Functional trajectories before and after a new cancer diagnosis among community-living older adults.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21547-e21547
Author(s):  
Carolyn Jean Presley ◽  
Arti Hurria ◽  
Ling Han ◽  
Linda S Leo-Summers ◽  
Cary Philip Gross ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Depressive Symptoms ◽  
Cancer Diagnosis ◽  
Functional Decline ◽  
Severe Disability ◽  
Factors Associated ◽  
Disability Scale ◽  
Incident Cancer ◽  
Before And After

e21547 Background: We characterized distinct functional trajectories among older adults in the year before and after a new cancer diagnosis and identified factors associated with functional decline. Methods: Among a cohort study of persons 70+ y, we identified 170 participants (lung (15.7%), breast (12.4%), prostate (7.8%); 31.8% incurable at diagnosis)) with an incident cancer diagnosis from 1998-2014. We followed their functional course using 13 basic, instrumental, and mobility activities measured during monthly interviews. To identify functional trajectories, we fit a group-based trajectory model of the 13-item disability scale 12-months before and 12-months after the cancer diagnosis. Regression modeling determined predictors of functional decline, defined as a higher count on the 13-item disability scale. Results: Three pre-cancer functional trajectories were identified (mean age at diagnosis: 83 y (73-105 y); similarly, 3 post-cancer functional trajectories were identified among the 158 non-decedents. Participants with severe disability pre-diagnosis remained severely disabled post-diagnosis. Approximately 40% of participants with mild or moderate disability pre-diagnosis transitioned to a worse functional trajectory post-diagnosis (see Table). Moderate and severe disability pre-diagnosis were significantly associated with functional decline post-diagnosis (moderate vs. mild aRR: 3.10; 95% CI: 2.24-4.30; severe vs. mild aRR: 5.71; 95% CI: 3.60-9.07). Depressive symptoms (RR, 1.40; 95% CI: 1.02-1.91), and incurable stage (RR, 2.16; 95% CI: 1.54-3.03) were also associated with functional decline. Conclusions: Approximately 40% of older adults experienced functional decline after a new cancer diagnosis. Pre-cancer diagnosis functional trajectory, depressive symptoms, and incurable stage were significant predictors of post-diagnosis functional decline. [Table: see text]

scholarly journals Factors Associated with Frailty According to Gender of Older Adults Living Alone

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 475
Author(s):  
Hye-Young Jang ◽  
Ji-Hye Kim
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Nutritional Status ◽  
Chronic Diseases ◽  
Multinomial Logistic Regression ◽  
Living Alone ◽  
Factors Associated ◽  
Chi Squared ◽  
Korean Elderly

This study was conducted to identify the factors associated with frailty according to gender of older adults living alone in Korea. Data from the National Survey of the Living Conditions of Korean Elderly in 2017 were used. Participants were 2340 older adults who live alone. Frailty was determined based on the frailty criteria developed by van Kan et al. that consist of fatigue, resistance, ambulation, and illness. The collected data were analyzed using descriptive statistics, chi-squared test, t-test, Jonckheere–Terpstra test and multinomial logistic regression. Among the older men living alone, 47.7% were in the pre-frail and 5.1% were in the frail. On the other hand, 51.8% were in the pre-frail and 12.2% were in the frail among the older women living alone. The factors associated with frailty according to gender are as follows. In males, depressive symptoms, limitation in IADL, and number of medications in pre-frail; BMI, limitation in IADL, and number of chronic diseases in frail. In females, depressive symptoms, number of chronic diseases, age, and nutritional status in pre-frail; limitation in IADL, depressive symptoms, age, number of chronic diseases, number of medications, nutritional status in frail. Based on the findings of this study, it is considered necessary to approach frailty management considering gender as well as the classification of frailty.

Abstract P347: Sex Differences in Barriers to Antihypertensive Medication Adherence: Findings from the Cohort Study of Medication Adherence among Older Adults (CoSMO)

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Elizabeth W Holt ◽  
Cara Joyce ◽  
Adriana Dornelles ◽  
Donald E Morisky ◽  
Larry S Webber ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Medication Adherence ◽  
Antihypertensive Medication ◽  
Administrative Databases ◽  
Medication Cost ◽  
Lifestyle Modifications ◽  
Cross Sectional ◽  
Men And Women ◽  
Factors Associated

