Longitudinal associations between time-varying insomnia symptoms and all-cause healthcare services utilization among middle-aged and older adults in the US

2021 ◽  
Author(s):  
Asos Mahmood ◽  
Satish Kedia ◽  
Aram Dobalian ◽  
Cyril F. Chang ◽  
SangNam Ahn
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Healthcare Services ◽  
Early Morning ◽  
Home Healthcare ◽  
Time Varying ◽  
Middle Aged ◽  
Services Utilization ◽  
Hospital Stays ◽  
Insomnia Symptoms

Abstract This study examines longitudinal associations between time-varying insomnia symptoms (including difficulty initiating sleep, difficulty maintaining sleep, early-morning awakenings, and nonrestorative sleep) and all-cause healthcare services utilization (HSU; overnight hospital stays, nursing home stays, and home healthcare services) among middle-aged and older adults. Data were obtained from 2002 through 2018 waves of the Health and Retirement Study in the US for a population-representative sample of 13,168 adults (aged ≥50 years; mean [SD] age= 66.8±9.4; females= 57.7%; ≥2 comorbid medical conditions= 52.5%). A marginal structural modeling approach and generalized estimating equations were implemented to capture time-varying biological, psycho-cognitive, lifestyle, or behavioral health factors and to adjust for selection bias due to differential loss to follow-up. At baseline, 38.9% of respondents reported experiencing at least one insomnia symptom. During the 16-year follow-up, 72.9%, 17.9%, and 35.1% reported overnight hospital stays, nursing home stays, and home healthcare services utilization, respectively. Higher numbers of insomnia symptoms on a cumulative scale were associated with more overnight hospital stays, nursing home stays, and home healthcare services utilization. Further, experiencing each of difficulty initiating and maintaining sleep, and nonrestorative sleep, as standalone symptoms, was associated with a higher likelihood of HSU compared to those not experiencing any of these symptoms. Independent associations of early-morning awakening with nursing home stays and home healthcare utilization were not significant. The results emphasize the roles of screening and addressing symptoms of insomnia among middle-aged and older adults or those prone to sleep disorders to reduce avoidable HSU. Future investigations should focus on the underlying causes and health systems pathways linking insomnia symptoms to HSU.

Longitudinal associations between insomnia symptoms and all-cause mortality among middle-aged and older adults: A population-based cohort study

SLEEP ◽  
2022 ◽  
Author(s):  
Asos Mahmood ◽  
Meredith Ray ◽  
Kenneth D Ward ◽  
Aram Dobalian ◽  
Sang Nam Ahn
Keyword(s):  
Older Adults ◽  
The United States ◽  
Early Morning ◽  
Time Varying ◽  
Middle Aged ◽  
Insomnia Symptom ◽  
All Cause Mortality ◽  
Longitudinal Associations ◽  
Insomnia Symptoms

Abstract To date, there is no scientific consensus on whether insomnia symptoms increase mortality risk. We investigated longitudinal associations between time-varying insomnia symptoms (difficulty initiating sleep, difficulty maintaining sleep, early-morning awakening, and non-restorative sleep) and all-cause mortality among middle-aged and older adults during 14 years of follow-up. Data were obtained from 2004 through 2018 survey waves of the Health and Retirement Study in the United States for a population-representative sample of 15,511 respondents who were ≥50 years old in 2004. Respondents were interviewed biennially and followed through the end of the 2018 survey wave for the outcome. Marginal structural discrete-time survival analyses were employed to account for time-varying confounding and selection bias. Of the 15,511 cohort respondents (mean [±SD] age at baseline, 63.7 [±10.2] years; 56.0% females), 5,878 (31.9%) died during follow-up. At baseline (2004), 41.6% reported experiencing at least one insomnia symptom. Respondents who experienced one (HR=1.11; 95% CI: 1.03–1.20), two (HR=1.12; 95% CI: 1.01–1.23), three (HR=1.15; 95% CI: 1.05–1.27), or four (HR=1.32; 95% CI: 1.12–1.56) insomnia symptoms had on average a higher hazard of all-cause mortality, compared to those who were symptom-free. For each insomnia symptom, respondents who experienced difficulty initiating sleep (HR=1.12; 95% CI: 1.02–1.22), early-morning awakening (HR=1.09; 95% CI: 1.01–1.18), and nonrestorative sleep (HR=1.17; 95% CI: 1.09–1.26), had a higher hazard of all-cause mortality compared to those not experiencing the symptom. The findings demonstrate significant associations between insomnia symptoms and all-cause mortality, both on a cumulative scale and independently, except for difficulty maintaining sleep. Further research should investigate the underlying mechanisms linking insomnia symptoms and mortality.

