Study finds racial/ethnic disparities in depressive trajectories among middle-aged or older adults

2012 ◽  
Author(s):  
J. Liang ◽  
X. Xu ◽  
A. R. Quinones ◽  
J. M. Bennett ◽  
W. Ye
Keyword(s):  
Older Adults ◽  
Ethnic Disparities ◽  
Middle Aged ◽  
Racial Ethnic

scholarly journals Investigating Racial/Ethnic Disparities in the Association Between AHEI-2010 and Change in Cystatin C in a Representative Sample of Older Americans

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1015-1015
Author(s):  
Nicholas Bishop ◽  
Jie Zhu
Keyword(s):  
Older Adults ◽  
Dietary Intake ◽  
Kidney Function ◽  
Cystatin C ◽  
Early Stage ◽  
Ethnic Disparities ◽  
Healthy Eating Index ◽  
Dietary Quality ◽  
Linear Modeling ◽  
Racial Ethnic

Abstract Objectives Cystatin C (Cys C) is a promising biomarker for early-stage chronic kidney disease. Dietary intake plays an essential role in the prevention of kidney function decline, which has yet to be examined in relation to changes in Cys C among older adults. Our objective was to test whether scores on the Alternative Healthy Eating Index-2010 (AHEI-2010) were associated with change in Cys C from 2012–2016 and if this varied by race/ethnicity. Methods Observations were drawn from the Health and Retirement Study. Blood spot collection and examination occurred in 2012 and 2016, participant attributes were measured in 2012, and dietary assessment was conducted by a validated dietary frequency questionnaire in 2013. The sample was restricted to respondents aged ≥65 years who were White (n = 789), Black (n = 108), or Hispanic (n = 61) and had biomarkers measured in 2012 and 2016 (n = 958). Serum Cys C (mg/L) was constructed to be equivalent to the 1999–2002 NHANES scale. Dietary quality was measured using AHEI-2010. Autoregressive linear modeling adjusting for covariates and sampling design was used to examine the associations of interest. Results Mean serum Cys C was 1.20 ± 0.44 mg/L (SD) in 2012 and 1.25 ± 0.45 mg/L in 2016, and mean AHEI-2010 score was 58.11 ± 11.0. Greater AHEI-2010 was associated with lower serum Cys C level at baseline (b = −.004, SE = .013, P = .002) and less rapid increase in the Cys C level from 2012–2016 (b = −.003, SE = .012, P = .024). The association between AHEI-2010 and change in serum Cys C was significantly different for Whites and Hispanics (b = .128, SE = .031, P < .001), but null when comparing Whites and Blacks. AHEI-2010 was negatively associated with change in Cys C for Whites, and positively associated with change in Cys C among Hispanics. Stratified analyses suggested that AHEI-2010 was not significantly different for Whites and Hispanics. Hispanics had significantly lower household income, assets, and educational attainment than Whites, and greater levels of food insecurity. Conclusions Our results indicate that dietary quality has a divergent association with change in serum Cys C for White and Hispanic older adults. These results suggest the need for examination of how disparities in socioeconomic status may influence the effect of dietary intake on kidney function for older adults from different racial/ethnic backgrounds. Funding Sources No funding.

scholarly journals Association Between Adverse Childhood Events and Multimorbidity in a Racial and Ethnic Diverse Sample of Middle-Aged and Older Adults

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Elizabeth Vásquez ◽  
Ana Quiñones ◽  
Stephanie Ramirez ◽  
Tomoko Udo
Keyword(s):  
Older Adults ◽  
Psychiatric Disorders ◽  
Healthy Aging ◽  
Middle Aged ◽  
Adverse Childhood Events ◽  
Epidemiologic Survey ◽  
Adverse Childhood ◽  
History Of ◽  
Middle Aged Adults ◽  
Racial Ethnic

Abstract Background and Objectives Adverse childhood events (ACEs) have been associated with increased health risks later in life. However, it is unclear whether ACEs may be associated with multimorbidity among diverse racial/ethnic middle-aged and older adults. We evaluated whether there were racial and ethnic differences in the association between ACEs and the number of somatic and psychiatric multimorbidity in a sample of U.S. middle-aged and older adults. Research Design and Methods Data from the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions (N = 10,727; ≥55 years) were used to test whether the number of self-reported somatic conditions (i.e., heart disease, hypertension, stroke, diabetes, arthritis, cancer, osteoporosis, and chronic lung problems) as well as DSM-5 psychiatric disorders (i.e., depression) during the past 12 months differed by history of ACEs while stratifying by age (i.e., 55–64 or ≥65) and racial/ethnic group (i.e., non-Hispanic White [NHW; n = 7,457], non-Hispanic Black [NHB; n = 1,995], and Hispanic [n=1275]). Results The prevalence of reporting more than two somatic conditions and psychiatric disorders was 48.8% and 11.4% for those with a history of ACEs, and 41.1% and 3.3% for those without a history of ACEs. Adjusting for sociodemographic and other health risk factors, ACEs was significantly associated with greater numbers of somatic multimorbidity among racial and ethnic middle-aged adults but this was not the case for older adults. Discussion and Implications Our findings suggest that middle-aged adults with a history of ACEs are more likely to suffer from somatic and psychiatric multimorbidity, highlighting the importance of screening for ACEs in promoting healthy aging.

scholarly journals RACIAL DISPARITIES IN ACCESS TO AND COST OF HEALTHCARE AMONG OLDER ADULTS WITH COGNITIVE LIMITATION: 2002 TO 2016

