A Decade of Decline in Serious Cognitive Problems Among Older Americans: A Population-Based Study of 5.4 Million Respondents

2021 ◽  
pp. 1-11
Author(s):  
Esme Fuller-Thomson ◽  
Katherine Marie Ahlin
Keyword(s):  
Educational Attainment ◽  
Generational Differences ◽  
Temporal Trends ◽  
Secondary Analysis ◽  
Population Based ◽  
Community Dwelling ◽  
Older Americans ◽  
Age Cohort ◽  
Nationally Representative ◽  
Cognitive Problems

Background: Numerous studies suggest the prevalence of dementia has decreased over the past several decades in Western countries. Less is known about whether these trends differ by gender or age cohort, and if generational differences in educational attainment explain these trajectories. Objective: 1) To detect temporal trends in the age-sex-race adjusted prevalence of serious cognitive problems among Americans aged 65+; 2) To establish if these temporal trends differ by gender and age cohort; 3) To examine if these temporal trends are attenuated by generational differences in educational attainment. Methods: Secondary analysis of 10 years of annual nationally representative data from the American Community Survey with 5.4 million community-dwelling and institutionalized older adults aged 65+. The question on serious cognitive problems was, “Because of a physical, mental, or emotional condition, does this person have serious difficulty concentrating, remembering, or making decisions?” Results: The prevalence of serious cognitive problems in the US population aged 65 and older declined from 12.2%to 10.0%between 2008 and 2017. Had the prevalence remained at the 2008 levels, there would have been an additional 1.13 million older Americans with serious cognitive problems in 2017. The decline in memory problems across the decade was higher for women (23%) than for men (13%). Adjusting for education substantially attenuated the decline. Conclusion: Between 2008 and 2017, the prevalence of serious cognitive impairment among older Americans declined significantly, although these declines were partially attributable to generational differences in educational attainment.

scholarly journals Age Cohort Differences and Depressive Symptoms Among Community-Dwelling Older Americans

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 61-61
Author(s):  
Ethan Siu Leung Cheung ◽  
Ada Mui
Keyword(s):  
Depressive Symptoms ◽  
Short Form ◽  
Cognitive Status ◽  
Community Dwelling ◽  
Independent Effect ◽  
Depression Symptoms ◽  
Older Americans ◽  
Age Cohorts ◽  
Cohort Differences ◽  
Age Cohort

Abstract This study uses Wave 3 National Social Life, Health and Aging Project to examine the correlation between age cohorts [60s (n=1204); 70s (n=1176); 80 and older (n= 724)], cognitive status, and depression symptoms. In the total sample, 53.90% were females, 76.15% Whites, 15.29% Blacks, and 8.56% Asians. Compared to the 60s and 70s cohorts, 80+ cohort was cognitively more impaired [Mean (SD) of MoCA Short Form were 10.7(2.9), 10.0(3.2), and 8.1(3.6)]. There were no age cohorts’ differences in depressive symptoms experienced (Mean of CESD Short Form = 21.03; SD = 4.06). In order to identify predictors of depression, multiple hierarchical regressions were performed. The 60s sample was the reference group to compare with 70s and 80s cohorts. Results showed that age cohort variables had a significant independent effect as well as a joint effect with cognitive status in explaining depression scores. For each age cohort group, parallel regression analyses were conducted and all models were significant. Findings suggest that ADL impairment was the only common predictor for depressive symptoms for the three cohort groups, and the association was the strongest for the 60s cohort (b = .31). Other unique predictors for 60s cohort were lower-income, more IADLs impairment, higher stress and cognitive impairment. For the 70s cohort, unique predictors of depressive symptoms were female gender, unmarried, and less socialization. For the 80 and above group, correlates of depression are female, White, and high stress level. Findings highlight the necessity of age-sensitive programs on depression support for community-dwelling older Americans.

scholarly journals Temporal Variations in the Intensity of Care Provided to Community and Nursing Home Residents Who Died of COVID-19 in Ontario, Canada

2020 ◽  
Author(s):  
Kevin A. Brown ◽  
Nick Daneman ◽  
Sarah A. Buchan ◽  
Adrienne K. Chan ◽  
Nathan M. Stall
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Temporal Trends ◽  
Nursing Home Residents ◽  
Admission Rate ◽  
Temporal Variations ◽  
Population Based ◽  
Community Dwelling ◽  
High Concentration ◽  
June July

