LOW LEVELS OF PHYSICAL ACTIVITY ARE ASSOCIATED WITH COGNITIVE DECLINE, DEPRESSIVE SYMPTOMS AND MOBILITY IMPAIRMENTS IN OLDER ADULTS  ENROLLED IN A HEALTH INSURANCE PLAN

ObjectivesTo (1) estimate the combined risks of cigarette smoking and physical inactivity for chronic disease, disability and depressive symptoms and (2) determine whether risks associated with these behaviours are additive or synergistic.Design and settingLongitudinal observational population study using data from Waves 2 (2004/2005) through 8 (2016/2017) of the English Longitudinal Study of Ageing, a prospective study of community-dwelling older adults in England.Participants6425 men and women aged ≥52 years (mean (SD) 65.88 (9.34) years) at baseline.Main outcome measuresSmoking status (never, former, current) and level of physical activity (high, defined as moderate/vigorous physical activity (MVPA) more than once a week; low, defined as MVPA once a week or less) were self-reported at Wave 2 baseline. Self-rated health, limiting long-standing illness, chronic conditions (coronary heart disease (CHD), stroke, cancer, chronic lung disease) and depressive symptoms were reported in each biennial wave.ResultsBoth smoking and low levels of physical activity were associated with increased risk of incident health problems over the 12-year follow-up period. Current smokers with low levels of physical activity had especially high risks of developing fair/poor self-rated health, CHD, stroke, cancer and chronic lung disease compared with highly active never smokers (adjusted relative risk range 1.89–14.00). While additive effects were evident, tests of multiplicative interactions revealed no evidence of large synergistic effects of smoking and low physical activity (Bayes factor range 0.04–0.61), although data were insensitive to detect smaller effects.ConclusionsAmong older adults in England, there was no evidence of large synergistic effects of smoking and low levels of physical activity on risk of developing chronic disease or depressive symptoms over 12 years. However, additive effects of smoking and low levels of physical activity were evident, underscoring the importance of each of these lifestyle risk behaviours for disease onset.

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Self-perceived health in a group of older adults covered by a health insurance plan

10.5327/z2447-212320202000040 ◽

2020 ◽

Vol 14 (2) ◽

pp. 91-97

Author(s):

Maria Elisa Gonzalez Manso ◽

Leticia Silva de Jesus ◽

Diego Reses de Gino

Keyword(s):

Older Adults ◽

Health Insurance ◽

Sleep Quality ◽

Activities Of Daily Living ◽

Daily Living ◽

Perceived Health ◽

Insurance Plan ◽

Health Insurance Plan ◽

Cross Sectional ◽

Instrumental Activities

INTRODUCTION: Self-perceived health reported by older adults is a tool of great importance for the health care system as it provides an indicator representing physical, cognitive, and emotional aspects of health. OBJECTIVE: To report how a group of older adults covered by a health insurance plan evaluate their self-perceived health and which variables influence their perception. METHOD: This quantitative cross-sectional study included 148 older adults living in the city of São Paulo, Brazil, in 2017. The study variables were sex, age, marital status, performance in basic activities of daily living and instrumental activities of daily living, sleep quality, leisure activity, number of diseases, and use of continuous medication. Statistical analysis was performed using Student’s t-test, χ2 test, or Fisher’s exact test, and logistic regression was used. RESULTS: Significant relationships were observed between poor self-perceived health and the following variables: being female, polypharmacy, number of diseases, sleep quality, and performance in instrumental activities of daily living. Dependence on the instrumental activities of daily living made these older adults 5.33 times more likely to have poor self-perceived health. Each comorbidity added to the health status of this group increased the chance of poor self-perceived health by 1.39 times. CONCLUSION: Self-perceived health in this group of older adults is influenced by several variables; however, degree of dependence and number of diseases were those with the greatest impact.

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PHYSICAL ACTIVITY MEDIATES THE EFFECTS OF DEPRESSIVE SYMPTOMS ON THE COGNITIVE FUNCTION OF OLDER ADULTS

Innovation in Aging ◽

10.1093/geroni/igz038.1388 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S378-S379

Author(s):

Yit Mui Khoo ◽

Hisako Matsuo

Keyword(s):

