National Sample Of Older Adults Research Articles

Further Evidence of Feasibility, Validity, and Reliability of Quality of Life-Aged Care Consumers: Evidence From Home-Based Care Settings

ObjectivesThe Quality of Life-Aged Care Consumers (QOL-ACC) is an aged-care-specific preference-based instrument currently being rolled out in residential care across Australia as part of the aged care Quality Indicator program. This study aimed to provide a comprehensive assessment of the feasibility, reliability, and construct validity of the QOL-ACC in a large national sample of older adults receiving aged care services at home. MethodsOlder adults receiving in-home aged care services completed a survey including the QOL-ACC, Quality of Care Experience-ACC, adult social care outcome tool, EQ-5D-5L, and 2 global single item measures of health and quality of life. Feasibility was assessed by missing responses (≤5%) and ceiling/floor effects (≤15%). Construct validity was assessed by exploring the relationship between the QOL-ACC and other instruments (convergent validity) and its ability to discriminate varying levels of self-rated health and quality of life (known-group validity). ResultsA total of 802 respondents (mean age, 74.5 ± 6.3 years; 56.0% females) completed the survey. The QOL-ACC had no missing responses, no floor effects, and very low ceiling effect (3.5%) and demonstrated moderate correlation with adult social care outcome tool (r = 0.59, P < .001), EQ-5D-5L (r = 0.65, P < .001), EQ-VAS (r = 0.53, P < .001), and a lower correlation with the QCE-ACC (r = 0.41, P < .001). Respondents with poor self-rated health and quality of life had significantly lower preference-weighted scores on the QOL-ACC. ConclusionsThe QOL-ACC demonstrated adequate feasibility, reliability, and construct validity in a large population of older people accessing government-subsidized aged care services at home. Further studies will explore the responsiveness of the QOL-ACC to aged-care-specific interventions both in home and residential aged care settings.

FAITH IS SIGNIFICANTLY ASSOCIATED TO SOCIODEMOGRAPHIC AND CLINICAL CHARACTERISTICS IN BRAZILIAN OLDER ADULTS

Abstract Religiosity is a strong factor related to health in older adults, which could positively affect physical and mental health. We aimed to observe the association between sociodemographic and clinical factors and the religiosity level in older adults. This is a secondary analysis of the Brazilian Older-adults Health Longitudinal Study (ELSI-Brazil) run by Fiocruz Institute in 2015 using a national sample of older adults (60+ year-old) population. The dependent variable was “How much the religious faith give meaning to your life?” and the independent were: sociodemographic (age-group, sex, race, marital status, and scholarly) and clinical (auto perception of health and non-transmittable chronic diseases diagnose - NTCD) characteristics, tested by Chi-Square with p&amp;lt;0.05 significant level. The total sample accounted for 4,669 participants, 4,080 (87.4%) answered that faith gives a lot of meaning to their lives. This percentage was significantly higher in women (91.2% vs 81.8% in men, p=0.003), indigenous race (95%, p=0.003), lower scholarly (p&amp;lt;0.001) and better auto perception of health (p=0.021). NTCD significantly related to higher importance of religiosity were hypertension (88.3%), dyslipidemia (90.0%), angina (93.9%), arthritis (90.5%), osteoporosis (91.0%), depression (88.7%), and cancer (90.4%). Participants with Diabetes (86.1%), pneumopathies (85.9%), and Parkinson (86.7%) had significant lower levels of religiosity. Religiosity had a significant association with sex, race, scholarly, health auto perception and NTCD, including cancer. The results evidence the important role of religious faith in the Brazilian older adult’s health. We concluded that religion and spiritual approach should always be considered to older adults.

