scholarly journals Emergency hospital admissions among older adults living alone in the community

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jon Barrenetxea ◽  
Kelvin Bryan Tan ◽  
Rachel Tong ◽  
Kevin Chua ◽  
Qiushi Feng ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Living Arrangements ◽  
Hospital Admissions ◽  
Living Arrangement ◽  
Joint Effect ◽  
Living Alone ◽  
Health Study ◽  
P Value ◽  
Singapore Chinese

Abstract Background Among older adults, living alone is often associated with higher risk of Emergency Department (ED) admissions. However, older adults living alone are very heterogeneous in terms of health. As more older adults choose to live independently, it remains unclear if the association between living alone and ED admissions is moderated by health status. We studied the association between living alone and ED admission outcomes (number of admissions, inpatient days and inpatient costs) among older adults with and without multimorbidity. Methods We used data from 16,785 individuals of the third follow-up of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese (mean age: 73(61-96) years). Participants were interviewed face-to-face from 2014 to 2016 for sociodemographic/health factors and followed-up for one year on ED admission outcomes using Singapore Ministry of Health’s Mediclaim Database. We first applied multivariable logistic regression and two-part models to test if living alone is a risk factor for ED admission outcomes. We then ran stratified and joint effect analysis to examine if the associations between living alone and ED admission outcomes were moderated by multimorbidity. Results Compared to living with others, living alone was associated with higher odds of ED admission [Odds Ratio (OR) 1.28, 95 % Confidence Interval(CI) 1.08-1.51)], longer inpatient days (+0.61, 95 %CI 0.25-0.97) and higher inpatient costs (+322 USD, 95 %CI 54-591). The interaction effects of living arrangement and multimorbidity on ED admissions and inpatient costs were not statistically different, whereas the interaction between living arrangements and multimorbidity on inpatient days was borderline significant (p-value for interaction=0.050). Compared to those living with others and without multimorbidity, the relative mean increase was 1.13 inpatient days (95 %CI 0.39-1.86) for those living alone without multimorbidity, and 0.73 inpatient days ( 95 %CI 0.29-1.17) for those living alone with multimorbidity. Conclusions Older adults living alone were at higher risk of ED admission and higher inpatient costs regardless of multimorbidity, while those living alone without multimorbidity had the longest average inpatient days. To enable aging in place while avoiding ED admissions, interventions could provide instrumental support and regular health monitoring to older adults living alone, regardless of their health status.

scholarly journals Emergency Department Admissions Among Older Adults Living Alone With Multimorbidity

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 583-584
Author(s):  
Jon Barrenetxea ◽  
Cynthia Chen ◽  
Woon-Puay Koh ◽  
Feng Qiushi ◽  
Kelvin Bryan Tan ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Living Arrangements ◽  
Population Based ◽  
Living Alone ◽  
Health Study ◽  
Risk Of Mortality ◽  
Hospitalization Costs ◽  
Singapore Chinese ◽  
One Year

Abstract Older adults living alone are at higher risk of mortality, morbidity and healthcare utilization. As more older adults live alone, Emergency Department (ED) admissions could rapidly increase, particularly among those with multimorbidity. We studied the association of living alone on ED admissions among older adults with multimorbidity. We used data from 16,785 older adults of the population-based Singapore Chinese Health Study (mean age: 73 years, range: 61-96 years) who were interviewed in 2014-2016 for living arrangements and medical history. Participants were followed-up for one year on ED admission outcomes (number of admissions, inpatient days and hospitalization costs). We used multivariable logistic regression to study the association between living alone and ED admission, and ran two-part models (probit & generalised linear model) to estimate the association of living alone on inpatient days and hospitalization cost. We found that compared to living with others, living alone was associated with a higher odds of ED admissions [Odds Ratio (OR) 1.28, 95% Confidence Interval (CI) 1.08-1.51)], longer inpatient days (+0.61, 95% CI 0.25-0.97) and higher hospitalization costs (+322 USD, 95% CI 54-591). Compared to those living with others without multimorbidity, living alone with multimorbidity was associated with higher odds of ED admission (OR 1.64 95% CI 1.33-2.03), longer inpatient days (+0.73, 95% CI 0.29-1.17) and higher hospitalization costs (+567 USD, 95% CI 230-906). In conclusion, living alone is associated with higher odds of ED admission, longer inpatient days and higher hospitalization costs among older adults, particularly among those with multimorbidity.

