Relationships Between Neighborhood Social Capital and The Occurrence of Outdoor Falls in Canadian Older Adults: A Multilevel Analysis

Objective: The aim of this study was to examine whether neighborhood-level social capital is a risk factor for falls outside of the home in older adults. Methods: Health questionnaires were completed by community-dwelling Canadians aged +65 years living in Kingston (Ontario) and St-Hyacinthe (Quebec), supplemented by neighborhood-level census data. Multilevel logistic regression models with random intercepts were fit. Variations in the occurrence of falls across neighborhoods were quantified by median odds ratio and 80% interval odds ratio. Results: Between-neighborhood differences explained 7% of the variance in the occurrence of falls; this variance decreased to 2% after adjustment for neighborhood-level variables. In the fully adjusted models, higher levels of social capital increased the odds of falls by almost 2 times: (odds ratio [OR] = 2.10, 95% confidence interval [CI] = [1.19, 3.71]). Discussion: Living in neighborhoods with higher levels of social capital was associated with higher risk of falling in older adults, possibly through more involvement in social activities.

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Effects of Older Adult Driving Resumption on All-Cause Mortality

The Journals of Gerontology Series B ◽

10.1093/geronb/gbz058 ◽

2019 ◽

Vol 75 (10) ◽

pp. 2263-2267

Author(s):

Kendra L Ratnapradipa ◽

Jing Wang ◽

Marla Berg-Weger ◽

and Mario Schootman

Keyword(s):

Logistic Regression ◽

Older Adult ◽

Mortality Risk ◽

Odds Ratio ◽

Regression Models ◽

Adjusted Odds Ratio ◽

Community Dwelling ◽

Driving Cessation ◽

Logistic Regression Models ◽

All Cause Mortality

Abstract Objectives Driving cessation is associated with adverse social and health outcomes including increased mortality risk. Some former drivers resume driving. Do resumed drivers have a different mortality risk compared to former drivers or continued drivers? Method We analyzed National Health and Aging Trends Study (2011–2015) data of community-dwelling self-responding ever drivers (n = 6,189) with weighted stratified life tables and discrete time logistic regression models to characterize mortality risk by driving status (continued, resumed, former), adjusting for relevant sociodemographic and health variables. Results Overall, 14% (n = 844) of participants died and 52% (n = 3,209) completed Round 5. Former drivers had the highest mortality (25%), followed by resumed (9%) and continued (6%) drivers. Former drivers had 2.4 times the adjusted odds of mortality compared with resumed drivers (adjusted odds ratio [aOR] = 2.41; 95% confidence interval [CI] = 1.51, 3.83), with no difference between continued and resumed drivers (aOR = 1.22; 95% CI = 0.74, 1.99). Discussion Those who resumed driving had better survival than those who did not. Practice implications include driver rehabilitation and retraining to safely promote and prolong driving.

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Association of Neighborhood Social Capital With Quality of Life Among Older People in Singapore

Journal of Aging and Health ◽

10.1177/0898264319857990 ◽

2019 ◽

Vol 32 (7-8) ◽

pp. 841-850 ◽

Cited By ~ 1

Author(s):

Anna P. Lane ◽

Chek Hooi Wong ◽

Špela Močnik ◽

Siqi Song ◽

Belinda Yuen

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Social Capital ◽

Social Cohesion ◽

Well Being ◽

Cognitive Status ◽

Community Dwelling ◽

Neighborhood Social Capital ◽

Community Dwelling Older Adults

Objective: To examine how neighborhood-based cognitive and structural social capital are associated with individual quality of life among a sample of community-dwelling older adults in Singapore. Method: Using survey data from 981 older adults (aged 55 years and above) in nine residential neighborhoods, multilevel models simultaneously estimated the effects of independent variables at the individual and neighborhood levels on quality of life (CASP-12). Results: Social cohesion (β = 1.39, p < .01) and associational membership (β = 19.16, p < .01) were associated with higher quality of life in models adjusted for neighborhood facilities and individual sociodemographics, social networks, functional limitations, global cognitive status, and medical conditions. Discussion: The results suggest that place-based or neighborhood social capital may be important for older person’s well-being. It identifies the contribution of structural (associational membership) and cognitive (social cohesion) social capital to the well-being of community-dwelling older adults in Singapore.

