Identifying pre-existing dementia in older adults diagnosed with cancer using a national claims database.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e18678-e18678
Author(s):  
Melody K. Schiaffino ◽  
Alison Moore ◽  
Jessica R. Schumacher ◽  
Paul Gilbert ◽  
Vinit Nalawade ◽  
...  
Keyword(s):  
Older Adults ◽  
Big Data ◽  
Chronic Conditions ◽  
Care Utilization ◽  
Cancer Prevalence ◽  
Significant Difference ◽  
Ethnic Subgroups ◽  
Cancer Types ◽  
Administrative Datasets

e18678 Background: Older adults over the age of 65 represent the majority of patients diagnosed with (60%), among them, 15-30% have a pre-existing Alzheimer’s disease or related dementia (ADRD) that puts them at higher risk for over and under treatment. Studying the role of pre-existing ADRD in cancer patients is vital to understanding treatment planning behavior, patterns of health care utilization, and adverse treatment outcomes. Massive administrative datasets, or “big data” represent the information rich environment that is useful for this endeavor. Methods: Our study utilized a clinically validated algorithm to assess the prevalence of pre-existing ADRD and cancer across six cancer types. We utilized the SEER-Medicare dataset for analyzing the study years 2004-2015 (N = 337 932). We extracted ICD-9 codes to identify ADRD using the Centers for Medicaid Services Chronic Conditions Warehouse (CCW) algorithm. In sensitivity analysis we compared the prevalence of ADRD+Cancer using the NCI (2014) and CCW algorithms. Results: We found a significant difference between the two algorithms (p < .0001) and a higher overall prevalence of comorbid ADRD+Cancer using the CCW (6.6%). Additionally, we found ADRD+Cancer prevalence was significantly higher among racial and ethnic subgroups compared to White and unstaged tumors compared with any numbered American Joint Committee on Cancer (AJCC) stages (p < .0001). Conclusions: Using a clinically validated algorithm we were able to identify more cases of ADRD+Cancer in big data. This figure remains underestimated for ADRD+cancer compared to clinically-validated studies. Further research into the validation approach and codes that are used for ADRD classification can improve how we identify ADRD in massive administrative data. This is critical given the growing population of diverse older adults in the U.S.

scholarly journals SAFER MEDICATION MANAGEMENT FOR HOME-DWELLING OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S758-S758
Author(s):  
Henk Verloo ◽  
Armin von Gunten ◽  
Boris Wernli ◽  
Marie SANTIAGO-DELEFOSSE ◽  
Maria Manuela MARTINS ◽  
...  
Keyword(s):  
Older Adults ◽  
Side Effects ◽  
Adverse Effects ◽  
Chronic Conditions ◽  
Medication Management ◽  
Informal Caregivers ◽  
Premature Death ◽  
Difficult Challenge ◽  
At Home

Abstract Taking several medications at the same time can lead to adverse effects and dangerous situations for home-dwelling older adults with chronic conditions. Accurate medication management can be a difficult challenge, especially for people living at home. However, little research has been carried out into the experience of older adults and their informal caregivers with medication management. The aim of the study is, first, to identify factors that can cause undesirable side effects and make taking multiple medications potentially dangerous for home-dwelling older adults. Second, the study will investigate the experiences of this group of patients with medication management. Third, the role of both professional and informal caregivers will be examined. Recommendations will be made on how to improve the safety of medication management for home-dwelling older adults with chronic conditions and should help to prevent the adverse effects and dangerous situations that can lead to hospitalization, institutionalization or premature death

scholarly journals Caregiver Stress and Empathy: Neural and Hormonal Correlates

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 179-179
Author(s):  
Shalmali Mirajkar ◽  
David Warren ◽  
Janelle Beadle
Keyword(s):  
Older Adults ◽  
Stress Reduction ◽  
Resting State ◽  
Chronic Conditions ◽  
Posterior Cingulate Cortex ◽  
Supramarginal Gyrus ◽  
Resting State Functional Connectivity ◽  
Tend And Befriend ◽  
The Right