scholarly journals Depressive symptoms and health service utilization among Chinese middle aged and older adults: A national population-based longitudinal survey

2020 ◽  
Author(s):  
Jing Guo ◽  
Dexia Kong ◽  
Anao Zhang ◽  
Liming Fang ◽  
Yingxue Zhu
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Health Services Utilization ◽  
Middle Aged ◽  
Cross Sectional ◽  
Services Utilization

Abstract Background: The prevalence of depressive symptoms has been steadily increasing in recent years, however middle aged and older adults was less likely to use mental health services. The aims of this study were to 1) examine the cross-sectional and longitudinal relationships between depressive symptoms and health services utilization among Chinese middle-aged and older adults; and 2) evaluate whether there exists a rural-urban difference in such relationships. Methods: Data was obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015, a nationally representative survey of 13,551 adults aged 45 years and above in China. Multivariate logistic regression analyses were conducted to assess the cross-sectional and longitudinal relationship between depressive symptoms and health services utilization in the whole sample, and urban and rural subsamples respectively. Results: Depressive symptoms were positively associated with a greater likelihood of outpatient and inpatient health services utilization. In addition, the relationships between depressive symptoms and health service use were consistent across rural and urban settings, indicating the robustness of such findings across geographic areas. Conclusions: Findings indicate that depressive symptoms are significantly associated with both in-patient and out-patient health service utilization among Chinese adults. Screening for depressive symptoms needs to be incorporated in these care settings in China.

scholarly journals Depressive symptoms and health service utilization among Chinese middle-aged and older adults: a national population-based longitudinal survey

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Jing Guo ◽  
Dexia Kong ◽  
Liming Fang ◽  
Yingxue Zhu ◽  
Bo Zhang
Keyword(s):  
Older Adults ◽  
Depressive Symptoms ◽  
Health Service ◽  
Health Services ◽  
Service Utilization ◽  
Health Service Utilization ◽  
Health Services Utilization ◽  
Middle Aged ◽  
Cross Sectional ◽  
Services Utilization

Abstract Objectives This study aimed to (1) examine the cross-sectional and longitudinal relationships between depressive symptoms and health services utilization among Chinese middle-aged and older adults; and (2) evaluate whether there exists a rural–urban difference in such relationships. Methods Data was obtained from China Health and Retirement Longitudinal Study (CHARLS) in 2013 and 2015, a nationally representative survey of 13,551 adults aged 45 years and above in China. Results Depressive symptoms were positively associated with a greater likelihood of outpatient and inpatient health services utilization. This association was consistent across rural and urban settings, indicating the robustness of such findings across geographic areas. Conclusions Findings indicate that depressive symptoms are significantly associated with both in-patient and out-patient health service utilization among Chinese adults. Screening for depressive symptoms needs to be incorporated in these care settings in China.

scholarly journals Insomnia and Health Services Utilization in Middle-Aged and Older Adults: Results From the Health and Retirement Study

2013 ◽  
Vol 68 (12) ◽  
pp. 1512-1517 ◽  
Author(s):  
Christopher N. Kaufmann ◽  
Sarah L. Canham ◽  
Ramin Mojtabai ◽  
Amber M. Gum ◽  
Natalie D. Dautovich ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Services ◽  
Health Services Utilization ◽  
Health And Retirement Study ◽  
Middle Aged ◽  
Services Utilization ◽  
Retirement Study

Social Support and Suicidal Ideation in Older Adults Using Home Healthcare Services

2006 ◽  
Vol 14 (9) ◽  
pp. 758-766 ◽  
Author(s):  
Jennifer L. Rowe ◽  
Yeates Conwell ◽  
Herbert C. Schulberg ◽  
Martha L. Bruce
Keyword(s):  
Social Support ◽  
Older Adults ◽  
Suicidal Ideation ◽  
Healthcare Services ◽  
Home Healthcare

scholarly journals “Susceptibility and risk of suffering SARS-COV-2 infection by demographic characteristics and pre-existing medical conditions among middle-aged and older adults in Tarragona, Spain: results from the COVID19 TARRACO Cohort Study, March-June 2020”

2021 ◽  
Author(s):  
EM. Satué-Gracia ◽  
A. Vila-Córcoles ◽  
C. de Diego-Cabanes ◽  
A. Vila-Rovira ◽  
C. Torrente-Fraga ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Nursing Home ◽  
Influenza Vaccination ◽  
Angiotensin Receptor Blockers ◽  
Medical Conditions ◽  
Middle Aged ◽  
Increased Risk ◽  
Receptor Blockers ◽  
Reduced Risk

