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The probability of nursing home use over a lifetime in Australia
- Author:
- LIU Zhibin
- Journal article citation:
- International Journal of Social Welfare, 9(3), July 2000, pp.169-180.
- Publisher:
- Wiley
This article further develops the life table models used in the USA by taking advantage of the superior data available in Australia. The probabilities of nursing home use over a lifetime are estimated for various ages for men and women. The results show that over one-third of the members of a female birth cohort will eventually enter nursing homes for long-term care at least once. The corresponding probability for males is one in five. A woman at age 65 faces a probability as high as 39% of using a nursing home for permanent care before her death compared with 25% for a man at age 65.
Technology adoption by older adults: findings from the PRISM trial
- Authors:
- MITZNER Tracy L., et al
- Journal article citation:
- Gerontologist, 59(1), 2019, pp.34-44.
- Publisher:
- Oxford University Press
Background and Objectives: There is growing evidence of the benefits of computers for older adults. Yet, adoption rates are lower compared with younger adults. Extant theoretical models of technology acceptance are limited in their application to older adults - studies on which these models are based included a limited sample of older adults or none at all; none assessed use of a technology specifically designed for older adults; and most only measured intention to use a technology or short-term use, rather than longer-term use (i.e., adoption). This study assessed adoption of a computer system specifically designed for older users, for a diverse sample, over an extended period of time. Research Design and Methods: This study analysed archival data from 150 ethnically diverse older adults (65–98 years of age) who participated in the Personal Reminder Information and Social Management (PRISM) randomized controlled trial (Czaja SJ et al.). The personalized reminder information and social management system (PRISM) trial: Rationale, methods and baseline characteristics. Contemp Clin Trials. 2015;40:35–46; Czaja SJ et al. Improving social support for older adults through technology: Findings from the PRISM randomized controlled trial. Gerontologist. 2017;58:467-477). This study examined the extent to which attitudes, personal characteristics (e.g., age, gender, and personality), and cognitive abilities predicted mid-term and long-term adoption of a computer system designed for older adults. Results: There were individual differences in PRISM use over time. Regression analyses indicated that individual differences in earlier use of the system, executive functioning, and computer efficacy predicted long-term use. Discussion and Implications: These data provide insights for broader-based models of technology acceptance to guide design, instruction, and deployment of products for older adults. Specifically, the provision of opportunities to foster efficacy and gain positive experience with computer technologies may play a critical role in the likelihood that older adults adopt such technologies. (Edited publisher abstract)
A comparative analysis of the use of maternal health services between teenagers and older mothers in sub-Saharan Africa: evidence from Demographic and Health Surveys (DHS)
- Authors:
- MAGADI Monica Akinyi, AGWANDA Alfred O., OBARE Francis O.
- Journal article citation:
- Social Science and Medicine, 64(6), March 2007, pp.1311-1325.
- Publisher:
- Elsevier
This paper uses Demographic and Health Surveys data from 21 countries in sub-Saharan Africa to examine the use of maternal health services by teenagers. A comparison of maternal health care between teenagers and older women, based on bivariate analysis shows little variation in maternal health care by age. However, after controlling for the effect of background factors such as parity, premarital births, educational attainment and urban/rural residence in a multivariate analysis, there is evidence that teenagers have poorer maternal health care than older women with similar background characteristics. The results from multilevel logistic models applied to pooled data across countries show that teenagers are generally more likely to receive inadequate antenatal care and have non-professional deliveries. An examination of country-level variations shows significant differences in the levels of maternal health care across countries. However, there is no evidence of significant variations across countries in the observed patterns of maternal health care by maternal age. This suggests that the observed patterns by maternal age are generalizable across the sub-Saharan Africa region.
Concepts of self-rated health: specifying the gender difference in mortality risk
- Authors:
- DEEG Dorly J. H., KRIEGSMAN Didi M. W.
- Journal article citation:
- Gerontologist, 43(2), June 2003, pp.376-386.
