Association between Skin Conditions and Depressive Disorders in Community-Dwelling Older Adults

2014 ◽  
Vol 18 (4) ◽  
pp. 256-264 ◽  
Author(s):  
Samantha Gontijo Guerra ◽  
Michel Préville ◽  
Helen-Maria Vasiliadis ◽  
Djamal Berbiche
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Depressive Disorders ◽  
Adult Population ◽  
Community Sample ◽  
The Elderly ◽  
Population Based ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Skin Conditions

Background: Depression is frequently observed in dermatologic patients. However, the association between depressive disorders and skin conditions has rarely been explored through population-based studies, especially within older-adult populations. Objective: To test this association in a representative sample of an older-adult population. Methods: Data came from the Survey on the Health of the Elderly (Enquête sur la Santé des Aînés [ESA]), a longitudinal survey conducted in Quebec among 2,811 older adults. Cross-lagged panel models were used to simultaneously examine cross-sectional and longitudinal relationships between the presence of skin conditions and depressive disorders. Results: The prevalence of skin conditions was 13%, and the prevalence of depressive disorders among participants presenting with skin conditions was 11%. Our results indicated significant cross-sectional correlation ( ζ = 0.20) between skin conditions and depressive disorders, but no longitudinal association was observed. Conclusion: Our results reinforce the hypothesis that skin conditions and depressive disorders are concurrently associated in older adults. However, no evidence of the predictive effect of skin problems on depression (and vice versa) was found in our community sample. Despite the deleterious effect of the coexistence of these problems in older adults, studies are lacking. This article highlights the importance of this issue and emphasizes the need for further research on this topic.

Chronic pain is associated with increased health care use among community-dwelling older adults in Brazil: the Pain in the Elderly (PAINEL) Study

2018 ◽  
Vol 36 (5) ◽  
pp. 594-599 ◽  
Author(s):  
Juliana L Torres ◽  
Silvia L A da Silva ◽  
Fabiane R Ferreira ◽  
Liliane P S Mendes ◽  
Luciana A Machado
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Chronic Pain ◽  
Pain Intensity ◽  
The Elderly ◽  
Population Based ◽  
Community Dwelling ◽  
Health Care Use ◽  
Cross Sectional ◽  
Doctor Visits

Abstract Background Chronic pain is known to increase health care use in high-income countries, but in Brazil, little is known. Objective To investigate the association between chronic pain and health care use among Brazilian older adults and explore the relationship between pain severity and health care use. Methods This cross-sectional study was derived from the population-based study Frailty in Brazilian Older People-FIBRA. Chronic pain, pain intensity and pain-related disability were assessed through additional telephone interviews. Health care use was measured by the number of doctor visits, hospitalization events and high health care use (highest quartile of the distribution for number of doctor visits) in the last 12 months. Associations were tested in regression analyses adjusted for predisposing, enabling and illness-level components from the Andersen Model. Results The 383 participants were predominantly female (71.0%), mean age was 75.6 (6.1 SD). The prevalence of chronic pain was 30.0%. Chronic pain was associated with number of doctor visits [unstandardized B coefficient 1.48; 95% confidence interval (CI) = 0.35–2.62] and high health care use [odds ratios (OR) = 2.27; 95% CI = 1.39–3.72]. Pain intensity was associated with high health care use in univariate (OR = 1.13; 95% CI = 1.06–1.20) but not multivariate analysis (OR = 1.12; 95% CI = 0.94–1.33). Pain-related disability was not associated with any outcome. Conclusion Chronic pain increased health care use among Brazilian older adults. Improving the quality of primary care management of individuals at greater risk of chronic pain should be a cornerstone of health policies directed towards reducing the personal and societal burden of ageing.

