Arthritis, Depression, and Falls Among Community-Dwelling Older Adults: Evidence From the Health and Retirement Study

2016 ◽  
Vol 37 (9) ◽  
pp. 1133-1149 ◽  
Author(s):  
Lien T. Quach ◽  
Jeffrey A. Burr
Keyword(s):  
Older Adults ◽  
Health Care Providers ◽  
Community Dwelling ◽  
Health And Retirement Study ◽  
Depression Symptoms ◽  
Care Providers ◽  
Significant Depression ◽  
Nationally Representative ◽  
Clinically Significant ◽  
Retirement Study

The aims of this study were to examine the association between different types of arthritis and falls and to investigate whether clinically significant depression symptoms (CSDS) moderate these relationships. The study used nationally representative data from the 2008 Health and Retirement Study ( n = 7,715, M age = 75, 62% female, and 90% White). Among the respondents, 42% experienced at least one fall during the previous 2 years. About one third had some form of arthritis: 22% osteoarthritis (OA), 4.8% rheumatoid arthritis (RA), 2.3% both OA and RA, and 7.9% with other arthritis types. About one fifth of respondents had CSDS. OA and CSDS are associated with the odds of falling (17% and 29%, respectively), adjusting for socio-demographic characteristics, lifestyle, health conditions, and psychiatric medications. There was no statistically significant interaction between types of arthritis and CSDS. Health care providers should pay attention to managing arthritis, especially OA, and CSDS to prevent falls among older adults.

754 Insomnia and Depression Symptoms in Primary Care Patients Referred for Mental Health Care

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A294-A294
Author(s):  
Ivan Vargas ◽  
Alexandria Muench ◽  
Mark Seewald ◽  
Cecilia Livesey ◽  
Matthew Press ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Primary Care Providers ◽  
Depression Symptoms ◽  
Care Providers ◽  
Mild Depression ◽  
Significant Depression ◽  
Clinically Significant

Abstract Introduction Past epidemiological research indicates that insomnia and depression are both highly prevalent and tend to co-occur in the general population. The present study further assesses this association by estimating: (1) the concurrence rates of insomnia and depression in outpatients referred by their primary care providers for mental health care; and (2) whether the association between depression and insomnia varies by insomnia subtype (initial, middle, and late). Methods Data were collected from 3,174 patients (mean age=42.7; 74% women; 50% Black) who were referred to the integrated care program for assessment of mental health symptoms (2018–2020). All patients completed an Insomnia Severity Index (ISI) and a Patient Health Questionnaire (PHQ-9) during their evaluations. Total scores for the ISI and PHQ-9 were computed. These scores were used to categorize patients into diagnostic groups for insomnia (no-insomnia [ISI < 8], subthreshold-insomnia [ISI 8–14], and clinically-significant-insomnia [ISI>14]) and depression (no-depression [PHQ-914]). Items 1–3 of the ISI were also used to assess the association between depression and subtypes of insomnia. Results Rates of insomnia were as follows: 34.6% for subthreshold-insomnia, 35.5% for clinically-significant insomnia, and 28.9% for mild-depression and 26.9% for clinically-significant-depression. 92% of patients with clinically significant depression reported at least subthreshold levels of insomnia. While the majority of patients with clinical depression reported having insomnia, the proportion of patients that endorsed these symptoms were comparable across insomnia subtypes (percent by subtype: initial insomnia 63%; middle insomnia 61%; late insomnia 59%). Conclusion According to these data, the proportion of outpatients referred for mental health evaluations that endorse treatable levels of insomnia is very high (approximately 70%). This naturally gives rise to at least two questions: how will such symptomatology be addressed (within primary or specialty care) and what affect might targeted treatment for insomnia have on health were it a focus of treatment in general? Support (if any) Vargas: K23HL141581; Perlis: K24AG055602

scholarly journals A Pilot Study to Test the Feasibility of a Home Mobility Monitoring System in Community-Dwelling Older Adults

2019 ◽  
Vol 16 (9) ◽  
pp. 1512 ◽  
Author(s):  
Heesook Son ◽  
Hyerang Kim
Keyword(s):  
Older Adults ◽  
Monitoring System ◽  
Health Care Providers ◽  
Community Dwelling ◽  
Care Providers ◽  
Remote Communication ◽  
Baseline Activity ◽  
Home Based ◽  
Health Related ◽  
Community Dwelling Older Adults

Technology enables home-based personalized care through continuous, automated, real-time monitoring of a participant’s health condition and remote communication between health care providers and participants. Technology has been implemented in a variety of nursing practices. However, little is known about the use of home mobility monitoring systems in visiting nursing practice. Therefore, the current study tested the feasibility of a home mobility monitoring system as a supportive tool for monitoring daily activities in community-dwelling older adults. Daily mobility data were collected for 15 months via home-based mobility monitoring sensors among eight older adults living alone. Indoor sensor outputs were categorized into sleeping, indoor activities, and going out. Atypical patterns were identified with reference to baseline activity. Daily indoor activities were clearly differentiated by sensor outputs and sensor outputs discriminated atypical activity patterns. During the year of monitoring, a health-related issue was identified in a participant. Our findings indicate the feasibility of a home mobility monitoring system for remote, continuous, and automated assessment of a participant’s health-related mobility patterns. Such a system could be used as a supportive tool to detect and intervene in the case of problematic health issues.

