Dataset Information

Caregiving for Older Adults with Obesity in the United States.

ABSTRACT: To determine the difference in receipt of activity of daily living (ADL) assistance between obese and normal-weight older adults.Retrospective cohort study.National Health and Aging Trends Study, 2011-2015.U.S. adults aged 65 and older with ADL disability and a body mass index (BMI) of 18.5 kg/m2 or greater (N = 5,612) MEASUREMENTS: BMI was classified as normal weight (18.5-24.9 kg/m2 ), overweight (25.0-29.9 kg/m2 ), or obese (?30.0 kg/m2 ). Primary outcome was self-reported receipt of help with specific ADLs. Models were adjusted for demographic characteristics (age, sex, race), degree of need (self-reported general health, severity of disability), household resources (income, marriage, people in household, number of children), and cognitive status (dementia, proxy respondent).Obese with disabilities had lower rates of receiving assistance with walking inside (odds ratio (OR) = 0.63, 95% confidence interval (CI) = 0.50-0.81), walking outside (OR = 0.76, 95% CI = 0.59-0.97), toileting (OR = 0.68, 95% CI = 0.52-0.89), and getting in and out of bed (OR = 0.67, 95% CI = 0.50-0.87) than normal-weight older adults after adjustment for respondent demographic characteristics. Level of need and cognitive status partially explained the associations. In fully adjusted models, older adults with obesity still had significantly lower odds of receiving assistance in getting in and out of bed than normal weight adults (OR = 0.69, 95% CI = 0.49-0.98).Older adults with obesity are less likely to receive assistance for ADL disabilities than their normal-weight counterparts-an important concern because of ongoing demographic changes in the United States.

SUBMITTER: Ankuda CK

PROVIDER: S-EPMC5603353 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Caregiving for Older Adults with Obesity in the United States.

Ankuda Claire K CK Harris John J Ornstein Katherine K Levine Deborah A DA Langa Kenneth M KM Kelley Amy S AS

Journal of the American Geriatrics Society 20170427 9

<h4>Objectives</h4>To determine the difference in receipt of activity of daily living (ADL) assistance between obese and normal-weight older adults.<h4>Design</h4>Retrospective cohort study.<h4>Setting</h4>National Health and Aging Trends Study, 2011-2015.<h4>Participants</h4>U.S. adults aged 65 and older with ADL disability and a body mass index (BMI) of 18.5 kg/m<sup>2</sup> or greater (N = 5,612) MEASUREMENTS: BMI was classified as normal weight (18.5-24.9 kg/m<sup>2</sup> ), overweight (25.0 ...[more]

PMID: 28449347

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Project description:ObjectiveThis study aimed to identify temporal time trends and risk factors associated with mortality for hospitalized older adults with status epilepticus (SE).DesignA retrospective study was performed.SettingHospitalized patients were identified utilizing an administrative database-The Nationwide Inpatient Sample database from 1998 through September 2015.PatientsPatients were older adults 65 years and older with SE.InterventionsNo interventions were undertaken.Measurements and main resultsDemographic, temporal trends, clinical characteristics, and outcome data were abstracted. The results indicated that hospitalized elderly Americans with SE increased over the 11-year study period. Univariate and multivariate analyses were performed to evaluate risk factors associated with mortality in the study cohort. From the weighted sample, 130,109 subjects were included. Overall mortality was 19%. For age subgroups, the mortality was highest for the >85 years age group (24.1%) compared to the 65-75 years (19%) and 75-85 years (23%) age groups. Among investigated etiologies, the three most common causes of SE were acute ischemic stroke (11.2% of total) followed by non-traumatic brain hemorrhage (5.4%) and malignant brain lesions (4.9%). The highest mortality by etiology was noted for acute traumatic brain injury (TBI) (31.5%), non-traumatic brain hemorrhage (31%), and acute ischemic stroke (AIS) (30.1%). Multivariate analysis indicated that non-survivors when compared to survivors were more like to have the following characteristics: older age group, acute TBI, brain neoplasms, non-traumatic brain hemorrhage, AIS and central nervous system (CNS) infections, and utilization of mechanical ventilation. Associated conditions significantly increasing risk of mortality were sodium imbalance, cardiac arrest, anoxic brain injury, pneumonia, and sepsis. Comorbidities associated with increased risk of mortality included valvular heart disease, renal failure, liver disease, and neoplasms.ConclusionsThe number of hospitalized elderly Americans with SE increased over the 11-year study period. Overall mortality was 19%, with even higher mortality among various patient subsets. Several demographic and co-morbid factors are associated with increased mortality in this age group.