Public transit stop density is associated with walking for exercise among a national sample of older adults

BackgroundWalking is the primary and preferred mode of exercise for older adults. Walking to and from public transit stops may support older adults in achieving exercise goals. This study examined whether density of neighborhood public transit stops was associated with walking for exercise among older adults.Methods2018 National Health and Aging Trends Study (NHATS) data were linked with the 2018 National Neighborhood Data Archive, which reported density of public transit stops (stops/mile2) within participants’ neighborhood, defined using census tract boundaries. Walking for exercise in the last month was self-reported. The extent to which self-reported public transit use mediated the relationship between density of neighborhood public transit stops and walking for exercise was examined. Covariates included sociodemographic characteristics, economic status, disability status, and neighborhood attributes. National estimates were calculated using NHATS analytic survey weights.ResultsAmong 4,836 respondents with complete data, 39.7% lived in a census tract with at least one neighborhood public transit stop and 8.5% were public transit users. The odds of walking for exercise were 32% higher (OR = 1.32; 95% confidence interval: 1.08, 1.61) among respondents living in a neighborhood with > 10 transit stops per mile compared to living in a neighborhood without any public transit stops documented. Self-reported public transit use mediated 24% of the association between density of neighborhood public transit stops and walking for exercise.ConclusionsDensity of neighborhood public transit stops was associated with walking for exercise, with a substantial portion of the association mediated by self-reported public transit use. Increasing public transit stop availability within neighborhoods may contribute to active aging among older adults.

Geriatricians, general internists, and potentially inappropriate medications for a national sample of older adults.

Older adults are often prescribed medications that are potentially dangerous and geriatricians have specialized training in treating polypharmacy that may benefit these patients. To examine this, we compared potentially inappropriate medication (PIM) prescribing rates between geriatricians and similar general internists in the United States. Using national cross-sectional data from 2013 to 2019, we compared annual PIM prescribing rates between 2815 outpatient geriatricians certified by the American Board of Internal Medicine in 1994-2018 and general internists matched 1:1 on IM certification exam score and year, residency exam pass rate, gender, and US birth and/or US medical school. PIM prescribing was based on the Healthcare Effectiveness Data and Information Set (HEDIS) PIM physician annual prescribing measures which consider medications flagged as potentially inappropriate in the American Geriatric Society Beers Criteria® guideline. We also examined prescribing of appropriate alternative medications. Prescribing rates were calculated as the percentage a physician's patients with Medicare fee-for-service part D enrollment seen in the outpatient setting in a given year (mean: 150 patients per physician) with a PIM prescription they prescribed. Across 30,677 physician-year observations, geriatricians were 16.7% less likely (95% confidence interval (CI): -19.8 to -13.7, p < 0.001) to prescribe a PIM (7.2% versus 8.7% of patients respectively) and 2.7% more likely (95% CI: 0.8 to 4.5, p = 0.004) to prescribe an appropriate alternative medication (52.0% versus 50.7% of patients respectively). Lower PIM prescribing was observed for most medication sub-types including central nervous system, anticholinergic, pain, and endocrine medications. In sensitivity analyses, differences in prescribing were similar when comparing recently trained physicians with more experienced physicians. Findings suggest geriatricians in the United States prescribe PIMs at lower rates than general internists. This highlights the value geriatricians provide as well as opportunities to embed key principles of geriatric care into internal medicine training and health care delivery systems.

Are we missing the beat in cancer end-of-life care: Prevalence and end-of-life monitoring of implantable cardioverter defibrillators in a population-based sample of older adults diagnosed with breast, colorectal, or pancreatic cancer.

