Australian Longitudinal Study Of Ageing Research Articles

Risk factors of oral health related quality of life: An evidence from Australian Longitudinal Study of Ageing

AbstractBackgroundOral disease and tooth loss have a significant negative impact on the quality of life and well‐being of older adults. As OHRQoL is a major feature of the daily experiences of older adults, alongside decreased general health and functioning, and shrinking social networks and activities, it is particularly important to examine whether a relationship between OHRQoL and amongst socioeconomic and psychological factors exists. Socioeconomic disparities in oral health have been consistently demonstrated for various indicators, mostly clinical and disease related but also subjective measures of oral health and quality of life. The key risk factors include poor general health, depression, anxiety, loneliness and low social participation and social support.MethodWe utilized secondary data from the seventh wave of Australian longitudinal study of Ageing (ALSA). ALSA was coordinated by the research teams of Flinders University, Australia. The data analysis included a sample of 257 (98‐male, 159‐female) participants from rural Australia. Chi‐square and Wilcoxon’s tests were applied on categorical variables to under the association between outcome and predictors. We created depression scale based on 20 indicators of depression among older people. The multinomial logistic regression model was used to study the strengths of relationships between oral health related quality of life (OHRQoL) and its possible risk factors.ResultThe study found a clear and significant association between OHRQoL and depression, loneliness, anxiety including socio‐economic factors such as age, sex, income and family structure. The older people who faced a little or no difficulty in performing the activities such as eating food, speaking clearly, smiling, laughing and showing teeth without embarrassment are more likely to live better life. Females are less likely to have good oral health related quality of life than men.ConclusionThis findings of this study would lead future work and will be beneficial to understand healthy ageing through oral health related quality of life (OHRQoL) and its risk factors as well as providing policy and practice recommendations improve overall quality of life in old age, and achieve targets laid out in Sustainable Development Goals for Health (SDG‐3).

Conscientiousness, Activity Engagement, and Momentary Affect in Oldest-Old Adulthood.

Remaining engaged with life is a hallmark of aging well and pursuing personally meaningful activities is presumably important for late-life affect. We examined how moment-to-moment variability in meaning and degree of challenge ascribed to daily activities relate to positive and negative affect in very old adults. Possible moderating effects of between-person differences in conscientiousness on meaning-affect associations were also examined. Participants were 73 adults aged 89 years on average from the Australian Daily Life Time-Sampling module of the Australian Longitudinal Study of Aging. Participants provided self-report data on activity engagement (meaning and challenge associated with activities) and affect, on 5 occasions per day for a period of 7 consecutive days. Within-person associations of activity meaning with affect varied as a function of within-person challenge ratings. Specifically, gains in positive affect associated with meaningful activity were more strongly evident when activities were regarded as more challenging. In contrast, meaningful activity was associated with higher negative affect when activities were regarded as more challenging and lower negative affect when activities were regarded as less challenging. Conscientiousness did not moderate associations of activity meaning with affect. Our findings shed light on the intricate interplay between maintaining meaningful engagement and daily emotional experiences in very old age. We discuss theoretical and practical implications and consider the role of late-life conscientiousness for self- and emotion regulation.

Predicting life expectancy of older people using respiratory symptoms and smoking status: Data from the Australian Longitudinal Study of Ageing.

Respiratory symptoms are recognizable to patients and may be markers of chronic disease and mortality risk. This risk may be easier to conceptualize if presented as remaining life expectancy (LE) rather than hazard ratios. We aimed to predict the remaining LE of older people with respiratory symptoms using data from the Australian Longitudinal Study of Ageing (ALSA). The ALSA is a prospective longitudinal cohort of older Australians (n = 2087) with 22 years of follow-up. The symptoms analysed were cough, shortness of breath (SOB) and wheeze. The implied impact on LE was estimated using a parametric survival function. SOB predicted shorter LE irrespective of smoking status. Cough predicted shorter LE in former smokers and wheeze predicted shorter LE in current smokers. The estimated remaining LE of a 70-year-old male never smoker with no symptoms was 16.6 (95% CI: 14.8-17.7) years. The years of life lost for a 70-year-old male current smoker with cough, SOB and wheeze compared to a never smoker with no symptoms was 4.93 (95% CI: 2.87-7.36) years with only 2.99 (95% CI: 1.35-4.97) years being attributed to their current smoking and the remainder to their respiratory symptoms. Respiratory symptoms predict mortality in older people. Cough in former smokers, wheeze in current smokers and all those with SOB require further investigations and disease-specific management.

