Limited research has examined how health varies across living arrangements among older adults. Adults aged 65 years and older were sampled from National Health Interview Survey 2009-2014. Four indicators of health (serious psychological distress, health status, functional limitations, and number of health conditions) were compared across older adults living alone, living with others related/unrelated, living with a spouse/partner (no children), and living with children (no spouse/partner). Regression models showed older adults living with others have the poorest health; they were less likely to report excellent or very good health, had serious psychological distress and limitations in activities of daily living (ADLs), and a greater number of health conditions compared with older adults living with a spouse/partner. However, older women living alone or with children were more likely to report two or more health conditions compared with women living with a spouse/partner, suggesting that in older age, there are gender variations in health across living arrangements.
Objective
To explore racial/ethnic difference in OROS-methylphenidate (OMPH) efficacy when added to nicotine patch and counseling for treating nicotine dependence among smokers with attention deficit hyperactivity disorder (ADHD).
Method
Participants were adult smokers with ADHD (202 whites and 51 non-whites) randomly assigned to OMPH or placebo in a multi-site, randomized controlled trial. Study outcomes were complete, prolonged, and point-prevalence abstinence at the end of treatment, and weekly ratings of ADHD symptoms, tobacco withdrawal symptoms, and desire to smoke.
Results
The rate of four-week complete abstinence (no slips or lapses) was significantly higher with OMPH than placebo among non-white (OMPH=42.9%, placebo =13.3%, χ2(1)=5.20, p=0.02) but not white participants (OMPH=23.1%, placebo =23.5%, χ2(1)=0.00, p=0.95). Patterns of prolonged and point-prevalence abstinence among non-whites were similar but fell short of statistical significance. OMPH reduced ADHD symptoms in both race/ethnic groups, and produced greater reductions in desire to smoke and withdrawal symptoms among the non-white than white participants. Change in desire to smoke, but not in withdrawal or ADHD symptoms predicted abstinence. The ability of OMPH to reduce desire to smoke among non-whites appeared to mediate the medication’s positive effect on abstinence.
Conclusion
Differential efficacy favoring non-whites of a medication for achieving smoking cessation is a potentially important finding that warrants further investigation. OROS-MPH could be an effective treatment for nicotine dependence among a subgroup of smokers.
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