Dataset Information

Effects of Older Adult Driving Resumption on All-Cause Mortality.

ABSTRACT: OBJECTIVES:Driving cessation is associated with adverse social and health outcomes including increased mortality risk. Some former drivers resume driving. Do resumed drivers have a different mortality risk compared to former drivers or continued drivers? METHOD:We analyzed National Health and Aging Trends Study (2011-2015) data of community-dwelling self-responding ever drivers (n = 6,189) with weighted stratified life tables and discrete time logistic regression models to characterize mortality risk by driving status (continued, resumed, former), adjusting for relevant sociodemographic and health variables. RESULTS:Overall, 14% (n = 844) of participants died and 52% (n = 3,209) completed Round 5. Former drivers had the highest mortality (25%), followed by resumed (9%) and continued (6%) drivers. Former drivers had 2.4 times the adjusted odds of mortality compared with resumed drivers (adjusted odds ratio [aOR] = 2.41; 95% confidence interval [CI] = 1.51, 3.83), with no difference between continued and resumed drivers (aOR = 1.22; 95% CI = 0.74, 1.99). DISCUSSION:Those who resumed driving had better survival than those who did not. Practice implications include driver rehabilitation and retraining to safely promote and prolong driving.

SUBMITTER: Ratnapradipa KL

PROVIDER: S-EPMC7664310 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Effects of Older Adult Driving Resumption on All-Cause Mortality.

Ratnapradipa Kendra L KL Wang Jing J Berg-Weger Marla M Schootman And Mario AM

The journals of gerontology. Series B, Psychological sciences and social sciences 20201101 10

<h4>Objectives</h4>Driving cessation is associated with adverse social and health outcomes including increased mortality risk. Some former drivers resume driving. Do resumed drivers have a different mortality risk compared to former drivers or continued drivers?<h4>Method</h4>We analyzed National Health and Aging Trends Study (2011-2015) data of community-dwelling self-responding ever drivers (n = 6,189) with weighted stratified life tables and discrete time logistic regression models to charact ...[more]

PMID: 31076775

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Project description:BackgroundVitamin D deficiency and systemic inflammation share common pathological mechanisms in muscle loss, cardio-pulmonary function decline, and abnormal metabolism, which are linked to chronic conditions, senescence, and early mortality. However, their combined effect on mortality in older adults has not been well established. This study longitudinal aimed to explore the independent and combined associations of serum 25-hydroxyvitamin D [25(OH)D] and high sensitivity C-reactive protein (hs-CRP) with mortality risk in Chinese community-based older people.Methods3072 older adults (86.07 ± 11.87 years, 54.52% female) from the Chinese Longitudinal Healthy Longevity Survey (2012-2018) were enrolled. Baseline 25(OH)D and hs-CRP levels were collected, and survival information was recorded in the 2014 and 2018 follow-up waves. Cox proportional hazard regressions were conducted to explore the associations between 25(OH)D, hs-CRP, and mortality. Demographic characteristics, health behaviors, and chronic disease biomarkers were adjusted.ResultsDuring 10,622.3 person-years of follow-up (median: 3.51 years), 1321 older adults died, including 448 deaths due to cardiovascular disease (CVD). Increased mortality risk was associated with lower 25(OH)D and higher hs-CRP quantiles, even after adjusting for each other and multiple covariates (all P-trend < 0.05). In combined analyses, the highest all-cause mortality (HR: 2.18, 95% CI: 1.73 ~ 2.56), CVD mortality (HR: 2.30, 95% CI: 1.64 ~ 3.21), and non-CVD mortality (HR: 2.19, 95% CI: 1.79 ~ 2.49) were obtained in participants with both 25(OH)D deficiency (< 50 nmol/L) and high hs-CRP (≥ 3.0 mg/L), respectively. We observed significant additive interactions of 25(OH)D and hs-CRP on all-cause mortality and non-CVD mortality (RERIS>0).ConclusionsLow 25(OH)D and high hs-CRP, both independently and jointly, increase mortality risk in Chinese community-dwelling older adults. Thus, priority should be given to early detection and appropriate intervention in older individuals with combined vitamin D deficiency and systemic inflammation. Molecular mechanisms of related adverse health effect are worthy of further investigation.

