scholarly journals Relative Clinical and Cost Burden of Community-Acquired Pneumonia Hospitalizations in Older Adults in the United States—A Cross-Sectional Analysis

Vaccines ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 59 ◽  
Author(s):  
Omotola Olasupo ◽  
Hong Xiao ◽  
Joshua Brown
Keyword(s):  
Older Adults ◽  
Length Of Stay ◽  
Disease Burden ◽  
Preventive Treatment ◽  
The United States ◽  
Community Acquired Pneumonia ◽  
Inpatient Mortality ◽  
Cross Sectional ◽  
The Mean ◽  
Sectional Analysis

The relative burden of community-acquired pneumonia (CAP) in older adults (≥65 years old) compared to other serious diseases is important to prioritize preventive treatment. A retrospective analysis was conducted using the 2014 National Readmission Database to evaluate the length of stay, inpatient mortality, 30-day readmissions, and costs of CAP compared to diabetes mellitus (DM), myocardial infarction (MI), and stroke. 275,790 hospitalizations were analyzed and represented a national estimate of 616,300 hospitalizations, including 269,961 for CAP, 71,284 for DM, 126,946 for MI, and 148,109 for stroke. The mean length of stay in CAP was 5.2 days, which was higher than DM (4.6) and MI (4.3) but similar to stroke (5.6). The inpatient mortality risk was lower for DM (RR: 0.37, 95% CI: 0.29–0.46) but higher for MI (RR: 1.67, 95% CI: 1.50–1.85) and stroke (RR: 1.67, 95% CI: 1.51–1.83). The median costs for CAP ($7282) were higher compared to DM ($6217) but lower compared to MI ($14,802) and stroke ($8772). The 30-day readmission rate was 17% in CAP, which was higher compared to MI (15%) and stroke (11.5%) and lower compared to DM (20.3%). In patients with CAP, disease burden is on par with other serious diseases. CAP should be prioritized for prevention in older adults with strategies such as vaccination and smoking cessation.

scholarly journals A Frailty Index from Next-of-Kin Data: A Cross-Sectional Analysis from the Mexican Health and Aging Study

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Mario Ulises Pérez-Zepeda ◽  
Matteo Cesari ◽  
María Fernanda Carrillo-Vega ◽  
Guillermo Salinas-Escudero ◽  
Pamela Tella-Vega ◽  
...  
Keyword(s):  
Older Adults ◽  
Frailty Index ◽  
Community Dwelling ◽  
Next Of Kin ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Aging Study ◽  
The Mean ◽  
Number Of Visits ◽  
Sectional Analysis

Objectives. To construct a frailty index from next-of-kin information of the last year of life of community-dwelling 50 years old or older adults and test its association with health services utilization. Methods. Cross-sectional analysis from next-of-kin data available from the last wave of the Mexican Health and Aging Study (MHAS). Measurements. Along with descriptive statistics, the frailty index (FI) was tested in regression models to assess its association with adverse outcomes previous to death: number of hospitalized days in the previous year and number of visits to a physician in the previous year, in unadjusted and adjusted models. Results. From a total of 2,649 individuals the mean of age was 74.8 (±11.4) and 56.3% (n = 1,183) were women. The mean of the FI was of 0.279 (±SD 0.131, R = 0.0–0.738) and distribution was biased to the right. There was a significant association (p < 0.001) between the FI and number of hospitalized days (β = 45.7, 95% CI 36.1–55.4, p < 0.001) and for the number of visits to a physician (β = 25.93, 95% CI 19.27–32.6, p < 0.001) both models adjusted for age and sex. Conclusion. The FI constructed with next-of-kin data showed similar characteristics to similar indexes of older adults. It was independently associated with health care use.