e18728 Background: More than 50,000 implantable cardioverter defibrillators (ICDs) are placed in adults aged 65 years and older in the United States each year to manage cardiac arrhythmias. Shared risk profiles between many cancers and heart disease, as well as cardiotoxic effects of anti-cancer treatments suggest individuals with cancer are likely to have ICD devices. Although ICDs have been studied extensively in Europe, little is known about the US population, and even less is known in populations with cancer. ICDs have critical implications for end-of-life care in patients with cancer. Many patients do not include wishes for their ICD in their advanced directives, and end-of-life shocks can cause pain and distress for patients and their families. We evaluated prevalence and end-of-life monitoring of ICDs in a national sample of older adults who had breast, colorectal, or pancreatic cancer. Methods: We analyzed Surveillance, Epidemiology and End Results (SEER) data for first incident breast, colorectal, and pancreas cancer cases linked to Medicare claims (years 2004-2016) in Medicare-beneficiaries aged ³66 years. We evaluated the prevalence of ICDs by cancer stage at diagnosis with descriptive statistics. For patients with late-stage cancer (III or IV) who died in our study period we also evaluated the prevalence of ICD monitoring at the end of life. Because ICD deactivation is not a billable code, we evaluated ICD monitoring as a proxy for having an active device, hence an opportunity to discuss device deactivation. Results: In our sample of 286,015 individuals with cancer, 6.8% of patients had evidence of an ICD in their Medicare claims (6.1% breast, 8.2% colorectal, 5.3% pancreas). Of these, 49.7% had evidence of an ICD before their cancer diagnosis. The prevalence of ICDs was lower among the 60,046 individuals diagnosed with late-stage cancer( p&lt; .001) (5.0% breast, 6.1% colorectal, 4.5% pancreas). Among individuals with late-stage cancer and evidence of an ICD, 27.0% of those who died had ICD monitoring in the last six months of life (21.1% breast, 27.9% colorectal, 29.3% pancreas, p= .001), and 6.2% had monitoring in the last month of life (5.1% breast, 6.5% colorectal, 6.3% pancreas, p= .46). Conclusions: To improve the quality of care at the end-of-life for people with advanced cancer, awareness, communication, and shared decision making about ICD device management options are important considerations. These data suggest there may be opportunities to discuss prognosis and implications of advanced-stage cancer at device monitoring visits or during cardio-oncology visits.

ROLE OF HOME ENVIRONMENT IN LTSS USE AMONG OLDER ADULTS IN THE US

Abstract Older adults have shown increasing preference towards having help and health care in the comfort of their own homes rather than in an institutional setting. Research suggests that about 1 in 5 older adults with limitations in activities of daily living report needing more help than they receive. There is insufficient research examining how home inaccessibility and disorder relates to LTSS use for community-dwelling older adults in the U.S. This study addresses a gap in the literature by directly examining the relationship between home environment quality and LTSS use for a national sample of older adults. Data was analyzed from round eight (2018) of the National Health and Aging Trends Study (NHATS), an epidemiological panel study of nationally representative Medicare beneficiaries ages 65 and older living in the communities (n = 4,806). The final analytic sample included respondents with valid data on all variables (n = 4,265). Community dwelling adults with greater home accessibility had lower odds of having two or more LTSS caregivers, compared to the counterpart with lower home accessibility (OR = 0.246, SE = 0.094, p &amp;lt; 0.01). However, poor housing conditions had lower odds of having two or more LTSS caregivers (OR = 0.333, SE = 0.156, p &amp;lt; 0.05). Community-dwelling older adults who have accessible and organized homes are more likely to be independent and are less likely to depend on LTSS caregiving. Policies to improve home environment quality could benefit both older adults and those who care for them.

EXPOSURE TO GENERATIVE MESSAGES BOOSTS COGNITIVE PERFORMANCE IN OLDER ADULTS

Abstract Both self-perceived and primed generativity has been found to be linked to better cognitive and physical functioning, psychological well-being, and longevity in older adulthood. A prior experiment also found that priming older individuals with messages regarding the generative, or contributory value of their social group (older adults) boosted cognitive performance compared to exposure to a message about the societal burden of one’s group (Hagood &amp; Gruenewald, 2018) . A key limitation of this earlier work was the lack of a neutral prime condition to determine whether being exposed to messages regarding the generativity of older adults enhanced their cognitive performance or being exposed to negative messages regarding the social burdens of one’s age group suppressed performance. This limitation was addressed in the current online experiment of 300 U.S. adults age 55 and older who were randomly exposed to either a social generativity, social burden, or neutral prime presented as a test of reading comprehension and recall. Participants completed other measures of cognitive ability before and after the priming task, including an assessment of verbal memory. An ANCOVA model including age as a covariate indicated a significant effect of priming condition (F(2,296) = 3.30, p = .038). Mean verbal memory performance did not vary between the neutral and social burden priming conditions, while performance was significantly higher in the generativity prime condition (d=.29). Experimental findings provide support for the hypothesis that exposure to generative messages about one’s social group can boost cognitive performance in a national sample of older adults.