scholarly journals Social Disconnection and Living Arrangements among Older Adults: The Singapore Chinese Health Study

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Jon Barrenetxea ◽  
Yi Yang ◽  
An Pan ◽  
Qiushi Feng ◽  
Woon-Puay Koh
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Living Arrangement ◽  
Community Dwelling ◽  
Living Alone ◽  
Health Study ◽  
Factors Associated ◽  
Self Rated Health ◽  
Singapore Chinese ◽  
Social Disconnection

<b><i>Introduction:</i></b> Although living alone is associated with social disconnection, older adults could be socially disconnected despite living with others. Understanding the factors associated with social disconnection by living arrangement could help identify vulnerable older adults in the community. We examined the sociodemographic and health factors associated with social disconnection among two groups of older adults: those living alone and those living with others. <b><i>Methods:</i></b> We used data from 16,943 community-dwelling older adults from the third follow-up of the Singapore Chinese Health Study (mean age: 73 years, range: 61–96 years). We defined social disconnection as having no social participation and scoring in the lowest decile on the Duke Social Support Scale of perceived social support. We ran logistic regression models to study the sociodemographic (age, gender, and education) and health (self-rated health, instrumental limitations, cognitive function, and depression) factors associated with social disconnection, stratified by living arrangement. <b><i>Results:</i></b> About 6% of our participants were socially disconnected. Although living alone was significantly associated with social disconnection (OR 1.93, 95% CI: 1.58–2.35), 85.6% of socially disconnected older adults lived with others, most of them (92%) with family. Lower education level, cognitive impairment, fair/poor self-rated health, instrumental limitations, and depression were independently associated with social disconnection. Among those living alone, men were more likely to experience social disconnection than women (OR 2.18, 95% CI: 1.43–3.32). <b><i>Discussion/Conclusion:</i></b> Though living alone is associated with social disconnection, most socially disconnected individuals lived with family. Community interventions could focus on those in poor health despite living with family and older men living alone.

Educational Differences in Self-Rated Health Trends Among Middle-Aged and Older Adults Living Alone, 1972–2018

2022 ◽  
pp. 089826432110527
Author(s):  
Esther O. Lamidi
Keyword(s):  
Older Adults ◽  
Living Arrangements ◽  
Living Arrangement ◽  
Living Alone ◽  
Middle Aged ◽  
Older Americans ◽  
Health Trends ◽  
Self Rated Health ◽  
Educational Differences ◽  
Middle Aged Adults

Objectives: This study examines educational differences in living alone and in self-rated health trends among middle-aged and older adults. Methods: We used logistic regression to analyze data from the 1972–2018 National Health Interview Survey ( n = 795,239 aged 40–64; n = 357,974 aged 65–84). Results: Between 1972–1974 and 2015–2018, living alone became more prevalent, particularly among men and at lower levels of education. Self-rated health trends varied by living arrangement and education. We found self-rated health declines among middle-aged adults having no college degree and living alone, but trends in self-rated health were mostly stable or even improved among middle-aged adults living with others. Among older adults, self-rated health improved over time, but for the least-educated older Americans living alone, the probability of reporting fair or poor health increased between 1972–1974 and 2015–2018. Discussion: The findings suggest growing disparities by social class, in living arrangements and in self-rated health.

scholarly journals Factors Associated With Social Isolation Among Older Adults: The Singapore Chinese Health Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 168-168
Author(s):  
Jon Barrenetxea ◽  
Yang Yi ◽  
Woon Puay Koh ◽  
Feng Qiushi
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Social Isolation ◽  
Well Being ◽  
Population Based ◽  
Living Alone ◽  
Health Study ◽  
Factors Associated ◽  
Singapore Chinese