Alternative methods of pain management for the older adult population: Review of topical pain medications

2015 ◽  
Vol 5 (3) ◽  
pp. 109-122
Author(s):  
Candice Tavares
Keyword(s):  
Older Adults ◽  
Pain Management ◽  
Older Adult ◽  
Adult Population ◽  
The Elderly ◽  
The United States ◽  
Community Dwelling ◽  
Alternative Methods ◽  
Pain Medications ◽  
Older Adult Population

Abstract The older adult population is one of the fastest growing age groups in the United States. As this population continues to expand, determining the safest way to provide pain management has become increasingly important. More than 50% of community-dwelling older adults experience pain on a daily basis, and up to 83% of those in assisted living facilities experience persistent pain. Pain is exceedingly challenging to treat safely and effectively in the elderly because of the physiologic changes that occur as people age. In addition, many nonnarcotic medications with analgesic properties are listed in both the 2012 American Geriatrics Society Beers Criteria for Potentially Inappropriate Medication Use in Older Adults and the Pharmacy Quality Alliance high-risk medications lists. An approach to the growing challenge of managing pain in the elderly that is gaining popularity among community-dwelling patients is the use of topical pain medications. The goal of this article is to review some of the available literature regarding the use of various topical analgesics alone or in combination, and to discuss their known or theoretical mechanisms of peripheral pain modulation. Commercially available or compounded topical pain medications may be used to replace or augment doses of oral medications in an effort to decrease the risk of adverse drug events for older adult patients. When prescribing topical pain medications physicians should consider the nature of the pain targeted, the type of analgesia expected from each ingredient, the potential for systemic absorption, and related side effects.

Abstract WMP57: Declining Blood Pressure is Associated with Subcortical Microinfarcts in Older Adults

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mekala R Raman ◽  
Jonathan Graff-Radford ◽  
Scott A Przybelski ◽  
Timothy G Lesnick ◽  
Michelle M Mielke ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Elderly Population ◽  
Adult Population ◽  
Blood Pressure Measurement ◽  
The Elderly ◽  
Pressure Measurements ◽  
Autopsy Study ◽  
Cross Sectional ◽  
Blood Pressures

Hypertension is highly prevalent in the elderly population and microinfarcts are the most common vascular brain pathology identified in older adults at autopsy. We investigated the associations between systolic and diastolic blood pressures measured antemortem and the presence of microinfarcts at autopsy. Study subjects (n=302; age range=71-95) were participants in the population-based Mayo Clinic Study of Aging autopsy study, who had blood pressure measurements recorded during life. We investigated both cross-sectional systolic and diastolic blood pressure measurements at the baseline visit and the change in blood pressure (slope). Presence and location (subcortical or cortical) of chronic microinfarcts was abstracted from the autopsy reports. Of the 302 study subjects, 47 (16%) had cerebral microinfarcts, and, of those, 18 (38%) had subcortical microinfarcts and 29 (62%) had only cortical microinfarcts. The baseline blood pressures were not different between subjects with no microinfarcts, subcortical microinfarcts, and only cortical microinfarcts. In a logistic regression model including time between last blood pressure measurement and death, a greater decline in systolic [OR= 1.06 (1.01, 1.11); p=0.02]) and greater decline in diastolic [OR= 1.11 (1.02, 1.20); p=0.01] blood pressures were predictors of the presence of subcortical microinfarcts at autopsy. However, these variables were not associated with the presence of cortical microinfarcts. In conclusion, microinfarcts are common in the older adult population, and most of them are located in the cortex. A greater decline in both systolic and diastolic blood pressures and their association with subcortical microinfarcts, but not with cortical microinfarcts, may have implications for aggressive lowering of blood pressure in the elderly population.

Predictors of Physical Activity Levels in Community-Dwelling Older Adults: A Multivariate Approach Based on a Socio-Ecological Framework

2018 ◽  
Vol 26 (1) ◽  
pp. 114-120 ◽  
Author(s):  
Koren L. Fisher ◽  
Elizabeth L. Harrison ◽  
Brenda G. Bruner ◽  
Joshua A. Lawson ◽  
Bruce A. Reeder ◽  
...  
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Environmental Factors ◽  
The Elderly ◽  
Home Care Services ◽  
Community Dwelling ◽  
Nursing Home Care ◽  
Activity Levels ◽  
Inverse Association ◽  
Cross Sectional

