Health Shocks and Initiation of Use of Preventive Services Among Older Adults

This article examines whether adverse changes to health or functioning serve as an impetus to begin using preventive services among older individuals with a history of non-use. Using data from the 1998-2008 Health and Retirement Study, the use of mammograms, pap smears, prostate cancer screenings, cholesterol checks, and flu shots is examined among 2,975 self-reported non-users of such services. Older women who experience a health shock are 1.86, 1.50, 1.79, and 1.46 times more likely to begin getting mammograms, pap smears, cholesterol checks, and flu shots, respectively. Older men who experience a health shock are 2.24, 2.72, and 1.64 times more likely to begin getting prostate cancer screenings, cholesterol checks, and flu shots, respectively. All of these results are statistically significant. Thus, older adults often improve their health behaviors after experiencing an adverse health event.

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Effects of Medicare Coverage of a “Welcome-to-Medicare” Visit on Use of Preventive Services among New Medicare Enrollees

Journal of Aging Research ◽

10.1155/2017/2074810 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 1

Author(s):

Boon Peng Ng ◽

Gail A. Jensen ◽

Heather Fritz

Keyword(s):

Prostate Cancer ◽

Physical Examination ◽

Preventive Services ◽

Pap Smears ◽

Logit Models ◽

Medicare Beneficiaries ◽

Policy Makers ◽

Men And Women ◽

Cancer Screenings ◽

Retirement Study

In January 2005, Medicare began covering a one-time initial preventive physical examination (IPPE), also called a “Welcome-to-Medicare” visit, during a beneficiary’s first 6 months under Part B. This paper examines the effects of offering Medicare IPPE coverage on the use of mammograms, breast self-exams, Pap smears, prostate cancer screenings, cholesterol screenings, and flu vaccines among beneficiaries new to Part B. We adopt a difference-in-difference estimator and estimate a set of multivariate logit models to quantify the effects of introducing Medicare IPPE coverage on the use of preventive services. Models are estimated separately for men and women. Data for the analysis come from the 1996–2008 Health and Retirement Study. Among both men and women, having coverage for a one-time IPPE under Medicare had no effects on the utilization of any of the preventive services listed above. In this study, we find that offering coverage for a one-time IPPE under Medicare was insufficient to spur greater use of preventive services among new Medicare beneficiaries. These findings are important and suggest that policy-makers may need to consider other approaches to increase the use of recommended preventive services.

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Discontinuing Cancer Screening for Older Adults: a Comparison of Clinician Decision-Making for Breast, Colorectal, and Prostate Cancer Screenings

Journal of General Internal Medicine ◽

10.1007/s11606-021-07121-9 ◽

2021 ◽

Author(s):

Justine P. Enns ◽

Craig E. Pollack ◽

Cynthia M. Boyd ◽

Jacqueline Massare ◽

Nancy L. Schoenborn

Keyword(s):

Prostate Cancer ◽

Older Adults ◽

Decision Making ◽

Cancer Screening ◽

Cancer Screenings

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Association of schistosomiasis and risk of prostate cancer development in residents of Murehwa rural community, Zimbabwe

Infectious Agents and Cancer ◽

10.1186/s13027-020-00327-2 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Emilia T. Choto ◽

Takafira Mduluza ◽

Francisca Mutapi ◽

Moses J. Chimbari

Keyword(s):