Comorbidities in older adults with opioid use disorders.

There is a growing number of opioid use disorders (OUDs) and overdose deaths in older adults. In addition, older adults with OUD routinely receive lower-quality preventive and chronic care that result in poorer overall health. The purpose of this study was to identify older patients with OUD at the study site and determine the prevalence of medical and psychiatric comorbidities. This retrospective study used a computer algorithm employed by a network of Federally Qualified Health Center primary care clinics in lower New York state. With the approval from institutional review board, the IT department of the organization captured data about older adults with an OUD diagnosis. The IT department identified 664 patients and provided anonymized demographic and medical history data of these patients for analysis. Patients with OUD had 2-3 times more medical and psychiatric co-occurring conditions than national sample of older adults with no OUD of similar age and income. The most frequent co-occurring medical conditions in the patients were heart or circulatory disorders, movement disorders, respiratory disorders, pain disorders, nutritional disorders, and metabolic disorders. The most common co-occurring psychiatric conditions were anxiety disorders, major depressive disorder, post-traumatic stress disorder (PTSD), and bipolar disorder. Older adults with OUD often have complex health care needs that often include one or more chronic medical and psychiatric conditions. Providers should be aware of the multiple needs of older adults with OUD so that appropriate and comprehensive care can be offered to the patients.

Identifying pathways to increased volunteering in older US adults

While growing evidence documents strong associations between volunteering and improved health and well-being outcomes, less is known about the health and well-being factors that lead to increased volunteering. Using data from 13,771 participants in the Health and Retirement Study (HRS)—a diverse, longitudinal, and national sample of older adults in the United States—we evaluated a large range of candidate predictors of volunteering. Specifically, using generalized linear regression models with a lagged exposure-wide approach, we evaluated if changes in 61 predictors spanning physical health, health behaviors, and psychosocial well-being (over a 4-year follow-up between t0; 2006/2008 and t1; 2010/2012) were associated with volunteer activity four years later (t2; 2014/2016). After adjusting for a rich set of covariates, certain changes in some health behaviors (e.g., physical activity ≥ 1x/week), physical health conditions (e.g., physical functioning limitations, cognitive impairment), and psychosocial factors (e.g., purpose in life, constraints, contact with friends, etc.) were associated with increased volunteering four years later. However, there was little evidence that other factors were associated with subsequent volunteering. Changes in several indicators of physical health, health behaviors, and psychosocial well-being may predict increased volunteering, and these factors may be novel targets for interventions and policies aiming to increase volunteering in older adults.

Smoking Status and Cognitive Function in a National Sample of Older Adults

AimsTo examine the correlation between smoking status and different domains of cognitive function in elderly Americans.MethodsWe used data from the 2011 to 2014 U.S. National Health and Nutrition Examination Survey (NHANES). Participants over 60 years with available smoking history and cognitive function data were enrolled in our analysis. The NHANES study included the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) assessment, the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST) to assess cognition. Multivariate regression analyses were used to estimate the association between cigarette smoking and cognitive function.ResultsA total of 2,932 participants were enrolled in the analysis, including 372 (12.7%) current smokers, 1,115 (38%) former smokers, and 1,445 (49.3%) never smokers. Never smokers had in average 3.82 (95% CI, 2.21 to 5.43) points more than current smokers in the DSST, whereas former smokers had 3.12 (95% CI, 1.51 to 4.73) points more than current smokers. Besides, smoking was not associated with the results of the AFT or the CERAD test.ConclusionsThis study suggests that cigarette smoking is associated with processing speed among the American elderly.

