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Does volunteering moderate the relation between functional limitations and mortality?
- Authors:
- OKUN Morris A., et al
- Journal article citation:
- Social Science and Medicine, 71(9), November 2010, pp.1662-1668.
- Publisher:
- Elsevier
It has previously been shown that functional limitations increase the risk of mortality in later life, while organisational volunteering decreases this risk. To date, however, no research has investigated the joint effect of functional limitations and organisational volunteering on mortality. In this study the authors tested the hypothesis that volunteering moderates the relation between functional limitations and risk of mortality. Survey data from a representative sample of 916 non-institutionalised adults 65 years old and older who lived in the United States were used. Data on mortality were extracted six years later from the National Death Index. Findings indicated that functional limitations were indeed associated with an increased risk of dying only among participants who never or almost never volunteered, suggesting that volunteering buffers the association between functional limitations and mortality. The authors suggest that while it may be more difficult for older adults with functional limitations to volunteer, they may receive important benefits from doing so.
Vulnerability to winter mortality in elderly people in Britain: population based study
- Authors:
- WILKINSON Paul, et al
- Journal article citation:
- British Medical Journal, 18.9.04, 2004, pp.647-51.
- Publisher:
- British Medical Association
Examines the determinants of vulnerability to winter mortality in British people 75 and over using a population based cohort study (119,389 person years of follow up) in 106 general practices from the Medical Research Council trial of assessment and management of older people in Britain. Mortality (10,123 deaths) was determined by follow up through the Office for National Statistics. Month to month variation accounted for 17% of annual all cause mortality, but only 7.8% after adjustment for temperature. Overall winter:non-winter rate ratio was 1.31. There was little evidence of geographical, age, personal, socioeconomic, or clinical variance except that after adjustment for all major covariates the winter:non-winter ratio in women compared with men was 1.11 (1.00 to 1.23), and those with self-reported history of respiratory illness had a winter:non-winter ratio of 1.20 (1.08 to 1.34) times that of people without such a history. There was no evidence that socioeconomic deprivation or self-reported financial worries were predictive of winter death. Except for female sex and pre-existing respiratory illness there was little evidence for vulnerability to winter death associated with factors thought to lead to vulnerability. The lack of socioeconomic gradient suggests that policies aimed at relief of fuel poverty may need to be supplemented by additional measures to tackle the burden of excess winter deaths in elderly people.
Physical and social causes of hypothermia
- Author:
- DALPHINIS Julie
- Journal article citation:
- Nursing Times, 109(49/50), 2013, pp.12-15.
- Publisher:
- Nursing Times
Hypothermia has a number of physical and social causes, particularly among older people. This article discusses the causes of hypothermia, signs and symptoms, preventative measures, and immediate treatment in the community. An assessment checklist is also provided. (Edited publisher abstract)
Anxiety and mortality risk in community-dwelling elderly people
- Authors:
- CARRIERE Isabelle, et al
- Journal article citation:
- British Journal of Psychiatry, 203(4), 2013, pp.303-309.
- Publisher:
- Cambridge University Press
Using data from 718 men and 1046 women aged 65 years and over, this study evaluates the 10-year mortality risk associated with anxiety in community-dwelling elderly people. In women, mortality risk was increased for anxiety disorder and GAD in multivariate Cox models, whereas for phobia it was nearly significant. Anxiety trait symptoms became non-significant as a result of the confounding effect of depressive symptoms. Anxiety disorder was associated with cardiovascular mortality in univariate analysis. No significant associations were found in men. The study suggests a gender-specific association of anxiety and mortality. (Edited publisher abstract)
Marital status and mortality in the elderly: a systematic review and meta-analysis
- Authors:
- MANZOLI Lamberto, et al
- Journal article citation:
- Social Science and Medicine, 64(1), January 2007, pp.77-94.
- Publisher:
- Elsevier
Although a relationship between marital status and mortality has long been recognized, no summary estimates of the strength of the association are available. A meta-analysis of cohort studies was conducted to produce an overall estimate of the excess mortality associated with being unmarried in aged individuals as well as to evaluate whether and to what degree the effect of marriage differs with respect to gender, geographical/cultural context, type of non-married condition and study methodological quality. All included studies were published after the year 1994, used multivariate analyses and were written in English. Pooling 53 independent comparisons, consisting of more than 250,000 elderly subjects, the overall relative risk (RR) for married versus non-married individuals (including widowed, divorced/separated and never married) was 0.88 (95% Confidence Interval: 0.85–0.91). This estimate did not vary by gender, study quality, or between Europe and North America. Compared to married individuals, the widowed had a RR of death of 1.11 (1.08–1.14), divorced/separated 1.16 (1.09–1.23), never married 1.11 (1.07–1.15). Although some evidence of publication bias was found, the overall estimate of the effect of marriage was robust to several statistical approaches and sensitivity analyses. When the overall meta-analysis was repeated with an extremely conservative approach and including eight non-significant comparisons, which were initially excluded because of data unavailable, the marriage protective influence remained significant, although the effect size was reduced (RR=0.94; 0.92–0.95). Despite some methodological and conceptual limitations, these findings might be important to support health care providers in identifying individuals “at risk” and could be integrated into the current programs of mortality risk estimation for the elderly.
Risk of dementia and death in community-dwelling older men with bipolar disorder
- Authors:
- ALMEIDA Osvaldo P., et al
- Journal article citation:
- British Journal of Psychiatry, 209(2), 2016, pp.121-126.
