scholarly journals Epidemiology of Geographic Disparities of Myocardial Infarction Among Older Adults in the United States: Analysis of 2000–2017 Medicare Data

2021 ◽  
Vol 8 ◽  
Author(s):  
Bin Yu ◽  
Igor Akushevich ◽  
Arseniy P. Yashkin ◽  
Julia Kravchenko
Keyword(s):  
Myocardial Infarction ◽  
Older Adults ◽  
Cox Model ◽  
The United States ◽  
Research Database ◽  
Online Data ◽  
Geographic Disparities ◽  
Lower Survival ◽  
Study Results ◽  
Incidence Prevalence

Background: There are substantial geographic disparities in the life expectancy (LE) across the U.S. with myocardial infarction (MI) contributing significantly to the differences between the states with highest (leading) and lowest (lagging) LE. This study aimed to systematically investigate the epidemiology of geographic disparities in MI among older adults.Methods: Data on MI outcomes among adults aged 65+ were derived from the Center for Disease Control and Prevention-sponsored Wide-Ranging Online Data for Epidemiologic Research database and a 5% sample of Medicare Beneficiaries for 2000–2017. Death certificate-based mortality from MI as underlying/multiple cause of death (CBM-UCD/CBM-MCD), incidence-based mortality (IBM), incidence, prevalence, prevalence at age 65, and 1-, 3-, and 5-year survival, and remaining LE at age 65 were estimated and compared between the leading and lagging states. Cox model was used to investigate the effect of residence in the lagging states on MI incidence and survival.Results: Between 2000 and 2017, MI mortality was higher in the lagging than in the leading states (per 100,000, CBM-UCD: 236.7–583.7 vs. 128.2–357.6, CBM-MCD: 322.7–707.7 vs. 182.4–437.7, IBM: 1330.5–1518.9 vs. 1003.3–1197.0). Compared to the leading states, lagging states had higher MI incidence (1.1–2.0% vs. 0.9–1.8%), prevalence (10.2–13.1% vs. 8.3–11.9%), pre-existing prevalence (2.5–5.1% vs. 1.4–3.6%), and lower survival (70.4 vs. 77.2% for 1-year, 63.2 vs. 67.2% for 3-year, and 52.1 vs. 58.7% for 5-year), and lower remaining LE at age 65 among MI patients (years, 8.8–10.9 vs. 9.9–12.8). Cox model results showed that the lagging states had greater risk of MI incidence [Adjusted hazards ratio, AHR (95% Confidence Interval, CI): 1.18 (1.16, 1.19)] and death after MI diagnosis [1.22 (1.21, 1.24)]. Study results also showed alarming declines in survival and remaining LE at age 65 among MI patients.Conclusion: There are substantial geographic disparities in MI outcomes, with lagging states having higher MI mortality, incidence, and prevalence, lower survival and remaining LE at age 65. Disparities in MI mortality in a great extent could be due to between-the-state differences in MI incidence, prevalence at age 65 and survival. Observed declines in survival and remaining LE require an urgent analysis of contributing factors that must be addressed.

scholarly journals Enhancing Older Adults’ Sense of Belonging and Subjective Well-Being Through Sport Game Attendance, Team Identification, and Emotional Support

2019 ◽  
Vol 32 (7-8) ◽  
pp. 530-542 ◽  
Author(s):  
Yuhei Inoue ◽  
Daniel L. Wann ◽  
Daniel Lock ◽  
Mikihiro Sato ◽  
Christopher Moore ◽  
...  
Keyword(s):  
Older Adults ◽  
Pilot Study ◽  
Emotional Support ◽  
Sense Of Belonging ◽  
Well Being ◽  
The United States ◽  
Team Identification ◽  
Subjective Well Being ◽  
Study Results ◽  
Game Attendance

Objective: We investigate how (a) attendance at sport games and (b) identification with a sport team as fans (i.e., team identification) influence older adults’ perceptions of emotional support, belonging, and subjective well-being (SWB). Method: An experimental pilot study was conducted with 50 older adults, followed by a main survey study administered to 534 older adults from various communities across the United States. Results: Pilot study results indicated that game attendance and team identification had a positive and significant influence on older adults’ perceptions of emotional support from fellow team fans. These results were replicated in the main study, which also showed that older adults’ perceived emotional support from fellow fans was positively associated with their sense of belonging which predicted their SWB. Discussion: The findings provide insights into how older adults may be engaged in meaningful forms of social life to help them maintain and enhance mental health.