SUMMARYObjectiveTo analyse susceptibility/risk of suffering COVID19 among adults with distinct underlying medical conditions.MethodsCohort study (population-based) including 79,083 people ≥50 years-old in Tarragona (Southern Catalonia, Spain). At study start (01/03/2020) baseline cohort characteristics (demographic, previous comorbidities, chronic medications and vaccinations’ history) were recorded. Primary outcome was laboratory-confirmed COVID19 incurred in cohort members throughout 01/03/2020-30/06/2020. Risk of suffering COVID19 was evaluated by Cox regression, estimating multivariable hazard ratios (HRs) adjusted for age/sex and previous comorbidities.ResultsAcross study period, 536 laboratory-confirmed COVID19 cases were observed (mean incidence: 39.5 cases per 100,000 persons-week). In multivariable-analysis, age/years (HR: 1.01; 95% CI: 1.00-1.02; p=0.050), nursing-home (HR: 20.19; 95% CI: 15.98-25.51; p<0.001), neurological disease (HR: 1.35; 95% CI: 1.03-1.77; p=0.029), taking diuretics (HR: 1.39; 95% CI: 1.10-1.75; p=0.006), antiplatelet (HR: 1.36; 95% CI: 1.05-1.76; p=0.021) and benzodiazepines (HR: 1.24; 95% CI:1.00-1.53; p=0.047) significantly increased risk; while smoking (HR: 0.57; 95%CI: 0.41-0.80; p=0.001), angiotensin converting enzyme inhibitors (HR: 0.78; 95% CI: 0.61-1.00; p=0.048), angiotensin II receptor blockers (HR: 0.70; 95%CI: 0.51-0.96; p=0.027) and statins (HR: 0.75; 95% CI: 0.58-0.96; p=0.025) were associated with reduced risk. Among non-institutionalised persons, cancer, renal and cardiac disease appeared also related to increased risk, whereas influenza vaccination was associated with reduced risk.ConclusionIn a setting with relatively low incidence of COVID19 across the first wave of pandemic period, age, nursing-home residence and multiple comorbidities appear predisposing for COVID19 among middle-aged/older adults. Conversely, statins, angiotensin-receptor blockers/inhibitors and influenza vaccination were related with decreased risk.

scholarly journals Evolving Transmission Network Dynamics of COVID-19 Cluster Infections in South Korea: a descriptive study

2020 ◽  
Author(s):  
Yejin Kim ◽  
Xiaoqian Jiang
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
South Korea ◽  
Transmission Dynamics ◽  
Contact Tracing ◽  
Transmission Network ◽  
Middle Aged ◽  
Reproduction Numbers ◽  
Path Lengths ◽  
Middle Aged Adults

AbstractBackgroundExtensive contact tracing and testing in South Korea allows us to investigate the transmission dynamics of the COVID-19 into diverse local communities.ObjectiveUnderstand the critical aspects of transmission dynamics in a different age, sex, and clusters with various activities.MethodsWe conducted a retrospective observational study with 3,127 confirmed cases’ contact tracing data from the Center for Disease and Prevention (CDC) of South Korea. We investigated network property concerning infected persons’ demographics and different infection clusters.FindingsOverall, women had higher centrality scores than men after week four, when the confirmed cases rapidly increased. Older adults have higher centrality than young/middle-aged adults after week 9. In the infection clusters, young/middle-aged adults’ infection clusters (such as religious gatherings and gym facilities) have higher average path lengths and diameter than older adult’s nursing home infection clusters.InterpretationSome women had higher reproduction numbers and bridged successive transmission than men when the confirmed cases rapidly increased. Similarly, some older adults (who were not residents of nursing homes) had higher reproduction numbers and bridged successive transmission than young/middle-aged adults after the peak has passed. The young/middle-aged adults’ religious gatherings and group workout have caused long successive transmissions. In contrast, the older adults’ nursing homes were a small world where the transmissions within a few steps can reach out to many persons.FundingUT Startup award, UT STARs award, and Cancer Prevention Research in Texas, and National Institute of General Medical SciencesResearch in contextEvidence before this study:On May 1, 2020, PubMed query (“COVID-19” OR “SARS-nCoV-2” OR “novel coronavirus” OR “nCoV”) AND (“transmission network” OR “transmission dynamics” OR “transmission pattern” OR “centrality”) AND (“cluster” OR “community”) yield eight peer-reviewed papers. These papers have provided an evolving epidemiology and transmission dynamics via estimated reproduction number. However, most of them have focused on the entire system in one location and there was no comparison between transmission dynamics of different clusters.Added value of this study:This study, to the best of our knowledge, is the first to compare the transmission dynamics of different cluster infections. We present the transmission dynamic with varying levels of granularity: entire country vs cluster infections as a longitudinal view. From the whole country-level analysis, we found that females have higher centrality (degree or betweenness) than males. From the cluster infection view, we found that young/middle-aged adults’ infection clusters (such as religious gatherings and gym facilities) have higher average path lengths and diameter than older adult’s nursing home infection clusters.Implications of all the available evidence:This study sheds light on different transmission dynamics concerning demographics (age and sex) and diverse behavior in cluster infections. These findings are essential for planning tailored policies to diverse communities. Our analysis code is publicly available to adapt to newly reported cases.