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Mild parkinsonian signs, energy decline, and striatal volume in community-dwelling older adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glab150 ◽

2021 ◽

Author(s):

Qu Tian ◽

Rebecca Ehrenkranz ◽

Andrea L Rosso ◽

Nancy W Glynn ◽

Lana M Chahine ◽

...

Keyword(s):

Older Adults ◽

Regression Models ◽

Rating Scale ◽

Gray Matter Volume ◽

Energy Levels ◽

Community Dwelling ◽

Linear Regression Models ◽

Logistic Regression Models ◽

Body Composition Study ◽

Using Data

Abstract Background Mild Parkinsonian Signs (MPS), highly prevalent in older adults, predict disability. It is unknown whether energy decline, a predictor of mobility disability, is also associated with MPS. We hypothesized that those with MPS had greater decline in self-reported energy levels (SEL) than those without MPS, and that SEL decline and MPS share neural substrates. Methods Using data from the Health, Aging and Body Composition Study, we analyzed 293 Parkinson’s Disease-free participants (83±3 years old, 39% Black, 58% women) with neuroimaging data, MPS evaluation by Unified Parkinson Disease Rating Scale in 2006-2008, and ≥ 3 measures of SEL since 1999-2000. Individual SEL slopes were computed via linear mixed models. Associations of SEL slopes with MPS were tested using logistic regression models. Association of SEL slope with volume of striatum, sensorimotor, and cognitive regions were examined using linear regression models adjusted for normalized total gray matter volume. Models were adjusted for baseline SEL, mobility, demographics, and comorbidities. Results Compared to those without MPS (n=165), those with MPS (n=128) had 37% greater SEL decline in the prior eight years (p=0.001). Greater SEL decline was associated with smaller right striatal volume (adjusted standardized β=0.126, p=0.029). SEL decline was not associated with volumes in other regions. The association of SEL decline with MPS remained similar after adjustment for right striatal volume (adjusted OR=2.03, 95% CI: 1.16 - 3.54). Conclusion SEL decline may be faster in those with MPS. Striatal atrophy may be important for declining energy but does not explain the association with MPS.

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The association between loneliness and medication use in older adults

Age and Ageing ◽

10.1093/ageing/afaa177 ◽

2020 ◽

Author(s):

Manav V Vyas ◽

Jennifer A Watt ◽

Amy Y X Yu ◽

Sharon E Straus ◽

Moira K Kapral

Keyword(s):

Older Adults ◽

Odds Ratio ◽

Regression Models ◽

Healthy Aging ◽

Multinomial Logistic Regression ◽

Medication Use ◽

Opioid Analgesics ◽

Adverse Outcomes ◽

University Of California ◽

Logistic Regression Models

Abstract Background Loneliness is common in older adults, and it is associated with unhealthy behaviours, including substance use. We evaluated the association between loneliness and self-reported use of opioids and benzodiazepines in older adults. Methods We used data from the Canadian Community Health Survey’s ‘Healthy Aging’ sub-survey and included adults 65 years or older who administered their own medications. We classified individuals as lonely if they scored 6 or more on the three -item University of California, Los Angeles’s Loneliness Scale. We used multinomial logistic regression models, adjusting for demographics and self-reported comorbidities, to describe the association between loneliness and daily or occasional use of opioids, benzodiazepines and non-opioid analgesics. We also explored the association between loneliness and polypharmacy. Results Our cohort included 15,302 older adults, of whom 2,096 (13.7%) were classified as lonely. Daily use of opioids (4.1%) and benzodiazepines (1.7%) were less common than daily use of non-opioid analgesics (33.9%). Lonely older adults had higher daily use of opioids (odds ratio [OR] 1.61, 1.31-1.98) and benzodiazepines (OR 1.66, 1.21-2.28), but not non-opioid analgesics (OR 1.05, 0.92-1.19). Loneliness was not associated with occasional use of opioids, benzodiazepines or non-opioid analgesics in older adults, but was associated with polypharmacy (OR 1.27, 1.06-1.52). Conclusions Loneliness in older adults is associated with increased daily use of opioids and benzodiazepines. Further research should evaluate patient- and physician-level factors that mediate this association, and develop strategies to mitigate loneliness and its attendant adverse outcomes.

