Positive Self-Perceptions of Aging and Lower Rate of Overnight Hospitalization in the US Population Over Age 50

Sun, Jennifer K.; Kim, Eric S.; Smith, Jacqui

doi:10.1097/psy.0000000000000364

Cited by 34 publications

(23 citation statements)

References 44 publications

(57 reference statements)

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“…Obstacles for healthcare access in older adults have been consistently associated with worsened outcomes and increased all-cause mortality, particularly for those facing social inequalities [27]. Previous research has shown that negative self-perceived aging influences healthcare-seeking behavior, particularly in settings of limited healthcare access [28,29]. Our results suggest that reduced healthcare access, as measured by increases in the social lag index, and lesser number of available hospital beds are associated with increased COVID-19 severity and lethality in older adults, likely reflecting the effect of structural inequalities across Mexican municipalities.…”

Section: Discussionmentioning

confidence: 99%

Unequal impact of structural health determinants and comorbidity on COVID-19 severity and lethality in older Mexican adults: Looking beyond chronological aging

Bello‐Chavolla

González-Díaz

Antonio-Villa

et al. 2020

Preprint

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BACKGROUND: COVID-19 has had a disproportionate impact on older adults. The population of Mexico is younger, yet the impact of COVID-19 on older adults is comparable to countries with older population structures. Here, we aim to identify health and structural determinants that increase susceptibility to COVID-19 in older Mexican adults beyond chronological aging. METHODS: We analyzed confirmed COVID-19 cases in older adults using data from the General Directorate of Epidemiology of Mexican Ministry of Health. We modeled risk factors for increased COVID-19 severity and mortality, using mixed models to incorporate multilevel data concerning healthcare access and marginalization. We also evaluated structural factors and comorbidity profiles compared to chronological age for improving COVID-19 mortality risk prediction. RESULTS: We analyzed 7,029 confirmed SARS-CoV-2 cases in adults aged ≥60 years. Male sex, smoking, diabetes, and obesity were associated with pneumonia, hospitalization and ICU admission in older adults, CKD and COPD were associated with hospitalization. High social lag indexes and access to private care were predictors of COVID-19 severity and mortality. Age was not a predictor of COVID-19 severity in individuals without comorbidities and structural factors and comorbidities were better predictors of COVID-19 lethality and severity compared to chronological age. COVID-19 baseline lethality hazards were heterogeneously distributed across Mexican municipalities, particularly when comparing urban and rural areas. CONCLUSIONS: Structural factors and comorbidity explain excess risk for COVID-19 severity and mortality over chronological age in older Mexican adults. Clinical decision-making related to COVID-19 should focus away from chronological aging onto more a comprehensive geriatric care approach.

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Section: Discussionmentioning

confidence: 99%

Unequal impact of structural health determinants and comorbidity on COVID-19 severity and lethality in older Mexican adults: Looking beyond chronological aging

Bello‐Chavolla

González-Díaz

Antonio-Villa

et al. 2020

Preprint

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“…Previous research that did not consider domain-speci c views on aging but looked at overall positive SPA showed that these views can buffer the negative effect of precariousness on health and well-being (23) and promote healthy behavior (24). Positive SPA are also associated with a lower rate of overnight hospitalizations after four years (25). Furthermore, the association of positive SPA and better self-reported physical function in late life is mediated by self-e cacy (8): This means that positive SPA subsequently foster a person's ability to cope successfully with aging-related challenges, which is then later re ected in better self-reported, and, presumably, also objective physical function.…”

Section: Aims and Hypothesesmentioning

confidence: 99%

Domain-Specific Self-Perceptions of Aging are Associated with Different Gait Patterns in Older Adults: A Cross-Sectional Latent Profile Analysis

