Sexual relations in later life: a national study of married persons

Sexual behavior among married persons 60 years of age and older was examined using data from the National Survey of Families and Households. About 53 percent of the entire sample, and 24 percent of those 76 years of age and older, report having had sexual relations at least once within the past month. Persons who have been sexually active within the past month report having sex about four times during the month. While respondent's age is significantly related to sexual behavior, the monthly incidence and overall sexual frequency variables are not influenced by gender, race, or a Gender by Spouse's Health Status interaction term. While the NSFH variables included in our model are poor predictors of elderly persons' sexual behavior, analyses reveal that a person's sense of self-worth/competence and his/her partner's health status are significantly and positively related to the incidence of sex within the past month.     

Expressive suppression and emotional eating in older and younger adults: An exploratory study

AimA clear gap exists in regard to emotional eating and the effects of affect and expressive suppression on emotional eating among older individuals. The aim was to compare the emotional eating patterns of younger and older individuals and assess the role of expressive suppression in the association between affectivity and emotional eating in each of the age groups.MethodsParticipants were 210 individuals recruited by means of a convenience sampling, which intentionally included a wide age range, along with varied socio-economic and education levels. Participants completed the short version of the Dutch Eating Behavior Questionnaire, The Positive affect (PA) and Negative Affect (NA) Schedule and the Courtauld emotional control scale. Data was analyzed for three age groups – young adults (aged 20–40), middle-aged adults (aged 41–60) and older adults (aged 61–87).ResultsEmotional eating was present among all three age groups, but it gradually decreased with age. The use of expressive suppression increased with age. Levels of PA and NA did not differ across the age groups and were not associated with emotional eating, but expressive suppression predicted higher emotional eating. The association between expressive suppression and emotional eating was moderated by age: with a stronger association for the younger group, a moderate association for the middle-aged group and no association for the older adults.ConclusionsEmotional eating is present among older adults, although in lower intensity than younger individuals, and should be identified and treated by health and mental health practitioners.     

Self-efficacy and depressive symptomatology in older adults: an exploratory study

This exploratory study concerns the relationship between self-efficacy and depressive symptomatology in older adults. Two hundred community-residing older adults were administered the Depression Adjective Checklist and three self-efficacy scales over the telephone. The results suggest a strong relationship between general, physical, and global self-efficacy and depression. Finally, physical and general self-efficacy were identified as the strongest predictors of depression. Implications of self-efficacy theory in relation to depressive symptoms as well as suggested practice implications are presented.     

Housing type is associated with objectively measured changes in movement behavior during the COVID-19 pandemic in older adults with hypertension: An exploratory study

PurposeTo investigate the association between housing characteristics with objectively measured changes in physical activity (PA) and sedentary behavior (SB) during the COVID-19 pandemic in older adults with hypertension.MethodsThirty-five older adults with hypertension were included in this exploratory study. Accelerometer-based PA and SB measures were assessed before and during a period of social distancing policy imposed due to the COVID-19 pandemic. Housing type, housing surface area and household size were tested as predictors of changes in PA and SB. A generalized linear mixed model was used for the analysis.ResultsHousing type was associated with changes in PA and SB. Individuals residing in an apartment showed a greater decrease in light PA on weekdays (β= –65 min/day, p=0.035) and a trend for an increase in SB (β= 55 min/day, p=0.056) compared to those residing in a detached house. Individuals residing in a row house showed a greater decrease in moderate-vigorous PA (β= –10 min/day, p=0.037) and steps/day (β= –2064, p=0.010) compared to those residing in a detached house. Individuals residing in an apartment showed a greater decrease in light PA on the weekends (β= –83 min/day, p=0.015) and an increase in SB (β= 72 min/day, p=0.036) compared to those residing in a detached house. No association was found for housing surface area and household size.ConclusionsOlder adults with hypertension residing in an apartment or row house have greater unhealthy changes in movement behavior during the COVID-19 pandemic. Further studies are needed to confirm our preliminary findings.     