Project description:Cause- and context-specific mortality data are imperative to understand the extent of health problems in low-income settings, where national death registration and cause of death identification systems are at a rudimentary stage. Aiming to estimate cause-specific mortality fractions, adult (15+ years) deaths between January 2008 and April 2020 were extracted from the Butajira health and demographic surveillance system electronic database. The physician review and a computerized algorithm, InterVA (Interpreting Verbal Autopsy), methods were used to assign the likely causes of death from January 2008 to April 2017 (the first) and May 2017 to April 2020 (the second) phase of the surveillance period, respectively. Initially, adult mortality rates per 1000py across sex and age were summarized. A total of 1,625 deaths were captured in 280, 461 person-years, with an overall mortality rate of 5.8 (95%CI: 5.5, 6.0) per 1000py. Principally, mortality fractions for each specific cause of death were estimated, and for 1,571 deaths, specific causes were determined. During the first phase, the leading cause of death was tuberculosis (13.6%), followed by hypertension (6.6%) and chronic liver disease (5.9%). During the second phase, digestive neoplasms (17.3%), tuberculosis (12.1%), and stroke (9.4%) were the leading causes of death, respectively. Moreover, tuberculosis was higher among persons aged 50+ (15.0%), males (13.8%), and in rural areas (14.1%) during the first phase. Hypertensive diseases were higher among females (7.9%) and in urbanities. In the second phase, digestive neoplasms were higher in the age group of 50–64 years (25.4%) and females (19.0%), and stroke was higher in older adults (65+) (10%) and marginally higher among males (9.7%). Our results showed that tuberculosis and digestive neoplasms were the most common causes of death. Hence, prevention, early detection, and management of cases at all levels of the existing healthcare system should be prioritized to avert premature mortality.

Project description:RationaleAs the older adult population increases, understanding the health effects of bias against older adults is increasingly important. Whether structural forms of age bias predict worse health has received limited attention.ObjectiveWe hypothesized that communities with greater age bias would have higher mortality among residents aged 65 and older. We expected the association to be unique to age bias, rather than general bias (i.e., sexual minority and racial bias), and that the age bias-mortality association would be strongest in predominantly White and younger communities.MethodsExplicit and implicit attitudes toward older adults (N = 1,001,735), sexual minorities (N = 791,966), and Black Americans (N = 2,255,808) were drawn from Project Implicit. Post-stratification relative to U.S. Census demographics was executed to improve the representativeness of county-level explicit and implicit bias estimates. County older adult mortality, estimated cross-sectionally with and longitudinally relative to bias scores, served as outcomes. Models controlled for relevant county-level covariates (e.g., median age) and included all U.S. counties (N = 3142).ResultsContrary to hypotheses but consistent with prior work, explicit age bias was cross-sectionally and longitudinally associated with lower mortality, over and above covariates and generalized community bias. The explicit age bias-lower mortality association only emerged in younger counties but did not depend on county ethnic composition. Implicit age bias was unassociated with outcomes. Post-hoc analyses supported that ageist communities may be associated with better health across the lifespan. Explicit age bias predicted lower mortality in young and middle adulthood; better mental health in middle adulthood, but not exercise or self-rated health, mediated the explicit age bias-older adult mortality association.ConclusionsResults highlight the uniqueness of older age relative to other stigmatized identities. Further examination of the association of community-level age bias with better health may improve longevity for all communities.

Dataset Information

Effects of Older Adult Driving Resumption on All-Cause Mortality.

Publications

Effects of Older Adult Driving Resumption on All-Cause Mortality.

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