The association between frailty and medicines use over time: an analysis using the Australian Longitudinal Study on Ageing population

AbstractBackgroundFrailty and medicine‐related problems are common among the elderly and have been associated with an increased risk of adverse outcomes. However, there has been limited research on the association between frailty and medicines use.AimTo determine the distribution of frailty among older people who used medicines and to examine the difference in frailty scores over time with continuation or discontinuation of specific medicines.MethodsThe study population was from the Australian Longitudinal Study of Ageing (ALSA). The data used in the analysis were collected in 1992 (wave 1) and in 1995 (wave 3). Frailty scores were assessed at both waves using a modified version of the Frailty Index. Non‐parametric tests were used to examine the difference in the distribution of frailty scores in relation to medicines used at baseline. Medicine use was categorised into continued or stopped by comparing use at wave 3 to use at baseline. A t‐test was used to compare the mean changes in frailty scores between the two groups, with a p‐value of <0.05 considered to be significant.ResultsData from 2087 participants were included. At baseline, a higher number of medicines used was associated with higher frailty scores (p < 0.0001). Stopping any preventive medicines, as well as beta‐blockers, or potassium‐sparing diuretics, was associated with a higher increase in mean frailty score changes than continuing these medicines, p = 0.01, p = 0.03 and p = 0.004, respectively.ConclusionsThere was an association between frailty and medicines use. Further study is needed to assess whether the progression of frailty was due to medicine cessation or vice versa.

Self-rated health and depressive symptoms in older adults: A growth mixture modeling approach

ObjectiveSelf-Rated Health (SRH) and depressive symptoms are important indicators of global quality of life in older adults. Prior research suggests associations between SRH and depressive symptoms. The current study assessed latent groups in levels and trajectories of these two subjective health indicators and how the latent groups relate to each other. MethodsParticipants from the Australian Longitudinal Study of Aging (N = 2,087, ages 65+) were assessed over six waves of data collection, spanning eight years. ResultsGrowth Mixture Models were run for SRH and depressive symptoms, each yielded three latent groups with similar patterns: for both SRH and depressive symptoms two groups differing in their level with worsening status over time, and a third stable, but poorer functioning group. Analysis of the assignment of the latent groups revealed a consistent pattern for the majority, but some people were high in depression and high in SRH and some were low in depression and low in SRH. ConclusionsSRH and depressive symptoms yielded both three latent groups whose combination supported the expected assignment for the majority and an unexpected assignment for some people. This may be a result of a protective factor existing for one variable but not the other.

Development and validation of a screening instrument to identify cardiometabolic predictors of mortality in older individuals with cancer: Secondary analysis of the Australian Longitudinal Study of Ageing (ALSA).

The objective of this study was to identify significant cardiometabolic predictors of mortality among older cancer survivors and develop and validate a screening instrument to assess individual risk of mortality. Retrospective cohort study used collected data from the ALSA. Cox proportional hazards model was used to derive the risk equation for mortality that could be evaluated at 10years. Measures of discrimination and calibration were calculated in the validation cohort. The equation was developed using 294 cancer survivors and validated in 127 different cancer survivors. Significant cardiometabolic predictors of mortality included in the final model are age, sex, history of cerebrovascular disease, non-adherence to exercise guidelines (150min moderate activity per week), and smoking. Discrimination and calibration were acceptable with minimal differences in C statistics (0.0442, 95% CI: -0.0149 to 0.103) and adjusted R2 values (0.0407, 95% CI: -0.181 to 0.0998) between the development and validation cohorts, respectively. We have developed and validated the first screening tool to predict cardiometabolic risk of mortality in older cancer survivors and defined centile values for risk classification. Further validation and research on the usability and usefulness of the tool in clinical practice are recommended in order to target cancer survivors for interventions. Cost effectiveness of such an approach should also be examined.