Abstract P339: Glycemic Excursions and Cognitive Function in Older Adults With Diabetes

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Andreea Rawlings ◽  
A. Richey Sharrett ◽  
Nisa Maruthur ◽  
Christina Parrinello ◽  
Casey Rebholz ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Glycemic Control ◽  
Cross Sectional ◽  
Cognitive Domains ◽  
Z Scores ◽  
The Mean ◽  
Sectional Analysis ◽  
Blood Glucose Concentrations ◽  
Physician Diagnosis

Introduction: The association between glucose excursions and cognitive function in older adults with diabetes is not well described. 1,5-anhydroglucitol (1,5-AG) is a novel biomarker of hyperglycemic excursions. Low 1,5-AG levels reflect blood glucose concentrations exceeding the renal filtration threshold (~180 mg/dl) over the prior 1-2 weeks. Our aim was to test the hypothesis that glucose excursions, as measured by 1,5-AG, were associated with lower cognitive function in older adults with diabetes. Methods: We conducted a cross-sectional analysis of 2000 participants with diabetes from ARIC visit 5 (2011-2013). Diabetes was defined based on self-reported physician diagnosis, diabetes medication use, or HbA1c ≥6.5%. Eleven neuropsychological tests were summarized using Z scores and were grouped into three cognitive domains representing memory, executive function, and language; a global measure of cognitive function was also calculated by averaging and standardizing scores from all tests. 1,5-AG was dichotomized at 10 μg/mL, with values <10 μg/mL reflecting glycemic excursions. Participants were categorized into one of four groups based on 1,5-AG categories and glycemic control (HbA1c <7% vs ≥7%). We used linear regression and adjusted for demographic and clinical characteristics. Results: The mean age of participants was 75 years, 57% were female, and 78% were white. For persons with HbA1c ≥7%, the adjusted differences in cognitive scores comparing 1,5-AG <10 to 1,5-AG ≥10 ug/mL were significantly lower in all domains except memory (Figure). For persons with HbA1c <7%, there were no significant differences in cognitive scores between 1,5-AG categories. Conclusions: Short-term glucose excursions are independently associated with lower cognitive scores in older adults with diabetes and with poor glycemic control (HbA1c ≥7%). Prospective studies are needed to determine if targeting hyperglycemic excursions can improve cognitive function in older adults with diabetes.

scholarly journals Dairy Product Intake and Long-Term Risk for Frailty among French Elderly Community Dwellers

Nutrients ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 2151
Author(s):  
Berna Rahi ◽  
Hermine Pellay ◽  
Virginie Chuy ◽  
Catherine Helmer ◽  
Cecilia Samieri ◽  
...  
Keyword(s):  
Older Adults ◽  
Dairy Product ◽  
Food Group ◽  
Community Dwelling ◽  
Physical Frailty ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Sectional Analysis ◽  
Community Dwelling Older Adults

Dairy products (DP) are part of a food group that may contribute to the prevention of physical frailty. We aimed to investigate DP exposure, including total DP, milk, fresh DP and cheese, and their cross-sectional and prospective associations with physical frailty in community-dwelling older adults. The cross-sectional analysis was carried out on 1490 participants from the Three-City Bordeaux cohort. The 10-year frailty risk was examined in 823 initially non-frail participants. A food frequency questionnaire was used to assess DP exposure. Physical frailty was defined as the presence of at least 3 out of 5 criteria of the frailty phenotype: weight loss, exhaustion, slowness, weakness, and low physical activity. Among others, diet quality and protein intake were considered as confounders. The baseline mean age of participants was 74.1 y and 61% were females. Frailty prevalence and incidence were 4.2% and 18.2%, respectively. No significant associations were observed between consumption of total DP or DP sub-types and frailty prevalence or incidence (OR = 1.40, 95%CI 0.65–3.01 and OR = 1.75, 95%CI 0.42–1.32, for a total DP consumption >4 times/d, respectively). Despite the absence of beneficial associations of higher DP consumption on frailty, older adults are encouraged to follow the national recommendations regarding DP.

scholarly journals Healthcare provider counselling for weight management behaviours among adults with overweight or obesity: a cross-sectional analysis of National Health and Nutrition Examination Survey, 2011–2018

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e039295
Author(s):  
Mary L. Greaney ◽  
Steven A. Cohen ◽  
Furong Xu ◽  
Christie L Ward-Ritacco ◽  
Deborah Riebe
Keyword(s):  
Older Adults ◽  
National Health ◽  
Weight Status ◽  
Calorie Intake ◽  
Nutrition Examination Survey ◽  
Cross Sectional ◽  
Health And Nutrition ◽  
Race Ethnicity ◽  
Sectional Analysis ◽  
Overweight Or Obesity