Abstract MP54: Increase in the Urban-Rural Divide in Cerebrovascular Mortality Among Middle-Aged Adults From 2013 to 2018

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Marek Cierny ◽  
Shumei Man ◽  
Ken Uchino
Keyword(s):  
African Americans ◽  
The United States ◽  
Mortality Rates ◽  
Research Database ◽  
Stroke Mortality ◽  
Middle Aged ◽  
Online Data ◽  
Rural Counties ◽  
Urban Rural ◽  
Middle Aged Adults

Introduction: Despite observed overall decline cerebrovascular mortality in the United States over the past 2 decades, geographic pockets of increasing cerebrovascular mortality among middle aged adults have been reported on county-level data; and factors driving this regional increase are poorly understood. Methods: We extracted cerebrovascular mortality rates (ICD tenth revision codes I60-I69) in middle aged adults (age 35-64) from Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiological Research database from 1999 to 2018. Variations in annual age-adjusted mortality rates, assessed with Joinpoint regression modeling, are expressed as estimated Annual Percentage Change [APC (95% confidence interval)], stratified by urbanization. In regions with increasing stroke mortality, race-ethnicity and gender subgroups were compared. Results: Mid-age cerebrovascular mortality decreased across urbanization strata between 1999 and 2012. Since 2013, stroke mortality has been increasing in Rural counties [APC +1.8% (+1.0% to +2.6%)] and stagnating in Small-to-Medium Metro counties [APC +0.7% (-0.1% to +1.5%)] and Large Metro counties [APC +0.1% (-0.8% to +0.9%)]. Focusing on rural counties, the profound rate difference between non-Hispanic African Americans and non-Hispanic whites decreased between 1999-2012 at Average APC -1.7% (-2.3% to -1.2%) and since then persisted [Average APC -0.2% (-2.1% to 1.8%)]. Both genders were affected. Conclusion: Since 2013, increase in cerebrovascular mortality in middle-aged adults in rural counties contributes to growing urban-rural divide; while the high stroke mortality rate in non-Hispanic African Americans have ceased to converge with non-Hispanic whites. Upstream drivers of stroke mortality in young and middle-aged rural residents and non-Hispanic African Americans should be further elucidated and vigorously targeted by public health initiatives.

scholarly journals Hip Fracture-Related Mortality among Older Adults in the United States: Analysis of the CDC WONDER Multiple Cause of Death Data, 1999–2013

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Carlos H. Orces
Keyword(s):  
United States ◽  
Older Adults ◽  
Hip Fracture ◽  
Cause Of Death ◽  
The United States ◽  
Mortality Rates ◽  
Online Data ◽  
Annual Percent Change ◽  
Death Record ◽  
Related Mortality

Objectives. To examine trends in hip fracture-related mortality among older adults in the United States between 1999 and 2013. Material and Methods. The Wide-Ranging Online Data for Epidemiological Research system was used to identify adults aged 65 years and older with a diagnosis of hip fracture reported in their multiple cause of death record. Joinpoint regression analyses were performed to estimate the average annual percent change in hip fracture-related mortality rates by selected characteristics. Results. A total of 204,254 older decedents listed a diagnosis of hip fracture on their death record. After age adjustment, hip fracture mortality rates decreased by −2.3% (95% CI, −2.7%, and −1.8%) in men and −1.5% (95% CI, −1.9%, and −1.1%) in women. Similarly, the proportion of in-hospital hip fracture deaths decreased annually by −2.1% (95% CI, −2.6%, and −1.5%). Of relevance, the proportion of cardiovascular diseases reported as the underlying cause of death decreased on average by −4.8% (95% CI, −5.5%, and −4.1%). Conclusions. Hip fracture-related mortality decreased among older adults in the United States. Downward trends in hip fracture-related mortality were predominantly attributed to decreased deaths among men and during hospitalization. Moreover, improvements in survival of hip fracture patients with greater number of comorbidities may have accounted for the present findings.