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S564-S564
Author(s):  
Elham Mahmoudi
Keyword(s):  
Older Adults ◽  
Prescription Drugs ◽  
Linear Models ◽  
Medical Expenditure Panel Survey ◽  
Ethnic Disparities ◽  
Office Visit ◽  
Medical Expenditure ◽  
Office Visits ◽  
Vulnerable Subpopulations ◽  
Racial Ethnic

Abstract Using 2002-2016 Medical Expenditure Panel Survey, we examined racial/ethnic disparities in office-visits and prescription-drugs among individuals with cognitive limitation (CL). Medicare beneficiaries (65+) with CL (N=9,369) were included. We used generalized linear models. Prevalence of CL increased overtime among all racial/ethnic groups. Our findings indicate that 96% of Whites vs. 93% of Blacks had at least one office visit (diff=0.03; 95% CI:0.01-0.04). Whites had 2 (95% CI: 1.0-0.4) and 4 (95% CI: 2.5-6.0) more office visits compared with Hispanics and Asians; and used 4 (95% CI: 1-6.9), 5 (95% CI:1.0-9.3) and 6 (95% CI: 1.0-11.5) more prescriptions than their Blacks, Hispanics, and Asians, respectively. Whites had higher annual expenditures for office-visits compared with Asians ($889; 95% CI:409-1,368) and higher expenditures for prescriptions compared with Blacks ($484; 95% CI:$151-$816) and Asians ($546; 95% CI:$28-$1064), respectively. Disparities in care among older adults with CL may put vulnerable subpopulations at a higher risk.

scholarly journals Racial Disparities in Post-Acute Home Health Care Referral and Utilization among Older Adults with Diabetes

2021 ◽  
Vol 18 (6) ◽  
pp. 3196
Author(s):  
Jamie M. Smith ◽  
Olga F. Jarrín ◽  
Haiqun Lin ◽  
Jennifer Tsui ◽  
Tina Dharamdasani ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Hospital Discharge ◽  
Home Health Care ◽  
Ethnic Disparities ◽  
The United States ◽  
Home Health ◽  
Urban Setting ◽  
Administrative Claims ◽  
Racial Ethnic

Racial and ethnic disparities exist in diabetes prevalence, health services utilization, and outcomes including disabling and life-threatening complications among patients with diabetes. Home health care may especially benefit older adults with diabetes through individualized education, advocacy, care coordination, and psychosocial support for patients and their caregivers. The purpose of this study was to examine the association between race/ethnicity and hospital discharge to home health care and subsequent utilization of home health care among a cohort of adults (age 50 and older) who experienced a diabetes-related hospitalization. The study was limited to patients who were continuously enrolled in Medicare for at least 12 months and in the United States. The cohort (n = 786,758) was followed for 14 days after their diabetes-related index hospitalization, using linked Medicare administrative, claims, and assessment data (2014–2016). Multivariate logistic regression models included patient demographics, comorbidities, hospital length of stay, geographic region, neighborhood deprivation, and rural/urban setting. In fully adjusted models, hospital discharge to home health care was significantly less likely among Hispanic (OR 0.8, 95% CI 0.8–0.8) and American Indian (OR 0.8, CI 0.8–0.8) patients compared to White patients. Among those discharged to home health care, all non-white racial/ethnic minority patients were less likely to receive services within 14-days. Future efforts to reduce racial/ethnic disparities in post-acute care outcomes among patients with a diabetes-related hospitalization should include policies and practice guidelines that address structural racism and systemic barriers to accessing home health care services.

scholarly journals Medically Assisted Treatment of Opioid Use Disorder Among Elderly and Non-Elderly Medicare Beneficiaries

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 54-54
Author(s):  
Jennifer Miles ◽  
Stephen Crystal ◽  
Peter Treitler ◽  
Richard Hermida
Keyword(s):  
Older Adults ◽  
Addiction Treatment ◽  
Elderly Population ◽  
Ethnic Disparities ◽  
The Elderly ◽  
Opioid Use Disorder ◽  
Close Monitoring ◽  
Medicare Beneficiaries ◽  
Opioid Use ◽  
Racial Ethnic

Abstract Although medication for addiction treatment (MAT) is known to be the most effective treatment for opioid use disorder (OUD), these medications are widely underutilized, especially among older adults and racial/ethnic minorities. Of the three main MAT modalities, Medicare covered buprenorphine and naltrexone in 2017; methadone was not covered until 2020. We examined MAT prescribing among elderly compared with non-elderly Medicare beneficiaries. Our sample was drawn from a ~40% random sample of 2017 Medicare beneficiaries with Part D coverage and was comprised of elderly beneficiaries (age 65+) with OUD (N=112,314) or who experienced opioid poisoning (N=9,657), and non-elderly Medicare beneficiaries (the Medicare disability population, age 0-64) with OUD (N=161,423) or opioid poisoning (N=13,591). MAT was underutilized in both Medicare populations, but especially in the elderly population. Of elderly beneficiaries with OUD, 5.1% and 0.8% were prescribed buprenorphine and naltrexone, respectively, compared to 15.5% and 2.3% among non-elderly. Among elderly beneficiaries with opioid poisoning, 3.1% and 0.8% were prescribed buprenorphine and naltrexone, respectively, compared to 10.1% and 3.2% in the non-elderly population. Sharp racial/ethnic disparities were identified within each age group. These findings highlight the need to expand access to MAT for Medicare beneficiaries, particularly older adults among whom underutilization is pronounced. Several recent Medicare policy changes have sought to address this issue, but continuing efforts and close monitoring are warranted in an effort to dramatically increase rates of treatment for elderly with opioid use disorder.

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