Project description:OBJECTIVES:To determine the prevalence and impact of common co-occurring symptoms among community-dwelling older adults in the United States. DESIGN:The National Health and Aging Trends Study is a nationally representative, prospective study with annual data collection between 2011 and 2017. SETTING:Community-based, in-person interviews (survey response rates, 71%-96%). PARTICIPANTS:A total of 7,609 community-dwelling Medicare beneficiaries, 65 years or older. MEASUREMENTS:Symptoms assessed at baseline include pain, fatigue, breathing difficulty, sleeping difficulty, depressed mood, and anxiety. Total symptom count ranged from zero to six. Several outcomes were examined, including grip strength, gait speed, and overall lower-extremity function as well as incidence of recurrent falls (two or more per year), hospitalization, disability, nursing home admission, and mortality. RESULTS:Prevalence of zero, one, two, three, and four or more symptoms was 25.0%, 26.6%, 20.7%, 14.0%, and 13.6%, respectively. Symptom count increased with advancing age and was higher in women than in men. Pain and fatigue were the most common co-occurring symptoms. Higher symptom count was associated with decreased physical capacity. For example, participants with one, two, three, and four or more symptoms had gait speeds that were 0.04, 0.06, 0.09, and 0.13 m/s slower, respectively, than those with no symptoms, adjusting for specific diseases, total number of diseases, and other potential confounders (P < .001). The risk of several adverse outcomes also increased with greater symptom count. For example, compared with those with no symptoms, the adjusted risk ratios for recurrent falls were 1.48 (95% confidence interval [CI] = 1.30-1.70), 1.54 (95% CI = 1.32-1.80), 1.90 (95% CI = 1.55-2.32), and 2.38 (95% CI = 2.00-2.83) for older adults with one, two, three, and four or more symptoms, respectively. CONCLUSIONS:Symptoms frequently co-occur among community-dwelling older adults and are strongly associated with increased risk of a range of adverse outcomes. Symptoms represent a potential treatment target for improving outcomes and should be systematically captured in health records. J Am Geriatr Soc 67:223-231, 2019.

Project description:BackgroundOlder adults are encouraged to use Medical Visit Companions (MVCs) for routine medical encounters; however, many vulnerable older adults attend alone or fail to attend. In the absence of available family or friends, community volunteers could potentially fill this gap. We aimed to understand the role and acceptability of volunteer MVCs accompanying older adults to medical visits and explore potential barriers and facilitators of increasing MVC availability and expanding roles beyond transportation.MethodsTwo moderators conducted 4 focus groups with 29 volunteers grouped by whether they provided (n = 15) or received (n = 14) rides to medical visits. All were members of Partners In Care (PIC), a community organization in Maryland, United States which offers a range of programs and services that support the independence of older adults including the provision of volunteer MVCs. Participants were asked to discuss why they were involved with PIC, and to describe their experiences with providing or receiving companionship during medical visits. Inductive thematic analysis was used to explore the views and experiences of participants, particularly around the roles played by MVCs and the feasibility of expanding these roles.ResultsAll participants reported benefits from their role whether that was giving or receiving rides. Many accompanied participants reported missing medical appointments prior to joining PIC and being able to avail of the services of a MVC. Volunteer roles varied and ranged from transportation only, help with care coordination and in some cases accompanying the person into their medical visit. A subgroup of volunteers expressed a willingness to take on additional roles during the physician visit following additional training and isolated older adults welcomed the prospect of their assistance.ConclusionOur qualitative data indicate that non-family, volunteer MVCs are willing and able to assist older people going to a medical visit. With appropriate training and support, volunteer companions could do much to improve the healthcare experience for those who otherwise would attend alone or would not attend medical visits.

Dataset Information

Caregiving for Older Adults with Obesity in the United States.

Publications

Caregiving for Older Adults with Obesity in the United States.

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