Introduction - Worldwide, nursing home residents have experienced disproportionately high COVID-19 mortality due to the intersection of congregate living, multimorbidity, and advanced age. Among 12 OECD countries, Canada has had the highest proportion of COVID-19 deaths in nursing home residents (78%), raising concerns about a skewed pandemic response that averted much transmission and mortality in community-dwelling residents, but did not adequately protect those in nursing homes. To investigate this, we measured temporal variations in hospitalizations among community and nursing home-dwelling decedents with COVID-19 during the first and second waves of the pandemic.Methods - We conducted a population-based cohort study of residents of Ontario, Canada with COVID-19 who died between March 11, 2020 (first COVID-19 death in Ontario) and October 28, 2020. We examined hospitalization prior to death as a function of 4 factors: community (defined as all non-nursing home residents) vs. nursing home residence, age in years (<70, 70-79, 80-89, ≥90), gender, and month of death (1st wave: March-April [peak], May, June-July 2020 [nadir], 2nd wave: August-October 2020).Results - A total of 3,114 people with confirmed COVID-19 died in Ontario from March to October, 2020 (Table 1), of whom 1,354 (43.5%) were hospitalized prior to death (median: 9 days before death, interquartile range: 4-19). Among nursing home decedents (N=2000), 22.4% were admitted to hospital prior to death, but this varied substantially from a low of 15.5% in March-April (peak of wave 1) to a high of 41.2% in June-July (nadir of wave 1). Among community-dwelling decedents (N=1,114), admission to acute care was higher (81.4%) and remained relatively stable throughout the first and second waves. Similar temporal trends for nursing home versus community decedents were apparent in age-stratified analyses (Figure 1). Women who died were less likely to have been hospitalized compared to men in both community (80% women vs 84% men) and nursing home (21% women vs 24% men) settings.Discussion - Only a minority of Ontario nursing home residents who died of COVID-19 were hospitalized prior to death, and that there were substantial temporal variations, with hospitalizations reaching their lowest point when overall COVID-19 incidence peaked in mid-April, 2020. While many nursing home residents had pre-pandemic advance directives precluding hospitalization, the low admission rate observed in March-April 2020 (15.5%) was inconsistent with both higher admission rates in subsequent months (>30%), and comparatively stable rates among community-dwelling adults. Our findings substantiate reports suggesting that hospitalizations for nursing home residents with COVID-19 were low during the peak of the pandemic’s first wave in Canada, which may have contributed to the particularly high concentration of COVID-19 mortality in Ontario’s nursing homes.

scholarly journals Latent profile analysis of dietary intake in a community-dwelling sample of older Americans

2019 ◽  
Vol 23 (2) ◽  
pp. 243-253 ◽  
Author(s):  
Nicholas J Bishop ◽  
Krystle E Zuniga ◽  
Christina M Ramirez
Keyword(s):  
Health Outcomes ◽  
Dietary Intake ◽  
Latent Profile Analysis ◽  
Profile Analysis ◽  
Secondary Analysis ◽  
Community Dwelling ◽  
Economic Resources ◽  
Food Groups ◽  
Older Americans ◽  
Latent Profile

AbstractObjective:To estimate latent dietary profiles in a community-dwelling sample of older Americans and identify associations between dietary profile membership and individual demographic, socio-economic and health characteristics.Design:Secondary analysis of the 2012 Health and Retirement Study (HRS) and linked 2013 Health Care and Nutrition Study (HCNS). Latent profile analysis identified mutually exclusive subgroups of dietary intake and bivariate analyses examined associations between dietary profile membership, participant characteristics and nutrient intakes.Setting:USA.Participants:An analytic sample of 3558 adults aged 65 years or older.Results:Four dietary profiles were identified with 15·5 % of the sample having a ‘Healthy’ diet, 42·0 % consuming a ‘Western’ diet, 29·7 % having a diet consisting of high intake of all food groups and 12·7 % reporting relatively low intake of all food groups. Members of the ‘Healthy’ profile reported the greatest socio-economic resources and health, and members of the ‘Low Intake’ profile had the fewest resources and worst health outcomes. Macronutrient and micronutrient intakes varied across profile although inadequate and excessive intakes of selected nutrients were observed for all profiles.Conclusions:We identified dietary patterns among older Americans typified by either selective intake of foods or overall quantity of foods consumed, with those described as ‘Low Intake’ reporting the fewest socio-economic resources, greatest risk of food insecurity and the worst health outcomes. Limitations including the presence of measurement error in dietary questionnaires are discussed. The causes and consequences of limited dietary intake among older Americans require further study and can be facilitated by the HRS and HCNS.

