Links between Primary Occupation and Functional Limitations among Older Adults in Mexico.
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ABSTRACT:
SUBMITTER: Beltran-Sanchez H
PROVIDER: S-EPMC5659182 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Background: Food insecurity refers to the physical, social, and economic inability to access and secure sufficient, safe and nutritious food. Food insecurity has been found to be associated with poor health status, obesity, and chronic disease. To date, a relationship between food insecurity and functional limitations has not been described in of older adults. Methods: We examined 9309 adults ?60 years old from the 2005-2014 National Health and Nutrition Examination Surveys (NHANES). Food security was categorized as full, marginal, low, and very low. Functional limitations were assessed as having difficulty in physical, basic or instrumental activities of daily living. Results: Of adults ?60 years old (mean age: 70.5?±?0.08, 51% female), the prevalence of full, marginal, low, or very low food insecurity was 7572 (81%), 717 (7%), 667 (8%), and 353 (4%), respectively. The prevalence of any functional limitations was 5895 (66.3%). The adjusted odds (OR [95%CI]) of having any functional limitation in marginal, low, and very low food security levels compared to full food security are: 1.08 [1.02-1.13], 1.16 [1.10-1.22], 1.14 [1.07-1.21], respectively. The association between levels of food insecurity and functional limitation is modified by race/ethnicity. Conclusions: Functional limitation is significantly associated with increasing food insecurity in older adults.
| S-EPMC6988737 | biostudies-literature
Project description:ObjectivesOlder adults often experience functional limitations that affect their everyday lives, but many of them continue to make positive contributions to society and benefit from these contributions themselves. We examine (a) whether older adults' functional limitations are associated with diurnal cortisol patterns and (b) whether these associations vary on volunteering days versus nonvolunteering days.MethodsParticipants were adults aged older than 60 years (N = 435) from the National Study of Daily Experiences, part of the Midlife in the United States Study. They completed an initial interview on functional limitations and background characteristics, indicated volunteering activities in daily interviews, and also provided salivary samples across 4 days.ResultsMultilevel models showed that older adults with greater functional limitations exhibited dysregulated cortisol awakening responses and diurnal cortisol slopes throughout the rest of the day, compared to older adults with lower limitations. Yet, we also observed a significant moderating effect of volunteering on these associations.DiscussionThis study advances our understanding of functional limitations and cortisol stress responses, revealing the benefits of volunteering to older adults who experience these limitations. Rather than treating these older adults solely as care recipients, interventions should offer them opportunities to help others.
| S-EPMC8557846 | biostudies-literature
Project description:BackgroundInequalities in mortality are often attributed to socioeconomic differences in education level, income, and wealth. Low socioeconomic status (SES) is generally related to worse health and survival across the life course. Yet, disadvantaged people are also more likely to hold jobs requiring heavy physical labor, repetitive movement, ergonomic strain, and safety hazards.ObjectiveWe examine the link between primary lifetime occupation, together with education and net worth, on survival among older adults in Mexico.MethodsWe use data from four waves (2001, 2003, 2012, and 2015) of the Mexican Health and Aging Study (MHAS). We estimate age-specific mortality rates for ages 50 and over using a hazards model based on a two-parameter Gompertz function.ResultsPrimary lifetime occupations have a stronger association with survival for women than men. Women with higher socioeconomic status have significantly lower mortality rates than lower status women, whether SES is assessed in terms of schooling, wealth, or occupation. Occupational categories are not jointly related to survival among men, even without controls for education and wealth. There are significant survival differences by wealth among men, but no disparities in mortality by education.ConclusionsConsistent with recent studies of the Mexican population, we fail to find the expected gradient in the association between some measures of SES and better survival among men.ContributionOur estimates extend this anomalous pattern among Mexican men to another dimension of SES, occupation. SES differentials in mortality are substantially larger for Mexican women, highlighting an important gender disparity.
| S-EPMC9917739 | biostudies-literature
Project description:When making choices between smaller, sooner rewards and larger, later ones, people tend to discount future outcomes. Individual differences in temporal discounting in older adults have been associated with episodic memory abilities and entorhinal cortical thickness. The cause of this association between better memory and more future-oriented choice remains unclear, however. One possibility is that people with perceptually richer recollections are more patient because they also imagine the future more vividly. Alternatively, perhaps people whose memories focus more on the meaning of events (i.e., are more "gist-based") show reduced temporal discounting, since imagining the future depends on interactions between semantic and episodic memory. We examined which categories of episodic details - perception-based or gist-based - are associated with temporal discounting in older adults. Older adults whose autobiographical memories were richer in perception-based details showed reduced temporal discounting. Furthermore, in an exploratory neuroanatomical analysis, both discount rates and perception-based details correlated with entorhinal cortical thickness. Retrieving autobiographical memories before choice did not affect temporal discounting, however, suggesting that activating episodic memory circuitry at the time of choice is insufficient to alter discounting in older adults. These findings elucidate the role of episodic memory in decision making, which will inform interventions to nudge intertemporal choices.
