Can a Neighborhood Affect an Older Adult’s Health?

Journal of the American Geriatrics Society Research Summary

According to a new study published in the Journal of the American Geriatrics Society, living in socially and economically disadvantaged neighborhoods can have a negative influence on older adults’ health and well-being.

Older adults who live in disadvantaged neighborhoods report having poorer health and have more difficulty getting around and performing daily tasks. What’s more, older adults living in disadvantaged neighborhoods tend to have more chronic illnesses and higher rates of death than do older adults who live in less disadvantaged neighborhoods.

Many issues affect the relationship between neighborhoods and health. One may be that disadvantaged neighborhoods have lower levels of social support for older adults and their caregivers. These neighborhoods also tend to have fewer physical resources, such as access to health care, retail stores, and recreational facilities.

Social and other resources are important for older adults. Therefore, older adults living in disadvantaged neighborhoods may find it harder to maintain well-being while aging. This can make it challenging for our society as a whole to benefit from our increased longevity.

The research team who conducted the study used the 2013 Medicare Health Outcome Survey (HOS) survey. This is a telephone and mail survey that was given to older adults enrolled in Medicare Advantage (MA) health plans (MA plans are insurance plans offered by private companies approved by Medicare). Around 17.6 million people are enrolled in MA plans. This is 31 percent of the population eligible for Medicare (the government program that provides health insurance to people 65-years-old and older). Information about 187,434 older adults was included in the study.

The researchers concluded that disadvantaged neighborhoods are an important predictor of mobility and other limitations among MA beneficiaries, particularly for those with multiple chronic conditions. Compared to those living in less disadvantaged neighborhoods, MA beneficiaries who have multiple chronic conditions and who live in the most disadvantaged neighborhoods are 12 percent more likely to report difficulty performing at least one daily task, such as bathing, dressing, or keeping house.

The researchers suggested that increasing resources in disadvantaged neighborhoods to support health programs for older adults could improve their health outcomes.

This summary is from “Linking Neighborhood Context and Health in Community-Dwelling Older Adults in the Medicare Advantage Program.” It appears online ahead of print in the Journal of the American Geriatrics Society. The study authors are Daniel Jung, BS; Amy Kind, MD, PhD; Stephanie Robert, MSW, PhD; William Buckingham, PhD; and Eva DuGoff, PhD, MPP.

Having Multiple Chronic Illnesses Plus Functional Limitations Increases Risk of Death among Older Adults with Heart Failure

Journal of the American Geriatrics Society Research Summary

Heart failure affects more than 6 million people in the U.S.—most of whom are older adults. Roughly half the older adults who have heart failure also live with five or more other chronic health conditions. This group of people may have difficulty performing daily activities, such as walking, bathing, and eating. And older adults who have multiple chronic illnesses plus heart failure generally require more frequent health care, including more visits to healthcare providers and hospitalizations.

Recently, researchers examined the impact of having multiple chronic conditions and having difficulty with daily activities on the health of older adults with heart failure. Until now, there’s been no research on the combined effects of having all three problems for older adults. The researchers published their findings in the Journal of the American Geriatrics Society.

The researchers sent questionnaires to 6,346 older adults who had been diagnosed with heart failure; 2,692 participants returned the questionnaires and were included in the study. Continue reading

Are High-Risk Anticholinergic Medicines Prescribed Too Often for Older Adults?

Journal of the American Geriatrics Society Research Summary

Anticholinergics are a class of medications that are often prescribed for allergies, lung disease, and urinary incontinence. They also often can increase health risks for older adults. These medicines can affect your memory and ability to think, and they can even lead to increases in the risk for falls, dementia, and death. Additionally, older adults often have a difficult time tolerating anticholinergics because of age-related physical changes, such as reduced liver and kidney function, and because medications can impact our brain chemistry more strongly as we age.

Experts use tools to help older adults and healthcare professionals understand the risks associated with medications like anticholinergics. One of these tools is the AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. The AGS Beers Criteria details medications with risks that may outweigh their benefits for older adults. The AGS Beers Criteria identifies 52 “high-risk” anticholinergics. Thirty-five of these are included on a list of medications worth avoiding altogether for older people, unless a healthcare professional has a compelling reason for prescribing them on a case-by-case basis.

Recently, a team of researchers decided to study how frequently healthcare providers prescribe potentially inappropriate medications like anticholinergics in light of recommendations like those from the AGS Beers Criteria. Their study was published in the Journal of the American Geriatrics Society. Continue reading

Older Adults Who Have Slower Walking Speeds May Have Increased Risk for Dementia

Journal of the American Geriatrics Society Research Summary

As of 2015, nearly 47 million people around the world had dementia, a memory problem significant enough to affect your ability to carry out your usual tasks. The most common cause of dementia is Alzheimer’s disease, but other forms exist, too.

Because there’s currently no cure for dementia, it’s important to know about the risk factors that may lead to developing it. For example, researchers have learned that older adults with slower walking speeds seem to have a greater risk of dementia than those with faster walking speeds. Recently, researchers from the United Kingdom teamed up to learn more about changes in walking speed, changes in the ability to think and make decisions, and dementia. They published their study in the Journal of the American Geriatrics Society.

The researchers examined information collected from the English Longitudinal Study of Aging. The study included adults aged 60 and older who lived in England. In their study, the researchers used information collected from 2002 to 2015. They assessed participants’ walking speed on two occasions in 2002-2003 and in 2004-2005, and whether or not the participants developed dementia after the tests from 2006-2015. Then, they compared the people who had developed dementia with those who had not. Continue reading

Helping Prevent Falls in Older Adults with Dementia

Journal of the American Geriatrics Society Research Summary

Annually, about one-third of all American adults aged 65 or older experience a fall. Falls are a major cause of medical problems, especially among those who have dementia. In fact, twice the number of older adults with dementia experience falls, compared to people without dementia.

What’s more, older adults with dementia or other cognitive problems who fall are five times more likely to be admitted to long-term care facilities, and are at higher risk for fractures, head injuries, and even death, compared to older adults without dementia who experience a fall.

Researchers have recently focused on the role that dementia and other cognitive problems may play in falling, in hopes of discovering ways to manage and prevent falls. They published their study in the Journal of the American Geriatrics Society. Continue reading