@article {6919, title = {Predicting Nursing Home Admission: Estimates from a seven-year follow-up of a nationally representative sample of older Americans}, journal = {Alzheimer Disease and Associated Disorders}, volume = {18}, year = {2004}, pages = {83-89}, publisher = {18}, abstract = {This study determines whether prevalence and predictors of nursing home admission changed in the 1990s, during a period of dramatic changes in the service provision for and medical care of chronic impairments. Data from the 1993-2000 surveys of the Asset and Health Dynamics Among the Oldest Old (AHEAD) Study, a longitudinal and nationally representative sample, were used. Proportional hazard models were used to determine the effects of dementia, physical functioning, clinical conditions, and sociodemographics on the likelihood of nursing home admission. Of the 6,676 respondents, 17 were admitted to a nursing home. Models excluding functional impairment demonstrated significant effects of chronic medical conditions and dementia on the risk of institutionalization. After controlling for functional impairment, dementia still had significant and strong effects on institutionalization but clinical conditions did not, suggesting that the impact of dementia goes beyond its effect on physical functioning. Nursing home admissions did not decrease during the study period, and the impact of dementia on the risk of nursing home admission did not decrease. Interventions for individuals with dementia should impact the behavioral aspects of the condition and slow disease progression in addition to improving physical functioning.}, keywords = {Demographics, Health Conditions and Status, Healthcare, Methodology}, author = {Banaszak-Holl, Jane and A. Mark Fendrick and Norman L Foster and A. Regula Herzog and Mohammed U Kabeto and Kent, David and Walter L. Straus and Kenneth M. Langa} } @article {6835, title = {Prevalence and correlates of depressive symptoms in a community sample of people suffering from heart failure.}, journal = {J Am Geriatr Soc}, volume = {50}, year = {2002}, month = {2002 Dec}, pages = {2003-8}, publisher = {50}, abstract = {

OBJECTIVES: To examine the rates and correlates of depressive symptoms and syndromal depression in people with self-reported heart failure participating in a community study of people aged 70 and older.

DESIGN: Cross-sectional.

SETTING: Community-based epidemiological study of older people from the continental United States.

PARTICIPANTS: Six thousand one hundred twenty-five older people participating in the longitudinal study of Assets and Health Dynamics. Participants had to be born in 1923 or earlier.

MEASUREMENTS: The short-form Composite International Diagnostic Interview assessed syndromal depression, and a revised version of the Center for Epidemiologic Studies-Depression scale assessed depressive symptoms. Medical illness was based on self-report. The authors compared the rates of syndromal depression and individual depressive symptoms in people with self-reported heart failure (n = 199) with those in people with other heart conditions (n = 1,856) and with no heart conditions (n = 4,070).

RESULTS: Eleven percent of those with heart failure met criteria for syndromal depression, compared with 4.8\% of people with other heart conditions and 3.2\% of those with no heart conditions. The association between heart failure and depression held even after controlling for disability, reported fatigue and breathlessness, and number of comorbid chronic illnesses.

CONCLUSION: Community-living older people with self-reported heart failure were at approximately twice the risk for syndromal depression of the rest of the community. Although fatigue and functional disability were also related to depression in this sample, these variables did not account for the association between syndromal depression and self-reported heart failure.

}, keywords = {Aged, depression, Female, Heart Failure, Humans, Longitudinal Studies, Male, Prevalence, United States}, issn = {0002-8614}, doi = {10.1046/j.1532-5415.2002.50612.x}, author = {Carolyn L. Turvey and Schultz, K. and Arndt, Stephan and Robert B Wallace and A. Regula Herzog} } @article {6751, title = {Patterns and risk factors of change in somatic and mood symptoms among older adults.}, journal = {Ann Epidemiol}, volume = {11}, year = {2001}, month = {2001 Aug}, pages = {361-8}, publisher = {11}, abstract = {

PURPOSE: This paper was concerned with patterns of individual-level, longitudinal change in depressive symptoms and factors related to those patterns among Americans 70+ years of age. Two types of depressive symptoms were considered, somatic and mood symptoms. The paper focused on whether the patterns of change and the risk factors for these two types of symptoms differed, as we might expect among old and oldest-old adults.