Abstract Social isolation is a determinant of mortality and well-being among older people. Factors associated with isolation could be different in societies where older adults live mainly with family, as individuals might feel isolated despite living with others. We studied the factors associated with isolation among 16,948 older adults from follow-up 3 of the Singapore Chinese Health Study, a population-based cohort of older Singapore Chinese (mean age of 73, range: 61-96 years). We defined social isolation as having “zero hour per week” of participation in social activities involving 3 or more people and scoring the lowest decile on the Duke Social Support Scale of perceived social support. We used multivariable logistic regressions to compute odds ratio (OR) and 95% confidence interval (CI) for factors associated with likelihood of social isolation. Although only 14.4% of isolated participants lived alone, living alone remained a significant factor associated with isolation (OR 1.93, 95% CI 1.58-2.35), together with cognitive impairment (OR 1.73, 95% CI 1.46-2.04) and depression (OR 2.44, 95% CI 2.12-2.80). Higher education level was inversely associated with isolation (p for trend&lt;0.001). In stratified analysis, among those living alone, compared to women, men had higher odds of social isolation (OR 2.18, 95% CI 1.43-3.32) than among those not living alone (OR 0.99, 95% CI 0.84-1.17) (p for interaction&lt;0.001). Our results showed that living alone, cognitive impairment and depression were indicators of isolation among older Singaporeans. In addition, among those living alone, men were more likely to experience social isolation than women.

scholarly journals Factors Contributing to Older Adults Living Alone and Thereby at Risk of Poor Health and Adverse Health Outcomes

2019 ◽  
Author(s):  
Nikki Shipley
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Health Status ◽  
Health Outcomes ◽  
Older Adult ◽  
Living Arrangements ◽  
Age At Onset ◽  
Poor Health ◽  
Living Child ◽  
Living Alone

Introduction: Extensive research demonstrates that older adults living alone tend to be less healthy, have poorer health outcomes and are at greater risk of dying. While many investigators have explored various aspects of aging, there has been limited work assessing factors that increase the chances of an older adult to live alone. This study examines the association between demographic characteristics; current health status; and social, cultural, and environmental factors among older adults (65 years of age and older) and the likelihood they will live alone Methods: Secondary analyses is conducted of survey data from the Americans' Changing Lives (ACL) cohort study initiated in 1986 (Wave 1) and continued through 2012, with four follow-up surveys conducted in 1989 (Wave II), 1994 (Wave III), 2001/02 (Wave IV), and 2011/12 (Wave V). All ACL participants 65 years and older at time of survey (Wave I – V) are included for this study (N=7,020). An analysis of variance (ANOVA) that included demographics, health status, and social support factors is employed to determine the relationship of these variables to an older adult reporting living alone. Additionally, the Cox proportional hazards model is used for survival analysis to predict the expected age at onset of living alone. Results: Four critical factors reduce the probability of an older adult living alone: 1) marital status (married), 2) gender (male), 3) presence of at least one living child, and 4) willingness to spend time in the garden (physical activity). An older female adult who is currently single and without a living child is most likely to report living alone (p<.001). Conclusions: Older adults living alone are at higher risk of poor health and health outcomes. The influx of baby boomers whose life expectancy is longer than the past, will cause a dramatic increase in senior adults living alone. This research suggests a guideline to public health professionals for identifying those at risk of being negatively impacted by living alone so that they can intervene and provide alternative living arrangements and support services, as necessary. Keywords: living alone, older adults, health outcomes

scholarly journals Greater Risk of Negative Health Outcomes of Older Adults Living Alone in Vietnam: A Community Survey

2021 ◽  
Vol 18 (21) ◽  
pp. 11115
Author(s):  
Man Thi Hue Vo ◽  
Keiko Nakamura ◽  
Kaoruko Seino ◽  
Thang Van Vo
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Rural Areas ◽  
Living Arrangements ◽  
Fear Of Falling ◽  
Living Arrangement ◽  
Community Survey ◽  
Living Alone ◽  
Cross Sectional ◽  
Solitary Living