Prostate Cancer ◽

Prostate Specific Antigen ◽

Specific Antigen ◽

Infection Intensity ◽

Public Health Problem ◽

Sub Saharan Africa ◽

Cancer Development ◽

Older Individuals ◽

Prostate Cancer Development ◽

History Of

Abstract Background Prostatic male genital schistosomiasis and prostate cancer co-existence cases are uncommon however, some studies have indicated that schistosomiasis may trigger development of prostate cancer regardless of age. Schistosomiasis is a public health problem in sub-Saharan Africa and may account for some undocumented cases of schistosomiasis prostatic cancer in schistosome endemic rural communities. It is against this background that we investigated the association between schistosomiasis and risk of prostate cancer development in residents of Murehwa Community, a schistosomiasis endemic area. Methodology We conducted a cross sectional study involving 366 men residing in Murehwa District, Zimbabwe. Schistosoma haematobium and S. mansoni infection was diagnosed using urine filtration and Kato Katz techniques, respectively. Haematuria was detected using urinalysis reagent strip test. A structured questionnaire was used to obtain history of schistosomiasis infection among study participants. Risk of prostate cancer development was assessed by measuring prostate-specific antigen levels in serum using the ELISA. Results Prevalence of S. haematobium and S. mansoni infection was 12.3% and 1.4%, respectively. Individuals with schistosomiasis had higher prostate-specific antigen levels (mean 1.208 ± SD 1.557 ng/mL) compared to those without schistosomiasis (mean 0.7721 ± SD 1.173 ng/mL; p < 0.05). Older individuals > 50 years had higher prostate specific antigen levels (mean 0.7212 ± SD 1.313 ng/mL) compared to individuals < 50 years old (mean 0.4159 ± SD 0.8622 ng/mL; p < 0.05). Prostate-specific antigen levels log10 (mean 0.2584 ± SD 0.2128 ng/mL) and were associated to S. haematobium infection intensity log10 (mean 1.121 ± SD 0.5371 eggs/10 mL), r(s) = − 0.3225, p < 0.05. There was a correlation between prostate-specific antigen levels log10 (mean 0.2246 ± SD 0.1858 ng/mL) and S. haematobium infection intensity log10 (mean 1.169 ± SD 0.5568 eggs/10 mL) among participants with a history of schistosomiasis infection (r(s) = − 0.3520; p < 0.05). There was no correlation between prostate-specific antigen levels of > 4 ng/mL (mean 5.324 ± SD1.568 ng/mL) and schistosome eggs log10 (mean 1.057 ± SD 0.6730 eggs/10 mL; p > 0.05). Conclusion Urogenital schistosome infections and history of schistosome infections were associated with prostate specific antigen levels, an indicator for risk of prostate cancer. Therefore, S. haematobium schistosome egg burden was associated with the risk of prostate cancer development in adult males residing in Murehwa District, Zimbabwe.

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Association of Type 1 Diabetes and Hypoglycemic and Hyperglycemic Events and Risk of Dementia

Neurology ◽

10.1212/wnl.0000000000012243 ◽

2021 ◽

pp. 10.1212/WNL.0000000000012243

Author(s):

Rachel A. Whitmer ◽

Paola Gilsanz ◽

Charles P. Quesenberry ◽

Andrew J. Karter ◽

Mary E. Lacy

Keyword(s):

Older Adults ◽

Type 1 Diabetes ◽

Healthcare Delivery ◽

Severe Hypoglycemia ◽

Older Individuals ◽

Healthcare Delivery System ◽

Dementia Risk ◽

History Of ◽

Cox Proportional Hazard Models

Objective:To determine whether severe hypoglycemic and hyperglycemic events are associated with longitudinal dementia risk in older adults with type 1 diabetes.Methods:A longitudinal cohort study followed 2,821 members of an integrated healthcare delivery system with type 1 diabetes from 1997-2015. Hypoglycemic and hyperglycemic events requiring emergency room or hospitalization were abstracted from medical records beginning 1/1/1996 through cohort entry. Participants were followed for dementia diagnosis through 9/30/2015. Dementia risk was examined using Cox proportional hazard models adjusted for age (as timescale), sex, race/ethnicity, HbA1c, depression, stroke, and nephropathy.Results:Among 2,821 older adults (mean age 56) with type 1 diabetes, 398 (14%) had a history of severe hypoglycemia, 335 (12%) severe hyperglycemia and 87 (3%) both. Over a mean 6.9 years of follow-up, 153 individuals (5.4%) developed dementia. In fully adjusted models, individuals with hypoglycemic events had 66% greater risk of dementia than those without a hypoglycemic event (HR=1.66; 95% CI: 1.09, 2.53), while those with hyperglycemic events had >2 times the risk (HR=2.11; 95% CI: 1.24, 3.59) than those without a hyperglycemic event. There was a 6-fold greater risk of dementia in individuals with both severe hypoglycemia and hyperglycemia versus those with neither (HR=6.20; 95% CI: 3.02, 12.70).Conclusions:For older individuals with type 1 diabetes, severe hypoglycemic and hyperglycemic events are associated with increased future risk of dementia.

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Physical Activity and Successful Aging in Canadian Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.17.2.223 ◽

2009 ◽

Vol 17 (2) ◽

pp. 223-235 ◽

Cited By ~ 54

Author(s):

Joseph Baker ◽

Brad A. Meisner ◽

A. Jane Logan ◽

Ann-Marie Kungl ◽

Patricia Weir

Keyword(s):

Physical Activity ◽

Older Adults ◽

Successful Aging ◽

Canadian Community Health Survey ◽

Older Individuals ◽

Physically Active ◽

Community Health Survey ◽

Using Data ◽

Demographic Covariates ◽

The Relationship

Rowe and Kahn (1987) proposed that successful aging is the balance of three components: absence of disease and disease-related disability, high functional capacity, and active engagement with life. This study examines the relationship between physical activity involvement and successful aging in Canadian older adults using data from the Canadian Community Health Survey, cycle 2.1 (N= 12,042). Eleven percent of Canadian older adults were aging successfully, 77.6% were moderately successful, and 11.4% were unsuccessful according to Rowe and Kahn’s criteria. Results indicate that physically active respondents were more than twice as likely to be rated as aging successfully, even after removing variance associated with demographic covariates. These findings provide valuable information for researchers and practitioners interested in age-specific interventions to improve older individuals’ likelihood of aging successfully.

