Abstract 18879: Low Income is Associated With Higher Risk of Cardiovascular Events and Mortality in Community Dwelling, Medicare Eligible, College Educated Older Adults With Background Professional Occupation

Abstract

Purpose: Community-dwelling older adults with low income have been shown to be at a higher risk for incident heart failure (HF) and other cardiovascular (CV) events (Circulation 2011; 124: A12064 ). In the current analysis, we further studied the impact of income in community-dwelling, Medicare-eligible, college-educated older adults with professional occupation. Methods: Of the 5795 community-dwelling Medicare-eligible adults ≥65 years old, in the Cardiovascular Health Study (1989-1999), 1404 had college or higher education and a background professional occupation. Of these, 465 (33%) had low income, defined as annual household income <$25,000 (2002 median income for Medicare beneficiaries, $20,400). Results: Patients had a mean (±SD) age of 73 (±5) years; 40% were women; and 13% African American. Unadjusted and age-sex-race-adjusted associations of low-income with outcomes during 13 years of follow-up are displayed in the Table . Conclusions: Nearly one-third of community-dwelling, Medicare-eligible, college-educated older adults with background professional occupation had low income, which was associated with higher risk of incident CV events and deaths. Future studies need to explore underlying mechanisms of these disparities despite Medicare coverage and if this disparity will be attenuated in the future under the new US health care reform law that makes provisions for free preventive care for Medicare beneficiaries.