scholarly journals Private Insurance and Mental Health among Older Adults with Multiple Chronic Conditions: A Longitudinal Analysis by Race and Ethnicity

2021 ◽  
Vol 18 (5) ◽  
pp. 2615
Author(s):  
Hankyung Jun ◽  
Emma Aguila
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Race And Ethnicity ◽  
Chronic Conditions ◽  
Private Insurance ◽  
The United States ◽  
Mental Illnesses ◽  
Multiple Chronic Conditions

Older adults with multiple chronic conditions have a higher risk than those without multiple conditions of developing a mental health condition. Individuals with both physical and mental conditions face many substantial burdens. Many such individuals also belong to racial and ethnic minority groups. Private insurance coverage can reduce the risks of developing mental illnesses by increasing healthcare utilization and reducing psychological stress related to financial hardship. This study examines the association between private insurance and mental health (i.e., depressive symptoms and cognitive impairment) among older adults in the United States with multiple chronic conditions by race and ethnicity. We apply a multivariate logistic model with individual fixed-effects to 12 waves of the Health and Retirement Study. Among adults with multiple chronic conditions in late middle age nearing entry to Medicare and of all racial and ethnic groups, those without private insurance have a stronger probability of having depressive symptoms. Private insurance and Medicare can mediate the risk of cognitive impairment among non-Hispanic Whites with multiple chronic conditions and among Blacks regardless of the number of chronic conditions. Our study has implications for policies aiming to reduce disparities among individuals coping with multiple chronic conditions.

scholarly journals Association between patterns of multiple chronic conditions and cognitive impairment in community‐dwelling older adults in Taiwan

2021 ◽  
Vol 17 (S10) ◽  
Author(s):  
Pei‐Iun Hsieh ◽  
Yen‐Ching Chen ◽  
Jeng‐Min Chiou ◽  
Ta‐Fu Chen ◽  
Su‐Ling Yeh ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Chronic Conditions ◽  
Community Dwelling ◽  
Multiple Chronic Conditions ◽  
Community Dwelling Older Adults

scholarly journals Seeking a pot of gold with integrated behavior therapy and research to improve health equity: insights from the RAINBOW trial for obesity and depression

2021 ◽  
Author(s):  
Elizabeth M Venditti ◽  
Lesley E Steinman ◽  
Megan A Lewis ◽  
Bryan J Weiner ◽  
Jun Ma
Keyword(s):  
Mental Health ◽  
Behavioral Medicine ◽  
Behavior Therapy ◽  
Chronic Conditions ◽  
The United States ◽  
Multiple Chronic Conditions ◽  
Dissemination And Implementation ◽  
Physical And Mental Health ◽  
Medicine Research ◽  
Increased Risk

Abstract More than one third of adults in the United States (U.S.) live with multiple chronic conditions that affect their physical and mental health, functional outcomes, independence, and mortality. The COVID-19 pandemic has exposed not only an increased risk for infection, morbidity, and mortality among those with chronic conditions but long-standing health inequities by age, race, sex, and other social determinants. Obesity plus depression represent one such prevalent comorbidity for which few effective integrated interventions exist, prompting concern about the potential for secondary physical and mental health pandemics post COVID-19. Translational behavioral medicine research can play an important role in studying integrated collaborative healthcare approaches and advancing scientific understanding on how to engage and more effectively treat diverse populations with physical and mental health comorbidities. The RAINBOW (Research Aimed at Improving Both Mood and Weight) clinical trial experience offers a wealth of insights into the potential of collaborative care interventions to advance behavior therapy research and practice. Primary care patients with co-occurring obesity and depression were assigned to either Integrated Coaching for Mood and Weight (I-CARE), which blended Group Lifestyle Balance (GLB) for weight management and the Program to Encourage Active Rewarding Lives (PEARLS) for depression, or usual care, to examine clinical, cost-effectiveness, and implementation outcomes. This commentary highlights the empirical findings of eight RAINBOW research papers and discusses implications for future studies, including their relevance in the U.S. COVID-19 context. Organized by key principles of translational behavioral medicine research, the commentary aims to examine and embrace the heterogeneity of baseline and intervention response differences among those living with multiple chronic conditions. We conclude that to prevent health and healthcare disparities from widening further, tailored engagement, dissemination, and implementation strategies and flexible delivery formats are essential to improve treatment access and outcomes among underrepresented populations.

scholarly journals DOES ONSET OF CHRONIC CONDITIONS MODERATE THE IMPACT OF RELATIONAL LIFE EVENTS ON DEPRESSED MOOD?

