scholarly journals Effect of Demographic and Health Dynamics on Cognitive Status in Mexico between 2001 and 2015: Evidence from the Mexican Health and Aging Study

Geriatrics ◽  
2021 ◽  
Vol 6 (3) ◽  
pp. 63
Author(s):  
Silvia Mejia-Arango ◽  
Jaqueline Avila ◽  
Brian Downer ◽  
Marc A. Garcia ◽  
Alejandra Michaels-Obregon ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cognitive Impairment ◽  
Cardiovascular Diseases ◽  
Educational Attainment ◽  
Access To Health Care ◽  
Sociodemographic Factors ◽  
Cognitive Status ◽  
Access To Health ◽  
Mexican Adults

Sources of health disparities such as educational attainment, cardiovascular risk factors, and access to health care affect cognitive impairment among older adults. To examine the extent to which these counteracting changes affect cognitive aging over time among Mexican older adults, we examine how sociodemographic factors, cardiovascular diseases, and their treatment relate to changes in cognitive function of Mexican adults aged 60 and older between 2001 and 2015. Self and proxy respondents were classified as dementia, cognitive impairment no dementia (CIND), and normal cognition. We use logistic regression models to examine the trends in dementia and CIND for men and women aged 60 years or older using pooled national samples of 6822 individuals in 2001 and 10,219 in 2015, and sociodemographic and health variables as covariates. We found higher likelihood of dementia and a lower risk of CIND in 2015 compared to 2001. These results remain after adjusting for sociodemographic factors, cardiovascular diseases, and their treatment. The improvements in educational attainment, treatment of diabetes and hypertension, and better access to health care in 2015 compared to 2001 may not have been enough to counteract the combined effects of aging, rural residence disadvantage, and higher risks of cardiovascular disease among older Mexican adults.

scholarly journals Older adults with disability in extreme poverty in Peru: How is their access to health care?

PLoS ONE ◽  
2018 ◽  
Vol 13 (12) ◽  
pp. e0208441
Author(s):  
Oscar Flores-Flores ◽  
Ruth Bell ◽  
Rodney Reynolds ◽  
Antonio Bernabé-Ortiz
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Access To Health Care ◽  
Extreme Poverty ◽  
Access To Health

scholarly journals The Sequence of Physical and Cognitive Impairment and the Association with Mortality Among Unimpaired Older Mexican Adults

2019 ◽  
Vol 75 (7) ◽  
pp. 1386-1392
Author(s):  
Brian Downer ◽  
Sadaf Milani ◽  
Rebeca Wong
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mortality Risk ◽  
Multinomial Logistic Regression ◽  
Cognitive Status ◽  
Cognitively Impaired ◽  
Proportional Hazard ◽  
Physical Impairments ◽  
Aging Study ◽  
Mexican Adults

Abstract Background Many older adults become physically and cognitively impaired. However, it is unclear whether unimpaired older adults are more likely to become physically or cognitively impaired first and if this sequence impacts mortality risk. Methods Data came from the Mexican Health and Aging Study. The sample included 1,283 participants aged ≥60 years who were physically and cognitively unimpaired in 2001. Multinomial logistic regression was used to estimate probabilities of being unimpaired, cognitively impaired only, physically impaired only, or cognitively-physically impaired in 2003. Proportional hazard models were used to estimate mortality risk through 2015 according to physical and cognitive status in 2003. Results The probabilities for being unimpaired, physically impaired only, cognitively impaired only, and cognitively-physically impaired in 2003 were 0.45, 0.22, 0.19, and 0.13, respectively. Older age, female sex, and arthritis were associated with significantly greater probability of becoming physically impaired only than cognitively impaired only in 2003. Cognitive impairment only (hazard ratio [HR] = 1.42, 95% confidence interval [CI] = 1.09–1.85) in 2003 but not physical impairment only (HR = 1.22, 95% CI = 0.94–1.58) was associated with greater mortality than being unimpaired in 2003. Cognitively-physically impaired participants had higher mortality risk than participants who were physically (HR = 1.58, 95% CI = 1.18–2.12) or cognitively (HR = 1.36, 95% CI = 1.01–1.84) impaired only. Discussion The likelihood of becoming only physically or cognitively impaired over 2 years varies by demographic and health characteristics. The mortality risk for unimpaired older adults who become cognitively impaired only is similar to those who become physically impaired only. Research should determine if the sequence of cognitive and physical impairments is associated with other outcomes.