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Pain as a Risk Factor for Loneliness Among Older Adults

Journal of Aging and Health ◽

10.1177/0898264317721348 ◽

2017 ◽

Vol 30 (9) ◽

pp. 1450-1461 ◽

Cited By ~ 8

Author(s):

Kerstin Emerson ◽

Ian Boggero ◽

Glenn Ostir ◽

Jayani Jayawardhana

Keyword(s):

Older Adults ◽

Regression Models ◽

Functional Decline ◽

Premature Mortality ◽

Community Dwelling ◽

Logistic Regression Models ◽

Community Dwelling Older Adults ◽

Retirement Study ◽

Time Point

Objective: The objective of this is to examine whether pain is associated with the onset of loneliness in a sample of community-dwelling older adults. Methods: We used data from the 2008 and 2012 Health and Retirement Study. We limited the sample to community-dwelling persons aged 60 years and over who were not lonely in 2008 in order to predict the risk of onset of loneliness (incidence) in 2012. Our analytic sample included 1,563 observations. Results: Approximately 31.7% of participants reported loneliness at follow-up (2012). Logistic regression models showed that the odds of loneliness onset was 1.58 higher for those with pain at both time points, compared with those who had pain at neither time point, even after controlling for other covariates. Discussion: The results indicate that pain may increase the risk of loneliness in older adults. This suggests that appropriate pain interventions could prevent future loneliness, which in turn could prevent functional decline, disability, and premature mortality.

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Assessment of Neck Grasp as a Screening Tool for Identifying Obstructive Sleep Apnea in Community-Dwelling Older Adults

Journal of Primary Care & Community Health ◽

10.1177/2150132720984421 ◽

2020 ◽

Vol 11 ◽

pp. 215013272098442

Author(s):

Oscar H. Del Brutto ◽

Robertino M. Mera ◽

Bettsy Y. Recalde ◽

Pablo R. Castillo

Keyword(s):

Older Adults ◽

Obstructive Sleep Apnea ◽

Logistic Regression ◽

Sleep Apnea ◽

Predictive Value ◽

Regression Models ◽

Community Dwelling ◽

Logistic Regression Models ◽

Obstructive Sleep ◽

Community Dwelling Older Adults

Background Inability to encircle the neck by hands (neck grasp) has been proposed as an indicator of obstructive sleep apnea (OSA) that would be useful for recognition of candidates for polysomnography (PSG). We assessed the value of neck grasp for predicting OSA in community-dwelling older adults of Amerindian ancestry. Methods Neck grasp was evaluated in individuals aged ≥60 years undergoing PSG. The association between neck grasp and OSA was assessed by logistic regression models adjusted for relevant covariates. Mediation analysis was used to establish the proportion of the effect of the association between neck grasp and OSA, which is mediated by the neck circumference (a well-known OSA biomarker). Receiver operator characteristics curve analysis was used to estimate diagnostic accuracy of neck grasp for predicting OSA. Results Of 201 individuals undergoing PSG, 167 (83%) had the neck grasp test. The remaining 34 could not perform the test because of different factors. Neck grasp was positive in 127 (76%) cases, and 114 (68%) individuals had OSA (apnea-hypopnea index ≥5). Multivariate logistic regression models disclosed a significant association between neck grasp and OSA. The neck circumference was the single covariate remaining independently significant in these models. Neck grasp was not efficient at predicting OSA (sensitivity: 83.3%, specificity: 39.6%, positive predictive value: 0.75 and negative predictive value: 0.53). The area under the curve disclosed only a moderate predictive capability (61.5%) of neck grasp. Conclusion Results do not support the use of neck grasp as an independent predictor of OSA in the study population.