| S-EPMC7156676 | biostudies-literature
Project description:Ageing and depression are associated with disability and have significant consequences for health systems in many other developing countries. Depression prevalence figures among the elderly are scarce in developing countries.To estimate the prevalence of depressive symptoms and their cross-sectional association with selected covariates in a community sample of Mexico City older adults affiliated to the main healthcare provider.Cross-sectional, multistage community survey.A total of 7,449 persons aged 60 years and older.Depression was assessed using the 30-item Geriatric Depression Scale (GDS); cognitive impairment, using the Mini-Mental State Examination; and health-related quality of life with the SF-36 questionnaire.The prevalence of significant depressive symptoms was estimated to be 21.7%, and 25.3% in those aged 80 and older. After correcting for GDS sensitivity and specificity, major depression prevalence was estimated at 13.2%. Comparisons that follow are adjusted for age, sex, education and stressful life events. The prevalence of cognitive impairment was estimated to be 18.9% in depressed elderly and 13.7% in non-depressed. SF-36 overall scores were 48.0 in depressed participants and 68.2 in non-depressed (adjusted mean difference = -20.2, 95% CI = -21.3, -19.1). Compared to non-depressed elderly, the odds of healthcare utilization were higher among those depressed, both for any health problem (aOR 1.4, 95% CI = 1.1, 1.7) and for emotional problems (aOR 2.7, 95% CI = 2.2, 3.2).According to GDS estimates, one of every eight Mexican older adults had major depressive symptoms. Detection and management of older patients with depression should be a high priority in developing countries.
| S-EPMC2596501 | biostudies-other
Project description:We investigated the association between functional limitations and telehealth use among older Medicare beneficiaries in 2020. We use logistic regression models to estimate associations between functional limitations and the use of technological tools (i.e., computers, Internet, telehealth). We consider Internet use and informal technological support as moderators for telehealth use. Respondents (N = 3151; Mage = 78.31) with more functional limitations were more likely to use video-based telehealth. Net of functional limitations, those with a consistent Internet use were more likely to use emails/texts/portal messages to communicate with a healthcare provider. Further, more functional limitations were associated with a higher probability of using emails/texts/portal messages, but only among respondents who received informal technological support. Healthcare access may have been more difficult for older adults with functional limitations during the COVID-19 pandemic, especially for those with little prior experience with the Internet, or those without friends/family to provide technological support.
| S-EPMC9790857 | biostudies-literature
Project description:ObjectiveTo understand the interaction of multimorbidity and functional limitations in determining health-care utilization and survival in older adults.MethodsOlmsted County, Minnesota, residents aged 60-89 years in 2005 were categorized into four cohorts based on the presence or absence of multimorbidity (≥3 chronic conditions from a list of 18) and functional limitations (≥1 limitation in an activity of daily living from a list of 9), and were followed through December 31, 2016. Andersen-Gill and Cox regression estimated hazard ratios (HRs) for emergency department (ED) visits, hospitalizations, and death using persons with neither multimorbidity nor functional limitations as the reference (interaction analyses).ResultsAmong 13,145 persons, 34% had neither multimorbidity nor functional limitations, 44% had multimorbidity only, 4% had functional limitations only, and 18% had both. Over a median follow-up of 11 years, 5906 ED visits, 2654 hospitalizations, and 4559 deaths occurred. Synergistic interactions on an additive scale of multimorbidity and functional limitations were observed for all outcomes; however, the magnitude of the interactions decreased with advancing age. The HR (95% confidence interval) for death among persons with both multimorbidity and functional limitations was 5.34 (4.40-6.47) at age 60-69, 4.16 (3.59-4.83) at age 70-79, and 2.86 (2.45-3.35) at age 80-89 years.ConclusionThe risk of ED visits, hospitalizations, and death among persons with both multimorbidity and functional limitations is greater than additive. The magnitude of the interaction was strongest for the youngest age group, highlighting the importance of interventions to prevent and effectively manage multimorbidity and functional limitations early in life.
