Peripheral edema: A common and persistent health problem for older Americans.
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ABSTRACT:
SUBMITTER: Besharat S
PROVIDER: S-EPMC8675752 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:Secondary prevention of peripheral arterial disease (PAD) includes administration of antiplatelet agents, and adherence to medication is a requirement for an effective treatment. The aim of this study was to analyse adherence measured using the proportion of days covered (PDC) index separately in persistent and non-persistent patients, and to identify patient- and medication-related characteristics associated with non-adherence in these patient groups. The study cohort of 9178 patients aged ≥ 65 years in whom PAD was diagnosed in 1/-12/2012 included 6146 persistent and 3032 non-persistent patients. Non-adherence was identified as PDC < 80%. Characteristics associated with non-adherence were determined using the binary logistic regression model. In the group of persistent patients, 15.3% of subjects were identified as non-adherent, while among non-persistent patients, 26.9% of subjects were non-adherent to antiplatelet medication. Administration of dual antiplatelet therapy (aspirin and clopidogrel) and a general practitioner as index prescriber were associated with adherence in both patient groups. Our study revealed a relatively high proportion of adherent patients not only in the group of persistent patients but also in the group of non-persistent patients before discontinuation. These results indicate that most non-persistent PAD patients discontinue antiplatelet treatment rapidly after a certain period of adherence.
| S-EPMC8698509 | biostudies-literature
Project description:To date, there has been no evidence about objectively measured sleep characteristics from a representative national probability sample of adults in the United States. We used actigraphy to measure the sleep characteristics of older Americans.Cross-sectional study.Sleep sub-study within Wave 2 (2010-2011) of the ongoing National Social Life, Health and Aging Project (NSHAP).Seven hundred and thirty-nine NSHAP participants aged 62-90.Not applicable.Study participants wore a wrist actigraph for 72 hours and sleep properties were compared across demographic, socioeconomic, and health-behavior related lines.Actigraph-estimated sleep time averaged 7.2 hours (SE 0.06 hr) each night; the majority of the sample (80%) slept between 5.8 and 8.6 hours/night. Average time spent awake after sleep onset (WASO) was 39 minutes (SE 1.2 min). Women had significantly more total sleep time and lower sleep fragmentation compared to men. Total sleep time increased significantly with age although sleep percentage decreased with age. Compared with White participants, African American participants had significantly more WASO (9.2 minutes, p < 0.01) and greater sleep fragmentation (2.3 percentage points, p < 0.001). WASO was significantly higher and sleep percentage significantly lower among those with less education.Both short sleepers and long sleepers - often conventionally defined as obtaining <6 and >9 hrs/night, respectively - are relatively rare among older Americans when sleep is estimated by actigraphy. Sleep quality is significantly poorer among men, African Americans, and those with less education.
| S-EPMC5555167 | biostudies-other
Project description:Background and objectivesThe US housing market has experienced considerable fluctuations over the last decades. This study aimed to investigate the impacts of housing price dynamics on physical health, mental health, and health-related behaviors for older American outright owners, mortgaged owners, and renters.Research design and methodsWe drew longitudinal data from the 1992-2016 Health and Retirement Study and merged it to the 5-digit zip code-level Housing Price Index. The analytic sample comprised 34 182 persons and 174 759 person-year observations. We used a fixed-effects model to identify the health impacts of housing price dynamics separately for outright owners, mortgaged owners, and renters.ResultsA 100% increase in Housing Price Index was associated with a 2.81 and 3.50 percentage points (pp) increase in the probability of reporting excellent/very good/good health status for mortgage owners and renters, respectively. It was also related to a lower likelihood of obesity (1.82 pp) for outright owners and a lesser chance of obesity (2.85 pp) and smoking (3.03 pp) for renters. All of these relationships were statistically significant (p < .05). Renters also experienced significantly decreased depression scores (-0.24), measured by the Center for Epidemiologic Studies-Depression scale, associated with the same housing price changes.Discussion and implicationsHousing price dynamics have significant health impacts, and renters are more sensitive to fluctuations in the housing market. Our study rules out the wealth effect as the mechanism through which changes in housing prices affect older adults' health. Our findings may inform policies to promote older adults' health by investing in local area amenities and improving socioeconomic conditions.
| S-EPMC8152867 | biostudies-literature
Project description:Polychlorinated biphenyls (PCBs), "famous" as persistent organic pollutants (POPs), have been managed nationally since the 1970s and globally under the Stockholm Convention on POPs since 2004, requiring environmentally sound management (ESM) of PCBs by 2028. At most, 30% of countries are on track to achieve ESM by 2028. Globally over 10 million tonnes of PCB-containing materials remain, mostly in countries lacking the ability to manage PCB waste. Canada (Ontario) and Czechia, both parties to the Stockholm Convention, are close to achieving the 2028 goal, having reduced their stocks of pure PCBs by 99% in the past 10 years. In contrast, the USA, not a party to the Stockholm Convention, continues to have a substantial but poorly inventoried stock of PCBs and only ∼3% decrease in mass of PCBs since 2006. PCB management, which depends on Stockholm Convention support and national compliance, portends major challenges for POP management. The failure to manage global PCB stocks >30 years after the end of production highlights the urgent need to prioritize reducing production and use of newer, more widely distributed POPs such as chlorinated paraffins and per- and polyfluorinated alkyl substances, as these management challenges are unlikely to be resolved in the coming decades.