METHODS: The analytic sample included self-respondents of the 1993--1995 Asset and Health Dynamics among the Oldest Old (AHEAD) study who were born in 1923 or earlier. Depressive symptoms were assessed using an abbreviated Center for Epidemiologic Studies-Depression (CES-D) Scale. The analyses involved examination of respondents{\textquoteright} change scores in depressive symptoms and multivariate models using ordinary least squares (OLS) and seemingly unrelated regressions (SUR).

RESULTS: In aggregate, somatic symptoms were more common than mood symptoms initially and over time. Despite differences in aggregate rates, AHEAD respondents{\textquoteright} individual-level patterns of change for the two types of symptoms were similar; i.e., stability was the principal trend (53--60\%), followed by improvement (21--26\%). A number of factors related to change in one aspect of depressive symptoms and not the other, or had greater effects on one aspect of depressive symptoms than the other; e.g., physical health had greater effects on somatic than mood symptoms.

CONCLUSIONS: This study suggests that, in investigations of the course and risk factors for depressive symptoms among people 70+ years of age, it is important to separate somatic symptoms from mood symptoms; their etiology may differ. In general, factors reflecting respondents{\textquoteright} social milieu (e.g., bereavement, residential relocation) may have greater effects on mood than somatic symptoms, whereas certain factors representing physical health may have greater effects on somatic symptoms.

}, keywords = {Age Factors, Aged, Depressive Disorder, Female, Follow-Up Studies, Geriatric Assessment, Humans, Least-Squares Analysis, Longitudinal Studies, Male, Mood Disorders, Regression Analysis, Risk Factors, Severity of Illness Index, Somatoform Disorders, United States}, issn = {1047-2797}, doi = {10.1016/s1047-2797(00)00219-2}, author = {Stephanie J. Fonda and A. Regula Herzog} } @article {6649, title = {Prevalence and severity of urinary incontinence in older African American and Caucasian women.}, journal = {J Gerontol A Biol Sci Med Sci}, volume = {54}, year = {1999}, month = {1999 Jun}, pages = {M299-303}, publisher = {54A}, abstract = {

BACKGROUND: Few studies have investigated the prevalence and severity of urinary incontinence in older African American women. Comparisons of findings with those for older Caucasian women could provide important clues to the etiology of urinary incontinence and be used in planning screening programs and treatment services.

METHODS: Data are from the first wave of the Asset and Health Dynamics Among the Oldest Old (AHEAD) study. A nationally representative sample of noninstitutionalized adults 70 years of age and older was interviewed. African Americans were oversampled to ensure that there would be enough minority respondents to compare findings across racial groups.

RESULTS: A statistically significant relationship was found between race and urinary incontinence in the previous year: 23.02\% of the Caucasian women reported incontinence, compared with 16.17\% of the African American women. Other factors that appear to increase the likelihood of incontinence include education, age, functional impairment, sensory impairment, stroke, body mass, and reporting by a proxy. Race was not related to the severity (as measured by frequency) of urine loss among incontinent older women.

CONCLUSION: This study identifies or confirms important risk factors for self-reported urinary incontinence in a national context, and suggests factors leading to protection from incontinence. Race is found to relate to incontinence, with older African American women reporting a lower prevalence.

}, keywords = {Aged, Aged, 80 and over, Black or African American, Female, Humans, Prevalence, Risk Factors, United States, Urinary incontinence, White People}, issn = {1079-5006}, doi = {10.1093/gerona/54.6.m299}, author = {Fultz, Nancy H. and A. Regula Herzog and Trivellore E. Raghunathan and Robert B Wallace and Diokno, A.C.} }