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Prevalence and incidence of possible vascular dementia among Mexican older adults: Analysis of the Mexican Health and Aging Study

PLoS ONE ◽

10.1371/journal.pone.0253856 ◽

2021 ◽

Vol 16 (7) ◽

pp. e0253856

Author(s):

Sara G. Yeverino-Castro ◽

Silvia Mejía-Arango ◽

Alberto J. Mimenza-Alvarado ◽

Carlos Cantú-Brito ◽

José A. Avila-Funes ◽

...

Keyword(s):

Older Adults ◽

Vascular Dementia ◽

The Elderly ◽

Cognitive Domains ◽

Aging Study ◽

History Of ◽

Incident Rate ◽

Using Data ◽

Age And Sex

Introduction Vascular dementia is the second most common cause of dementia. Physical disability and cognitive impairment due to stroke are conditions that considerably affect quality of life. We estimated the prevalence and incidence of possible vascular dementia (PVD) in older adults using data from the Mexican Health and Aging Study (MHAS 2012 and 2015 waves). Methods The MHAS is a representative longitudinal cohort study of Mexican adults aged ≥50 years. Data from 14, 893 participants from the 2012 cohort and 14,154 from the 2015 cohort were analyzed to estimate the prevalence and incidence of PVD. Self-respondents with history of stroke were classified as PVD if scores in two or more cognitive domains in the Cross-Cultural Cognitive Examination were ≥ 1.5 standard deviations below the mean on reference norms and if limitations in ≥ 1 instrumental activities of daily living were present. For proxy respondents with history of stroke, we used a score ≥3.4 on the Informant Questionnaire on Cognitive Decline in the Elderly. Crude and standardized rates of prevalent and incident PVD were estimated. Results Prevalence of PVD was 0.6% (95% CI, 0.5–0.8) (0.5 with age and sex- standardization). Rates increased with age reaching 2.0% among those aged 80 and older and decreased with educational attainment. After 3.0 years of follow-up, 87 new cases of PVD represented an overall incident rate of 2.2 (95% CI, 1.7–2.6) per 1,000 person-years (2.0 with age and sex- standardization). Incidence also increased with advancing age reaching an overall rate of 9.4 (95% CI, 6.3–13.6) per 1,000 person-years for participants aged >80 years. Hypertension and depressive symptoms were strong predictors of incident PVD. Conclusion These data provide new estimates of PVD prevalence and incidence in the Mexican population. We found that PVD incidence increased with age. Males aged 80 years or older showed a greater incidence rate when compared to females, which is comparable to previous estimates from other studies.

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Perceived Voice Disorders in Older Adults and Impact on Social Interactions

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2020_persp-20-00059 ◽

2021 ◽

pp. 1-8

Author(s):

Connie K. Porcaro ◽

Clare Singer ◽

Boris Djokic ◽

Ali A. Danesh ◽

Ruth Tappen ◽

...

Keyword(s):

Older Adults ◽

Social Interactions ◽

Social Engagement ◽

Leisure Activities ◽

Treatment Strategies ◽

Voice Disorders ◽

Community Dwelling ◽

Vocal Performance ◽

Older Individuals ◽

Cross Sectional

Purpose Many aging individuals, even those who are healthy, report voice changes that can impact their ability to communicate as they once did. While this is commonly reported, most do not seek evaluation or management for this issue. The purpose of this study was to investigate the prevalence and differences in voice disorders in older adults, along with the effect of fatigue on their social interactions. Method This is a cross-sectional investigation of a community-dwelling sample of individuals aged 60 years or older. Participants completed the Questionnaire on Vocal Performance, the Social Engagement Index subset “Engagement in Social or Leisure Activities,” and the Fatigue Severity Scale. Results Results indicated 32.5% of the 332 participants reported symptoms of voice problems with no difference found between male and female respondents. A slight increase in report of voice problems was noted with each year of age. Participants who self-reported voice problems indicated less interaction in social activities involving communication than those who did not. Finally, as severity of self-reported voice problems increased, an increase was reported by the same individuals for signs of fatigue. Conclusions Voice problems and resulting decreased social interaction are commonly experienced by older individuals. Voice symptoms in older adults have been found to benefit from evidence-based treatment strategies. It is critical to provide education to encourage older individuals to seek appropriate evaluation and management for voice issues through a speech-language pathologist or medical professional.

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