COVID-19 Pandemic Beverages Consumption Among White and Non-White Older Adults in the United States

ObjectivesThe aim is to examine how consumption of different beverages (i.e., juice, milk, and alcohol) among White and Non-white populations changed since COVID-19 pandemic. MethodsAn online cross-sectional survey was conducted among a national sample of older adults by Qualtrics between August 9 and September 15, 2020, in urban areas across the four U.S. census regions. A total of 9,903 adults 40–100 years old. The online survey included questions on demographic variables and a Dietary Screening Tool (DST) and asked participants to respond to questions from pre-pandemic and pandemic conditions. The internal consistency reliability for the DST was 0.61 and 0.62for the pre-pandemic and pandemic respectively. The beverages were questions about “How often do you drink some kind of juice at breakfast?”, “How often do you drink a glass of milk?”, and “Do you usually drink wine, beer or other alcoholic beverages?”. To analyze the data, pre and post pandemic responses were compared by Wilcoxon signed-rank tests and McNamar tests via SPSS software. ResultsParticipants were 75% White and 25% Non-white including African American (14%), Hispanic (4%), and Asian (7%). They were 57% female and 43% male. According to the analysis, juice and milk consumption reduced significantly among non-white participants (P = .007, and P = 0.04) while no change was observed in White participants since the pandemic. Interestingly, Alcoholic beverages consumption significantly reduced among both Non-white (P = 0.05) and White participants (P < .001). Also, according to the gender analysis, both male and female White participants only showed a significantly reduced consumption of alcoholic beverage (P = .02). However, Non-white male participants had significantly reduction in all three beverages (Juice (P = .01), milk (P < .001), and alcoholic beverages (P = .004) while white female participants only consumed a reduced number of alcoholic beverages (P < .001). ConclusionsDifferent beverage consumption were reduced among male Non-white participants since COVID-19 pandemic, while just alcohol consumption was reduced among (male/female White and female Non-white) participant. The reductions in certain beverage consumption may be directly related to financial instability and health knowledge of male Non-white groups. Funding SourcesUSDA/NIFA.

0272 Decreased Risk of 2-Year Incidence of Alzheimer’s Disease Among Older Adults Who Report Sleep Symptoms

Abstract Introduction Those with dementia or Alzheimer’s Disease report an elevated amount of sleep difficulties compared to age-matched controls. Sleep-based interventions may be especially useful for this group, such as cognitive behavioral therapy for insomnia or pharmacological interventions. Therefore, it is important to expand the current understanding of the nature of sleep difficulties in those with Alzheimer’s Disease. Methods Data from the 2018 Health and Retirement Survey was collected from 17,146 older adults. Poisson regression analyses were used to explore the relationship between Alzheimer’s Disease as diagnosed by a doctor and sleep difficulties. Individuals who reported no Alzheimer’s Disease in the previous wave (N=16,751) were asked if they had since become diagnosed. N=101 individuals reported incident Alzheimer’s Disease in the 2-year gap between assessments. Sleep difficulties were assessed by asking participants if they had difficulties initiating or maintaining sleep, waking up too early, and how rested they felt upon awakening. All 4 of these symptoms were coded as “never,” “sometimes,” or “often.” Results Unexpectedly, there was a significant decreased risk of developing Alzheimer’s Disease among those who reported difficulties maintaining sleep (IRR=0.9962; 95%CI[0.9936,0.9988]; p=0.004), and early morning awakenings (IRR=0.9961; 95%CI[0.9938,0.9984]; p=0.001) “sometimes”. When the model was adjusted for sex, race, ethnicity, age, and depression, a similar finding of decreased risk for Alzheimer’s Disease for those who reported difficulties maintaining sleep (IRR=0.9953; 95%CI[0.9927,0.9980]; p&amp;lt;0.001), and early morning awakenings (IRR=0.9954; 95%CI[0.9930,0.9978]; p=0.001), “sometimes” were maintained. Conclusion Although previous studies have shown that poor sleep may lead to increased risk of Alzheimer’s and related dementias, the present study, which examined longitudinal data from a large, national sample of older adults, found that there was no association between frequent sleep disturbances and 2-year incidence of Alzheimer’s Disease, and a small association between more mild symptoms and decreased risk. It is possible that the 2-year observation window was insufficient to detect effects. Also, there is a risk of measurement error in collecting self-reported data on sleep and Alzheimer’s diagnoses. Support (If Any) The HRS (Health and Retirement Study) is sponsored by the National Institute on Aging (grant number NIA U01AG009740) and is conducted by the University of Michigan.

