.48)). No urban-rural differences in gait speed were observed. Conclusions: Older adults residing in urban regions of the United States were weaker compared to their rural counterparts. This report is the first to describe urban-rural differences in handgrip strength and slow gait speed in older adults living in the United States.

scholarly journals Education-Related Inequalities in Dental Services Use among Older Adults in 23 Countries

2020 ◽  
Vol 99 (12) ◽  
pp. 1341-1347
Author(s):  
F. Bof de Andrade ◽  
J.L.F. Antunes ◽  
F.C.D. Andrade ◽  
M.F.F. Lima-Costa ◽  
J. Macinko
Keyword(s):  
United States ◽  
Older Adults ◽  
South Korea ◽  
The United States ◽  
Self Report ◽  
Absolute Difference ◽  
Dental Services ◽  
Cross Sectional ◽  
Relative Index ◽  
Index Of Inequality

This study aimed to measure the magnitude of education-related inequalities in the use of dental services among older adults (aged 50 y or older) from a sizable multicountry sample of 23 upper-middle- and high-income countries. This study used cross-sectional data from nationally representative surveys of people aged 50 y and over. Countries included in the Health and Retirement Study surveys were the following: Brazil, China, South Korea, Mexico, United States, Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, France, Germany, Greece, Italy, Israel, Luxembourg, Poland, Portugal, Slovenia, Spain, Sweden, and Switzerland. The dependent variable was the use of dental services, based on the self-report of having had a dental visit within the previous year, except for the United States and South Korea, which used 2-y recall periods. Educational level was used as the measure of socioeconomic position and was standardized across countries. Multivariate logistic regression modeling was used to evaluate the factors associated with the use of dental services, and the magnitude of education inequalities in the use of dental services was assessed using the slope index of inequality (SII) to measure absolute inequalities and the relative index of inequality for relative inequalities. The pooled prevalence of the use of dental services was 31.7% and ranged from 18.7% in China to 81.2% in Sweden. In the overall sample, the absolute difference in the prevalence of use between the lowest and highest educational groups was 20 percentage points. SII was significant for all countries except Portugal. Relative educational inequalities were significant for all countries and ranged from 3.2 in Poland to 1.2 in Sweden. There were significant education-related inequalities in the use of dental care by older adults in all countries. Monitoring these inequalities is critical to the planning and delivery of dental services.

scholarly journals Acceptability and Results of Dementia Screening Among Older Adults in the United States

2017 ◽  
Vol 15 (1) ◽  
pp. 51-55 ◽  
Author(s):  
Amanda Harrawood ◽  
Nicole R. Fowler ◽  
Anthony J. Perkins ◽  
Michael A. LaMantia ◽  
Malaz A. Boustani
Keyword(s):  
United States ◽  
Older Adults ◽  
Primary Care ◽  
The United States ◽  
Cognitive Screening ◽  
Cross Sectional ◽  
Community Screening ◽  
Positive Screen ◽  
Dementia Screening ◽  
Primary Care Patients

Objectives: To measure older adults acceptability of dementia screening and assess screening test results of a racially diverse sample of older primary care patients in the United States. Design: Cross-sectional study of primary care patients aged 65 and older. Setting: Urban and suburban primary care clinics in Indianapolis, Indiana, in 2008 to 2009. Participants: Nine hundred fifty-four primary care patients without a documented diagnosis of dementia. Measurements: Community Screening Instrument for Dementia, the Mini-Mental State Examination, and the Telephone Instrument for Cognitive Screening. Results: Of the 954 study participants who consented to participate, 748 agreed to be screened for dementia and 206 refused screening. The overall response rate was 78.4%. The positive screen rate of the sample who agreed to screening was 10.2%. After adjusting for demographic differences the following characteristics were still associated with increased likelihood of screening positive for dementia: age, male sex, and lower education. Patients who believed that they had more memory problems than other people of their age were also more likely to screen positive for dementia. Conclusion: Age and perceived problems with memory are associated with screening positive for dementia in primary care.

scholarly journals Endogenous Selection Bias and Cumulative Inequality over the Life Course: Evidence from Educational Inequality in Subjective Well-Being

2020 ◽  
Vol 36 (3) ◽  
pp. 333-350
Author(s):  
Fabian Kratz ◽  
Alexander Patzina
Keyword(s):  
United States ◽  
Panel Data ◽  
Life Course ◽  
Panel Study ◽  
Well Being ◽  
The United States ◽  
Subjective Well Being ◽  
Interviewer Effects ◽  
Endogenous Selection ◽  
The Life Course

Abstract According to theories of cumulative (dis-)advantage, inequality increases over the life course. Labour market research has seized this argument to explain the increasing economic inequality as people age. However, evidence for cumulative (dis-)advantage in subjective well-being remains ambiguous, and a prominent study from the United States has reported contradictory results. Here, we reconcile research on inequality in subjective well-being with theories of cumulative (dis-)advantage. We argue that the age-specific endogenous selection of the (survey) population results in decreasing inequalities in subjective well-being means whereas individual-level changes show a pattern of cumulative (dis-)advantage. Using repeated cross-sectional data from the European Social Survey (N = 15,252) and employing hierarchical age-period-cohort models, we replicate the finding of decreasing inequality from the United States with the same research design for Germany. Using panel data from the German Socio-Economic Panel Study (persons = 47,683, person-years = 360,306) and employing growth curve models, we show that this pattern of decreasing inequality in subjective well-being means is accompanied by increasing inequality in intra-individual subjective well-being changes. This pattern arises because disadvantaged groups, such as the low educated and individuals with low subjective well-being show lower probabilities of continuing to participate in a survey and because both determinants reinforce each other. In addition to allowing individual changes and attrition processes to be examined, the employed multi-cohort panel data have further key advantages for examining inequality in subjective well-being over the life course: They require weaker assumptions to control for period and cohort effects and make it possible to control for interviewer effects that may influence the results.

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