The purpose of this study was to explore cross-sectional relationships between self-reported physical activity (PA) and personal, social, and environmental factors in community-dwelling adults aged 50 years and older. Accounting for clustering by neighborhood, generalized estimating equations were used to examine associations between selected correlates and the Physical Activity Scale for the Elderly (PASE) score while adjusting for confounders. Data for 601 participants were analyzed: 79% female, 37% married, mean age 76.8 (± 8.7) years, mean PASE score 112.6 (± 64.8). Age, living in seniors’ housing, using nursing/home care services, receiving encouragement to be active, and having benches available in the neighborhood were inversely associated with PASE. Self-efficacy, SF-12 score, PA barriers, social support, and the presence of trails showed positive associations. Several personal, social, and environmental factors associated with PA were identified. The inverse association between PA and living in seniors’ housing units should be considered when developing PA programs for older adults.

scholarly journals A bio-psycho-social approach for frailty amongst Singaporean Chinese community-dwelling older adults – evidence from the Singapore Longitudinal Aging Study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Nigel Teo ◽  
Pei Shi Yeo ◽  
Qi Gao ◽  
Ma Shwe Zin Nyunt ◽  
Jie Jing Foo ◽  
...  
Keyword(s):  
Older Adults ◽  
Nursing Home ◽  
Functional Disability ◽  
Empirical Studies ◽  
Social Contact ◽  
Population Based ◽  
Community Dwelling ◽  
Severe Disability ◽  
Cross Sectional ◽  
Increased Risk

Abstract Background Few empirical studies support a bio-psycho-social conceptualization of frailty. In addition to physical frailty (PF), we explored mental (MF) and social (SF) frailty and studied the associations between multidimensional frailty and various adverse health outcomes. Methods Cross-sectional and longitudinal analyses were conducted using data from a population-based cohort (SLAS-1) of 2387 community-dwelling Singaporean Chinese older adults. Outcomes examined were functional and severe disability, nursing home referral and mortality. PF was defined by shrinking, weakness, slowness, exhaustion and physical inactivity, 1–2 = pre-frail, 3–5 = frail; MF was defined by ≥1 of cognitive impairment, low mood and poor self-reported health; SF was defined by ≥2 of living alone, no education, no confidant, infrequent social contact or help, infrequent social activities, financial difficulty and living in low-end public housing. Results The prevalence of any frailty dimension was 63.0%, dominated by PF (26.2%) and multidimensional frailty (24.2%); 7.0% had all three frailty dimensions. With a few exceptions, frailty dimensions share similar associations with many socio-demographic, lifestyle, health and behavioral factors. Each frailty dimension varied in showing independent associations with functional (Odds Ratios [ORs] = 1.3–1.8) and severe disability prevalence at baseline (ORs = 2.2–7.3), incident functional disability (ORs = 1.1–1.5), nursing home referral (ORs = 1.5–3.4) and mortality (Hazard Ratios = 1.3–1.5) after adjusting for age, gender, medical comorbidity and the two other frailty dimensions. The addition of MF and SF to PF incrementally increased risk estimates by more than 2 folds. Conclusions This study highlights the relevance and utility of PF, MF and SF individually and together. Multidimensional frailty can better inform policies and promote the use of targeted multi-domain interventions tailored to older adults’ frailty statuses.

scholarly journals Dietary Patterns and Associations with Chronic Diseases of Ageing: Evidence from The Irish Longitudinal Study on Ageing (TILDA)

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Deirdre O'Connor ◽  
Siobhan Scarlett ◽  
Rose Anne Kenny
Keyword(s):  
Older Adults ◽  
Dietary Patterns ◽  
Adult Population ◽  
Health Assessment ◽  
Community Dwelling ◽  
Nutritional Epidemiology ◽  
Processed Foods ◽  
Cross Sectional ◽  
Obesity And Diabetes ◽  
Nationally Representative