| S-EPMC9228072 | biostudies-literature
Project description:IntroductionChurch-based interventions have been shown to improve the dietary health of underserved populations, yet few studies have examined sustainability of health behavior change over time. This paper examines dietary outcomes over a 24-month period (baseline and 6, 18, and 24 months) for fruit and vegetable and fat consumption behaviors of African-American participants in the Health for Hearts United church-based intervention in North Florida.Study designThis quasi-experimental, longitudinal trial was conducted from 2009 to 2012. Data were analyzed in 2018.Setting/participantsSix churches in a 2-county area (3 treatment, 3 comparison) were selected for the study using community-based participatory research approaches. Participants were African-American adults (aged ?45 years; n=211 at baseline) randomly selected from the churches, stratified by age and sex.InterventionHealth for Hearts United intervention was developed by the 3 treatment churches. The 18-month intervention was implemented in 3 6-month phases, framed around 3 conceptual components, which included 4 types of programs and 4 key messages.Main outcome measuresFruit and vegetable consumption was assessed using a single item (fruit and vegetable intake) and the National Cancer Institute Fruit and Vegetable Screener. Fat consumption was determined using a single item (fat intake) and the National Cancer Institute Fat Screener. Background characteristics included age, sex, educational level, and marital status.ResultsSignificant time effects only were found for daily fruit and vegetable intake (p<0.001), fat intake (p<0.001), and the Fat Screener (p<0.001) with dietary improvements in both treatment and comparison groups across the intervention phases. Fruit and Vegetable Screener results showed that time (p<0.001) and the interaction between time and treatment (p<0.01) were significant, with increases in fruit and vegetable consumption over time for both the treatment and comparison groups and with the increase differing between groups. Post hoc analysis revealed that the treatment group had greater increases in fruit and vegetable consumption than the comparison group between Phases 1 and 3 (p=0.03).ConclusionsDietary behaviors of mid-life and older African Americans can be improved and sustained over 24 months using a church-based heart health intervention, with similar improvements noted for both comparison and treatment participants.Trial registrationThis study is registered at www.clinicaltrials.govNCT03339050.
| S-EPMC7039745 | biostudies-literature
Project description:BackgroundCardiometabolic risk (CMR) is a key indicator of physiological decline with age, but age-related declines in a nationally representative older US population have not been previously examined.MethodsWe examined the trajectory of CMR over 8 years of aging, from 2006/2008 to 2014/2016, among 3528 people older than age 50 in the Health and Retirement Study. We used growth curve models to examine change in total CMR as well as in individual cardiometabolic biomarkers to understand how baseline differences and rates of change vary across sociodemographic characteristics, by smoking status, and medication use.ResultsTotal CMR did not change among respondents who survived over 8 years. Despite significant differences in CMR across demographic and education groups at baseline, the pace of change with age did not differ by these characteristics. Among individual biomarkers, risk levels of diastolic blood pressure, resting heart rate, and total cholesterol decreased over 8 years while glycosylated hemoglobin, waist circumference, and pulse pressure increased over that time. Both the statistical significance levels and the magnitudes of the reduction over time with age in diastolic blood pressure, resting heart rate, and total cholesterol in models adjusted for age, race/ethnicity, gender, smoking, and education were reduced after controlling for blood pressure and cholesterol medication.ConclusionsThe relatively constant total CMR level over 8 years occurred because some indicators improved with age while some deteriorated in this period. Medication use contributed to the improvement in blood pressure, resting heart rate, and total cholesterol.
| S-EPMC8599082 | biostudies-literature
Project description:Practical relevanceWhile scratching is a normal, beneficial behavior for cats, it can create problems when cats scratch objects owners deem as inappropriate. However, if veterinarians make suitable recommendations from the first veterinary visit, owners will be able to implement effective preventive strategies to develop good scratching patterns for life. Educating owners as to why cats scratch, how to guide cats to scratch only on desirable surfaces (ie, a scratching post), which types of scratching posts are preferred by most cats, the benefits of pheromone products, as well as other strategies to avoid destructive scratching, helps to preserve the cat-owner bond and reduces the risk of relinquishment.Clinical challengesClients may not directly ask veterinarians for their assistance regarding their cat's destructive scratching, and may not be aware that anything can be done except for declawing their cat.Evidence basePublished studies on scratching are limited. Destructive scratching has been documented as a reason for the relinquishment of cats to shelters and the negative effects of declaw surgeries are being increasingly discovered. Among recent scientific publications are studies assessing kitten and cat preferences for scratching substrates, and the use of pheromones to encourage appropriate scratching behavior. This review draws on these studies, among other resources, as well as the authors' personal experiences.