Abstract Providing care to older adults with chronic conditions can be emotionally meaningful and stressful. The tend-and-befriend theory highlights the role of affiliation/empathy in stress reduction, but it has not been established whether this theory extends to caregivers for older adults. Addressing this gap, we assessed caregiver empathy and stress through behavioral, hormone, and neuroimaging measures. In Experiment 1, we compared 19 caregivers (Mage=67.1) to 24 non-caregivers (Mage=72.6), and found that caregivers with a greater reduction in cortisol to an empathic context showed greater prosocial behavior (r2=0.3). In experiment 2 (N=32), we examined differences between caregivers and non-caregivers in whole brain resting-state functional connectivity (RSFC) with seed regions of interest (posterior cingulate cortex (PCC); amygdala), and covariation of RSFC with empathy (α=0.05). For emotional empathy, caregivers had stronger connectivity between the PCC seed, medial prefrontal cortex, and right supramarginal gyrus, and between the amygdala seed and the right middle frontal gyrus.

scholarly journals Correlates of Influenza Vaccination Among Underserved Latinx Middle-Aged and Older Adults: A Cross-sectional Survey

2021 ◽  
Author(s):  
Mohsen Bazargan ◽  
Adrienne Martinez-Hollingsworth ◽  
Sharon Cobb ◽  
Lucy Kibe
Keyword(s):  
Older Adults ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Medical Care ◽  
Chronic Conditions ◽  
Vaccine Uptake ◽  
Financial Strain ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract Background: Vaccination is a powerful tool in the fight against seasonal influenza, among underserved, middle-age and older, Latinx adults. Yet, vaccine hesitancy and inconsistent uptake in this population continues to represent a substantial challenge to public health. A better understanding of factors impacting influenza vaccination behaviors in this group could result in more effective messaging and initiatives promoting universal vaccination among Latinx. Methods: In this cross-sectional survey, we explore correlates of influenza vaccination uptake among underserved, Latinx, older adults. Our focus was on the role of socio-demographics, living arrangements, financial strain, access and satisfaction with medical care, and the presence of major chronic conditions in terms of vaccine uptake. Middle-aged and older Latinx residents diagnosed with diabetes and/or hypertension (n=165), were recruited from the South Los Angeles Service Plan Area (SPA), a historically under-resourced community. Bi-variate and multi-variate logistical regression were performed on survey data to explore independent correlates of influenza vaccination.Results: Almost half of underserved Latinx older adults in our study (45%) reported influenza vaccination within the 12 months prior to the study. The majority (~85%) reported receiving this recommendation from their primary care provider. However, one-third (30%) of those receiving this advice did not get the vaccine. A decreased likelihood of vaccination was significantly associated with living alone (p=0.026), lacking Medicare coverage (0.028), or higher levels of financial strain (0.020). Difficulty accessing medical care (p=0.008) or dissatisfaction with these experiences (p=0.001) were also strongly associated with decreased likelihood of vaccination. Participants diagnosed with COPD had 9.5 (CI: 1.76 – 51.3) higher odds of being vaccinated compared to those without; no correlation was detected for other chronic conditions.Conclusion: The high number of unvaccinated Latinx participants receiving a vaccine recommendation from a provider is consistent with studies among other ethnic/racial minority older adults and highlights the pivotal role of the provider in influenza vaccine adoption. Additional findings reflect negative impact of Social Determinates of Health (SDoH) on preventive care efforts in this group. Further efforts to quantify these associations are needed to explore structural and human factors impacting influenza vaccine uptake.

scholarly journals The Etiological Role of Common Respiratory Viruses in Acute Respiratory Infections in Older Adults: A Systematic Review and Meta-analysis

2019 ◽  
Vol 222 (Supplement_7) ◽  
pp. S563-S569 ◽  
Author(s):  
Ting Shi ◽  
Andrew Arnott ◽  
Indre Semogas ◽  
Ann R Falsey ◽  
Peter Openshaw ◽  
...  
Keyword(s):  
Older Adults ◽  
Disease Burden ◽  
Causal Attribution ◽  
Respiratory Viruses ◽  
Case Control ◽  
Case Control Studies ◽  
Significant Difference ◽  
Syncytial Virus ◽  
Tract Infections