scholarly journals Literacy, Numeracy, and Health Information Seeking Among Middle-Aged and Older Adults in the United States

2018 ◽  
Vol 32 (1-2) ◽  
pp. 33-41 ◽  
Author(s):  
Takashi Yamashita ◽  
Anthony R. Bardo ◽  
Darren Liu ◽  
Phyllis A. Cummins
Keyword(s):  
United States ◽  
Older Adults ◽  
Health Literacy ◽  
Health Information ◽  
Health Care Providers ◽  
Information Seeking ◽  
The United States ◽  
Health Information Seeking ◽  
Care Providers ◽  
Nationally Representative

Objectives: Health literacy is often viewed as an essential skill set for successfully seeking health information to make health-related decisions. However, this general understanding has yet to be established with the use of nationally representative data. The objective of this study was to provide the first nationally representative empirical evidence that links health information seeking behaviors with health literacy among middle-age to older adults in the United States. Methods: Data were obtained from the 2012/2014 Program for the International Assessment of Adult Literacy (PIAAC). Our analytic sample is representative of adults age 45 to 74 years ( N = 2,989). Results: Distinct components of health literacy (i.e., literacy and numeracy) were uniquely associated with the use of different health information sources (e.g., health professionals, the Internet, television). Discussion: Findings should be useful for government agencies and health care providers interested in targeting health communications, as well as researchers who focus on health disparities.

scholarly journals MP34: Elder abuse in the emergency department: a systematic scoping review

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S54-S55
Author(s):  
E. Mercier ◽  
A. Nadeau ◽  
A. Brousseau ◽  
M. Emond ◽  
J. Lowthian ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Emergency Department ◽  
Physical Abuse ◽  
Health Care Providers ◽  
Scoping Review ◽  
Elder Abuse ◽  
Community Dwelling ◽  
Screening Tools ◽  
Care Providers

Introduction: This systematic scoping review aims to synthetize the available evidence on the epidemiology, risk factors, clinical characteristics, screening tools, prevention strategies, interventions and knowledge of health care providers regarding elder abuse in the emergency department (ED). Methods: A systematic literature search was performed using three databases (Medline, Embase and Cochrane Library). Grey literature was scrutinized. Studies were considered eligible when they were observational studies or randomized control trials reporting on elder abuse in the prehospital and/or ED setting. Data extraction was performed independently by two researchers and a qualitative approach was used to synthetize the findings. Results: A total of 443 citations were retrieved from which 58 studies published between 1988 and 2018 were finally included. Prevalence of elder abuse following an ED visit varied between 0.01% and 0.03%. Reporting of elder abuse to proper law authorities by ED physicians varied between 2% to 50% of suspected cases. The most common reported type of elder abuse detected was neglect followed by physical abuse. Female gender was the most consistent factor associated with elder abuse. Cognitive impairment, behavioral problems and psychiatric disorder of the patient or the caregiver were also associated with physical abuse and neglect as well as more frequent ED consultations. Several screening tools have been proposed, but ED-based validation is lacking. Literature on prehospital- or ED-initiated prevention and interventions was scarce without any controlled trial. Health care providers were poorly trained to detect and care for older adults who are suspected of being a victim of elder abuse. Conclusion: Elder abuse in the ED is an understudied topic. It remains underrecognized and underreported with ED prevalence rates lower than those in community-dwelling older adults. Health care providers reported lacking appropriate training and knowledge with regards to elder abuse. Dedicated ED studies are required.

Factors influencing older adults to complete advance directives

2010 ◽  
Vol 8 (3) ◽  
pp. 267-275 ◽  
Author(s):  
Gloria J. Alano ◽  
Renee Pekmezaris ◽  
Julia Y. Tai ◽  
Mohammed J. Hussain ◽  
Jose Jeune ◽  
...  
Keyword(s):  
Older Adults ◽  
New York ◽  
Health Care Providers ◽  
Female Gender ◽  
Community Dwelling ◽  
Major Surgery ◽  
Care Providers ◽  
Media Campaigns ◽  
Tertiary Teaching ◽  
Relief Of Suffering