| S-EPMC6734596 | biostudies-literature
Project description:BackgroundHospitalization-associated functional decline is a common problem for older adults, but it is unclear how hospitalizations affect physical performance measures such as gait speed. We sought to determine hospitalization-associated change in gait speed and likelihood of new limitations in mobility and activities of daily living (ADLs).MethodsWe used longitudinal data over 5 years from the Health, Aging and Body Composition Study, a prospective cohort of black and white community-dwelling men and women, aged 70-79 years, who had no limitations in mobility (difficulty walking 1/4 mile or climbing 10 steps) or ADLs (transferring, bathing, dressing, and eating) at baseline. Gait speed, and new self-reported limitations in mobility and ADLs were assessed annually. Selected participants (n = 2,963) had no limitations at the beginning of each 1-year interval. Hospitalizations were self-reported every 6 months and verified with medical record data. Generalized estimating equations were used to examine hospitalization-associated change in gait speed and odds of new limitations over each 1-year interval. Fully adjusted models included demographics, hospitalization within the past year, health conditions, symptoms, body mass index, and health-related behaviors.ResultsIn fully adjusted models, any hospitalization was associated with decrease in gait speed (-0.04 m/s; 95% confidence interval [CI]: -0.05 to -0.03) and higher odds of new limitations in mobility or ADLs (odds ratio = 1.97, 95% CI: 1.70-2.28), and separately with increased odds of new mobility limitation (odds ratio = 2.22, 95% CI: 1.90-2.60) and new ADL limitations (odds ratio = 1.84, 95% CI: 1.53-2.21). Multiple hospitalizations within a year were associated with gait speed decline (-0.06 m/s; 95% CI: -0.08 to -0.04) and greater odds of new limitations in mobility or ADLs (odds ratio = 2.96, 95% CI: 2.23-3.95).ConclusionsFunctionally independent older adults experienced hospitalization-associated declines in gait speed and new limitations in mobility and ADLs.
| S-EPMC6748735 | biostudies-literature
Project description:An increase in the number of older adults may raise the demand for health and care services, whereas decreasing prevalence of disability and functional limitations among them might counteract this demographic effect. However, the trends in health are inconsistent between studies and countries. In this article, we estimated the trends in mild disability and functional limitations among older Norwegians and analyzed whether they differ between socio-demographic groups. Data were obtained from repeated cross-sectional surveys conducted in 1987, 1991, 1995, 2002, 2005, and 2008, in total 4,036 non-institutionalized persons aged 67 years or older. We analyzed trends using multivariate logistic regression. On average, the age-adjusted trend in functional limitations was -3.3% per year, and in disability 3.4% per year. The risk for functional limitations or disability was elevated for women compared to men, for married compared to non-married, and was inversely associated with educational level The trends were significantly weaker with increasing age for disabilities, whereas none of the trends differed significantly between subgroups of sexes, educational level or marital status. Both functional limitations free and disability-free life expectancy appeared to have increased more than total life expectancy at age 67 during this period. The analysis suggests downward trends in the prevalence of mild disability and functional limitations among older Norwegians between 1987 and 2008 and a compression of lifetime in such health states. The reduced numbers of older people with disability and functional limitations may have restrained the demand for health and care services caused by the increase in the number of older adults.
| S-EPMC3047681 | biostudies-other
Project description:BackgroundAlthough tooth loss appears to be related to functional limitations, the mechanisms that underpin this relationship are unknown. We sought to address this knowledge gap by examining a multiple mediation hypothesis whereby tooth loss is predicted to indirectly affect functional limitations through social participation, subjective well-being, and cognitive function.MethodsThis study included 7,629 Chinese adults from the 2017/2018 Chinese Longitudinal Healthy Longevity Survey wave. The serial mediation effects were examined using Model 6 in the Hayes' PROCESS macro for SPSS.ResultsTooth loss was significantly related to functional limitations. There was a direct (β = - 0.0308; 95% CI, - 0.0131 to - 0.0036) and indirect (β = - 0.0068; 95% CI, - 0.0096 to - 0.0041) association between tooth loss and instrumental activities of daily living (IADL) limitations, but only an indirect correlation with activities of daily living (ADL) limitations (β = - 0.0188; 95% CI, - 0.0259 to - 0.0121). Social participation, subjective well-being, and cognitive function serially mediated the relationship between tooth loss and ADL/IADL limitations.ConclusionThe association between tooth loss and functional limitations is serially mediated by social participation, subjective well-being, and cognitive function. Our findings underscore the necessity of considering psychological and social factors as integrated healthcare approaches for the functional health of older adults.
| S-EPMC10938731 | biostudies-literature