Objectives: We assessed whether socio-demographic, clinical, health care system, psychosocial, and behavioral factors are differentially associated with low antihypertensive medication adherence scores among older men and women. Methods: We conducted a cross-sectional analysis using baseline data from the Cohort Study of Medication Adherence in Older Adults (CoSMO, n=2,194). Low antihypertensive medication adherence was defined as a score <6 on the 8-item Morisky Medication Adherence Scale. Risk factors for low adherence were collected using telephone surveys and administrative databases. Results: The prevalence of low medication adherence scores did not differ by sex [15.0% (193 of 1,283) in women and 13.1% (119 of 911) in men p=0.208]. In sex-specific multivariable models, having issues with medication cost and practicing fewer lifestyle modifications for blood pressure control were associated with low adherence scores among both men and women. Factors associated with low adherence scores in men but not women included reduced sexual functioning (OR = 2.03; 95% CI: 1.31, 3.16 for men and OR = 1.28; 95% CI: 0.90, 1.82 for women), and BMI ≥25 (OR = 3.23; 95% CI: 1.59, 6.59 for men and 1.23; 95% CI: 0.82, 1.85 for women). Factors associated with low adherence scores in women but not men included dissatisfaction with communication with their healthcare provider (OR = 1.75; 95% CI: 1.16, 2.65 for women and OR =1.16 95% CI: 0.57, 2.34 for men) and depressive symptoms (OR = 2.29; 95% CI: 1.55, 3.38 for women and OR = 0.93; 95% CI: 0.48, 1.80 for men). Conclusion: Factors associated with low antihypertensive medication adherence scores differed by sex. Interventions designed to improve adherence in older adults should be tailored to account for the sex of the target population.

Alcohol Consumption and Factors Associated With Depressive Symptoms Among Older Adults in Mainland China

2017 ◽  
Vol 48 (6) ◽  
pp. 400-408
Author(s):  
Yujun Liu ◽  
Yimeng Xie ◽  
Nancy Brossoie ◽  
Karen A. Roberto ◽  
Kerry J. Redican
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Alcohol Consumption ◽  
Mainland China ◽  
Factors Associated

Depressive Symptoms and Malnutrition are Associated with Other Geriatric Syndromes and Increase Risk for 30-Day Readmission in Hospitalized Older Adults: A Prospective Cohort Study

2022 ◽  
Author(s):  
Laura Tay ◽  
Melvin Chua ◽  
Yew Yoong Ding
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Functional Decline ◽  
Oral Intake ◽  
Index Admission ◽  
Geriatric Syndromes ◽  
Poor Oral Intake ◽  
Hospitalized Older Adults ◽  
Minimal Adjustment

Abstract Background: Readmission in older adults is typically complex with multiple contributing factors. We aim to examine how two prevalent and potentially modifiable geriatric conditions – depressive symptoms and malnutrition – relate to other geriatric syndromes and 30-day readmission in hospitalized older adults. Methods: Consecutive admissions of patients >65 years to a general medical department were recruited over 15 months. Patients were screened for depression, malnutrition, delirium, cognitive impairment, and frailty at admission. Medical records were reviewed for intermediary events including poor oral intake and functional decline during hospitalization. Unplanned readmission within 30-days of discharge was tracked through the hospital’s electronic health records and follow-up telephone interviews. We use directed acyclic graphs (DAGs) to depict the relationship of depressive symptoms and malnutrition with geriatric syndromes that constitute covariates of interest and 30-day readmission outcome. Multiple logistic regression was performed for the independent associations of depressive symptoms and malnutrition with 30-day readmission, adjusting for variables based on DAG-identified minimal adjustment set. Results: We recruited 1619 consecutive admissions, with mean age 76.4 (7.9) years and 51.3% females. 30-day readmission occurred in 331 (22.0%) patients. Depressive symptoms (OR 1.55, 95% CI 1.15-2.07), malnutrition (OR 1.59, 95% CI 1.14-2.23), higher comorbidity burden, hospitalization in the one-year preceding index admission, frailty, delirium, as well as functional decline and poor oral intake during the index admission, were more commonly observed among patients who were readmitted within 30 days of discharge (P<0.05). Patients with active depressive symptoms were significantly more likely to be frail (OR=1.62, 95% CI 1.22-2.16), had poor oral intake (OR=1.35, 95% CI 1.02-1.79) and functional decline during admission (OR=1.58, 95% CI 1.11-2.23). Malnutrition at admission was significantly associated with frailty, delirium, cognitive impairment and poor oral intake during hospitalization (P<0.05). In minimal adjustment set identified by DAG, depressive symptoms (OR=1.38, 95% CI 1.02-1.86) remained significantly associated with 30-day readmission. The association of malnutrition with 30-day readmission was attenuated after adjusting for age, ethnicity and depressive symptoms in the minimal adjustment set (OR=1.40, 95% CI 0.99-1.98, P=0.06). Conclusion: The observed causal associations support screening and targeted interventions for depressive symptoms and malnutrition during admission and in the post-acute period.