We are in this together

Lifespan theoretical notions have long acknowledged that regulative capacities of the self are relatively robust well into old age. This general trend notwithstanding, people often differ substantially throughout life in their levels of and change trajectories in self-esteem. One prime contributing factor may be perceptions of social inclusion. Because functioning and development in many domains of life are often linked across partners, we examine whether and how self-esteem and its late-life change are intertwined between long-term married partners. To do so, we make use of six occasions over 18-year longitudinal data from 382 married couples in the Australian Longitudinal Study of Aging (Mage = 75 years at baseline, SD = 5.3, range 65–91). Applying SEM-based continuous time panel models revealed that discrete time autoregressive effects, which capture the stability of self-esteem, were declining over time. Most important for our question, across-partner (cross-lagged) effects indicated substantial differences between spouses such that change in husbands’ self-esteem predicts subsequent changes in the wives’ self-esteem, but not vice versa. We discuss potential conditions and challenges of dyadic associations in how late-life self-esteem and its change are intertwined between partners.

Construct Validity of Four Frailty Measures in an Older Australian Population: A Rasch Analysis.

Individuals identified as frail have been shown to be at an increased risk of adverse health outcomes. However, there is no gold standard frailty measure and frailty status can vary depending on the measure used, suggesting the measures perform differently. Construct validity can be used to assess a measure's performance. This study aimed to examine the construct validity of four frailty measures in an Australian older population using Rasch analysis. Frailty status among the 2087 participants aged 65 years and above from the Australian Longitudinal Study of Ageing (ALSA) was assessed using: frailty phenotype--FP, simplified frailty phenotype--SFP, frailty index--FI, and prognostic frailty score--PFS. Rasch analysis was used to assess the unidimensionality of the measures, which is the extent to which the underlying characteristic of frailty is assessed. The criteria for unidimensionality from principal component analysis of the residuals was when 50% or more of the raw variance was explained by the measures, and less than 5% was unexplained variance. Only FI meet the unidimensionality criteria with 74% of explained variance and 2.1% of unexplained variance. SFP did not show a unidimensional construct with 13.3% of explained variance and 47.1% of unexplained variance. FP and PFS had 39.6%, 18.1% and 46.5%, 8.7% of explained and unexplained variance, respectively. Our findings showed that FI has better construct validity than the other three measures in assessing frailty among the Australian older population.

Predictive performance of four frailty measures in an older Australian population

There are several different frailty measures available for identifying the frail elderly. However, their predictive performance in an Australian population has not been examined. To examine the predictive performance of four internationally validated frailty measures in an older Australian population. A retrospective study in the Australian Longitudinal Study of Ageing (ALSA) with 2,087 participants. Frailty was measured at baseline using frailty phenotype (FP), simplified frailty phenotype (SFP), frailty index (FI) and prognostic frailty score (PFS). Odds ratios (OR) were calculated to measure the association between frailty and outcomes at Wave 3 including mortality, hospitalisation, nursing home admission, fall and a combination of all outcomes. Predictive performance was measured by assessing sensitivity, specificity, positive and negative predictive values (PPV and NPV) and likelihood ratio (LR). Area under the curve (AUC) of dichotomised and the multilevel or continuous model of the measures was examined. Prevalence of frailty varied from 2% up to 49% between the measures. Frailty was significantly associated with an increased risk of any outcome, OR (95% confidence interval) for FP: 1.9 (1.4-2.8), SFP: 3.6 (1.5-8.8), FI: 3.4 (2.7-4.3) and PFS: 2.3 (1.8-2.8). PFS had high sensitivity across all outcomes (sensitivity: 55.2-77.1%). The PPV for any outcome was highest for SFP and FI (70.8 and 69.7%, respectively). Only FI had acceptable accuracy in predicting outcomes, AUC: 0.59-0.70. Being identified as frail by any of the four measures was associated with an increased risk of outcomes; however, their predictive accuracy varied.

