scholarly journals Longitudinal and reciprocal associations between financial strain, home characteristics and mobility in the National Health and Aging Trends Study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
L. J. Samuel ◽  
S. L. Szanton ◽  
C. L. Seplaki ◽  
T. K. M. Cudjoe ◽  
R. J. Thorpe ◽  
...  
Keyword(s):  
Older Adults ◽  
National Health ◽  
Walking Speed ◽  
Structural Equation Models ◽  
Financial Strain ◽  
Sampling Weights ◽  
Lower Odds ◽  
Home Modifications ◽  
Reduced Mobility ◽  
Over Time

Abstract Background Older adults need homes that suit their physical capacity. Financial strain may limit home repairs and modifications and prompt relocations; repairing, relocating or modifying may increase financial strain. Likewise, reciprocal relationships may exist between financial strain and home characteristics and mobility; financial strain and home characteristics may influence mobility and mobility declines may increase financial strain, limit home repairs and modifications and prompt relocations. We test cross-lagged associations between financial strain, home disorder, relocation, home modifications and mobility. Methods In the National Health and Aging Trends Study, ability to complete a walking test, speed among those able to complete, financial strain, home disorder, relocating and modifying the home were recorded annually for 3 years (2012–2014). Structural equation models separately examined ability to walk and walking speed among those able, accounting for sociodemographic characteristics, social support, health prior health characteristics and autoregressive effects. Sampling weights accounted for the complex survey design and non-response over time. Results In both models (n = 3234 and n = 2467), financial strain predicted greater home disorder and vice versa, but cross-lagged associations were not found with relocating and modifications. Greater home disorder predicted lower odds of ability to walk and slower speed among those able. Financial strain and home modifications predicted lower odds of ability to walk. Also, faster walking speed predicted lower odds of subsequent financial strain and lower subsequent home disorder scores and ability to walk predicted less subsequent home disorder and lower odds of relocating. Conclusions Home disorder links financial strain with reduced mobility in a national sample of U.S. older adults. Cross-lagged associations between financial strain and home disorder and between home disorder and mobility suggest reciprocal effects that may accumulate over time. Also, financial strain, reduced mobility, relocations and modifications predicted greater home disorder. Together, these results highlight home disorder as a social determinant of mobility for older adults. Greater attention should be given to repairing and modifying home environments and supporting stable housing for older adults with financial strain.

scholarly journals DOES PAIN PREDICTS FRAILTY AMONG OLDER ADULT AMERICANS: FINDINGS FROM THE NATIONAL HEALTH AND AGING TRENDS STUDY.

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S871-S871
Author(s):  
Jaspreet k Sodhi ◽  
Lin-Na Chou ◽  
Soham Al Snih
Keyword(s):  
Older Adults ◽  
National Health ◽  
Equation Model ◽  
Outcome Variable ◽  
Frailty Phenotype ◽  
Common Causes ◽  
Prevalence Of Pain ◽  
Key Variables ◽  
Over Time

Abstract Musculoskeletal pain is highly prevalent among older adults and is one of the common causes of disability. The objective of this study was to examine the effect of pain on becoming frail among American older adults over 6 years of follow-up. We studied 5,229 participants aged ≥ 65 years from the National Health and Aging Trends Study (2011-2017) who were non-frail at baseline. Key variables included pain, socio-demographic characteristics (age, gender, race/ethnicity, marital status, and education), depression, comorbidities, and body mass index. The outcome variable was frailty assessed using the frailty phenotype, defined as meeting three or more of the following criterions: shrinking, weakness, exhaustion, slowness, and low physical activity. General estimation equation model was fitted to test the effect of pain on frailty over time. Prevalence of pain in American older adults was 48.9% at baseline. The prevalence of frailty ranged from 6.7 % at baseline to 7.4 % at wave 6 among those with pain. The odds ratio (OR) of becoming frail overtime was 1.07 (95% CI 1.02 – 1.12) over time. The OR of becoming frail over time as a function of pain was 1.76 (95% CI 1.51-2.05), after controlling for all covariates. Other predictor factors of becoming frail were being ≥ 75 years, having one or more comorbid conditions, and with high depressive symptoms. Participants with higher level of education were less likely to become frail. These findings suggest that early treatment of pain may reduce frailty and improve the quality of life in this population

scholarly journals Types of Insomnia Mediate the Relation between Anxiety and Depressive Symptoms Longitudinally in Late Life