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Longitudinal Relationships Between Favorite Activities and Homebound Status in Older Adults

Innovation in Aging ◽

10.1093/geroni/igaa057.1603 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 496-496

Author(s):

Xiaocao Sun ◽

Minhui Liu ◽

Christina Miyawaki ◽

Yuxiao Li ◽

Tianxue Hou ◽

...

Keyword(s):

Older Adults ◽

Logistic Regression ◽

Regression Models ◽

Community Dwelling ◽

Logistic Regression Models ◽

New Information ◽

Homebound Older Adults ◽

Watching Tv ◽

Community Dwelling Older Adults ◽

Longitudinal Relationships

Abstract Favorite activities are usually meaningful to older adults and may influence their homebound status and vice versa. Using Round 1 (R1, in 2011) and Round 5 (R5, in 2015) data from the National Health and Aging Trends Study, we examined the patterns of favorite activity by homebound status and investigated their relationship among community-dwelling older adults (N=3,332). Homebound status (non-homebound, semi-homebound, and homebound) was determined by the frequency, difficulty, and needing help of outdoor mobility. Favorite activities were named by participants verbatim and then were classified into two categories (active and non-active) based on the estimated energy needed to perform the activity. Logistic regression models were used to determine whether homebound status at R1 predicted the types of favorite activity in R5, and ordinal logistic regression models for predictions from the types of favorite activity at R1 to homebound status at R5, adjusting for demographics and health conditions. The sample was, on average, 76±7.23 years old, non-Hispanic White (72.9%), and female (59.7%). Regardless of the homebound status, reading and walking are the top two favorite activities. Homebound older adults enjoyed “non-active” activities (e.g., watching TV), while non-homebound counterparts preferred “active” outdoor maintenance. Being homebound at R1 predicted non-active favorite activity in R5 (OR=.257, p<0.001), and R1 non-active favorite activity also predicted homebound status in R5 (OR=1.219, p =0.039). These findings provide new information on the activity preferences of older adults with different homebound status and how their preferences may influence their future homebound status.

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Conceptualizing Food Insecurity Among Older Adults: Development of a Summary Indicator in the National Health and Aging Trends Study

The Journals of Gerontology Series B ◽

10.1093/geronb/gbaa147 ◽

2020 ◽

Author(s):

Emma L Tucher ◽

Tamra Keeney ◽

Alicia J Cohen ◽

Kali S Thomas

Keyword(s):

Social Support ◽

Older Adults ◽

Food Insecurity ◽

National Health ◽

Regression Models ◽

Functional Limitations ◽

Community Dwelling ◽

Financial Barriers ◽

Logistic Regression Models ◽

The Impact

Abstract Objectives Measurement of food insecurity in older adults is focused on financial barriers to food access. Given that older adults are particularly susceptible to additional access-related barriers including functional limitations and lack of social support, the objective of this study was to construct a summary indicator of food insecurity incorporating these domains. Methods We used nationally representative survey data from Round 5 of the National Health and Aging Trends Study (NHATS; n = 7,070). We constructed a summary indicator of food insecurity using factors within the following three domains: functional, social support, and financial limitations. First, we identified the prevalence of food insecurity among the sample as defined by the new summary indicator. Then, we estimated unadjusted and adjusted logistic regression models to assess the association between the expanded measure of food insecurity and biopsychosocial factors. Results In 2015, 4.3% (95% confidence interval [CI] 3.75–4.94) of community-dwelling older adults, approximately 1,673,775 million people, were characterized as having food insecurity. Multivariable-adjusted regression models identified that being homebound (odds ratio [OR] 3.49, 95% CI 2.03, 6.00), frail (OR 9.50, 95% CI 4.92–18.37), and experiencing community disability (OR 5.19, 95% CI 3.90–6.90) was associated with food insecurity. Discussion Food insecurity among older adults is broader than lacking adequate financial resources to obtain food; it is also associated with social and functional limitations. A more comprehensive conceptualization will aid future study on the impact of food insecurity on health status, utilization, and outcomes to inform senior nutrition program targeting and services.