scholarly journals Temporal trends in physical activity levels across more than a decade – a national physical activity surveillance system among Norwegian children and adolescents

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Jostein Steene-Johannessen ◽  
Sigmund Alfred Anderssen ◽  
Elin Kolle ◽  
Bjørge Herman Hansen ◽  
Mari Bratteteig ◽  
...  
Keyword(s):  
Physical Activity ◽  
Children And Adolescents ◽  
Large Population ◽  
Temporal Trends ◽  
Population Based ◽  
School Level ◽  
Cluster Sampling ◽  
Activity Levels ◽  
Gender And Age ◽  
Nationally Representative

Abstract Background There is a scarcity of device measured data on temporal changes in physical activity (PA) in large population-based samples. The purpose of this study is to describe gender and age-group specific temporal trends in device measured PA between 2005, 2011 and 2018 by comparing three nationally representative samples of children and adolescents. Methods Norwegian children and adolescents (6, 9 and 15-year-olds) were invited to participate in 2005 (only 9- and 15-year-olds), 2011 and 2018 through cluster sampling (schools primary sampling units). A combined sample of 9500 individuals participated. Physical activity was assessed by hip worn accelerometers, with PA indices including overall PA (counts per minute), moderate-to-vigorous intensity PA (MVPA), and PA guideline adherence (achieving on average ≥ 60 min/day of moderate-to-vigorous PA). Random-effects linear regressions and logistic regressions adjusted for school-level clusters were used to analyse temporal trends. Findings In total, 8186 of the participating children and adolescents provided valid PA data. Proportions of sufficiently active 6-year-olds were almost identical in 2011 and 2018; boys 95% (95% CI: 92, 97) and 94% (95%CI: 92, 96) and girls 86% (95% CI: 83, 90) and 86% (95% CI: 82, 90). Proportions of sufficiently active 15-year-olds in 2005 and 2018 were 52% (95% CI: 46, 59) and 55% (95% CI: 48, 62) in boys, and 48% (95% CI: 42, 55) and 44% (95% CI: 37, 51) in girls, respectively, resulting from small differences in min/day of MVPA. Among 9-year-old boys and girls, proportions of sufficiently active declined between 2005 and 2018, from 90% (95% CI: 87, 93) to 84% (95% CI: 80, 87)) and 74% (95% CI: 69, 79) to 68% (95% CI: 64, 72), respectively. This resulted from 9.7 min/day less MVPA in boys (95% CI: − 14.8, − 4.7; p < 0.001) and 3.2 min/day less MVPA (95% CI: − 7.0, 0.7; p = 0.106) in girls. Conclusions PA levels have been fairly stable between 2005, 2011 and 2018 in Norwegian youth. However, the declining PA level among 9-year-old boys and the low proportion of 15-year-olds sufficiently active is concerning. To evaluate the effect of, and plan for new, PA promoting strategies, it is important to ensure more frequent, systematic, device-based monitoring of population-levels of PA.

scholarly journals Prevalence and Incidence of Osteoarthritis: A Population-Based Retrospective Cohort Study

2021 ◽  
Vol 10 (18) ◽  
pp. 4282
Author(s):  
Rola Hamood ◽  
Matanya Tirosh ◽  
Noga Fallach ◽  
Gabriel Chodick ◽  
Elon Eisenberg ◽  
...  
Keyword(s):  
Western Europe ◽  
Middle Eastern ◽  
Temporal Trends ◽  
Population Based ◽  
Therapeutic Interventions ◽  
P Value ◽  
Modifiable Risk Factors ◽  
The Us ◽  
Nationally Representative ◽  
Care Database

While trends data of osteoarthritis (OA) are accumulating, primarily from Western Europe and the US, a gap persists in the knowledge of OA epidemiology in Middle Eastern populations. This study aimed to explore the prevalence, incidence, correlations, and temporal trends of OA in Israel during 2013–2018, using a nationally representative primary care database. On 31 December 2018, a total of 180,126 OA patients were identified, representing a point prevalence of 115.3 per 1000 persons (95% CI, 114.8–115.8 per 1000 persons). Geographically, OA prevalence was not uniformly distributed, with the Southern and Northern peripheral districts having a higher prevalence than the rest of the Israeli regions. OA incidence increased over time from 7.36 per 1000 persons (95% CI 6.21–7.50 per 1000 persons) in 2013 to 8.23 per 1000 persons (95% CI 8.09–8.38 per 1000 persons) in 2017 (p-value for trend = 0.02). The incidence was lowest in patients under 60 years (in both sexes) and peaked at 60–70 years. In older ages, the incidence leveled off in men and declined in women. The growing risk of OA warrants a greater attention to timely preventive and therapeutic interventions. Further population-based studies in the Middle East are needed to identify modifiable risk factors for timely preventive and therapeutic interventions.