AbstractObjective:The purpose of this study was to determine the factors which influence advance directive (AD) completion among older adults.Method:Direct interviews of hospitalized and community-dwelling cognitively intact patients >65 years of age were conducted in three tertiary teaching settings in New York. Analysis of AD completion focused on its correlation with demographics, personal beliefs, knowledge, attitudes, and exposure to educational media initiatives. We identified five variables with loadings of at least 0.30 in absolute value, along with five demographic variables (significant in the univariate analyses) for multiple logistic regression. The backward elimination method was used to select the final set of jointly significant predictor variables.Results:Of the 200 subjects consenting to an interview, 125 subjects (63%) had completed ADs. In comparing groups with and without ADs, gender (p < 0.0002), age (p < 0.0161), race (p < 0.0001), education (p < 0.0039), and religion (p < 0.0104) were significantly associated with having an AD. Factors predicting AD completion are: thinking an AD will help in the relief of suffering at the end of life, (OR 76.3,p < 0.0001), being asked to complete ADs/ or receiving explanation about ADs (OR 55.2,p < 0.0001), having undergone major surgery (OR 6.3,p < 0.0017), female gender (OR 11.1,p < 0.0001) and increasing age (76–85vs.59–75: OR 3.4,p < 0.0543; <85vs. 59–75: OR 6.3,p < 0.0263).Significance of results:This study suggests that among older adults, the probability of completing ADs is related to personal requests by health care providers, educational level, and exposure to advance care planning media campaigns.

scholarly journals Preparing for the New Normal: Chronicling the Impact of COVID-19 on Older Adults and Providers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 585-585
Author(s):  
Rose Ann DiMaria-Ghalili ◽  
Justine Sefcik
Keyword(s):  
Older Adults ◽  
Health Care Providers ◽  
Healthcare Delivery ◽  
Community Dwelling ◽  
Retirement Community ◽  
Continuing Care ◽  
Care Providers ◽  
New Normal ◽  
Continuing Care Retirement Community ◽  
The Impact

Abstract COVID-19 and social distancing heralded an unprecedented change in the way older adults and health care providers live, work, socialize and manage their health. Early “calls-to-action” included the call for researchers to chronicle the impact of the COVID-19 pandemic on care of older adults to inform models of care and best practices in the new normal. This symposium explores the impact of COVID-19 on the health of older adults across the care continuum and healthcare delivery augmented by technology. The perspectives of older adults living in the community and providers who care for this population are highlighted. Additionally, there is a focus on the most vulnerable, those living in skilled care facilities and continuing care retirement communities. Fisher analyzes the key themes in 37 COVID-19 video communiques over 11 months at a continuing care retirement community. Sefcik explores coping strategies including outdoor activities among community-dwelling older adults. DiMaria-Ghalili examined patterns of physical and mental health, technology usage and loneliness in older adults, including those living in the community and a continuing care retirement community. Using longitudinal data and COVID-19 supplemental survey data from the National Health and Aging Trends Study, Huh-Yoo discusses disparities in online patient-provider communication and implications for the Post-COVID era. Coates discusses the facilitators and barriers perceived by interdisciplinary providers deploying telehealth during the COVID-19 pandemic and implications for healthcare delivery in older adults. The symposium will conclude with a discussion by Dr. Sefcik on the implications for research, practice and policy in the post COVID-19 era.

DECREASED HANDGRIP STRENGTH IS ASSOCIATED WITH IMPAIRMENTS IN EACH AUTONOMOUS LIVING TASK FOR AGING ADULTS IN THE UNITED STATES

2018 ◽  
pp. 1-5
Author(s):  
R. McGrath ◽  
K. M. Erlandson ◽  
B.M. Vincent ◽  
K.J. Hackney ◽  
S.D. Herrmann ◽  
...  
Keyword(s):  
United States ◽  
Health Care Providers ◽  
Handgrip Strength ◽  
The United States ◽  
Grocery Shopping ◽  
Care Providers ◽  
Nationally Representative ◽  
And Performance ◽  
Aging Adults ◽  
Retirement Study

Objectives: The primary purpose of this study was to determine the time-varying associations between decreased handgrip strength (HGS) and individual instrumental activities of daily living (IADL) impairments for a nationally-representative sample of aging adults in the United States. Design: Longitudinal-Panel. Setting: Detailed interviews were completed in person and core interviews were typically completed over the telephone. Participants: A total of 15,336 participants aged at least 50 years who participated in the 2006 wave of the Health and Retirement Study were followed biennially for 8-years. Measurements: A hand-held dynamometer assessed HGS and performance in IADLs were self-reported. Results: Every 5-kilogram decrease in HGS was associated with an increased odds ratio for the following IADL impairments: 1.11 (95% confidence interval (CI): 1.09, 1.13) for using a map, 1.10 (CI: 1.07, 1.12) for grocery shopping, 1.09 (CI: 1.05, 1.14) for taking medications, 1.07 (CI: 1.05, 1.09) for preparing hot meals, 1.06 (CI: 1.04, 1.08) for managing money, and 1.05 (CI: 1.02, 1.09) for using a telephone. Conclusions: Decreased HGS was associated with each IADL impairment, and slightly different associations were observed in individual IADL tasks for aging adults in the United States. Our findings suggest that decreased HGS, which is reflective of reduced function of the neuromuscular system, is associated with diminished performance in autonomous living tasks during aging. Losses in HGS may lead to the development of an IADL impairment. Therefore, health-care providers working with aging adults should utilize measures of HGS as a screening tool for identifying future deficits in neuromuscular functioning. Interventions designed to preserve IADLs in aging adults should also include measures of HGS for detecting early changes in IADL capacity, and intervening at the onset of HGS declines may help aging adults retain their ability to live autonomously.

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