Factors associated with the overlap of frailty and nutrition in institutionalized older adults: A multicenter study

ObjectivesThis multicenter cross-sectional study aimed to investigate the factors associated with the overlap of frailty and nutrition in older adults residing in nursing homes.MethodOlder adults (n = 344, mean age ± SD = 77.7 ± 9.1) were selected from 17 nursing homes, 10 in Piracicaba and seven in João Pessoa, Brazil. The modified Fried’s questionnaire and the Mini Nutrition Assessment Short-Form (MNA-SF) were used for screening frailty phenotypes and nutritional status, respectively. These variables overlapped into (1) frail and malnourished; (2) nonfrail and malnourished or frail and nourished; and (3) nonfrail and nourished. The independent variables were sex, age, mobility, number of medications, dependence for activities of daily living (ADL), maximal grip strength, muscle mass, body fat and body mass index (BMI). Spearman’s correlation and Poisson regression were used to analyze the data (α = 0.05).ResultsThe Spearman’s test demonstrated a moderate correlation (r²=-0.441) between frailty (mean ± SD = 2.8 ± 1.7) and nutritional status (mean ± SD = 10.5 ± 2.9). Regarding the overlap of frailty and nutrition, 139 participants (40.5 %) were frail and malnourished, 121 (35.3 %) were nonfrail and malnourished or frail and nourished, and 83 (24.2 %) were nonfrail and nourished. The Poisson regression showed association of the coexistence of frailty and malnutrition with age (PR = 1.009, 95 % CI = 1.003−1.016), number of medications (PR = 1.016, 95 % CI = 1.006−1.027), dependence for ADL (PR = 1.061, 95 % CI = 1.016−1.108), maximal grip strength (PR = 0.992, 95 % CI = 0.986−0.998) and BMI (PR = 0.997, 95 % CI = 0.996−0.998).ConclusionsThe findings showed that frailty and malnutrition were prevalent in institutionalized older adults and associated with advanced age, greater use of medicines, dependence for ADL, lower maximal grip strength and lower BMI.     

Factors associated with immune checkpoint inhibitor use among older adults with late-stage melanoma: A population-based study

Improvement in overall survival by immune checkpoint inhibitors (ICI) treatment in clinical trials encourages their use for late-stage melanoma. However, in the real-world, heterogeneity of population, such as older patients with multimorbidity, may lead to a slower diffusion of ICIs. The objective of this study was to examine the association of multimorbidity and other factors to ICI use among older patients with late-stage melanoma using real world data.A retrospective cohort study design with a 12-month baseline and follow-up period was adopted with data from the linked Surveillance, Epidemiology, and End Results cancer registry/Medicare database. Older patients (>65 years) with late-stage (stage III/IV) melanoma diagnosed between 2012 and 2015 were categorized as with or without multimorbidity (presence of 2 or more chronic conditions) and ICI use was identified in the post-index period. Chi-square tests and logistic regression were used to evaluate factors associated with ICI use.In the study cohort, 85% had multimorbidity, 18% received any treatment (chemotherapy, radiation, and/or ICI), and 6% received ICI. Only 5.5% of older patients with multimorbidity and 6% without multimorbidity received ICIs. Younger age, presence of social support, lower economic status, residence in northeastern regions, and recent year of diagnosis were significantly associated with ICI use; however, multimorbidity, sex, and race were not associated with ICI use.In the real-world clinical practice, only 1 in 18 older adults with late stage melanoma received ICI, suggesting slow pace of diffusion of innovation. However, multimorbidity was not a barrier to ICI use.     

Factors associated with enrollment of older adults into a physical activity promotion program

This article investigates the extent to which a proactive two-phased recruitment approach resulted in recruitment of a representative sample of older adults from two lower income congregate housing facilities into a physical activity promotion program. Enrollees were similar to nonenrollees with respect to education, gender, marital status, race/ethnicity, self-rated health, physical functioning, psychological distress, exercise frequency, level of social contact, having a confidant, use of alcohol, and smoking status. However, enrollees were younger, more likely to speak English as a primary language, less likely to be completely sedentary, and more likely to be overweight. Overall, 21% of the target population were recruited into the program. Recruitment strategies such as those used in this study appeared to enable enrollment of a reasonably representative sample of a small well-defined population.     