- Publisher:
- Oxford University Press
Purpose: This study addresses the question of how the relation between self-rated health (SRH) and mortality differs between genders. In addition to the general question, four specific concepts of SRH are distinguished: SRH in comparison with age peers, SRH in comparison with one's own health 10 years ago, and current and future health perceptions. For these concepts, the gender-specific risks of mortality were evaluated for a short and a longer follow-up period. Baseline and mortality data from the Longitudinal Aging Study Amsterdam (N = 1917, initial ages 55-85 years) were used. Mortality risks were evaluated in Cox regression models at 3 and 7.5 years of follow-up, both adjusted for age and for sociodemographic characteristics, indicators of functional and mental health, lifestyle, and social involvement. All SRH measures were scaled from 1 (positive) to 5 (negative). Baseline correlations between SRH concepts were similar for men and women. After 3 years, 12% of the men and 7% of the women had died; after 7.5 years, these percentages were 27 and 15, respectively. In fully adjusted models, current health perceptions predicted 3-year mortality in men (risk ratio of 1.33). At 7.5 years, mortality in men was predicted by current health perceptions and by SRH compared with age peers (risk ratios of 1.25 and 1.23, respectively). In women, no SRH concept predicted either 3-year or 7.5-year mortality. SRH was a predictor of mortality only in men, not in women. The gender difference showed most clearly at longer follow-up, in the SRH concept "comparison with age peers."
Differences between older men and women in the self-rated health-mortality relationship
- Author:
- BATH Peter A.
- Journal article citation:
- Gerontologist, 43(2), June 2003, pp.387-395.
- Publisher:
- Oxford University Press
The aims of this study were to examine differences between older men and women: in the ability of self-rated health to predict mortality, in the effect of different follow-up periods on the self-rated health mortality relationship, and in the relative importance of self-rated health and self-rated change in health in predicting mortality. By using data from the Nottingham Longitudinal Study of Activity and Ageing, the author assessed relationships between self-rated health and self-rated change in health and 4- and 12-year mortality in separate unadjusted and adjusted Cox proportional hazards regression models in men and women. The differences between men and women in the hazard ratios for poor self-rated health were not significant, although there were differences in the explanatory factors. The relationship between self-rated health and short-term and long-term mortality was explained by age and health among men. The relationship between self-rated health and short-term mortality was explained by age, physical and mental health, and physical activity among women. The relationship between self-rated health and long-term mortality was explained by age, physical health, and physical activity among women. The relationship between self-rated change in health and short-term mortality was explained by age among men and women. The relationship between self-rated change in health and long-term mortality was explained by age and physical health among men and women. Social engagement was an independent predictor of short- and long-term mortality among men and women in this study. The finding that low self-rated health was not an independent predictor of mortality among men or women, contrary to many, but not all, previous studies, may be related to differences in study design and/or across cultures. Further research investigating relationships between self-rated health and mortality and potential explanatory variables should analyze men and women separately and should consider the length of follow-up period. The benefits of individual physical and social activities in reducing mortality merit further investigation.
Are gender differences in the relationship self-rated health and mortality enduring?: results from three birth cohorts in Melton Mowbray, United Kingdom
- Authors:
- SPIERS Nicola, et al
- Journal article citation:
- Gerontologist, 43(2), June 2003, pp.406-411.
- Publisher:
- Oxford University Press
The purpose of this study was to assess whether there is an enduring gender difference in the ability of self-rated health to predict mortality and investigate whether self-reported physical health problems account for this difference. Cox models for 4-year survival were fitted to data from successive cohorts aged 75-81 years registered with a primary care practice in the U.K. Midlands surveyed in 1981, 1988, and 1993-1995. Self-rated health was consistently a stronger predictor in men (hazard ratio ; 95% confidence interval 2.1-3.5) than it was in women ( 1.5-2.4). Women surveyed in 1993-1995 were more likely than men to report problems that were disabling but not life-threatening, whereas men were more likely to report potentially life-threatening problems. However, these differences did not explain the association of self-rated health with mortality. More than half of those who reported a potentially life-threatening problem said that their health was good. Self-rated health is more strongly associated with mortality in men, but this is unlikely to be explained by differences in the nature of their physical health problems.
There is always a difference: they're higher up
- Author:
- PROCTOR Gillian
- Journal article citation:
- Journal of Dementia Care, 6(6), November 1998, pp.16-17.