scholarly journals Proactive Coping and Mindfulness are Associated with Less Stress in Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 909-909
Author(s):  
Lyndsey Graham ◽  
Shevaun Neupert
Keyword(s):  
Older Adults ◽  
Online Survey ◽  
Negative Impact ◽  
Well Being ◽  
The United States ◽  
Proactive Coping ◽  
Present Moment ◽  
Life Event ◽  
Study Results ◽  
The Impact

Abstract We examined the consequences of both chronic and life-event stressors for older adults, as well as antecedent strategies, such as proactive coping and mindfulness, that may mitigate stress. Given the potential negative outcomes associated with stress in older adulthood, exploring strategies to reduce or mitigate the negative impact of stress may be useful in promoting well-being in adulthood. Proactive coping involves an accumulation of resources that leads to reduced or avoided stressors in the future (Aspinwall & Taylor, 1997). Mindfulness calls an individual’s attention to the present moment, or may be characterized as an open, accepting attitude (Brown & Ryan, 2003). Using data from the Mindfulness and Anticipatory Coping Everyday study (English et al., 2019; Neupert & Bellingtier, 2017), 296 older adults in the United States, aged 60-90 years (M = 64.67, SD = 4.36), participated in relevant online survey measures. Results from multiple regression analyses suggested that people high in both chronic stress and life event stress had worse health, and that people high in proactive coping and mindfulness reported less stress. Study results underscore the impact of stress on health outcomes, and provide support for the use of antecedent strategies to address negative impacts of stress.

scholarly journals Trends in mortality of alcoholic liver disease among adults in the United States, 1999-2017

2020 ◽  
Author(s):  
Emily Ryu ◽  
Harry H. Xia ◽  
Grace L Guo ◽  
Lanjing Zhang
Keyword(s):  
United States ◽  
Liver Disease ◽  
Alcoholic Liver Disease ◽  
The United States ◽  
Elderly Subjects ◽  
Mortality Data ◽  
Research Database ◽  
Online Data ◽  
Related Factors ◽  
Alcoholic Fatty Liver

AbstractSome subtypes of alcoholic liver disease (ALD) recently had increasing prevalence or mortality. Prevalence of alcoholic fatty liver disease was increased. Mortality of alcoholic hepatitis and cirrhosis also had upward trends. However, trends in ALD- mortality and related factors are unclear. We therefore examined trends in age-standardized ALD-mortality among U.S. adults by factors using multivariable piecewise log-linear models. We collected mortality-data (age-standardized for the 2000 U.S. standard population) from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database (CDC WONDER), using the Multiple Cause of Death Data to identify all ALD deaths in the United States for 1999-2017. We identified 296,194 deaths of ALD during 1999-2017. Trends in multivariable-adjusted, age-standardized mortality did not differ by sex, race, age or urbanization. The age-standardized mortality ratios of male/female, White/non-White and Metropolitan/Non-Metropolitan were 2.346, 1.657 and 0.851 in 2017, respectively. Strikingly, our multivariable model showed that subjects of 65+ years had the highest and the fastest growing mortality in the 3 age-groups. These findings highlight the continuation of health disparities in ALD, particularly in elderly subjects. Further works are warranted to validate and delineate the associated factors.