Technology and Access to Health Care Services Among Older Adults

2008 ◽  
Author(s):  
Sara J. Czaja ◽  
Joseph Sharit ◽  
Chin Chin Lee ◽  
Sankaran N. Nair
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Care Services ◽  
Access To Health

Access to Health Care and Self-Rated Health Among Community-Dwelling Older Adults

2001 ◽  
Vol 20 (3) ◽  
pp. 307-321 ◽  
Author(s):  
R. Turner Goins ◽  
Judith C. Hays ◽  
Lawrence R. Landerman ◽  
Gerry Hobbs
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Access To Health Care ◽  
Community Dwelling ◽  
Self Rated Health ◽  
Access To Health ◽  
Community Dwelling Older Adults

scholarly journals The Impact of Cognitive Impairment on Resource Utilization During Medicare Home Health Care

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 260-260
Author(s):  
Julia Burgdorf ◽  
Jennifer Wolff
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cognitive Impairment ◽  
Resource Utilization ◽  
Home Health Care ◽  
Cognitive Status ◽  
Home Health ◽  
Payment System ◽  
Health Payment ◽  
The Relationship

Abstract Older adults with cognitive impairment have unique care needs that often lead to greater levels of health care utilization. Prior work suggests that older adults with cognitive impairment access home health care at higher rates; yet, recent Medicare home health payment system revisions exclude patient cognitive status when determining risk adjustment. This research examines the relationship between patient cognitive status and resource utilization during Medicare home health care. We examine 1,217 (weighted n=2,134,620) community-dwelling older adults who received Medicare-funded home health between 2011-2016, using linked nationally representative survey data from the National Health and Aging Trends Study (NHATS), home health patient assessment data, Medicare claims data, and Medicare Provider of Services files. We use weighted, multivariable negative binomial regressions to model the relationship between patient dementia status and the expected number of total visits and number of each visit type (nursing, therapy, and aide) during home health. Models adjusted for patient sociodemographic characteristics and health and functional status during home health, as well as home health provider characteristics. Among Medicare home health patients, the presence of cognitive impairment during home health is associated with 2.87 additional total visits (p<0.001), 1.27 additional nursing visits (p<0.01), and 1.23 additional therapy visits (p=0.04) during the home health episode. Findings suggest that recent revisions to the Medicare home health payment system may disincentivize home health care for older adults with dementia and/or financially penalize home health providers whose patient populations have a greater dementia burden.

Disparities in Access to Health Care Among Middle-Aged and Older Adults with Disabilities

2014 ◽  
Vol 26 (4) ◽  
pp. 324-346 ◽  
Author(s):  
Nancy A. Miller ◽  
Adele Kirk ◽  
Michael J. Kaiser ◽  
Lukas Glos
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Access To Health Care ◽  
Middle Aged ◽  
Adults With Disabilities ◽  
Access To Health

scholarly journals Inpatient and outpatient health care utilization and expenditures among older adults aged 50 years and above in India

2016 ◽  
Vol 15 (2) ◽  
pp. 11-19 ◽  
Author(s):  
Ankit Anand
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Access To Health Care ◽  
Health Care Services ◽  
Adult Population ◽  
Socioeconomic Characteristics ◽  
Care Services ◽  
Access To Health ◽  
Older Adult Population

Background: Social and economic inequality in utilization of health care services, as well as high out of pocket expenditures are prevalent in overall Indian population. The situation among older adults will be much more critical as they require long-term health care services. The objective of this study is to assess the utilization of outpatient and inpatient care among older adults and incurred out of pocket health expenditure. It also tried to explore the association between socioeconomic factors on receiving health care services and out of pocket health expenditure among older adults in India.Data source: The data from the Study on Global Ageing and Adult Health (SAGE) Wave 1 was used, which was conducted in 2007-08 in India. Respondents aged 50 and above are taken as older adult population. The final sample size was 7150 respondents aged 50 years and above.Results: The percentage of older adults aged 50 years and above receiving outpatient and inpatient health care service were 87.5% and 14.6% respectively. The use of private health facilities was high compared to government health facility. High utilization of outpatient among women and high use of inpatient care among men were found, which was insignificant after adjusting for other variables. Socioeconomic characteristics also play an important role in access to health care among older adults. Place of residence, marital status, caste, education and presence of morbidity were related to the utilization of health care services. Place of residence, education and wealth quintile were also significantly associated with health expenditures.Conclusion: Requirement of long-term health care among older adult population may result in increasing burden of health care expenditures. Socioeconomic characteristics also play an important role in access to health care among older adults. Developing quality and affordable health care services for older adults to ensure equity in accessibility and affordablility will be a major task for the public health system in India.

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