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Pain severity and analgesics use in the community-dwelling older population: a drug utilization study from Germany

European Journal of Clinical Pharmacology ◽

10.1007/s00228-020-02954-5 ◽

2020 ◽

Vol 76 (12) ◽

pp. 1695-1707

Author(s):

Thi Ngoc Mai Nguyen ◽

Dana Clarissa Laetsch ◽

Li-Ju Chen ◽

Walter Emil Haefeli ◽

Andreas D Meid ◽

...

Keyword(s):

Older Adults ◽

Chronic Pain ◽

Logistic Regression ◽

High Intensity ◽

Regression Models ◽

Community Dwelling ◽

Pain Severity ◽

Older Population ◽

Logistic Regression Models ◽

Pain Duration

Abstract Purpose Chronic pain is common in the older population and a significant public health concern. However, comprehensive studies on analgesics use in this age group from Germany are scarce. This study aims to give a comprehensive overview on the use of the most common therapeutic groups of analgesics in community-dwelling older adults from Germany. Methods A cross-sectional study was carried out using data from a German cohort of 2038 community-dwelling adults aged 63–89 years. Descriptive statistics and logistic regression models were applied to assess the utilization of analgesics by age, sex, pain severity, pain duration, and locations. Results One out of four study participants was suffering from high-intensity or disabling pain. Approximately half of those taking analgesics still reported to suffer from high-intensity or disabling pain. Among analgesics users, occasional non-steroidal anti-inflammatory drugs (NSAIDs) use was the most frequent pain therapy (in 43.6% of users), followed by metamizole (dipyrone) use (16.1%), regular NSAIDs use (12.9%), strong opioids use (12.7%), and weak opioids use (12.0%). In multivariate logistic regression models, higher age, higher pain severity, longer pain duration, abdominal pain, and back pain were statistically significantly associated with opioids use. Metamizole use was also statistically significantly associated with higher pain severity but inversely associated with pain duration. Conclusions A significant number of older German adults are affected by high-intensity and disabling chronic pain despite receiving analgesics. Long-term studies are needed to compare the effectiveness and safety of different treatments for chronic pain in older adults.

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Association between Experience of Pet Ownership and Psychological Health among Socially Isolated and Non-Isolated Older Adults

Animals ◽

10.3390/ani11030595 ◽

2021 ◽

Vol 11 (3) ◽

pp. 595

Author(s):

Tomoko Ikeuchi ◽

Yu Taniguchi ◽

Takumi Abe ◽

Satoshi Seino ◽

Chiho Shimada ◽

...

Keyword(s):

Older Adults ◽

Psychological Health ◽

Regression Models ◽

Community Dwelling ◽

Pet Ownership ◽

Cross Sectional ◽

Logistic Regression Models ◽

Dog Ownership ◽

Socially Isolated ◽

Community Dwelling Older Adults

The psychological health effects of pet ownership have been widely studied, but only a few studies investigated its impact among socially isolated older adults. The present study aims to investigate the psychological health of older adults with or without the experience of pet (i.e., dog or cat) ownership who are socially isolated or not socially isolated. This study used cross-sectional data from 9856 community-dwelling older adults in a metropolitan area of Japan. Social and non-social isolation and type of pet ownership (i.e., dog or cat) were stratified to examine the psychological health. Logistic regression models indicated that, after adjusting for demographic and potential confounders, socially isolated older adults who never owned a dog were 1.22 times more likely to report lower psychological health in comparison to socially isolated current or past dog owners. No such difference was observed among cat owners. The results suggest that the experience of dog ownership may be effective to improve the psychological health among socially isolated older adult.

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