Do dietary patterns in older age influence the development of cancer and cardiovascular disease: A longitudinal study of ageing

The association between diet and cancer, and diet and cardiovascular disease (CVD) is well established in younger adults, however limited evidence exists to demonstrate that these associations persist for older adults, particularly in the context of dietary patterns. To investigate whether the dominant dietary patterns identified in a cohort of older adults are predictive of cancer or CVD development. This study was a secondary analysis of data from the Australian Longitudinal Study of Ageing (ALSA). The ALSA is a multi-dimensional population based study of human ageing which commenced in 1992 with 2087 participants aged 65 years or more. Data from a 170-item food frequency questionnaire administered at baseline in 1992 to 1034 older adults free from cancer and CVD was explored using factor analysis to identify dominant dietary patterns, being those patterns which comprise foods commonly consumed by the sample. Pooled logistic regression from data available at baseline, 2 and 8 years of follow-up was used to determine whether any associations existed between dietary patterns and development of or death from cancer or CVD. Five dominant dietary patterns were identified and labelled 'discretionary choices and breads and cereals', 'vegetable and fruit', 'white meat and milk products', 'breads and cereals, sweet bakery goods and milk products' and 'red meat and protein alternatives'. None of the dominant dietary patterns demonstrated a significant overall trend for the development of or death from cancer or CVD with the exception of the 'red meat and protein alternatives' pattern where an increased risk of cancer development or death was observed with adjustment for age, gender, smoking, overweight and obesity and total number of comorbidities (tertile 2: OR 1.46, 95% CI 1.03-2.07; tertile 3: OR 1.28, 95% CI 0.87-1.90). These results suggest that the development of or death from cancer and CVD may be independent of most dietary patterns in those who are free of either condition at age 70 years or older. Importantly, there was an association observed between the 'red meat and protein alternatives' pattern and cancer development and death. If these findings are confirmed then dietary guidelines for older adults may require further revision.

Subjective Beliefs, Memory and Functional Health: Change and Associations over 12 Years in the Australian Longitudinal Study of Ageing

Background: Neither subjective memory beliefs, nor remembering itself, can be isolated from the overall context in which one is aging, nor are the drivers of memory complaints well specified. Sense of control is an important self-regulatory resource that drives cognitive and physical health over the lifespan. Existing findings are equivocal concerning both the extent of stability or change in control beliefs over time as well as their contribution to changes in behavior. Objective: Subjective beliefs may play a role when engaging memory processes or identifying memory complaints, and it has been argued that self-regulatory potential in general may be limited by age-related changes in the domains of health and cognition. We aimed to examine trajectories of change and shed light on relationships among subjective beliefs and indicators of memory and functional health. Methods: Participants' data were drawn from four measurement occasions over up to a 12-year period (1992-2004) from the Australian Longitudinal Study of Ageing (ALSA), a population-based study of older adults [age 65-100 years; mean age(SD) at the first and final occasion 78.2 (6.7) and 84.9 (4.9) years, respectively]. Participants completed three questionnaires assessing subjective beliefs concerning (1) memory knowledge and control, (2) health control, and (3) expectancy of control over a range of lifestyle situations. Memory comprised a recall composite. Functional health tapped mobility and disability. Latent growth curve models incorporated informative covariates (baseline age, gender, self-rated health, education, and chronic conditions). Results: While subjective memory control beliefs, but not subjective knowledge of memory tasks, improved over 12 years, neither was associated with level of memory performance. Knowledge of memory tasks was linked to a significant memory decline. Beliefs about memory, health, and lifestyle were interrelated. Declines in remembering and health were also coupled; moreover, changes in both were coupled with change in lifestyle control beliefs. Conclusions: This is the first examination of individual differences in changes in, and relationships among, psychological domains of subjective beliefs about memory, health, and lifestyle, and objective remembering and functional health in very late life. Findings point to a system of coupled changes in memory and health in late life that is related to underlying beliefs about control over lifestyle.