The Association Between Discrimination and Falling. A National Sample of Older Adults

To assess the relationship between discrimination and falling among older people. A cross-sectional nationwide population-based face-to-face survey, 2015. The SABE (Salud, Bienestar y Envejecimiento) Colombia Study, 19,004 community-dwelling adults aged ≥60years. Recurrent falling was defined as ≥2 falls during the prior year. Main independent variable was discrimination. Multivariate logistic regression models showed that recurrent falling was significantly associated with a number of reasons for experiences of everyday discrimination (due to racial, socioeconomic status, gender, age, religion, sexual orientation, or disability) (OR = 1.27, 95% CI 1.21-1.33), childhood discrimination score (never = 0 to many times = 3) (OR = 1.23, 95% CI 1.13-1.33), and number of situations for discrimination during the last 5years due to skin color (group activities, public places, inside the family, or health centers) (OR = 1.12, 95% CI 1.08-1.17). Discrimination experiences were associated with higher odds of recurrent falling.

Long-Term Correlates of Racially Diverse Schooling: Education, Wealth, and Social Engagement in Later Life

Racially diverse educational settings yield various benefits according to past research. However, researchers have not fully considered how longlasting the benefits are and whether they exist for adults who attended school prior to the Civil Rights Act of 1964. We analyze a national sample of older adults born between 1931 and 1953 to test for an association between attending a race discordant school in early life and socioeconomic status and social engagement in later life. We use OLS regression and propensity adjusted regression to account for early life factors that select children into race discordant schools. Findings indicate that race discordant schooling is associated with long-term educational benefits for Hispanic adults and greater wealth for Black adults at age 65. Attending a race discordant school was not correlated with socioeconomic outcomes in later life for Whites. Additionally, Black and White older adults who attended discordant schools reported higher levels of social engagement at age 65. To the extent our models successfully account for selection, early exposure to race discordant schools yielded some later-life benefits to all racial/ethnic groups and reduced racial/ethnic inequalities among older adults, despite growing up in a time of entrenched institutional racism and significant White opposition to school integration.

Psychological well-being, education, and mortality.

Research on older adults often focuses on mitigating health risks, and less is known about protective factors that contribute to longer, healthier lives. We examine longitudinal associations between psychological well-being and mortality among a national sample of older adults and test competing hypotheses about whether the education/mortality association depends on the level of psychological well-being. We use six waves (2006-2016) of the Health and Retirement Study, a national sample of adults over age 50 (n = 21,172), with 14 years of mortality follow-up. Psychological well-being is measured up to three times and includes positive affect, life satisfaction, purpose in life, social support, and optimism. Discrete-time survival models examine (a) the association between time-varying psychological well-being and mortality, and (b) interactions between psychological well-being and education on mortality. Higher purpose in life, positive affect, optimism, social support, and life satisfaction predicted lower mortality. A 1 SD increase in most measures of psychological well-being was associated with a 2-4 year increase in life expectancy at age 50. Positive affect and purpose in life moderated the education/mortality association-the inverse association between education and mortality was stronger for those with high psychological well-being. We find strong evidence that psychological well-being predicts lower mortality risk and modifies the association between education and mortality. The inverse association between education and mortality becomes stronger at higher levels of purpose in life and positive affect. Therefore, efforts to promote life satisfaction, social support, and optimism may support longer lives without widening education disparities. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Does Diversity of Social Ties Really Matter More for Health and Leisure Activity than Number of Social Ties? Evidence from Later Adulthood.