scholarly journals Trends in the prevalence and treatment of depressive symptoms in Peru: a population-based study

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e036777
Author(s):  
David Villarreal-Zegarra ◽  
Milagros Cabrera-Alva ◽  
Rodrigo M Carrillo-Larco ◽  
Antonio Bernabe-Ortiz
Keyword(s):  
Depressive Symptoms ◽  
Rural Areas ◽  
Secondary Analysis ◽  
Specific Treatment ◽  
Population Based ◽  
Treatment Gap ◽  
Treatment Rate ◽  
Population Based Study ◽  
Patient Health ◽  
Nationally Representative

ObjectivesThis study aimed to estimate the trends in the prevalence and treatment of depressive symptoms using nationally representative surveys in Peru from 2014 to 2018.DesignA secondary analysis was conducted using five nationally representative surveys carried out consecutively in the years between 2014 and 2018.SettingThe study was conducted in Peru.ParticipantsIndividuals, men and women, aged ≥15 years who participated in the selected surveys. Sampling was probabilistic using a two-stage approach.Main outcome measuresTwo versions of the Patient Health Questionnaire (PHQ-9) that focused on the presence of depressive symptoms were administered (one in the last 2 weeks and other in the last year). Scores ≥15 were used as the cut-off point in both versions of the PHQ-9 to define the presence of depressive symptoms. Also, the treatment rate was based on the proportion of individuals who had experienced depressive symptoms in the last year and who had self-reported having received specific treatment for these symptoms. The age-standardised prevalence was estimated.ResultsA total of 161 061 participants were included. There was no evidence of a change in age-standardised prevalence rates of depressive symptoms at the 2 weeks prior to the point of data collection (2.6% in 2014 to 2.3% in 2018), or in the last year (6.3% in 2014 to 6.2% in 2018). Furthermore, no change was found in the proportion of depressive cases treated in the last year (14.6% in 2014 to 14.4% in 2018). Rural areas and individuals with low-level of wealth had lower proportion of depressive cases treated.ConclusionsNo changes in trends of rates of depressive symptoms or in the proportion of depressive cases treated were observed. This suggests the need to reduce the treatment gap considering social determinants associated with inequality in access to adequate therapy.

scholarly journals Determinants of Hearing Aid Use Among Older Americans With Hearing Loss

2018 ◽  
Vol 59 (6) ◽  
pp. 1171-1181 ◽  
Author(s):  
Michael M McKee ◽  
HwaJung Choi ◽  
Shelby Wilson ◽  
Melissa J DeJonckheere ◽  
Philip Zazove ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Health Care Providers ◽  
Hearing Aids ◽  
Qualitative Interviews ◽  
Insurance Coverage ◽  
Secondary Analysis ◽  
Care Providers ◽  
Data Set ◽  
Older Americans ◽  
Nationally Representative

Abstract Background and Objectives Hearing loss (HL) is common among older adults and is associated with significant psychosocial, cognitive, and physical sequelae. Hearing aids (HA) can help, but not all individuals with HL use them. This study examines how social determinants may impact HA use. Research Design and Methods We conducted an explanatory sequential mixed methods study involving a secondary analysis of a nationally representative data set, the Health and Retirement Study (HRS; n = 35,572). This was followed up with 1:1 qualitative interviews (n = 21) with community participants to clarify our findings. Both samples included individuals aged 55 and older with a self-reported HL, with or without HA. The main outcome measure was the proportion of participants with a self-reported HL who use HA. Results and Discussion Analysis of HRS data indicated that younger, nonwhite, non-Hispanic, lower income, and less-educated individuals were significantly less likely to use HA than their referent groups (all p values < .001). Area of residence (e.g., urban) were not significantly associated with HA use. Qualitative findings revealed barriers to HA included cost, stigma, vanity, and a general low priority placed on addressing HL by health care providers. Facilitators to obtaining and using HA included family/friend support, knowledge, and adequate insurance coverage for HA. Implications Many socioeconomic factors hinder individuals’ ability to obtain and use HA, but these obstacles appeared to be mitigated in part when insurance plans provided adequate HA coverage, or when their family/friends provided encouragement to use HA.