scholarly journals Diabetes care management patterns before and after a cancer diagnosis: A SEER‐Medicare matched cohort study

Cancer ◽  
2020 ◽  
Vol 126 (8) ◽  
pp. 1727-1735 ◽  
Author(s):  
Laura C. Pinheiro ◽  
Orysya Soroka ◽  
Lisa M. Kern ◽  
John P. Leonard ◽  
Monika M. Safford
Keyword(s):  
Cohort Study ◽  
Cancer Diagnosis ◽  
Diabetes Care ◽  
Care Management ◽  
Matched Cohort ◽  
Matched Cohort Study ◽  
Before And After

scholarly journals Factors Associated with Functional Decline in Older Adults After Discharge from an Acute-Care Hospital

2019 ◽  
Vol 13 (3) ◽  
pp. 192-199
Author(s):  
Hai-Won Yoo ◽  
Myo-Gyeong Kim ◽  
Doo-Nam Oh ◽  
Jeong-Hae Hwang ◽  
Kun-Sei Lee
Keyword(s):  
Older Adults ◽  
Acute Care ◽  
Functional Decline ◽  
Acute Care Hospital ◽  
Care Hospital ◽  
Factors Associated

scholarly journals Body mass index trajectories and functional decline in older adults: Three-City Dijon cohort study

2015 ◽  
Vol 31 (1) ◽  
pp. 73-83 ◽  
Author(s):  
Fanny Artaud ◽  
Archana Singh-Manoux ◽  
Aline Dugravot ◽  
Béatrice Tavernier ◽  
Christophe Tzourio ◽  
...  
Keyword(s):  
Older Adults ◽  
Body Mass Index ◽  
Cohort Study ◽  
Body Mass ◽  
Functional Decline ◽  
Body Mass Index Trajectories

scholarly journals Age Paradox: Depressive Symptomatology For Older Men and Women in Taiwan

2021 ◽  
Author(s):  
Ching-Ju Chiu ◽  
Chun-Yu Tsai ◽  
Tsung-Yu Tsai
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Social Participation ◽  
Protective Factor ◽  
Depressive Symptomatology ◽  
Depression Scale ◽  
Advanced Age ◽  
Men And Women ◽  
Factors Associated

Abstract Background: To discern if prevalence of depressive symptoms in adults aged 65 and above in Taiwan changed during the past decade and to identify if protective and risk factors of depressive symptomatology differ by gender. Method: Data of nationally representative older adults (65+) interviewed from the 2005, 2009 and 2013 National Health Interview Survey (NHIS) in Taiwan was analyzed (n=8,832). The Center for Epidemiologic Studies Depression Scale (CES-D) was used for the measurement of depressive symptomatology. Results: Age adjusted prevalence rate of depressive symptomatology among older adults in Taiwan reduced from 20.6% to 13.3% (X2=-7.5, p<.05) in the community. The most significant factors associated with higher depressive symptomatology in both gender was too much carbohydrates intake, which was significantly associated with 8.8 (95%CI=5.1-15.2) and 7.9 (95%CI=5.2-11.8) times depressive symptomatology in men and women respectively. Factors associated with lower depressive symptomatology in both gender include advanced age (over the age of 85), exercise and social participation. The advanced age for men and women reduced about 63% (AOR over the age of 85=0.4, 95%CI=0.2-0.9) and 62% (AOR over the age of 85=0.4, 95%CI=0.2-0.8) of depressive symptomatology for men and women respectively; Exercise reduced about 50% (AOR exercise=0.5, 95%CI=0.3-0.6) and 58% (AOR exercise=0.5, 95%CI=0.3-0.6) of depressive symptomatology for men and women respectively; social participation reduced about 55% (AOR social participation=0.5, 95%CI=0.3-0.7) and 36% (AOR social participation=0.6, 95%CI=0.5-0.9) of depressive symptomatology for men and women respectively.Conclusions: For adults aged over 65, advanced age, which is 85+ for men and 75+ for women, is a significant protective factor guarding against depressive symptoms. Carbohydrates, cognitive disorder, heart disease and falls were associated with higher depressive symptomatology in both gender. The pulmonary disease, underweight and educational level were risk factors for men; metabolic disease and milk intake were risks for women. Common factors associated with lower depressive symptomatology in both gender includes advanced age, exercise and social participation. Tea and coffee intake and married status were associated with lower depressive symptomatology for women.

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