Blawert

Krumpoch

Freiberger

et al. 2021

Preprint

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Background: Previous studies have pointed to the impact of self-perceptions of aging (SPA) on self-reported physical function in later life. However, less is known about the role of SPA for objectively measured physical function, especially gait. Research that examined other psychological variables and objectively measured gait has focused on single gait parameters such as gait speed, which seems to fall short for the complexity of this movement. Some approaches have proposed ways to identify gait patterns in specific patient groups (such as patients with hemiplegia), but not in community samples. Our goal was a) to identify gait patterns based on a combination of important gait parameters in a community sample, and b) to investigate differential associations of gain- and loss-related SPA with these gait patterns.Methods: The study used an electronic walkway to assess gait parameters of 150 community dwelling adults aged 71-93 years (61.0% women) at their usual and maximum gait speed. SPA were assessed with a questionnaire. We used latent profile analysis (LPA) to identify groups exhibiting distinct gait patterns and binary logistic regression to investigate associations of SPA with these groups, controlling for personality traits, number of illnesses, age, gender, and education. To compare overall function between groups, a t-test for scores in the Short Physical Performance Battery was used.Results: LPA revealed two distinct groups in both gait speed conditions. The fit group exhibited a stable, well-coordinated and faster gait pattern while the functionally limited group’s gait pattern was less stable, less coordinated and slower. The odds of belonging to the functionally limited group were increased by loss-related SPA at usual gait speed, while the odds of belonging to the fit group were increased by gain-related SPA at individual maximum speed. Conclusions: The findings a) suggest LPA as a useful approach to investigate complex gait patterns considering several gait parameters simultaneously, and b) provide first evidence for the differential role of gain- and loss-related SPA for gait patterns at usual and maximum gait speed. Intervention studies addressing gait in older adults should additionally address gain-related views on aging.Trial registration: NA

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“…The level of SWB declines later in life (25,26). Regardless of functional limitation, high life satisfaction has been associated with fewer doctor visits and higher use of preventive health care services (27), and fewer overnight hospitalizations (28). Individuals with disabilities spend less time on work and productive activities and more time on passive leisure (29), and they experience increased frustration and decreased activity-related happiness.…”

Section: Frailty and Resiliencementioning

confidence: 99%

Pathways, Contributors, and Correlates of Functional Limitation Across Specialties: Workshop Summary

Kritchevsky

Forman

Callahan

et al. 2018

The Journals of Gerontology: Series A

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Traditional clinical care models focus on the measurement and normalization of individual organ systems and de-emphasize aspects of health related to the integration of physiologic systems. Measures of physical, cognitive and sensory, and psychosocial or emotional function predict important health outcomes like death and disability independently from the severity of a specific disease, cumulative co-morbidity, or disease severity measures. A growing number of clinical scientists in several subspecialties are exploring the utility of functional assessment to predict complication risk, indicate stress resistance, inform disease screening approaches and risk factor interpretation, and evaluate care. Because a substantial number of older adults in the community have some form of functional limitation, integrating functional assessment into clinical medicine could have a large impact. Although interest in functional implications for health and disease management is growing, the science underlying functional capacity, functional limitation, physical frailty, and functional metrics is often siloed among different clinicians and researchers, with fragmented concepts and methods. On August 25-26, 2016, participants at a trans-disciplinary workshop, supported by the National Institute on Aging and the John A. Hartford Foundation, explored what is known about the pathways, contributors, and correlates of physical, cognitive and sensory functional measures across conditions and disease states; considered social determinants and health disparities; identified knowledge gaps, and suggested priorities for future research. This paper summarizes those discussions.

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Positive Self-Perceptions of Aging and Lower Rate of Overnight Hospitalization in the US Population Over Age 50

Cited by 34 publications

References 44 publications

Unequal impact of structural health determinants and comorbidity on COVID-19 severity and lethality in older Mexican adults: Looking beyond chronological aging

Unequal impact of structural health determinants and comorbidity on COVID-19 severity and lethality in older Mexican adults: Looking beyond chronological aging

Domain-Specific Self-Perceptions of Aging are Associated with Different Gait Patterns in Older Adults: A Cross-Sectional Latent Profile Analysis

Pathways, Contributors, and Correlates of Functional Limitation Across Specialties: Workshop Summary

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