Claims that the diversity of social ties matters more for health than the sheer number of ties have largely gone untested. This study accordingly compared the unique associations of number versus diversity of social ties with key health-related outcomes: functional limitations and leisure activities. Additionally, positive and ambivalent ties were distinguished. Social networks, health, and leisure activities were assessed in a national sample of older adults (N = 874; ages 65-91). Regression analyses revealed that number of ties related to each outcome at a magnitude comparable to, or exceeding, that of diversity in most models. For positive ties, number related more strongly than diversity to greater leisure activities. For ambivalent ties, number related more strongly than diversity to worse functional limitations. Contrary to prevailing views, diversity of ties is not necessarily more important than number of ties. Findings extend scientific understanding and approaches to interventions.

Social Participation and Elder Mistreatment in a National Sample of Older Adults

Little is known about how social participation influences older adults' susceptibility to elder mistreatment. We conducted a cross-sectional analysis of a national probability sample of community-dwelling U.S. adults from 2015-2016 (1,268 women and 973 men; mean age 75 and 76 years, respectively; 82% non-Hispanic white). Frequency of participation in formal activities (community meetings, religious services, and volunteering) and informal social activities (socializing with friends and family) was assessed by questionnaire. Additional measures assessed emotional, physical, and financial mistreatment since age 60. Multivariable logistic regression examined associations between social participation and elder mistreatment, adjusting for age, race/ethnicity, education, and comorbidity. Forty percent of women and 22% of men reported at least one form of mistreatment (emotional, physical, or financial). Women reporting at least monthly formal social participation were more likely to report emotional mistreatment (adjusted odds ratio (AOR) 1.57, 95% confidence interval (CI) 1.08-2.29) and financial mistreatment (AOR 1.56, 95% CI 1.02-2.38) than women with less frequent engagement. Older women who socialized at least weekly were more likely to report emotional mistreatment (AOR 0.59, 95% CI 0.44-0.78) and financial mistreatment (AOR 0.59, 95% CI 0.42-0.85). These associations were not seen among older men. Frequent social engagement in the community does not preclude risk for elder mistreatment, and informal socializing may be associated with decreased exposure to certain forms of mistreatment. Assessment of older adults’ social activities may help guide strategies for detecting and mitigating elder mistreatment in the community.

Determinants of acquired disability and recovery from disability in Indian older adults: longitudinal influence of socio-economic and health-related factors

BackgroundThere is a higher burden of functional disability for Indian older adults with substantial variations across different geographic regions and socioeconomic groups as compared to other ageing Asian countries. Thus, using a national sample of older adults aged 60+ years, we aim to explore how common is acquiring of disability and recovery from disability among the older population of a developing country like India, and how do the various socioeconomic and health-related conditions impact this transition in disability status.MethodThe current study uses two waves of the India Human Development Survey (IHDS) and is based on panel data of 10,527 older adults. Both bivariate and multiple variable regression analysis were performed using two binary outcome variables in this study – whether older adults acquired disability and recovered from disability between round-I and round-II, respectively.Results Nearly 31.5% and 4.4 % of older adults have acquired and recovered disability across the two rounds respectively. About 38.5% and 45.8 % of female older adults’ disability status changes to disable and recovered in round-II respectively. A lesser proportion of older adults have recovered from a disability who have a chronic disease in round-I. Cataract chronic conditions among older adults in round-I had shown 1.45 times (CI: 1.07–1.97) a significantly higher likelihood of acquiring disability in round-I. Older adults who were unmarried and were not working in round-I have 1.12 times (CI: 1.01–1.25) and 1.21 times (CI: 1.06–1.39) higher likelihood of acquiring disability in round-II respectively. Recovering from disability was mostly seen among older adults who belong to the richest (OR: 2.38, CI: 1.31–4.33) and medium (OR: 2.16, CI: 1.27–3.69) wealth quintile households. Older adults residing in the central region of India have 2.72 times (CI: 2.31–3.19) significantly higher chance of acquiring disability than those who were residing in northern regions.ConclusionAppropriate measures are required to highlight the importance of chronic physical diseases and several socio-demographic factors that may negatively affect the trajectory of disability in older ages.

