Subjective Social Status and Functional Decline in Older Adults

Chen, Bonnie; Covinsky, Kenneth E.; Cenzer, Irena Stijacic; Adler, Nancy E.; Williams, Brie

doi:10.1007/s11606-011-1963-7

Cited by 66 publications

(61 citation statements)

References 38 publications

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“…Age, marital status, race/ethnicity, education, employment, yearly family income, subjective social status [28], number of comorbid physical diseases [29], and study recruitment site were self-reported at study entry.…”

Section: Sociodemographic and Medical Variablesmentioning

confidence: 99%

Depressive episodes, symptoms, and trajectories in women recently diagnosed with breast cancer

Stanton

Wiley

Krull

et al. 2015

Breast Cancer Res Treat

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Depression carries serious psychosocial, physical, and economic consequences for cancer survivors. Study goals were to characterize patterns and predictors of depressive symptoms and major depressive episodes in recently diagnosed breast cancer patients. Consecutively recruited women (N = 460) completed a validated interview (CIDI) and questionnaire measure (CES-D) of depression within 4 months after invasive breast cancer diagnosis and at six additional assessments across 12 months. Outcomes were major depressive episodes, continuous symptom scores, and latent symptom trajectory classes. Across 12 months, 16.6 % of women met criteria for a major depressive episode. Unemployment predicted depressive episodes after other correlates were controlled. Distinct trajectory classes were apparent: an estimated 38 % of women had chronically elevated symptoms (High trajectory), 20 % recovered from elevated symptoms (Recovery), and 43 % had lower symptoms (Low and Very Low trajectories). Although 96 % of episodes occurred in the High or Recovery classes, 66 % of women in the High trajectory did not have an episode. Women in the Low (vs High) trajectory were more likely to be older, retired, more affluent, and have fewer comorbid diseases and briefer oncologic treatment. Women in the Recovery trajectory (vs High) were more likely to be married and more affluent and have fewer comorbid diseases. Assuming available therapeutic resources, assessment of both depressive symptoms and episodes over several months after diagnosis is important. Identification of patients at risk for persistently high depressive symptoms (e.g., younger, longer treatment course) opens targeted opportunities to prevent and promote rapid recovery from depression.

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Section: Sociodemographic and Medical Variablesmentioning

confidence: 99%

Depressive episodes, symptoms, and trajectories in women recently diagnosed with breast cancer

Stanton

Wiley

Krull

et al. 2015

Breast Cancer Res Treat

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“…Predisposing factors are those features of individuals that exist at or before the outset of the disablement process, such as demographic and biological characteristics. Evidence has shown that younger age, male, and more educational attainment are likely to be found in functionally independent older adults (Beckett et al, 1996;Chen, Covinsky, Stijacic Cenzer, Adler, & Williams, 2012;Liang, Wang, et al, 2010), whereas living with comorbidities and depressive symptoms are common in older adults with functional disabilities (Barry, Murphy, & Gill, 2011;Dalle Carbonare et al, 2009;Hung, Ross, Boockvar, & Siu, 2012). As for the intra-and extra-individual factors, the disablement process asserts that these factors serve as buffers, which may increase the individual's capacity or decrease environmental demands in an attempt to retard or reverse the progression of disablement.…”

Section: Studies Have Shown That Older Adults With Disabilities In Admentioning

confidence: 99%

Disability trajectories and associated disablement process factors among older adults in Taiwan

Chen

Chiang

et al. 2015

Archives of Gerontology and Geriatrics

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“…7 Other factors that have been cited include lack of financial resources and possible provider bias. 20 Additionally, it is possible that age and culture-related issues such as patient-provider communication, 21 patient selfhealth awareness, 22 and overall social support structures 23 may contribute to disparities in receipt of diagnostic and therapeutic treatments.…”

Section: Differences In Carementioning

confidence: 99%

Differences in Short-Term Versus Long-Term Outcomes of Older Black Versus White Patients With Myocardial Infarction

et al. 2014

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Background-Blacks are less likely than whites to receive coronary revascularization and evidence-based therapies after acute myocardial infarction, yet the impact of these differences on long-term outcomes is unknown. Methods and Results-We linked Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes WithEarly Implementation of American College of Cardiology/American Heart Association Guidelines (CRUSADE) registry data to national Medicare claims, creating a longitudinal record of care and outcomes among 40 500 patients with non-STsegment-elevation myocardial infarction treated at 446 hospitals to examine mortality and readmission rates (mean follow-up, 2.4 years) among black and white patients. Relative to whites (n=37 384), blacks (n=3116) were more often younger and female; more often had diabetes mellitus and renal failure; and received less aggressive interventions, including cardiac catheterization (60.7% versus 54.0%; P<0.001), percutaneous coronary intervention (32.1% versus 23.8%; P<0.001), and coronary bypass surgery (9.2% versus 5.7%; P<0.001). Although blacks had lower 30-day mortality (9.1% versus 9.9%; adjusted hazard ratio, 0.80; 95% confidence interval, 0.71-0.92), they had higher observed mortality at 1 year (27.9% versus 24.5%; P<0.001), although this was not significant after adjustment on long-term follow-up (hazard ratio, 1.00; 95% confidence interval, 0.94-1.07). Black patients also had higher 30-day (23.6% versus 20.0%; P<0.001) and 1-year (62.0% versus 54.6%; P<0.001) all-cause readmission, but these differences were no longer significant after risk adjustment on 30-day (hazard ratio, 1.02; 95% confidence interval, 0.92-1.13) and long-term (hazard ratio, 1.05; 95% confidence interval, 1.00-1.11) follow-up. Conclusions-Although older blacks with an acute myocardial infarction had lower initial mortality rates than whites, this early survival advantage did not persist during long-term follow-up. The reasons for this are multifactorial but may include differences in comorbidities and postdischarge care. Methods Data SourcesThe CRUSADE registry was a voluntary observational data collection and quality-improvement initiative that collected prospective data on patients with non-ST-segment elevation acute coronary syndrome from January 2001 to December 2006. CRUSADE was designed to track guideline adherence, to provide feedback about performance, and to develop quality improvement tools to improve adherence to ACC/AHA recommendations for the treatment of acute coronary syndrome patients. 9 Inclusion and exclusion criteria, data collection, and variables have previously been described. 9 The individual institutional review board of each reporting hospital approved participation in CRUSADE. All data were abstracted retrospectively and anonymously; therefore, informed consent was not required.The process of linking clinical registry data to CMS administrative data has been described previously.10 Briefly, we used indirect identifiers (ie, site, age, admission and dis...

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Subjective Social Status and Functional Decline in Older Adults

Cited by 66 publications

References 38 publications

Depressive episodes, symptoms, and trajectories in women recently diagnosed with breast cancer

Depressive episodes, symptoms, and trajectories in women recently diagnosed with breast cancer

Disability trajectories and associated disablement process factors among older adults in Taiwan

Differences in Short-Term Versus Long-Term Outcomes of Older Black Versus White Patients With Myocardial Infarction

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