@article {7207, title = {Identification of dementia: agreement among national survey data, medicare claims, and death certificates.}, journal = {Health Serv Res}, volume = {43}, year = {2008}, month = {2008 Feb}, pages = {313-26}, publisher = {43}, abstract = {

OBJECTIVE: To estimate the proportion of seniors with dementia from three independent data sources and their agreement.

DATA SOURCES: The longitudinal Asset and Health Dynamics among the Oldest Old (AHEAD) study (n=7,974), Medicare claims, and death certificate data.

STUDY DESIGN: Estimates of the proportion of individuals with dementia from: (1) self- or proxy-reported cognitive status measures from surveys, (2) Medicare claims, and (3) death certificates. Agreement using Cohen{\textquoteright}s kappa; multivariate logistic regression.

PRINCIPAL FINDINGS: The proportion varied substantially among the data sources. Agreement was poor (kappa: 0.14-0.46 depending upon comparison assessed); the individuals identified had relatively modest overlap.

CONCLUSIONS: Estimates of dementia occurrence based on cognitive status measures from three independent data sources were not interchangeable. Further validation of these sources is needed. Caution should be used if policy is based on only one data source.

}, keywords = {Aged, Consensus, Data Interpretation, Statistical, Death Certificates, Dementia, Female, Health Surveys, Humans, Incidence, Insurance Claim Review, Male, Mass Screening, Medicare, Research Design, United States}, issn = {0017-9124}, doi = {10.1111/j.1475-6773.2007.00748.x}, author = {Truls Ostbye and Donald H. Taylor Jr. and Elizabeth C. Clipp and Lynn Van Scoyoc and Brenda L Plassman} } @article {7019, title = {The impact of own and spouse{\textquoteright}s urinary incontinence on depressive symptoms.}, journal = {Soc Sci Med}, volume = {60}, year = {2005}, month = {2005 Jun}, pages = {2537-48}, publisher = {60}, abstract = {

This study investigated the impact of own and spouse{\textquoteright}s urinary incontinence on depressive symptoms. Attention was paid to the possibility that gender and caregiving might be important factors in understanding significant effects. We used negative binomial regression to analyze survey data for 9974 middle-aged and older respondents to the Health and Retirement Study in the USA. Results supported the hypothesis that the respondents{\textquoteright} own urinary incontinence was associated with depressive symptoms (unadj. IRR = 1.73, 95\% CIs = 1.53, 1.95 for men; unadj. IRR = 1.50, 95\% CIs = 1.38, 1.63 for women). Controlling sociodemographic and health variables reduced this relationship, but it remained statistically significant for both men and women. Having an incontinent wife put men at greater risk for depressive symptoms (unadj. IRR = 1.13, 95\% CIs = 1.02, 1.25), although this relation became nonsignificant with the addition of control variables. No relation between women{\textquoteright}s depressive symptoms and husbands{\textquoteright} (in)continence status was found. Caregiving was not a significant variable in the adjusted analyses, but spouses{\textquoteright} depressive symptoms emerged as a significant predictor of the respondents{\textquoteright} own depressive symptoms. Health care providers must be sensitive to the emotional impact of urinary incontinence. Our findings also suggest the importance of considering the patient{\textquoteright}s mental health within a wider context, particularly including the physical and mental health of the patient{\textquoteright}s spouse.

}, keywords = {Aged, Caregivers, Cohort Studies, depression, Female, Humans, Male, Middle Aged, United States, Urinary incontinence}, issn = {0277-9536}, doi = {10.1016/j.socscimed.2004.11.019}, author = {Fultz, Nancy H. and Kristi Rahrig Jenkins and Truls Ostbye and Donald H. Taylor Jr. and Mohammed U Kabeto and Kenneth M. Langa} }