AbstractIn the field of nutritional epidemiology, principal component analysis (PCA) has been used to derive dietary patterns, but this has never been conducted in a large, nationally representative sample of older adults in Ireland. The aim was to identify dietary patterns amongst older adults in Ireland derived through PCA and to examine cross-sectional associations with common comorbidities of ageing.PCA was performed using data from Wave 3 of TILDA (2014), a nationally representative cohort of community-dwelling adults aged ≥ 54 (n = 4,395). We derived major dietary patterns from a PCA of reported intake from a Food Frequency Questionnaire (FFQ). Objective measures for Body Mass Index (BMI), diabetes (HbA1c), bone density(heel bone ultrasound), blood pressure and total cholesterol were collected during a health assessment. The Mini-Mental State Examination (MMSE) was also performed during health assessment with trained interviewers, as a measure of global cognitive function.Statistical analyses were conducted using multivariate logistic regression, adjusting for age, sex, marital status, income, educational attainment, alcohol consumption, smoking and physical activity.With the use of PCA, five dietary patterns were identified in the sample - Pattern 1 (fresh fruit, vegetable, fresh fish and dairy), Pattern 2 (confectionary, fatty and processed foods), Pattern 3 (meats, processed meats and salty foods), Pattern 4 (carbohydrates and processed foods) and Pattern 5 (savoury snacks, spreads and processed foods). Those characterized by Pattern 4 were more likely to be overweight (adjusted RRR 0.12, 95% CI 0.05–0.20; p = 0.001), obesity (adjusted RRR 0.18, 95% CI 0.10–0.27; p = 0.001) and have diabetes (adjusted RRR 0.10, 95% CI 0.01–0.19; p = 0.024) after adjusting for known covariates.Our results suggest that in the older adult population of Ireland, a dietary pattern typified by consumption of refined grains and processed carbohydrates is associated with higher prevalence of overweight, obesity and diabetes.

scholarly journals Is the prevalence of dehydration among community-dwelling older adults really low? Informing current debate over the fluid recommendation for adults aged 70+years

2005 ◽  
Vol 8 (8) ◽  
pp. 1275-1285 ◽  
Author(s):  
Jodi Dunmeyer Stookey ◽  
Carl F Pieper ◽  
Harvey Jay Cohen
Keyword(s):  
Older Adults ◽  
Functional Status ◽  
The Elderly ◽  
Community Dwelling ◽  
Plasma Sodium ◽  
Current Debate ◽  
Creatinine Ratio ◽  
Cross Sectional ◽  
Low Prevalence ◽  
Community Dwelling Older Adults

AbstractObjectiveThe fluid recommendation for adults aged 70+ years has been criticised on the basis of a low prevalence of dehydration in community-dwelling older adults. This study explores whether the low prevalence might reflect limitations of individual dehydration indices.DesignCross-sectional data on plasma sodium, blood urea nitrogen (BUN), creatinine, glucose and potassium were used to classify 1737 participants of the 1992 Established Populations for Epidemiologic Studies of the Elderly (EPESE) (70+ years) according to multiple dehydration indices. Associations between dehydration indices, health and functional status were evaluated.ResultsDepending on the indicator used, the prevalence of dehydration ranged from 0.5% for hypotonic hypovolaemia only (plasma tonicity <285 mOsm l−1 with orthostatic hypotension) to 60% with dehydration defined as either plasma sodium ≥145 mEq l−1, BUN/creatinine ratio ≥20, tonicity ≥295 mOsm l−1, or hypotonic hypovolaemia. Elevated tonicity and BUN/creatinine ratio were respectively associated with chronic disease and functional impairment.ConclusionsThe true prevalence of dehydration among community-dwelling adults may be low or high, depending on the indicator(s) used to define dehydration. Before we can pinpoint a generalisable prevalence of dehydration for community-dwelling seniors and draw conclusions about fluid recommendations, validation studies of dehydration indices and longitudinal studies of dehydration, health and functional status are needed.

scholarly journals Characteristics and Circumstances of Falls in the Community-Dwelling Older Adult Population

2020 ◽  
Vol 11 ◽  
pp. 215013272094050 ◽  
Author(s):  
María Pilar Molés Julio ◽  
Ana Lavedán Santamaría ◽  
Teresa Botigué Satorra ◽  
Olga Masot Ariño ◽  
Aurora Esteve Clavero ◽  
...  
Keyword(s):  
Health Care ◽  
Older Adult ◽  
Statistical Significance ◽  
Adult Population ◽  
Community Dwelling ◽  
Survey Study ◽  
Single Family ◽  
Cross Sectional ◽  
Randomized Sampling ◽  
Older Adult Population