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 901-901
Author(s):  
Courtney Bolstad ◽  
Michael Nadorff
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Direct Effect ◽  
National Health ◽  
Late Life ◽  
Anxiety Symptoms ◽  
Clinical Samples ◽  
Confounding Variables ◽  
Significant Direct Effect ◽  
Over Time

Abstract The current study examined onset and maintenance insomnia as mediators of the relation between anxiety and depressive symptoms over a three-year period in a sample of older adults. We hypothesized that anxiety symptoms at timepoint one would significantly predict depressive symptoms at timepoint four, while controlling for depressive symptoms at timepoint one. We also hypothesized that this effect would be significantly reduced when adding onset and maintenance insomnia at timepoint two and three, respectively, as mediators. Participants included 3,484 older adults, ages 66 to 103 (M = 77, SD = 7), included in the National Health and Aging Trends Study who completed measures of types of insomnia, anxiety, and depressive symptoms at four different timepoints (2012 through 2015). The model showed a significant direct effect of anxiety on depressive symptoms at timepoint four, independent of baseline depressive symptoms. The relation was mediated by onset and maintenance insomnia, though a significant direct effect remained. Therefore, types of insomnia contribute to the development of depressive symptoms in older adults with anxiety symptoms over time, even when controlling for baseline depressive symptoms. Further, onset and maintenance insomnia are unique outcomes and predictors of anxiety and depressive symptoms, respectively, even when controlling for baseline depressive symptoms. Our findings provide a foundation for future intervention research with clinical samples that control for confounding variables in further elucidating the development and change in depressive symptoms among older adults with anxiety through onset and maintenance insomnia.

scholarly journals Impact of tooth loss on walking speed decline over time in older adults: a population-based cohort study

2016 ◽  
Vol 29 (4) ◽  
pp. 793-800 ◽  
Author(s):  
Anna-Karin Welmer ◽  
Debora Rizzuto ◽  
Marti G. Parker ◽  
Weili Xu
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Tooth Loss ◽  
Walking Speed ◽  
Population Based ◽  
Over Time

scholarly journals Factors Associated With Aging Biomarkers: Findings From the National Health and Aging Trends Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 589-589
Author(s):  
Laura Samuel ◽  
Thomas K M Cudjoe ◽  
Eileen Crimmins
Keyword(s):  
National Health ◽  
High Sensitivity ◽  
Well Being ◽  
Dried Blood Spots ◽  
Financial Strain ◽  
Subjective Well Being ◽  
Sampling Weights ◽  
Environmental Characteristics ◽  
Biomarkers Of Aging ◽  
Nationally Representative

Abstract Few studies have examined associations between socioeconomic, psychosocial and environmental characteristics with biological markers of aging among nationally representative older adult samples. This symposium will present results from four studies that examine the associations between 1) socioeconomic factors (i.e. financial strain and income to poverty ratio), 2) environmental characteristics (i.e. home disorder, street block disorder and community social cohesion) 3) social isolation (i.e. household size and social network),and 4) subjective well-being (i.e. positive affect, self-realization and personal mastery) as they relate to biomarkers of aging (hemoglobin A1c, IL-6, high-sensitivity CRP, and cytomegalovirus). Biomarker samples were obtained in 2017 via dried blood spots from 4,648 (88%) of the 5,265 self-responding participants of the National Health and Aging Trends Study (NHATS). NHATS is an ongoing study that conducts annual in-home interviews, which recruited a nationally representative cohort of Medicare beneficiaries aged 65+ residing in the contiguous United States in 2011 and replenished the sample in 2015. All analyses for the four studies presented in this symposium adjusted for demographic and socioeconomic characteristics and other potential confounders. Sampling weights were applied to account for study design and non-response so that inferences can be generalized to US adults aged ≥67 in 2017. Sessions of this symposium will highlight the socioeconomic, psychosocial and environmental characteristics that are associated with aging biomarkers. These results have clinical, policy and public health implications. These results can inform the development of interventions and policies aimed at improving biologic aging across the lifespan and reducing disparities in biologic aging.