In modern Asian societies, there has been a shift in the living arrangements of older adults away from living with others. Knowing the health characteristics of individuals living alone can help identify high-risk groups. This cross-sectional study aimed to describe characteristics of the Vietnamese older adults and to investigate the association between living alone and their reported health outcomes by utilizing survey data of individuals aged ≥60 years in Vietnam in 2018. The community survey included questions about sociodemographic factors, living arrangement, and self-reported physical functional status. Multivariate logistic regression was used to examine whether or not living alone was a predictor of health outcomes. Of 725 study participants, 8.9% lived alone. These participants were more likely to be female, aged 70–79 years, living in rural areas, and currently single or previously married. After adjusting for covariates, older adults who were living alone were more likely to have arthritis (adjusted odds ratio [AOR] = 1.95, 95% confidence interval [CI]: 1.10–3.45), a history of falling (AOR = 2.44, 95% CI: 1.02–5.82), visual difficulties (AOR = 1.89, 95% CI: 1.04–3.41), feelings of loneliness (AOR = 1.95, 95% CI: 1.10–3.47), and high fear of falling (AOR = 1.88, 95% CI: 1.02–3.46). Older adults living alone in Vietnam were at greater risk of negative health consequences than those living with others. Screening and providing adequate social support for this specific population is important in preventing the adverse effects of solitary living among these older adults.

Relationships Between Living Arrangements and Health Status Among Older Adults in the United States, 2009-2014: Findings From the National Health Interview Survey

2016 ◽  
Vol 37 (1) ◽  
pp. 7-25 ◽  
Author(s):  
Judith D. Weissman ◽  
David Russell
Keyword(s):  
Older Adults ◽  
Psychological Distress ◽  
Health Status ◽  
National Health ◽  
Living Arrangements ◽  
National Health Interview Survey ◽  
Living Alone ◽  
Health Conditions ◽  
Serious Psychological Distress ◽  
Interview Survey

Limited research has examined how health varies across living arrangements among older adults. Adults aged 65 years and older were sampled from National Health Interview Survey 2009-2014. Four indicators of health (serious psychological distress, health status, functional limitations, and number of health conditions) were compared across older adults living alone, living with others related/unrelated, living with a spouse/partner (no children), and living with children (no spouse/partner). Regression models showed older adults living with others have the poorest health; they were less likely to report excellent or very good health, had serious psychological distress and limitations in activities of daily living (ADLs), and a greater number of health conditions compared with older adults living with a spouse/partner. However, older women living alone or with children were more likely to report two or more health conditions compared with women living with a spouse/partner, suggesting that in older age, there are gender variations in health across living arrangements.

A Longitudinal Analysis of the Association Between Living Arrangements and Health Among Older Adults in China

2016 ◽  
Vol 40 (1) ◽  
pp. 72-97 ◽  
Author(s):  
Zi Zhou ◽  
Fanzhen Mao ◽  
Jiaping Ma ◽  
Shichao Hao ◽  
Zhengmin (Min) Qian ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Living Arrangements ◽  
Living Arrangement ◽  
Well Being ◽  
Living Alone ◽  
Psychological Well Being ◽  
Self Rated Health ◽  
Health Differences ◽  
Adl Disability

This article used the nationally representative Chinese Longitudinal Healthy Longevity Survey to explore the associations between living arrangements and health among older adults. Living arrangements were stratified into six categories. Health was measured by self-rated health, activities of daily living (ADL) disability, and cognitive impairment. Random-effects ordered probit regressions were applied. The results indicated that coresidence had a positive effect on self-rated health compared with living alone. After introducing psychological well-being, the health differences observed in living with a spouse and living with both spouse and children were not significant. Participants with each of the living arrangement were more likely to have a higher rate of cognitive impairment and ADL disability than those living alone. Living arrangements were associated with older adults’ health. Psychological well-being was a key factor in this association, which may result from living with a spouse, and could contribute to the self-rated health of older adults.

scholarly journals Coresidence Increases Risk of Testing Positive for COVID-19 Among Older Brazilians