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S260-S260
Author(s):  
Aaron M Ogletree ◽  
Rosemary Blieszner ◽  
Rachel Pruchno ◽  
Jyoti Savla ◽  
Laura P Sands
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Depressive Symptoms ◽  
Life Events ◽  
Chronic Conditions ◽  
Chronic Condition ◽  
Process Model ◽  
Mixed Effect ◽  
The Impact ◽  
Over Time

Abstract More than 62% of adults aged 65+ have more than one chronic condition; this number increases to more than 82% for those 85+. Older adults simultaneously experience changes in their relationships due to negative relational life events, including illness, injury, or death of a loved one. Stressors occurring in tandem can overload psychological resources and increase risk for poor mental health. Informed by the stress process model, we assessed the influence of relational life events on depressive symptoms over time and evaluated the moderating effects of chronic condition onset. Self-reports of four stressful life events, five chronic conditions, and depressive symptoms as measured by the CES-D came from 2,948 older adults participating in the ORANJ BOWL panel. Using longitudinal multilevel mixed effect modeling, we examined trajectories of depressive symptoms across three waves. While depressive symptoms increased over time, they were greater for people who experienced more relational life events and the onset of more chronic conditions. Participants who reported experiencing all four relational life events but no chronic conditions had an average CES-D score of 5.28 (p<.0001); average CES-D score increased to 12.72 (p<.0001) for those who reported four life events and the onset of four or more new chronic conditions during the study period. In summary, chronic condition onset moderated the relationship between life events and depressive symptoms. Findings highlight the need for practitioner awareness of increased mental health risks for people experiencing stressors in multiple domains of life.

scholarly journals The Engagement in Physical Activity for Middle-Aged and Older Adults with Multiple Chronic Conditions: Findings from a Community Health Assessment

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Wei-Chen Lee ◽  
Marcia G. Ory
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Chronic Conditions ◽  
Health Assessment ◽  
The United States ◽  
Cross Sectional Study ◽  
Multiple Chronic Conditions ◽  
Middle Aged ◽  
Cross Sectional ◽  
Musculoskeletal Systems

The current aging trends accompanying the increasing prevalence of multiple chronic conditions (MCCs) and decreasing participation in physical activity (PA) have swept the United States. In light of the magnitude of this phenomenon, this study seeks to identify the most common MCC combinations and their relationships with PA level. A cross-sectional study,Brazos Valley Health Assessment, was conducted between October 2009 and July 2010. All data analyses were performed by STATA 12.0. The overall sample which met the inclusion criteria is 2,603. Among people older than 45 years, chronic conditions of cardiovascular, endocrine, and musculoskeletal systems were the most prevalent. Participants with three chronic conditions were less likely to meet the PA standard than those with only two chronic conditions. Younger age, women, rural residence, and unsafe environments were related to the lower PA level. After adjusting for seven covariates, all MCCs combinations adversely affect the level of PA (, ). People with MCCs were among the least active subgroups despite the health benefits of doing exercise. Given the well-documented benefits of physical activity for delaying the onset or progression of MCCs, public health efforts to enhance regular PA in middle-aged and older adults are recommended.

scholarly journals Cognitive Impairment, Depression, and Cooccurrence of Both among the Elderly in Panama: Differential Associations with Multimorbidity and Functional Limitations

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Alcibiades E. Villarreal ◽  
Shantal Grajales ◽  
Lineth Lopez ◽  
Gabrielle B. Britton ◽  
Panama Aging Research Initiative
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Chronic Conditions ◽  
Mental Health Problems ◽  
Functional Limitations ◽  
Depression Scale ◽  
The Elderly ◽  
Community Dwelling ◽  
Multinomial Regression

Cognitive impairment and depression are common mental health problems among the elderly, although few studies have examined their cooccurrence in older adults in Latin America. The purpose of this study was to examine cognitive impairment, depression, and cooccurrence of the two conditions and associated factors in a sample of older adults in Panama. This study included 304 community-dwelling elderly (≥65 years) individuals. Participants underwent a clinical interview and assessments of cognitive function by the Minimental State Examination and depressive symptoms by the Geriatric Depression Scale. Limitations in basic (BADL) and instrumental (IADL) activities in daily living and the presence of chronic illnesses were recorded. Multinomial regression analysis revealed that cooccurrence of cognitive impairment and depressive symptoms was explained by increasing age (OR: 3.2, 95% CI: 1.20, 8.30), low education (OR: 3.3, 95% CI: 1.33, 8.38), having four or more chronic conditions (OR: 11.5, 95% CI: 2.84, 46.63), and BADL limitations (OR: 5.0, 95% CI: 1.26, 19.68). Less education and limitations in BADL and IADL increased the odds of cognitive impairment alone, while less education and three or more chronic conditions increased the odds of depression alone. These findings underscore the relevance of assessing cognitive impairment in the elderly as part of a long-term approach to managing depression and vice versa.

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