- Publisher:
- Cambridge University Press
Background: Bipolar disorder has been associated with cognitive decline, but confirmatory evidence from a community-derived sample of older people is lacking. Aims: To investigate the 13-year risk of dementia and death in older adults with bipolar disorder. Method: Cohort study of 37 768 men aged 65–85 years. Dementia (primary) and death (secondary), as recorded by electronic record linkage, were the outcomes of interest. Results: Bipolar disorder was associated with increased adjusted hazard ratio (HR) of dementia (HR = 2.30, 95% CI 1.80–2.94). The risk of dementia was greatest among those with <5 years of history of bipolar disorder or who had had illness onset after 70 years of age. Bipolar disorder was also associated with increased mortality (HR = 1.51, 95% CI 1.28–1.77). Competing risk regression showed that bipolar disorder was associated with increased hazard of death by suicide, accidents, pneumonia or influenza, and diseases of the liver and digestive system. Conclusions: Bipolar disorder in later life is associated with increased risk of dementia and premature death. (Publisher abstract)
Informal caregiving and its impact on health: a reappraisal from population-based studies
- Authors:
- ROTH David L., FREDMAN Lisa, HALEY William E.
- Journal article citation:
- Gerontologist, 55(2), 2015, pp.309-319.
- Publisher:
- Oxford University Press
This article aims to re-examine some of the existing evidence on the health effects of caregiving, focusing in particular on one commonly cited claim that family caregiving is associated with an increased risk for mortality. The authors discuss important methodological concerns on the definition of caregiving, the composition of different caregiving subgroups, the sampling of caregivers, and the sampling and recruitment of appropriate noncaregiving comparison groups. A landmark study by Schulz and Beach reported higher mortality rates for strained spouse caregivers. However, five subsequent population-based studies found reduced mortality and extended longevity for caregivers as a whole compared with noncaregiving controls. Most caregivers also report benefits from caregiving, and many report little or no caregiving-related strain. The article stresses the importance of achieving more balanced and updated portrayal of the health effects of caregiving is needed to encourage more persons to take on caregiving roles, and to better target evidence-based services to the subgroup of caregivers who are highly strained or otherwise at risk. Recommendations are discussed for research that will better integrate and clarify both the negative and potential positive health effects of informal caregiving. (Edited publisher abstract)
Mortality and causes of death in older patients with schizophrenia
- Authors:
- TALASLAHTI Tiina, et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 27(11), November 2012, pp.1131-1137.
- Publisher:
- Wiley
This study evaluated mortality and causes of death in older patients with schizophrenia in comparison with the general population in Finland. The study sample consists of 9,461 patients over 65 years by the first of January 1999, with schizophrenia as the main diagnosis during the period 1969–1998. The sample was collected from nationwide registers and followed up between 1999 and 2008. Overall Standard Mortality Ratio (SMR) of the older schizophrenia patients was 2.69. For natural causes of death, overall SMR was 2.58, and for unnatural causes of death, it was 11.04. The most common causes of death matched those in the general population. Of patients who died during follow-up, 31% had at least one psychiatric hospitalization within 5 years before follow-up. The SMR for this group was higher than in those patients with no such treatment during that time. Mortality of older patients with schizophrenia was almost threefold that of general population. They died for similar reasons to the general population; however, deaths for unnatural causes, such as accidents and suicides, were especially common. The authors concluded that patients experiencing relapses in older age have an increased risk of death compared with those with schizophrenia in remission.
Dementia in the acute hospital: prospective cohort study of prevalence and mortality
- Authors:
- SAMPSON Elizabeth L., et al
- Journal article citation:
- British Journal of Psychiatry, 195(1), July 2009, pp.61-66.
- Publisher:
- Cambridge University Press
Increasing numbers of people will die with dementia, many in the acute hospital. It is often not perceived to be a life-limiting illness. This study set out to investigate the prevalence of dementia in older people undergoing emergency medical admission and its effect on outcomes. A longitudinal cohort study of 617 people (aged over 70) was carried out. The main outcome was mortality risk during admission. Of the cohort, 42.4% had dementia (only half diagnosed prior to admission). In men aged 70–79, dementia prevalence was 16.4%, rising to 48.8% of those over 90. In women, 29.6% aged 70–79 had dementia, rising to 75.0% aged over 90. Urinary tract infection or pneumonia was the principal cause of admission in 41.3% of the people with dementia. These individuals had markedly higher mortality; 24.0% of those with severe cognitive impairment died during admission. The authors conclude that the rising prevalence of dementia will have an impact on acute hospitals. Extra resources will be required for intermediate and palliative care and mental health liaison services.
Subjective cognitive functioning as a predictor of all cause mortality in an Israeli national sample of community dwelling older adults
- Author:
- AYALON Liat
- Journal article citation:
- International Journal of Geriatric Psychiatry, 23(8), August 2008, pp.830-836.
- Publisher:
- Wiley
Cognitive functioning has been identified as a predictor of all cause mortality in several epidemiological studies. As a result, researchers have suggested the use of short cognitive screens as prognostic indicators in older adults. Little is known, however, about subjective complaints of cognitive functioning as predictors of all cause mortality. A 7-year follow-up of a national sample of 4,921 Israelis over the age of 60. Main predictors were subjective complaints of memory problems, confusion, and recognition problems. Outcome was time to death. As expected, in the fully adjusted model, age, gender, subjective health, baseline health, and ADL and IADL impairments were significant predictors of all cause mortality. In addition, complaints about difficulties recognizing familiar people also were associated with a greater risk for mortality. Subjective complaints about recognition problems serve as a risk for all cause mortality above and beyond well-known risk factors. Health care professionals can use this information about subjective cognitive functioning in conjunction with other measures in order to identify older adults at risk for an earlier death.