Objective: The study aimed to describe the characteristics and circumstances of falls in the community-dwelling older adult population. Design: This was a cross-sectional observational and descriptive study involving primary health care centers in Lleida and Castellón de la Plana, Spain. Randomized sampling was used to include 966 individuals aged 75 years or older residing in single-family homes and in possession of a health care card. Data were obtained using the Survey on Fragility in Older People in Lleida (FRALLE survey). Study variables included the occurrence of falls in the past year and fall characteristics such as whether it was a first or successive fall, cause, season, and time of the day the fall occurred, whether the respondent fell flat on the ground, and time the participant remained on the floor. Other variables involved the circumstances of the fall, including the general location of the fall and specific location within the home if applicable, lighting/weather conditions, objects which may have precipitated the fall, floor conditions, and type of footwear. Results: The prevalence of falls was 25.9% with regard to the previous year, with 70% of these participants reporting having fallen previously. Falls most often occurred by accident, during the daytime, and in the winter. Variables that showed statistical significance with regard to age group were: falling flat on the ground ( P = .031), fall location ( P = .000), presence of an object favoring the fall ( P = .039), floor conditions ( P = .011), and type of footwear ( P = .029). By sex, variables that showed statistical significance included the need for assistance to get up ( P = .045) and type of footwear ( P = .028). Conclusions: The prevalence of falls was found to be similar in the studied cities. The results show the most common characteristics and circumstances of falls in older adults in the community, making it possible to guide future preventive strategies.

scholarly journals Relationship Between Dietary Lutein and Cognition in an Older Adult Population (P14-030-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Krystle Zuniga ◽  
Alexandria Turner ◽  
Nicholas Bishop
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Older Adult ◽  
Verbal Memory ◽  
Adult Population ◽  
Panel Study ◽  
Community Dwelling ◽  
Leafy Vegetables ◽  
Cognitive Domain ◽  
Word Recall

Abstract Objectives The dietary carotenoid lutein accumulates in the brain, and lutein supplementation has been demonstrated to improve cognitive function in older adults. The purpose of the study was to examine the association between dietary lutein intake and cognitive function in a recent and representative sample of the older adult U.S. population. Additionally, we aimed to identify the major contributors to dietary lutein intake in older adults. Methods Observations were drawn from the 2012 Health and Retirement Study (HRS), a nationally-representative panel study of older U.S. adults, and the 2013 Health Care and Nutrition Study (HCNS), which assessed dietary intake via food frequency questionnaire in a subsample of HRS respondents. The analytic sample included 7045 respondents age 50 and older. Cognitive function was evaluated on the cognitive domain of episodic verbal memory, assessed using immediate word recall (IWR) and delayed word recall (DWR). Quartiles of lutein intake were calculated then used to compare IWR and DWR scores in 2012. Descriptive statistics and bivariate comparisons were adjusted for the complex survey design of the HRS and HCNS with results representative of community-dwelling older Americans in 2013. Results The average age of the sample was 65.6 ± 10.3 years old. Leafy vegetables, cruciferous vegetables, dark yellow vegetables, eggs, fruit and other vegetables were significant predictors of dietary lutein intake. Lutein intake was significantly different between quartiles (P < 0.001) with lutein intakes of 720 ± 231 ug/day (Q1), 1468 ± 229 ug/day (Q2), 2394 ± 324 ug/day (Q3), and 5632 ± 3029 ug/day (Q4). Quartiles 3 and 4 had significantly higher IWR and DWR scores than quartiles 1 and 2 (P < 0.001). Conclusions Older adults may benefit from higher lutein intake through consumption of various vegetables, fruits, and eggs, as lutein may specifically protect episodic memory. Further research is needed to identify the mechanism of lutein's cognitive benefits. Funding Sources American Egg Board/Egg Nutrition Center.

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