Library services to an aging population: A nation-wide study in the United States

2019 ◽  
Vol 52 (3) ◽  
pp. 738-748 ◽  
Author(s):  
Noah Lenstra ◽  
Fatih Oguz ◽  
Courtnay S. Duvall
Keyword(s):  
United States ◽  
Older Adults ◽  
Staff Development ◽  
Large Scale ◽  
Sampling Method ◽  
Public Libraries ◽  
Public Library ◽  
The United States ◽  
Library Services ◽  
Study Results

This study presents a large-scale study of public library services to older adults in the United States. A random sampling method was used to identify public libraries (n=226) for the study. Results suggest that libraries serve their aging communities in multiple ways. Some libraries provide a plethora of specialized programs focused on the specific needs of older adults. Others extend core library services to ensure they are accessible to older adults. Others invest in infrastructure and staff development to prepare for an aging society. Some do not provide any specialized programs or services for older adults. There is great unevenness in terms of library services for older adults across the nation. The discussion suggests additional work needed to better understand this unevenness, and to address it.

P6206Death, debility, and destitution following recurrent myocardial infarction in older adults

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Levitan ◽  
B Poudel ◽  
H Zhao ◽  
V Bittner ◽  
M M Safford ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Older Adults ◽  
Nursing Home ◽  
Health Insurance ◽  
Recurrent Events ◽  
The United States ◽  
Functional Independence ◽  
Financial Strain ◽  
Recurrent Myocardial Infarction

Abstract Background Most prior research on outcomes among older adults with established cardiovascular diseases focuses on recurrent events and hospitalizations. However, older adults value financial security and functional independence in addition to these disease-focused metrics. Recurrent cardiovascular events may increase risk of long-term nursing home residence and financial strain. Purpose To compare the risk for death, debility (long-term residence in a nursing home), and destitution (eligibility for health insurance programs for impoverished individuals) among older adults with recurrent myocardial infarction (MI) and controls. Methods We conducted a retrospective cohort study using administrative data from the United States Medicare program, a health insurance program for older adults. Among all patients who experienced a first overnight hospitalization with a discharge diagnosis of MI between 1 January 2007 and 30 June 2016, we identified patients with a recurrent MI hospitalization. Additionally, we selected controls from the same population of patients with MI, matched on calendar year of the initial MI and days since the initial MI. We included 194,481 patients aged 66 years and older with recurrent MI hospitalizations and 777,924 controls. Patients were followed for death, debility, and destitution until 31 December 2016. We used Kaplan-Meier curves and Cox proportional hazards models adjusted for sociodemographic factors, comorbidities, and healthcare utilization to compare patients with recurrent MI and matched controls. Results The average age of the population was 80.0 (standard deviation 8.3) years and 56.7% were women. Patients with recurrent MI were more likely to have a history of diabetes, chronic kidney disease, heart failure and peripheral artery disease than controls. The cumulative incidence of death, debility, and destitution were all higher among patients with recurrent MI than their matched controls (Figure). Comparing patients with recurrent MI to controls, the hazard ratios (95% confidence intervals) were 2.11 (2.09–2.13) for death, 0.92 (0.89–0.94) for debility, and 1.34 (1.29–1.39) for destitution after multivariable adjustment. Death, debility, and destitution Conclusion Preventing recurrent MIs has the potential to reduce not only mortality but also destitution. Acknowledgement/Funding Amgen, Inc

Refining Evidence-Based Treatments for Late-Life Depression

GeroPsych ◽  
2015 ◽  
Vol 28 (2) ◽  
pp. 67-76
Author(s):  
Grace C. Niu ◽  
Patricia A. Arean
Keyword(s):  
Older Adults ◽  
Mental Illness ◽  
Brain Plasticity ◽  
Late Life ◽  
Aging Population ◽  
The United States ◽  
Future Research ◽  
Evidence Based ◽  
Late Life Depression ◽  
Evidence Based Treatments

The recent increase in the aging population, specifically in the United States, has raised concerns regarding treatment for mental illness among older adults. Late-life depression (LLD) is a complex condition that has become widespread among the aging population. Despite the availability of behavioral interventions and psychotherapies, few depressed older adults actually receive treatment. In this paper we review the research on refining treatments for LLD. We first identify evidence-based treatments (EBTs) for LLD and the problems associated with efficacy and dissemination, then review approaches to conceptualizing mental illness, specifically concepts related to brain plasticity and the Research Domain Criteria (RDoc). Finally, we introduce ENGAGE as a streamlined treatment for LLD and discuss implications for future research.

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