Social resource correlates of levels and time-to-death-related changes in late-life affect.

Little is known regarding how well psychosocial resources that promote well-being continue to correlate with affect into very late life. We examined social resource correlates of levels and time-to-death related changes in affect balance (an index of affective positivity) over 19 years among 1,297 by now deceased participants (aged 69 to 103 at first assessment, M = 80 years; 36% women) from the Australian Longitudinal Study of Aging. A steeper decline in affect balance was evident over a time-to-death metric compared with chronological age. Separating time-varying social resource predictors into between- and within-person components revealed several associations with level of affect balance, controlling for age at death, gender, functional disability, and global cognition. Between-person associations revealed that individuals who were more satisfied with family, and more socially active, expressed greater positivity compared with those who were less satisfied, and less socially active. Within-person associations indicated that participants reported higher positivity on occasions when they were more socially active. In addition, lower affect balance was associated with more frequent contact with children. Our results suggest that social engagement and satisfying relationships confer benefits for affective well-being that are retained into late life. However, our findings do not provide evidence to indicate that social resources protect against terminal decline in well-being.

A longitudinal study of constipation and laxative use in a community-dwelling elderly population

BackgroundLittle is known about laxative use, the association of constipation with laxative use, risk factors for constipation and how each of these changes over time in the community-dwelling elderly. ObjectiveThe aim was to explore the prevalence of laxative use and of self-reported constipation, and identify risk factors (including age) associated with constipation, in a cohort of community-dwelling elderly residents. MethodsData from the Australian Longitudinal Study of Ageing (ALSA) was used to compare differences in constipation and laxative use in the community-dwelling elderly between 1992–1993 and 2003–2004. ResultsRelevant data was available for 239 ALSA participants. The prevalence of self-reported constipation increased from 14% in 1992–1993 to 21% in 2003–2004. There was a corresponding increase in the prevalence of laxative use from 6% to 15% over the same period. At both time points, females reported a higher prevalence of both constipation and laxative use however the female:male prevalence ratios decreased over time indicating higher increases in the prevalence of each among males. Persistent chronic constipation occurred in 9% of the cohort. The association between laxative use and self-reported constipation was poor and laxative use was associated with self-reported constipation in less than a third of cases. ConclusionThe prevalence of both constipation and laxative use increases with age in the elderly, and these increases are greater for males than for females. Discrepancies between self-reported constipation and laxative use may suggest sub-optimal management of constipation in the community-dwelling elderly and further work is needed to fully understand this.

Cohort Profile: The Australian Longitudinal Study of Ageing (ALSA).

In response to the expressed need for more sophisticated and multidisciplinary data concerning ageing of the Australian population, the Australian Longitudinal Study of Ageing (ALSA) was established some two decades ago in Adelaide, South Australia. At Baseline in 1992, 2087 participants living in the community or in residential care (ranging in age from 65 to 103 years) were interviewed in their place of residence (1031 or 49% women), including 565 couples. By 2013, 12 Waves had been completed; both face-to-face and telephone personal interviews were conducted. Data collected included self-reports of demographic details, health, depression, morbid conditions, hospitalization, gross mobility, physical performance, activities of daily living, lifestyle activities, social resources, exercise, education and income. Objective performance data for physical and cognitive function were also collected. The ALSA data are held at the Flinders Centre for Ageing Studies, Flinders University. Procedures for data access, information on collaborations, publications and other details can be found at [http://flinders.edu.au/sabs/fcas/].

