@article {13783, title = {Unrelenting Growth and Diversification: Using the Health and Retirement Study to Illuminate Cannabis Use among Aging Americans.}, journal = {The Gerontologist}, year = {Forthcoming}, abstract = {

BACKGROUND AND OBJECTIVES: Cannabis use among aging Americans continues to increase. We examine correlates of cannabis use including attitudes, state of residence, health status and service use.

RESEARCH DESIGN AND METHODS: Using the 2018 Health and Retirement Study Cannabis module completed by 1,372 respondents aged 50 and older, we distinguished current cannabis users from those who have never used or have some prior use. We linked 2018 and 2016 core HRS data and used multinomial regressions to identify associations among current use, attitudes, place of residence, as well as current (2018) and past (2016) medical conditions, pain and sleep issues. We also examined associations among cannabis use, hospital stays and outpatient medical visits.

RESULTS: Past year cannabis use reached 10.3\% among aging Americans. Attitudes toward cannabis have changed over time with 4 of 5 survey respondents currently holding a favorable attitude. Attitude and state of residence were associated with current use. Cannabis users reported higher levels of pain, were more likely to use prescription opioids, and report activity limitations in both 2016 and 2018. Associations between cannabis use and sleep issues or concurrent healthcare use were not observed.

DISCUSSION AND IMPLICATIONS: Changing attitudes and state legalization appear important for late middle age and older persons, and as many as 1 of every 5 persons over 50 may be using cannabis by 2030. Cannabis use among aging Americans warrants increased attention from care providers, program administrators and policy makers, especially as a prevention or harm reduction strategy relative to prescription opioids.

}, keywords = {health retirement survey, Marijuana, Older Adults, Opioids, pain}, issn = {1758-5341}, doi = {10.1093/geront/gnae016}, author = {Kaskie, Brian and Bhagianadh, Divya and Bobitt, Julie and Martinos, Fadi and Milavetz, Gary and Arora, Kanika} } @article {7231, title = {Emergency department utilization patterns among older adults.}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {63}, year = {2008}, month = {2008 Feb}, pages = {204-9}, publisher = {63A}, abstract = {

BACKGROUND: We identified 4-year (2 years before and 2 years after the index [baseline] interview) ED use patterns in older adults and the factors associated with them.

METHODS: A secondary analysis of baseline interview data from the nationally representative Survey on Assets and Health Dynamics Among the Oldest Old linked to Medicare claims data. Participants were 4310 self-respondents 70 years old or older. Current Procedural Terminology (CPT) codes 99281 and 99282 identified low-intensity use, and CPT codes 99283-99285 identified high-intensity use. Exploratory factor analysis and multivariable multinomial logistic regression were used.

RESULTS: The majority (56.6\%) of participants had no ED visits during the 4-year period. Just 5.7\% had only low-intensity ED use patterns, whereas 28.9\% used the ED only for high-intensity visits, and 8.7\% had a mixture of low-intensity and high-intensity use. Participants with lower immediate word recall scores and those who did not live in major metropolitan areas were more likely to be low-intensity-only ED users. Older individuals, those who did not live in rural counties, had greater morbidity and functional status burdens, and lower immediate word recall scores were more likely to be high-intensity-only ED users. Participants who were older, did not live in major cities, had lower education levels, had greater morbidity and functional status burdens, and lower immediate word recall scores were more likely to have mixed ED use patterns.

CONCLUSIONS: Nearly half of these older adults used the ED at least once over a 4-year period, with a mean annual ED use percentage of 18.4. Few, however, used the ED only for visits that may have been avoidable. This finding suggests that triaging Medicare patients would not decrease ED overcrowding, although continued surveillance is necessary to detect potential changes in ED use patterns among older adults.

}, keywords = {Aged, Emergency Service, Hospital, Factor Analysis, Statistical, Female, Humans, Logistic Models, Male, Medicare, Risk Factors, United States}, issn = {1079-5006}, doi = {10.1093/gerona/63.2.204}, author = {Frederic D Wolinsky and Li Liu and Thomas R Miller and An, Hyonggin and John F Geweke and Kaskie, Brian and Kara B Wright and Elizabeth A Chrischilles and Claire E Pavlik and Elizabeth A Cook and Robert L. Ohsfeldt and Kelly K Richardson and Gary E Rosenthal and Robert B Wallace} }