- Publisher:
- Hawker
The inevitable power differences between people with dementia and staff working with them are bound to affect our attempts to listen and truly hear their views about services. Discusses the issues.
Linking depressive symptoms and functional disability in late life
- Authors:
- GALLO J. J., et al
- Journal article citation:
- Aging and Mental Health, 7(6), November 2003, pp.469-480.
- Publisher:
- Taylor and Francis
The authors hypothesized that the relationship of depressive symptoms to functional disability might be mediated by cognitive processes such as memory and problem-solving. The study sample consisted of 147 community-dwelling older adults (mean age = 74.0 years, SD = 5.9). In regression models that included terms for age, gender, and years of education, depressive symptoms were significantly inversely associated with two performance-based measures of functioning: everyday problems test (g = m0.15, p = 0.04) and observed tasks of daily living (g = m0.14, p = 0.02). When memory and problem-solving ability were added to the model, the relationship of depressive symptoms with function was attenuated. A structural equation model based on our conceptual framework revealed that both memory and problem-solving abilities were important mediators in the relationship of depressive symptoms and functional disability. The results suggest that intervention studies intended to limit functional disability secondary to depression among older adults may need to consider the effect of depression on cognition.
Alternative statistical approaches to identifying dementia in a community-dwelling sample
- Authors:
- KUCHIBHATLA M., FILLENBAUM G. G.
- Journal article citation:
- Aging and Mental Health, 7(5), September 2003, pp.383-389.
- Publisher:
- Taylor and Francis
Little attention has been paid to examining the extent to which alternative statistical models may facilitate identification of persons with dementia. Using a sub-sample of the Duke Established Populations for Epidemiologic Studies of the Elderly, two analytical approaches were compared: logistic regression (which focuses on identifying specific characteristics predictive here of dementia), and recursive partitioning methods using tree-based models (which permit identification of the characteristics of those groups with high dementing disorder). In the stepwise multiple logistic regression model which included as potential predictors, gender, age, history of chronic health conditions, scales of basic and instrumental activities of daily living (IADL), and cognitive status, only IADL and cognitive status were significant predictors, with cognitive status the single most important factor. The classification tree approach, which permits identification of the characteristics of those groups with particularly high dementia rates, identified cognitive status as the most important criterion for dementia (as did logistic regression analysis). Among those without cognitive impairment, older age was a risk factor, confirming findings consistently reported in the literature. Among the cognitively impaired, IADL was an important risk factor. Those with five or more IADL problems were further classified into two risk groups, based on number of ADL problems. While classification tree analysis encourages identification of groups at risk, logistic regression encourages targeting of specific characteristics.
Gender differences in the self-rated health-mortality association: is it poor self-rated health that predicts mortality or excellent self-rated health that predicts survival?
- Authors:
- BENYAMINI Yael, et al
- Journal article citation:
- Gerontologist, 43(2), June 2003, pp.396-405.
- Publisher:
- Oxford University Press
This study investigates gender differences in the association between self-rated health (SRH) and mortality. This association has been well-documented, but findings regarding gender differences are inconsistent. The specific objectives were (a) to examine these differences in a short and a long time frame, (b) to examine these differences among old and old-old people, and (c) to address the question of whether this association is based on the accuracy of poor SRH as a predictor of future decline, and/or of better SRH as a predictor of longevity. The study is based on an Israeli nationally representative sample of 622 women and 730 men who were interviewed about their SRH, as well as sociodemographic information and other measures of health, physical functioning, cognitive status, and depression. For both genders, SRH was associated only with shorter term mortality (within the next 4 years) and not with longer-term mortality (9 years of follow-up). This association was strongest among the old (ages 75-84) women, compared with the old men and with the old-old (85-94) women and men. A possible explanation may be related to differences in the accuracy of excellent SRH at very old age. The SRH-mortality association may differ among age and gender groups. Identifying the conditions under which it is more accurate will enable researchers and practitioners to know when it can be utilized. It is important to assess differences in the accuracy of poor SRH as well as of excellent SRH as predictors of future health outcomes.