scholarly journals Association of Sleep Duration and Insomnia Symptoms with Components of Metabolic Syndrome and Inflammation in Middle-Aged and Older Adults with Metabolic Syndrome in Taiwan

Nutrients ◽  
2019 ◽  
Vol 11 (8) ◽  
pp. 1848 ◽  
Author(s):  
Ahmad Syauqy ◽  
Chien-Yeh Hsu ◽  
Hsiao-Hsien Rau ◽  
Adi Lukas Kurniawan ◽  
Jane C-J Chao
Keyword(s):  
Older Adults ◽  
Metabolic Syndrome ◽  
Sleep Duration ◽  
Fasting Blood Glucose ◽  
International Diabetes Federation ◽  
Density Lipoprotein ◽  
Middle Aged ◽  
Cross Sectional ◽  
Long Sleep ◽  
Insomnia Symptoms

The study determined the association of sleep duration and insomnia symptoms with the components of metabolic syndrome and inflammation in middle-aged and older adults with metabolic syndrome in Taiwan. This cross-sectional study used the database compiled in Taiwan between 2004–2013. A total of 26,016 volunteers aged 35 years and above were selected. Metabolic syndrome was defined according to the International Diabetes Federation. Compared with regular sleep duration (6–8 h/day), short (<6 h/day) or long sleep duration (>8 h/day) and insomnia symptoms significantly increased the odds ratios of high waist circumference, high blood pressure, low high-density lipoprotein-cholesterol, high triglycerides, high fasting blood glucose, and high C-reactive protein. Insomnia symptoms did not modify the effects of sleep duration on the components of metabolic syndrome and inflammation. Our study suggests that short or long sleep duration and insomnia symptoms may have an adverse effect on metabolic syndrome and inflammation.

scholarly journals NUTRITIONAL RISK PREDICTS HEALTH SERVICES UTILIZATION AND DEATH OVER 1 YEAR: RESULTS FROM THE UAB STUDY OF AGING II

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S347-S347
Author(s):  
David R Buys ◽  
Richard E Kennedy ◽  
Yue Zhang ◽  
Julie Locher ◽  
Cynthia J Brown
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Nursing Home ◽  
Health Services ◽  
Community Dwelling ◽  
Emergency Department Visits ◽  
Nutritional Risk ◽  
Nursing Home Admission ◽  
Services Utilization

Abstract Nutritional risk has been demonstrated to be associated with poor health outcomes, increased risk of health services utilization (HSU), and mortality among older adults. The aim of this study was to assess the prospective relationship between nutritional risk; HSU focusing separately on emergency department visits, hospitalization, and nursing home admission; and mortality. Using the University of Alabama-Birmingham Study of Aging II, we examined this relationship among 419 community-dwelling older Alabamians (75+years). We used the Mini-Nutrition Assessment (MNA), a well-validated nutritional risk assessment, which classifies individuals as either well-nourished, at-risk or malnourished, collected at baseline. We assessed HSU by asking about healthcare encounters since the last monthly follow-up call for 12 months and verified death with family reports and official documents. We completed univariate, bivariate, and Cox proportional hazards regression analyses with one-year of follow-up data, adjusting for social support, social isolation, comorbidities, and demographic variables. Accounting for covariates, being either at-risk or malnourished, relative to well-nourished, was associated with emergency department visits (HR: 1.30, 95% CI:1.14,1.48), hospitalization (HR: 1.58, 95% CI:1.37,1.82), nursing home admission (HR: 8.94, 95% CI:3.99,20.02), and mortality (HR: 1.90, 95% CI:1.25,2.88). These findings underscore the growing awareness that nutritional risk, particularly for older adults, is a significant factor affecting their well-being and particularly their ability to continue living in the community. Nutrition assessment, interventions, and services for community-dwelling older adults may lead to a reduction in health care utilization, particularly nursing home placement, and ultimately to reduced healthcare costs to families and taxpayers.

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