Longitudinal Change of Self-Perceptions of Aging and Mortality

To understand the association between self-perceptions of aging (SPA) and mortality in late life. Method. The sample (n = 1,507) was drawn from the Australian Longitudinal Study of Aging (baseline age = 65-103 years). We used joint growth curve and survival models on 5 waves of data for a period of 16 years to investigate the random intercept and slope of SPA for predicting all-cause mortality. The unadjusted model revealed that poor SPA at baseline, as well as decline in SPA, increased the risk of mortality (SPA intercept hazard ratio [HR] = 1.21, 95% confidence interval [CI] = 1.13, 1.31; SPA slope HR = 1.17, 95% CI = 1.02, 1.33). This relationship remained significant for the SPA intercept after adjusting for other risk factors including demographics, physical health, cognitive functioning, and well-being. These findings suggest that a single measurement of SPA in late life may be very informative of future long-term vulnerability to health decline and mortality. Furthermore, a dynamic measure of SPA may be indicative of adaptation to age-related changes. This supports a "self-fulfilling" hypothesis, whereby SPA is a lens through which age-related changes are interpreted, and these interpretations can affect future health and health behaviors.

The relationship between change in self-perceptions of aging and physical functioning in older adults.

Negative self-perceptions of aging (SPA) have been linked to poor physical health and functioning outcomes in late life, yet the direction of this relationship remain unclear. Using data from the Australian Longitudinal Study of Aging, we investigated the directionality of the dynamic relationship between self-perceptions of aging and physical functioning in 1,212 adults 65 years and above (mean age = 76.89, SD = 6.12) over 5 waves (up to 16 years). Bivariate Dual Change Score Models (BDCSM) revealed that the best fitting model for the data was that which allowed SPA to predict change in physical functioning over time lags of 1 year. The direction of the relationship remained after controlling for age, gender, partner status, residential care, number of medical conditions, self-rated health, and psychological well-being. Findings suggest that more positive SPA may be protective of decline in physical functioning in late life.

Subjective Well-Being Dynamics in Couples from the Australian Longitudinal Study of Aging

Background: There is growing evidence for spousal associations in late-life development among key functional domains. Spousal interrelations in subjective well-being (SWB) have primarily been discussed in the context of a model of ‘transmission’, an indicator of well-being. Typically, depression is used to mark this, but few studies have examined if such transmission can be found over the long term in older couples’ SWB. Objective: We aimed to determine whether longitudinal dyadic interrelations exist among older couples in the SWB domain, as indicated by morale. Methods: We applied dynamic models to 11-year longitudinal data of 316 couples from the Australian Longitudinal Study of Aging (median age = 75 years at baseline) to explore whether the levels of SWB for one partner predict change in SWB for the other. Results: Spousal interrelations emerged and were found to be gender-specific with wives predicting subsequent change among husbands, but not the reverse pattern of influence. Husbands whose wives reported higher initial SWB showed a relatively shallower decline over time relative to husbands whose wives reported lower initial SWB levels. These associations were robust after covarying for differences in age, education, health and marital characteristics (number of children and length of marriage). Conclusion: Our study is consistent with, and illustrates empirically that close relationships shape individual developmental outcomes. The findings suggest that wives play an important role in setting the affective tone in older couples. We discuss possible factors underlying such interrelations.

The choice of self-rated health measures matter when predicting mortality: evidence from 10 years follow-up of the Australian longitudinal study of ageing

BackgroundSelf-rated health (SRH) measures with different wording and reference points are often used as equivalent health indicators in public health surveys estimating health outcomes such as healthy life expectancies and mortality for older adults. Whilst the robust relationship between SRH and mortality is well established, it is not known how comparable different SRH items are in their relationship to mortality over time. We used a dynamic evaluation model to investigate the sensitivity of time-varying SRH measures with different reference points to predict mortality in older adults over time.MethodsWe used seven waves of data from the Australian Longitudinal Study of Ageing (1992 to 2004; N = 1733, 52.6% males). Cox regression analysis was used to evaluate the relationship between three time-varying SRH measures (global, age-comparative and self-comparative reference point) with mortality in older adults (65+ years).ResultsAfter accounting for other mortality risk factors, poor global SRH ratings increased mortality risk by 2.83 times compared to excellent ratings. In contrast, the mortality relationship with age-comparative and self-comparative SRH was moderated by age, revealing that these comparative SRH measures did not independently predict mortality for adults over 75 years of age in adjusted models.ConclusionsWe found that a global measure of SRH not referenced to age or self is the best predictor of mortality, and is the most reliable measure of self-perceived health for longitudinal research and population health estimates of healthy life expectancy in older adults. Findings emphasize that the SRH measures are not equivalent measures of health status.