Factors associated with emergency department revisits among older adults in two Swedish regions: A prospective cohort study

ObjectivesTo assess the association between baseline characteristics at an index ED visit and ED revisit within 30 days among adults aged ≥ 65 years in two Swedish regions.MethodsThis was a register-based prospective cohort study. The sample included (N=16 688; N=101 017) older adults who have had an index ED visit in 2014 at hospital based EDs in the regions of Dalarna and Stockholm, Sweden. Several registers were linked to obtain information on sociodemographic factors, living conditions, social care, polypharmacy and health care use. Multivariate logistic regression was used to analyse the data.ResultsSeventeen percent of the study sample in Dalarna and 20.1% in Stockholm revisited ED within 30 days after an index ED visit. In both regions, male gender, being in the last year of life, excessive polypharmacy (≥ 10 drugs), ≥11 primary care visits and ED care utilization were positively associated with ED revisits. In Stockholm, but not in Dalarna, low level of education, polypharmacy, and institutional care was also associated with ED revisits. In contrast, home help was associated with ED revisits in Dalarna but not in Stockholm.ConclusionThese findings call for further in-depth examinations of variations within single countries. ED revisits among older adults are driven by need of care but also by the social and care situation.     

Factors associated with falls in active older adults in Japan and Brazil

Background/PurposeAging populations are a global public health concern. The risk of falls increases with age, so fall prevention is becoming an important health issue. However, few studies have focused on cross-cultural analyses of falls. Therefore, we aimed to compare the incidence of falls and compare anthropometric measures and physical function between active Japanese and Brazilian older adults.Materials and methodsWe measured the incidence of falls (investigated by self-reported questionnaire), body mass index (BMI), waist circumference (WC), grip strength (GS), one-legged stance (BALANCE), frequency of physical activity (PA), medication use (MU), and hospitalization history in 114 physically active community-dwelling adults 65 years of age and older in Japan (73.9 ± 4.0 years, n = 40) and Brazil (70.7 ± 4.5 years, n = 74).ResultsThe Japanese elderly were older (p < 0.01), but had a better BALANCE score (p < 0.05) than the Brazilian elderly. Nevertheless, Brazilian elderly showed higher engagement in PA and had higher BMI and WC (p < 0.01). Despite the lack of a difference in the incidence of falls between the two cohorts, Japanese elderly who fell had decreased GS compared to Japanese elderly who did not fall [odds ratio (OR): 0.83, 95% confidence interval (CI) 0.72–0.97, p < 0.05]. In Brazil, those who fell had larger WC than those who did not fall (OR: 1.07, 95% CI 1.01 – 1.13, p < 0.01).ConclusionOur results indicate that physical function (i.e., grip strength) is a more important predictor of falls in Japanese elderly. However, increasing waist size is a predictor of falls in Brazilian elderly. These findings suggest that risk factors for falls are multifactorial and vary according to setting.     

Factors associated with poor balance ability in older adults of nine high-altitude communities

IntroductionPoor balance ability in older adults result in multiple complications. Poor balance ability has not been studied among older adults living at high altitudes. In this study, we analysed factors associated with poor balance ability by using the Functional Reach (FR) among older adults living in nine high-altitude communities.Material and methodsAnalytical cross-sectional study, carried out in inhabitants aged 60 or over from nine high-altitude Andean communities of Peru during 2013–2016. FR was divided according to the cut-off point of 8 inches (20.32 cm) and two groups were generated: poor balance ability (FR less or equal than 20.32 cm) and good balance ability (greater than 20.32 cm). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regression models were constructed to identify factors associated with poor balance ability. Prevalence ratio (PR) with 95% confidence intervals (95CI%) are presented.ResultsA total of 365 older adults were studied. The average age was 73.0 ± 6.9 years (range: 60–91 years), and 180 (49.3%) participants had poor balance ability. In the adjusted Poisson regression analysis, the factors associated with poor balance ability were: alcohol consumption (PR = 1.35; 95%CI: 1.05–1.73), exhaustion (PR = 2.22; 95%CI: 1.49–3.31), gait speed (PR = 0.67; 95%CI: 0.50–0.90), having had at least one fall in the last year (PR = 2.03; 95%CI: 1.19–3.46), having at least one comorbidity (PR = 1.60; 95%CI: 1.10–2.35) and having two or more comorbidities (PR = 1.61; 95%CI: 1.07–2.42) compared to none.ConclusionsApproximately a half of the older adults from these high-altitude communities had poor balance ability. Interventions need to be designed to target these balance issues and prevent adverse events from concurring to these individuals.