Physical Activity ◽

Older Adults ◽

Depressive Symptoms ◽

Cognitive Function ◽

Cognitive Decline ◽

Mediation Analysis ◽

Vigorous Physical Activity ◽

Chronically Ill ◽

Hierarchical Regression ◽

The Relationship

Abstract Evidence suggests that depressive symptoms among older adults were associated with cognitive impairment and affect cognitive decline over time, while physical activity was associated with lower risk of cognitive decline or have positive effect on cognitive function. The purpose of this study is to examine whether physical activity could mediate the effects of depressive symptoms on the cognitive function of older adults. Data from the 2014 Health and Retirement Survey (HRS) of older adults ≥ 60 years (N=9,753) were used. Hierarchical regression was conducted to examine the relationship between depressive symptoms, physical activity, and cognitive function. Mediation analysis was used to examine whether physical activity could mediate the effects of depressive symptoms on cognitive function. Regression results indicated that increased depressive symptoms was associated with poorer cognitive function, while increased moderate and mild physical activity were associated with better cognitive function. Mediation analysis indicated that the direct effect of depressive symptoms on cognitive function was significant. The indirect effect of depressive symptoms on cognitive function mediated by moderate and mild physical activity were also significant. Findings suggest that physical activity could potentially improve the cognitive function of older adults who have depressive symptoms. Moderate and mild physical activity could benefit older adults with depressive symptoms and reduce the risk of cognitive decline. Frail, disabled or chronically ill older adults are less likely to participate in vigorous physical activity, but they could benefit from moderate or mild physical activity and have better cognitive health.

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Things You Wanted to Know About Employer Health Insurance Plan (But Were Afraid to Ask)

PsycEXTRA Dataset ◽

10.1037/e311542004-004 ◽

1999 ◽

Author(s):

Alan Goldberg

Keyword(s):

Health Insurance ◽

Insurance Plan ◽

Health Insurance Plan ◽

Employer Health Insurance

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Uncertainty and health insurance

10.1093/oso/9780198794837.003.0010 ◽

2017 ◽

Author(s):

Jan Abel Olsen

Keyword(s):

Health Insurance ◽

Excess Demand ◽

Financial Protection ◽

Insurance Plan ◽

Welfare Gain ◽

Health Insurance Plan ◽

Insurance Contracts ◽

Efficiency Losses ◽

Potential Efficiency

This chapter seeks to explain why most people prefer to have a health insurance plan. Two types of uncertainty give rise to the demand for financial protection: people do not know if they will ever come to need healthcare, and they do not know the full financial implications of illness. Health insurance would take away—or at least reduce—such financial uncertainties associated with future illnesses. A model is presented to show the so-called welfare gain from health insurance. This is followed by an investigation into the potential efficiency losses of health insurance, due to excess demand for services. In the last section, a different efficiency problem is discussed: when people have an incentive to signal ‘false risks’, this can lead to there being no market for insurance contracts which reflect ‘true risks’.

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A Comparison Between Subjective and Objective Methods of Predicting Health Care Expenses to Support Consumers’ Health Insurance Plan Choice

MDM Policy & Practice ◽

10.1177/2381468318781093 ◽

2018 ◽

Vol 3 (1) ◽

pp. 238146831878109 ◽

Cited By ~ 1

Author(s):

Mary C. Politi ◽

Enbal Shacham ◽

Abigail R. Barker ◽

Nerissa George ◽

Nageen Mir ◽

...

Keyword(s):

Health Care ◽

Health Insurance ◽

Health Care Utilization ◽

Subjective Health ◽

Care Utilization ◽

Insurance Plan ◽

Health Insurance Plan ◽

Subjective Health Status ◽

Reported Health ◽

Nationally Representative

Objective. Numerous electronic tools help consumers select health insurance plans based on their estimated health care utilization. However, the best way to personalize these tools is unknown. The purpose of this study was to compare two common methods of personalizing health insurance plan displays: 1) quantitative healthcare utilization predictions using nationally representative Medical Expenditure Panel Survey (MEPS) data and 2) subjective-health status predictions. We also explored their relations to self-reported health care utilization. Methods. Secondary data analysis was conducted with responses from 327 adults under age 65 considering health insurance enrollment in the Affordable Care Act (ACA) marketplace. Participants were asked to report their subjective health, health conditions, and demographic information. MEPS data were used to estimate predicted annual expenditures based on age, gender, and reported health conditions. Self-reported health care utilization was obtained for 120 participants at a 1-year follow-up. Results. MEPS-based predictions and subjective-health status were related ( P < 0.0001). However, MEPS-predicted ranges within subjective-health categories were large. Subjective health was a less reliable predictor of expenses among older adults (age × subjective health, P = 0.04). Neither significantly related to subsequent self-reported health care utilization ( P = 0.18, P = 0.92, respectively). Conclusions. Because MEPS data are nationally representative, they may approximate utilization better than subjective health, particularly among older adults. However, approximating health care utilization is difficult, especially among newly insured. Findings have implications for health insurance decision support tools that personalize plan displays based on cost estimates.

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