scholarly journals Obesity and Multimorbidity in the USA: National Health and Nutrition Examination Surveys 2005-2014

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 616-617
Author(s):  
David Lynch ◽  
Curtis Petersen ◽  
Hillary Spangler ◽  
Anna Kahkoska ◽  
John Batsis
Keyword(s):  
Older Adults ◽  
National Health ◽  
Survey Design ◽  
The United States ◽  
Obesity Prevalence ◽  
Health And Nutrition ◽  
The Us ◽  
The Usa ◽  
Over Time

Abstract Declining mortality rates and an aging population have contributed to increasing rates of multimorbidity (≥2 chronic conditions) in the United States. Obesity is an important risk factor for the development of chronic diseases. We evaluated the association between obesity and multimorbidity, and how the prevalence of concomitant obesity has changed over time. We used data from 8,883 individuals aged ≥60 years with data on body mass index (BMI) and self-reported comorbidities from the National Health and Nutrition Examination Surveys 2005-2014. Logistic regression was used to quantify the association between BMI categories (<18.5, 18.5-24.9, 25-29.9, ≥30 kg/m2) and multimorbidity (yes/no). Change in proportions of obesity coexisting with multimorbidity by year was tested through linear regression. All analysis used NHANES survey design and weighting to be representative of the US population. The overall proportion of individuals with concomitant multimorbidity and obesity was 75%. As compared to a normal BMI (18.5-24.9 kg/m2), older adults with obesity (BMI ≥30 kg/m2) had higher odds of multimorbidity (OR 1.78, 95% CI 1.49,2.12). Persons with obesity had higher odds of decline in physical (1.41 [1.06,1.88]), basic (1.56 [1.13,2.15]), and instrumental activities of daily living (OR 1.58 [1.03,2.40]). The proportion of individuals with obesity and multimorbidity increased over time, but did not reach significance (β = 0.008, p=0.051). These results emphasize the role of obesity as a contributing factor to the burden of multimorbidity among older adults and underscore the importance of identifying and addressing obesity and multimorbidity via interventions to decrease obesity prevalence.

scholarly journals When Will My Patient Fall? Sensor-Based In-Home Walking Speed Identifies Future Falls in Older Adults

2019 ◽  
Vol 75 (5) ◽  
pp. 968-973 ◽  
Author(s):  
Antoine Piau ◽  
Nora Mattek ◽  
Rachel Crissey ◽  
Zachary Beattie ◽  
Hiroko Dodge ◽  
...  
Keyword(s):  
Older Adults ◽  
Regression Models ◽  
Walking Speed ◽  
Mixed Effects ◽  
Functional Tests ◽  
Laboratory Studies ◽  
Clinical Tests ◽  
Falls In Older Adults ◽  
Clinical Measures ◽  
Over Time