Abstract Acute respiratory tract infections (ARI) constitute a substantial disease burden in adults and elderly individuals. We aimed to identify all case-control studies investigating the potential role of respiratory viruses in the etiology of ARI in older adults aged ≥65 years. We conducted a systematic literature review (across 7 databases) of case-control studies published from 1996 to 2017 that investigated the viral profile of older adults with and those without ARI. We then computed a pooled odds ratio (OR) with a 95% confidence interval and virus-specific attributable fraction among the exposed (AFE) for 8 common viruses: respiratory syncytial virus (RSV), influenza virus (Flu), parainfluenza virus (PIV), human metapneumovirus (HMPV), adenovirus (AdV), rhinovirus (RV), bocavirus (BoV), and coronavirus (CoV). From the 16 studies included, there was strong evidence of possible causal attribution for RSV (OR, 8.5 [95% CI, 3.9–18.5]; AFE, 88%), Flu (OR, 8.3 [95% CI, 4.4–15.9]; AFE, 88%), PIV (OR, not available; AFE, approximately 100%), HMPV (OR, 9.8 [95% CI, 2.3–41.0]; AFE, 90%), AdV (OR, not available; AFE, approximately 100%), RV (OR, 7.1 [95% CI, 3.7–13.6]; AFE, 86%) and CoV (OR, 2.8 [95% CI, 2.0–4.1]; AFE, 65%) in older adults presenting with ARI, compared with those without respiratory symptoms (ie, asymptomatic individuals) or healthy older adults. However, there was no significant difference in the detection of BoV in cases and controls. This review supports RSV, Flu, PIV, HMPV, AdV, RV, and CoV as important causes of ARI in older adults and provides quantitative estimates of the absolute proportion of virus-associated ARI cases to which a viral cause can be attributed. Disease burden estimates should take into account the appropriate AFE estimates (for older adults) that we report.

scholarly journals CANCER PREVALENCE AND THE ROLE OF MULTIMORBIDITY AMONG OLDER ADULTS: USING NHANES 2011-2016

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S460-S460
Author(s):  
Fei Tang ◽  
Elizabeth Vasquez
Keyword(s):  
Older Adults ◽  
Cancer Risk ◽  
Cancer Prevention ◽  
Chronic Conditions ◽  
Smoking Status ◽  
Simultaneous Presentation ◽  
Epidemiologic Studies ◽  
Multiple Chronic Conditions ◽  
Cancer Prevalence ◽  
Logistic Regression Models

Abstract Cancer risk increases as age, understanding the potential risk factors of cancer is essential for cancer prevention. Biological and epidemiologic studies suggest relationships between individual chronic conditions and increased cancer risk. However, limited researches have analyzed the association between multimorbidity (simultaneous presentation of two or more chronic diseases) and cancer. The current study is aimed to evaluate whether having multimorbidity is associated with increased all-site and site-specific cancer prevalence among older adults. Data of 5,200 older adults aged 55 years and older who participated in the 2011-2016 National Health and Nutrition Examination Survey (NHANES) were included in the study. Single and multiple logistic regression models were used to evaluate the associations between multimorbidity and cancer. 3,623 (70%) individuals in our study were identified as having multimorbidity and 992 (19%) individuals were diagnosed with cancer. After adjusting for demographic covariates and smoking status, having multimorbidity was significantly associated with having all-site cancer (AOR: 1.57; 95% CI: 1.25 – 1.98) and lung cancer (AOR: 8.91; 95% CI: 1.51 - 52.73). Multimorbidity was associated with increased odds of having cancers among older adults. Our findings add to the evidence suggesting the potential relationships between multimorbidity and cancer. Future longitudinal studies are needed to examine the biological mechanisms and temporality of the association. If the association between multimorbidity and cancer is affirmed, it could have substantial implications in public health, as management of multiple chronic conditions could also advantage cancer prevention among older adults.

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