ObjectivesTo determine if adults with overweight or obesity received counselling from their healthcare providers (HCPs) to lose weight and/or adopt healthful behaviours associated with weight loss, and whether they took action on their HCPs’ recommendations.DesignCross-sectional analysis of 2011–2018 National Health and Nutrition Examination Survey (NHANES) data.SampleNHANES respondents aged 18+ who were overweight/obese and had seen an HCP in the previous 12 months (n=13 158).MethodsRespondents reported if their HCPs recommended they control/lose weight, increase exercise/physical activity (PA) and/or reduce fat/calorie intake, and if they adopted the offered recommendation(s). Weighted logistic regression models examined receipt of HCP counselling by sex, age, race/ethnicity, and weight status accounting for demographic characteristics and complex sampling. Similar analyses examined reported adoption of HCPs’ recommendations.ResultsThe sample was 53.1% women, 45.0% were overweight and 55.0% had obesity. In total, 40.4% received counselling to control/lose weight, 49.5% to increase exercise/PA and 38.9% to reduce fat/calorie intake. The following groups were less likely (p<0.001) to receive counselling: men; younger adults (aged 18–39) versus middle-aged (aged 40–64) and older adults (aged 65+); White versus Black and Hispanic respondents; overweight respondents versus respondents with obesity. Approximately half of those advised to make changes reported doing so (53.6% controlled/lost weight, 57.3% increased exercise/PA, 51.8% reduced fat/calorie intake). Differences in the adoption of recommendations were identified by sex, age group, race/ethnicity and weight status (all p<0.05); women, middle-aged and older adults, Black and Hispanic respondents and individuals with obesity were more likely to adopt one or more recommendations.ConclusionMost respondents did not receive HCP counselling, and approximately half of those who received counselling reported taking action. HCPs may need training to provide counselling and to offer recommendations tailored to the social contexts of populations less likely to adopt weight control related recommendations.

The Opioid Epidemic and Homicide in the United States

2021 ◽  
pp. 002242782098684
Author(s):  
Richard Rosenfeld ◽  
Joel Wallman ◽  
Randolph Roth
Keyword(s):  
United States ◽  
Death Rate ◽  
The United States ◽  
Opioid Epidemic ◽  
Drug Markets ◽  
Cross Sectional ◽  
Homicide Rates ◽  
Overdose Death ◽  
Sectional Analysis ◽  
The Relationship

Objectives: Evaluate the relationship between the opioid epidemic and homicide rates in the United States. Methods: A county-level cross-sectional analysis covering the period 1999 to 2015. The race-specific homicide rate and the race-specific opioid-related overdose death rate are regressed on demographic, social, and economic covariates. Results: The race-specific opioid-related overdose death rate is positively associated with race-specific homicide rates, net of controls. The results are generally robust across alternative samples and model specifications. Conclusions: We interpret the results as reflecting the violent dynamics of street drug markets, although more research is needed to draw definitive conclusions about the mechanisms linking opioid demand and homicide.

scholarly journals Longer Residence in the United States is Associated With More Physical Function Limitations in African Immigrant Older Adults

2020 ◽  
pp. 073346482097760
Author(s):  
Manka Nkimbeng ◽  
Yvonne Commodore-Mensah ◽  
Jacqueline L. Angel ◽  
Karen Bandeen-Roche ◽  
Roland J. Thorpe ◽  
...  
Keyword(s):  
United States ◽  
Older Adults ◽  
Confidence Interval ◽  
Physical Function ◽  
Racial Discrimination ◽  
African Immigrants ◽  
The United States ◽  
African Immigrant ◽  
High Discrimination ◽  
The Mean

Acculturation and racial discrimination have been independently associated with physical function limitations in immigrant and United States (U.S.)-born populations. This study examined the relationships among acculturation, racial discrimination, and physical function limitations in N = 165 African immigrant older adults using multiple linear regression. The mean age was 62 years ( SD = 8 years), and 61% were female. Older adults who resided in the United States for 10 years or more had more physical function limitations compared with those who resided here for less than 10 years ( b = −2.62, 95% confidence interval [CI] = [–5.01, –0.23]). Compared to lower discrimination, those with high discrimination had more physical function limitations ( b = −2.51, 95% CI = [–4.91, –0.17]), but this was no longer significant after controlling for length of residence and acculturation strategy. Residing in the United States for more than 10 years is associated with poorer physical function. Longitudinal studies with large, diverse samples of African immigrants are needed to confirm these associations.

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