Abstract Background Although there are known clinical measures that may be associated with risk of future falls in older adults, we are still unable to predict when the fall will happen. Our objective was to determine whether unobtrusive in-home assessment of walking speed can detect a future fall. Method In both ISAAC and ORCATECH Living Laboratory studies, a sensor-based monitoring system has been deployed in the homes of older adults. Longitudinal mixed-effects regression models were used to explore trajectories of sensor-based walking speed metrics in those destined to fall versus controls over time. Falls were captured during a 3-year period. Results We observed no major differences between those destined to fall (n = 55) and controls (n = 70) at baseline in clinical functional tests. There was a longitudinal decline in median daily walking speed over the 3 months before a fall in those destined to fall when compared with controls, p < .01 (ie, mean walking speed declined 0.1 cm s−1 per week). We also found prefall differences in sensor-based walking speed metrics in individuals who experienced a fall: walking speed variability was lower the month and the week just before the fall compared with 3 months before the fall, both p < .01. Conclusions While basic clinical tests were not able to differentiate who will prospectively fall, we found that significant variations in walking speed metrics before a fall were measurable. These results provide evidence of a potential sensor-based risk biomarker of prospective falls in community living older adults.

scholarly journals FINANCIAL STRAIN PREDICTS INCIDENT DISABILITY IN OLDER ADULTS IN THE NATIONAL HEALTH AND AGING TRENDS STUDY

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 341-341
Author(s):  
L Samuel ◽  
L Roberts ◽  
R Thorpe ◽  
S Szanton
Keyword(s):  
Older Adults ◽  
National Health ◽  
Financial Strain

Psychological vulnerability of widowhood: financial strain, social engagement and worry about having no care-giver as mediators and moderators

2017 ◽  
Vol 38 (11) ◽  
pp. 2356-2375 ◽  
Author(s):  
JOOHONG MIN ◽  
YAWEN LI ◽  
LING XU ◽  
IRIS CHI
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Social Engagement ◽  
Structural Equation ◽  
Structural Equation Models ◽  
Least Square ◽  
Financial Strain ◽  
Psychological Wellbeing ◽  
Care Giver ◽  
Moderating Effects

ABSTRACTThis study examined how financial strain, worry about having no care-giver and social engagement modify the association between widowhood and depressive symptoms among older adults in China. Using national representative data from older adults in China in 2006, we ran structural equation models and ordinary least square regressions to investigate the mediating and moderating effects of financial strain, worry about having no care-giver and social engagement on the association between widowhood and depressive symptoms. All three variables significantly mediated the association between widowhood and depressive symptoms. Compared to their married counterparts, widowed older adults showed more worry about having no care-giver, increased financial strain and lower social engagement, which were significantly associated with depressive symptoms. Higher level of worry about having no care-giver and lower social engagement significantly exacerbated the adverse effects of widowhood on depressive symptoms in the moderation analyses. Our finding of mediating effects suggests that widowhood is negatively related to psychological wellbeing via financial strain, social engagement and care resources. The results regarding moderating effects suggest that alleviating worry about having no care-giver and increasing social engagement may buffer the deleterious effect of widowhood on psychological wellbeing in later life.

Biopsychosocial Patterning of Multimorbidity and Its Consequences

2018 ◽  
pp. 220-236
Author(s):  
Elliot Friedman ◽  
Beth LeBreton ◽  
Lindsay Fuzzell ◽  
Elizabeth Wehrpsann
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Functional Outcomes ◽  
The United States ◽  
Chronic Medical Conditions ◽  
Quality Of Life Research ◽  
Increased Risk ◽  
Over Time

By many estimates the majority of adults over age 65 have two or more chronic medical conditions (multimorbidity) and are consequently at increased risk of adverse functional outcomes. Nonetheless, many older adults with multimorbidity are able to maintain high levels of function and retain good quality of life. Research presented here is designed to understand the influences that help ensure better functional outcomes in these older adults. This chapter presents findings that draw on data from the Midlife in the United States study. The independent and interactive contributions of diverse factors to multimorbidity and changes in multimorbidity over time are reviewed. The degree that multimorbidity increases risk of cognitive impairment and disability is examined. The role of inflammation as a mediator is considered. Multimorbidity is increasingly the norm for older adults, so better understanding of factors contributing to variability in multimorbidity-related outcomes can lead to improved quality of life.

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