| S-EPMC11373750 | biostudies-literature
Project description:Practical relevanceUrine spraying (synonymous terms include urine marking or scent marking) is commonly described as urine deposited on vertical surfaces while the cat is in a standing position. With the increasing trend of keeping cats indoors in some countries and the potential resultant increase in frustration-related behaviors, urine spraying may occur in the home. Although also a normal feline behavior, it is usually not deemed acceptable when the cat targets household possessions. Urine spraying is a common behavioral complaint that practitioners receive from cat owners and has the potential to disrupt the human-cat bond. In fact, feline elimination issues are a frequent reason cited by owners when they relinquish their cats to shelters and rescue organizations.Clinical challengesWhile the location of the deposited urine should be diagnostic, this is not always the case. Urine marking can occur on horizontal surfaces, thus complicating the diagnosis. Urine spraying by intact males and females is used to signal availability for mating but the behaviour can also be exhibited by neutered animals. Multiple factors including medical problems can trigger the onset and maintenance of urine spraying, and correct identification of these is necessary for treatment to be most successful.Evidence baseThis review draws on information from multiple studies that have been published on the normal aspects of urine spraying in cats, the frequency as reported by owners, the relationship of urine spraying to intercat aggression and various treatment options including behavior modification, pheromone therapy and use of psychoactive medication.
| S-EPMC11373755 | biostudies-literature
Project description:BACKGROUND:The majority of U.S. older adults consume alcoholic beverages. The older population is projected to almost double by 2050. Substantially more drinkers are likely. PURPOSE:To describe gender-specific trends (1997 to 2014) in prevalence of drinking status (lifetime abstention, former drinking, current drinking [including average volume], and binge drinking) among U.S. adults ages 60+ by age group and birth cohort. METHODS:In the 1997 to 2014 National Health Interview Surveys, 65,303 respondents ages 60+ (31,803 men, 33,500 women) were current drinkers; 6,570 men and 1,737 women were binge drinkers. Prevalence estimates and standard errors were computed by age group (60+, 60 to 64, 65 to 69, 70 to 74, 75 to 79, 80+) and birth cohort (<1925, 1925 to 1935, 1936 to 1945, 1946 to 1954). Trends were examined using joinpoint regression and described as average annual percent change (AAPC; overall change 1997 to 2014) and annual percent change (APC; in-between infection points). Primary analyses were unadjusted. All analyses (unadjusted and adjusted for demographics/lifestyle) were weighted to produce nationally representative estimates. Statistical procedures accounted for the complex survey design. RESULTS:Among men ages 60+, unadjusted prevalence of current drinking trended upward, on average, 0.7% per year (AAPC, p = 0.02); average volume and prevalence of binge drinking remained stable. Adjusted results were similar. Among women age 60+, unadjusted prevalence of current drinking trended upward, on average, 1.6% per year (AAPC, p < 0.0001), but average volume remained stable; prevalence of binge drinking increased, on average, 3.7% per year (AAPC, p < 0.0001). Adjusted results were similar. Trends varied by age group and birth cohort. Among men born 1946 to 1954, unadjusted prevalence of current drinking trended upward, on average, 2.4% per year (AAPC, p = 0.02); adjusted results were nonsignificant. CONCLUSIONS:Our finding of upward trends in drinking among adults ages 60+, particularly women, suggests the importance of public health planning to meet future needs for alcohol-related programs.
| S-EPMC5439499 | biostudies-literature
Project description:Studies of children and adolescents indicate that success in life is determined in part by attributes such as conscientiousness, emotional stability and sense of control, independently of childhood socioeconomic status and cognitive ability. Less is known about the role of these characteristics at older ages. This study investigated the relationship of five life skills - conscientiousness, emotional stability, persistence, optimism and sense of control - with a range of outcomes in 8,843 participants (mean age 72.57 years) in the Health and Retirement Study, a representative study of older Americans. More life skills were associated with greater wealth and income, better emotional wellbeing, stronger social relationships, less loneliness, better health, fewer chronic illnesses and impaired activities of daily living, better mobility and less obesity, after controlling for childhood socioeconomic status and current cognitive ability. Longitudinally, more life skills predicted emotional wellbeing, less loneliness and more prosocial behavior, better health and mobility over a 4 year period. Associations were independent of gender, ethnicity, family background, education and cognitive ability. The number of attributes was important rather than any single life skill. Life skills continue to matter at advanced ages, and fostering these characteristics in older adults may pay dividends in terms of later life health and wellbeing.
| S-EPMC6033934 | biostudies-literature