scholarly journals Index coronary angiography use in Manitoba, Canada: a population-level descriptive analysis of First Nations and non-First Nations recipients

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e020856 ◽  
Author(s):  
Annette S H Schultz ◽  
Lindsey Dahl ◽  
Elizabeth McGibbon ◽  
R Jarvis Brownlie ◽  
Catherine Cook ◽  
...  
Keyword(s):  
First Nations ◽  
Descriptive Analysis ◽  
Temporal Trends ◽  
Secondary Analysis ◽  
Population Level ◽  
Cardiovascular Death ◽  
Population Based ◽  
Secondary Outcome ◽  
Income Quintile ◽  
Comorbidity Scores

ObjectivesTo investigate recipient characteristics and rates of index angiography among First Nations (FN) and non-FN populations in Manitoba, Canada.SettingPopulation-based, secondary analysis of provincial administrative health data.ParticipantsAll adults 18 years or older who received an index angiogram between 2000/2001 and 2008/2009.Primary and secondary outcome measures(1) Descriptive statistics for age, sex, income quintile by rural and urban residency and Charlson Comorbidity Index for FN and non-FN recipients. (2) Annual index angiogram rates for FN and non-FN populations and among those rates of ‘urgent’ angiograms based on acute myocardial infarction (AMI)-related hospitalisations during the previous 7 days. (3) Proportions of people who did not receive an angiogram in the 20 years preceding an ischaemic heart disease (IHD) diagnosis or a cardiovascular death; stratified by age (<65 or ≥65 years old).ResultsFN recipients were younger (56.3vs63.8 years; p<0.0001) and had higher Charlson Comorbidity scores (1.32vs0.78; p<0.001). During all years examined, index angiography rates were lower among FN people (2.67vs3.33 per 1000 population per year; p<0.001) with no notable temporal trends. Among the index angiogram recipients, a higher proportion was associated with an AMI-related hospitalisation in the FN group (28.8%vs25.0%; p<0.01) and in both groups rates significantly increased over time. FN people who died from cardiovascular disease or were older (65+years old) diagnosed with IHD were more likely to have received an angiogram in the preceding 20–30 years (17.8%vs12.5%; p<0.01 and 50.9%vs49.5%; p<0.03, respectively). FN people diagnosed with IHD who were under the age of 65 were less likely to have received an angiogram (47.8%vs53.1%; p<0.01)ConclusionsIndex angiogram use differences are suggested between FN and non-FN populations, which may contribute to reported IHD disparities. Investigating factors driving these rates will determine any association between ethnicity and angiography services.

Planning to move into a nursing home in old age: does sexual orientation matter?

2020 ◽  
Author(s):  
Elzbieta Buczak-Stec ◽  
Hans-Helmut König ◽  
André Hajek
Keyword(s):  
Sexual Orientation ◽  
Nursing Homes ◽  
Physical Functioning ◽  
Sexual Minorities ◽  
Population Based ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Health Related ◽  
Nationally Representative ◽  
Lgbt Individuals

Abstract Background Qualitative studies showed that community-dwelling Lesbian, Gay, Bisexual and Transgender (LGBT) individuals perceive that LGBT individuals are discriminated against in nursing homes (NHs) due to their sexual orientation. Therefore, the objective of this quantitative, population-based study was to investigate the link between sexual orientation and planning to move into a NH in oldage. Methods Cross-sectional data from the most recent sixth wave of the nationally representative German Ageing Survey (n = 4,645) were used. The sexual orientation was dichotomized (heterosexual; sexual minorities including gay/lesbian, bisexual and other). Planning to move into a NH in the future (yes/no) was our outcome measure. Multiple logistic regressions were performed (adjusting for various socioeconomic, psychosocial and health-related covariates). Results Regressions showed that sexual orientation was not significantly associated with plans to move to a NH. Preference to move into NH were consistently positively associated with age (OR: 1.04 (1.02–1.07), not having at least one child (OR: 2.17 (1.41–3.36)), high education (OR: 3.82 (1.32–11.11)), greater loneliness (OR: 1.44 (1.05–1.96)) and worse physical functioning (OR: 0.99 (0.98–1.00)). Conclusions Unexpectedly, our results showed that plans to move to a NH did not differ significantly between heterosexual individuals and sexual minorities. This indicates that sexual orientation does not play a significant role in shaping preferences around moving into a NH ‘in general’. In contrast, other factors like age, greater loneliness and worse physical functioning were important. Those factors should be taken into account when shaping and updating policies on nursing homes.

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