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 972-972
Author(s):  
Flavia Andrade ◽  
Nekehia Quashie ◽  
Luisa Schwartzman
Keyword(s):  
Older Adults ◽  
Living Arrangements ◽  
Living Arrangement ◽  
Family Members ◽  
Physical Contact ◽  
Living Alone ◽  
Sample Survey ◽  
Vulnerable Groups ◽  
Intergenerational Coresidence ◽  
Nationally Representative

Abstract Brazil is among the countries hit hardest by COVID-19, and older adults are among the vulnerable groups. Intergenerational coresidence and interdependence among family members, both prevalent in Brazil, likely increase social and physical contact. Using nationally representative data from the COVID-19 module of the Brazilian National Household Sample Survey, collected from July to November of 2020, we examined the association between living arrangements and exposure to and testing for COVID-19 among 63,816 Brazilians 60+. Our multivariate analyses utilize multilevel mixed-effects Poisson regression to examine the association between living arrangements and the COVID-19 outcome measures. Results show that those living alone were more likely to report having symptoms and having had a test for COVID-19. However, older adults in multigenerational (PR=1.532, 95% CI 1.15, 2.04, p&lt;0.001) and skipped generation households (PR=1.607, 95% CI 1.04, 2.48, p&lt;0.001) were more likely than solo-dwellers to test positive for COVID-19. Those with symptoms were more likely to test, regardless of their living arrangement. Among older adults without symptoms, those living alone had a higher probability of testing than those living in multigenerational or skipped-generation households. Overall, our findings suggest that coresidence with younger family members is a risk factor for older adults’ health due to the higher COVID-19 positivity. As younger Brazilians are increasingly vulnerable to COVID-19 and experiencing severe outcomes, policy makers need to be more attentive to the health needs of households that comprise older and younger cohorts, which are also more prevalent in poor and marginalized segments of the population.

scholarly journals Living Arrangement Modifies the Associations of Loneliness with Adverse Health Outcomes in Older Adults: Evidence From the CLHLS

2021 ◽  
Author(s):  
Kai Wei ◽  
Yong Liu ◽  
Junjie Yang ◽  
Nannan Gu ◽  
Xinyi Cao ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Living Arrangements ◽  
Living Arrangement ◽  
Community Dwelling ◽  
Living Alone ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Physical Functions ◽  
Community Dwelling Older Adults

Abstract Background: Although it has been suggested that loneliness is a risk factor for adverse health outcomes, living arrangement may confound the association. This study aimed to investigate whether the associations of loneliness with adverse health outcomes differ in community-dwelling older adults according to different living arrangements.Methods: In the 2008/2009 wave of Chinese Longitudinal Healthy Longevity Survey, 16255 community-dwelling older adults (≥65 years) were recruited. Living arrangements and feelings of loneliness were assessed. Health outcomes including cognitive and physical functions were assessed using MMSE, ADL/IADL scales and Frailty Index in the 2008/2009 and 2011/2012 waves; mortality was assessed in the 3-year follow-up from 2008/2009 to 2011/2012. The associations of loneliness with adverse health outcomes accroding to different living arrangements were estimated using logistic regression or Cox proportional hazards regression models. Interactions between living arrangement and loneliness on adverse health outcomes were also investigated.Results: Older adults who were lonely (47.8% of those living alone and 25% of those living with others) had higher prevalence of cognitive impairment, frailty and 3-year mortality than older adults without loneliness, especially among those who lived with others (OR=1.31, 95% CI=1.15-1.51; OR=1.42, 95% CI=1.26-1.60; HR=1.16, 95% CI=1.07-1.26, respecitvely). In contrast, among the living alone older adults, loneliness was only associated with higher prevalence of frailty (OR=1.41, 95% CI=1.06-1.88). Living arrangement modified the associations of loneliness with prevalent cognitive impairment and mortality (P values for interactions=0.006 and 0.015, respectively).Conclusions: Living arrangement modifies the associations of loneliness with adverse health outcomes in community-dwelling older adults, and those who lived with others but felt lonely had worse cognitive and physical functions as well as higher mortality. Special attention should be paid to this population to reduce adverse health outcomes.

Sign in / Sign up

Export Citation Format

Share Document