The national prevalence of malnutrition in older adults living in the community and residential care (non-nursing home) is not known. We determined the prevalence of malnutrition (Mini-Nutritional Assessment) in a representative sample (N=4472) living in the community (95%) or residential care (5%), and examined known nutrition risk factors (inflammation [hsCRP, IL-6], socio-demographic variables). The majority (68%) were nourished, 26% were at risk, and 6% were malnourished. Those living in residential care vs community were more likely to be malnourished (12% vs 5%, respectively p<.01). Compared to nourished group, those with malnutrition were more likely to have hsCRP greater than median (1.36) (OR = 1.45 [95% CI 1.01-1.92]) and those at nutritional risk were more likely to have IL-6 greater than median (4.22) (OR=1.34 [95% CI 1.09-1.63]). Malnourished older adults were more likely to be older, female, live alone, report worse self-reported health, and use Meals on Wheels (p <.05).
Little is known about community-dwelling older adults’ outdoor activity and the relationship between physical function and frequency of going outside. Using the 2017 NHATS (N = 4,465), we looked at self-reported outdoor frequency (Likert scale: every day to once a week or less) and the Short Physical Performance Battery (SPPB; participants completed five different physical activities to measure physical performance; total scores ranged from 0, not attempted, to 12, the best). A logistic model comparing community-dwelling older adults going out most days (18.3%), some days (10.3%), or rarely/never (3.4%) to those going out every day found ORs of 0.85, 0.70, and 0.58 respectively (all p<0.0001) for a one-unit increase in SPPB score. Interdisciplinary teams can use findings to assess disabled community-dwelling older adults’ frequency of going outdoors. Implications for interventions to assist with increasing times leaving the home (e.g. mobility devices, caregiver assistance) will be discussed.
A gap in knowledge exists related to the socio-demographic and health characteristics of older adults receiving wound care from a family caregiver in the home. We created a cohort (N=992) of older adults from NHATS who lived in the community or residential care (non-nursing home) and had a family caregiver complete the NSOC question “provides help with skin care related to wounds or sores”. Approximately one third (32%) of these older adults received wound care from a family caregiver. These older adults were more likely to be men, live with others, have lower levels of physical function, be malnourished (OR = 1.63 [95% CI = 1.02-2.60]), and have inflammation (hsCRP > median 1.89), P < .05. These findings can inform the needs of older adults receiving wound care from a family caregiver and lead to development of additional supports for caregivers (e.g., multi-component interventions).
Older adults experience adverse drug events (ADEs) putting them at risk for increased morbidity and mortality. Utilizing the 2018 Healthcare Cost and Utilization Project’s National Inpatient Sample, we identified the prevalence of ADE admissions among adults 65 and older and examined the differences in characteristics and discharge outcomes in those with and without a primary diagnosis of an ADE (n=2,647,673). ADEs accounted for 7.4% of discharges and had higher odds of needing post-discharge care including transfer to a skilled nursing facility (OR=1.08, 95% CI [1.07, 1.09]) and home-health care (OR=1.1, 95% CI [1.09,1.1]). In the ADE group, hospital charges were higher ($39,609 vs. $38,649, p< .01) and length of stay (6+ days) longer (OR=1.53, 95% CI [1.52,1.55]). Opiates, diabetic agents, benzodiazepines and narcotics were frequently associated with ADEs. Older adults discharged after an ADE have increased healthcare utilization. Education on medication self-management is needed to prevent ADEs in older adults.
Older adults self-administer prescribed medication regimens to treat chronic diseases which can lead to mismanagement, medication related harm and hospitalizations. We examined the extent to which source of purchased medications influenced the occurrence of self-reported medication mistakes and hospitalizations in community-dwelling participants who managed medications independently (N= 3899). The majority (65%) picked-up medications, 18% had medications delivered, and 17% used both (picked-up and delivery). Compared to those picking up their medications, those using delivery only were less likely to have a hospital stay (OR=0.691 [95% CI 0.507-0.943]) and no difference in odds of medication mistakes (OR=1.051 [95% CI 0.764-1.445]), while those using both methods were more likely to report hospital stays (OR=1.429 [95% CI 1.106-1.846]) and medication mistakes (OR = 1.576[95% CI 1.078-2.304]). Older adults who picked-up medications from a local pharmacy and had medications delivered were more likely to report medication mistakes and hospitalizations.
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