Antidepressant use and depressive symptomatology among older people from the Australian Longitudinal Study of Ageing

Depression is one of the leading contributors to the burden of non-fatal diseases in Australia. Although there is an overall increasing trend in antidepressant use, the relationship between use of antidepressants and depressive symptomatology is not clear, particularly in the older population. Data for this study were obtained from the Australian Longitudinal Study of Ageing (ALSA), a cohort of 2087 people aged over 65 years at baseline. Four waves of home interviews were conducted between 1992 and 2004 to collect information on sociodemographic and health status. Depressive symptoms were measured by the Center for Epidemiologic Studies - Depression Scale. Use of antidepressants was based on self-report, with the interviewer able to check packaging details if available. Longitudinal analysis was performed using logistic generalized estimating equations to detect if there was any trend in the use of antidepressants, adjusting for potential confounding factors. The prevalence of depressive symptoms was 15.2% in 1992 and 15.8% in 2004 (p > 0.05). The prevalence of antidepressant users increased from 6.5% to 10.9% (p < 0.01) over this period. Among people with depressive symptoms, less than 20% were taking antidepressants at any wave. Among people without depressive symptoms, the prevalence of antidepressant use was 5.2% in 1992 and 12.0% in 2004 (p < 0.01). Being female (OR = 1.67, 95%CI: 1.25-2.24), having poor self-perceived health status (OR = 1.17, 95%CI: 1.04-1.32), having physical impairment (OR = 1.48, 95%CI: 1.14-1.91) and having depressive symptoms (OR = 1.62, 95%CI: 1.24-2.13) significantly increased the use of antidepressants, while living in community (OR = 0.51, 95%CI: 0.37-0.71) reduced the risk of antidepressant use. Use of antidepressants increased, while depressive symptoms remained stable, in the ALSA over a 12-year period. Use of antidepressants was low for people with depressive symptoms.

Self-medication with over-the-counter drugs and complementary medications in South Australia's elderly population

BackgroundA number of surveys have examined use of complementary and alternative medicines (CAM) in Australia. However, there are limited Australian data on use of CAM and over-the-counter (OTC) medicines in the elderly population. The main aims of this study were to examine self-medication practices with CAM and OTC medicines among older Australians and variables associated with their use.MethodsThe Australian Longitudinal Study of Ageing (ALSA) is an ongoing multidisciplinary prospective study of the older population which commenced in 1992 in South Australia. Data collected in 4 waves of ALSA between 1992 and 2004 were used in this study with a baseline sample of 2087 adults aged 65 years and over, living in the community or residential aged care. OTC medicines were classified according to the World Health Organization Anatomical Therapeutic Chemical (ATC) classification. CAM were classified according a modified version of the classification adopted by the Therapeutics Goods Administration (TGA) in Australia.ResultsThe prevalence of CAM or OTC use ranged from 17.7% in 2000-2001 to 35.5% in 2003-2004. The top classes of CAM and OTC medicines used remained relatively constant over the study period. The most frequent classes of CAM used were vitamins and minerals, herbal medicines and nutritional supplements while the most commonly used OTC were analgesics, laxatives and low dose aspirin. Females and those of younger age were more likely to be CAM users but no variable was associated with OTC use.ConclusionParticipants seemed to self-medicate in accordance with approved indications, suggesting they were informed consumers, actively looking after their own health. However, use of analgesics and aspirin are associated with an increased risk of adverse drug events in the elderly. Future work should examine how self-medication contributes to polypharmacy and increases the risk of adverse drug reactions.