Residential Street Block Disorder and Biological Markers of Aging in Older Adults: The National Health and Aging Trends Study.

Residential environments are associated with older adults' health, but underlying physiologic causal mechanisms are not well understood. As adults age, street blocks are likely more relevant to their health than the larger neighborhood environment. This study examined the effects of adverse street block conditions on aging biomarkers among older adults. We included community-dwelling Medicare beneficiaries aged 67 and older with 2017 biomarker data from the nationally representative National Health and Aging Trends Study (n = 4357). Street block disorder in 2016 was measured using interviewer report of any trash/glass/litter, graffiti, or vacant buildings on participants' blocks. Propensity score models were used to create balanced groups with regard to multiple 2015 participant characteristics, including demographic, socioeconomic, residence, and early-life characteristics. Linear regressions modeled street block disorder as a predictor of 4 aging biomarkers, hemoglobin A1C, high-sensitivity C-reactive protein, interleukin-6, and cytomegalovirus antibodies, before and after applying propensity score weighting. Adjusting for participant sociodemographic characteristics and applying propensity score weights, living on a block with any disorder was associated with 2% higher mean hemoglobin A1C levels (95% confidence interval [CI]: 0.002-0.03), 13% higher C-reactive protein (95% CI: 0.03-0.23), 10% higher interleukin-6 (95% CI: 0.02-0.19), and 19% more cytomegalovirus antibodies (95% CI: 0.09-0.29) compared to living on a block with no disorder. Street block disorder predicted subsequent aging biomarkers after applying a propensity score approach to account for confounding among a national sample of older adults. Targeting street-level residential contexts for intervention may reduce the risk for poor health in older adults.

Formal and informal social participation and elder mistreatment in a national sample of older adults.

Older adults' susceptibility to mistreatment may be affected by their participation in social activities, but little is known about relationships between social participation and elder mistreatment. Cross-sectional analysis. National probability sample of older community-dwelling U.S. adults interviewed in 2015-2016, including 1268 women and 973 men (mean age 75 years and 76 years, respectively; 82% non-Hispanic white). Frequency of participation in formal activities (organized meetings, religious services, and volunteering) and informal social activities (visiting friends and family) was assessed by questionnaire. Elder mistreatment included emotional (four items), physical (two items), and financial mistreatment (two items) since age 60. Multivariable logistic regression examined associations between each type of social participation and elder mistreatment among men and women, adjusting for age, race/ethnicity, education, and comorbidity. Forty percent of women and 22% of men reported at least one form of mistreatment (emotional, physical, or financial). Women reporting at least monthly engagement in formal social activities were more likely to report emotional mistreatment (adjusted odds ratio (AOR) 1.59, 95% confidence interval (CI) 1.09-2.33). Among men, monthly organized meeting attendance was associated with increased odds of emotional mistreatment (AOR 1.34, 95% CI 1.01-1.93). Weekly informal socializing was inversely associated with emotional mistreatment (AOR 0.59, 95% CI 0.44-0.78) and financial mistreatment (AOR 0.59, 95% CI 0.42-0.85) among women. In this national cohort, older adults who were frequently engaged in formal social activities reported similar or higher levels of mistreatment than those with less frequent organized social participation. Older women with regular informal contact with family or friends were less likely to report some kinds of mistreatment. Strategies for detecting and mitigating elder mistreatment should consider differences in patterns of formal and informal social participation and their potential contribution to mistreatment risk.