%0 Journal Article %J Health Justice %D 2018 %T Older adults in jail: high rates and early onset of geriatric conditions. %A Greene, Meredith %A Cyrus Ahalt %A Stijacic-Cenzer, Irena %A Metzger, Lia %A Brie A Williams %K Criminal justice %K Health Conditions and Status %K Public Health %X

BACKGROUND: The number of older adults in the criminal justice system is rapidly increasing. While this population is thought to experience an early onset of aging-related health conditions ("accelerated aging"), studies have not directly compared rates of geriatric conditions in this population to those found in the general population. The aims of this study were to compare the burden of geriatric conditions among older adults in jail to rates found in an age-matched nationally representative sample of community dwelling older adults.

METHODS: This cross sectional study compared 238 older jail inmates age 55 or older to 6871 older adults in the national Health and Retirement Study (HRS). We used an age-adjusted analysis, accounting for the difference in age distributions between the two groups, to compare sociodemographics, chronic conditions, and geriatric conditions (functional, sensory, and mobility impairment). A second age-adjusted analysis compared those in jail to HRS participants in the lowest quintile of wealth.

RESULTS: All geriatric conditions were significantly more common in jail-based participants than in HRS participants overall and HRS participants in the lowest quintile of net worth. Jail-based participants (average age of 59) experienced four out of six geriatric conditions at rates similar to those found in HRS participants age 75 or older.

CONCLUSIONS: Geriatric conditions are prevalent in older adults in jail at significantly younger ages than non-incarcerated older adults suggesting that geriatric assessment and geriatric-focused care are needed for older adults cycling through jail in their 50s and that correctional clinicians require knowledge about geriatric assessment and care.

%B Health Justice %V 6 %P 3 %8 02/2018 %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/29455436?dopt=Abstract %R 10.1186/s40352-018-0062-9 %0 Journal Article %J Alzheimers Dement %D 2009 %T "Below average" self-assessed school performance and Alzheimer's disease in the Aging, Demographics, and Memory Study. %A Kala M. Mehta %A Anita L Stewart %A Kenneth M. Langa %A Kristine Yaffe %A Sandra Y. Moody-Ayers %A Brie A Williams %A Kenneth E Covinsky %K Aged %K Aged, 80 and over %K Aging %K Alzheimer disease %K Apolipoprotein E4 %K Cognition Disorders %K Educational Status %K Female %K Geriatric Assessment %K Humans %K Male %K Memory %K Neuropsychological tests %K Risk Factors %X

BACKGROUND: A low level of formal education is becoming accepted as a risk factor for Alzheimer's disease (AD). Although increasing attention has been paid to differences in educational quality, no previous studies addressed participants' own characterizations of their overall performance in school. We examined whether self-assessed school performance is associated with AD beyond the effects of educational level alone.

METHODS: Participants were drawn from the population-representative Aging, Demographics, and Memory Study (ADAMS, 2000-2002). The ADAMS participants were asked about their performance in school. Possible response options included "above average," "average," or "below average." The ADAMS participants also underwent a full neuropsychological battery, and received a research diagnosis of possible or probable AD.

RESULTS: The 725 participants (mean age, 81.8 years; 59% female; 16% African-American) varied in self-assessed educational performance: 29% reported "above average," 64% reported "average," and 7% reported "below average" school performance. Participants with a lower self-assessed school performance had higher proportions of AD: 11% of participants with "above average" self-assessed performance had AD, as opposed to 12% of participants with "average" performance and 26% of participants with "below average" performance (P < 0.001). After controlling for subjects' years in school, a literacy test score (Wide-Range Achievement Test), age, sex, race/ethnicity, apolipoprotein E-epsilon4 status, socioeconomic status, and self-reported comorbidities, respondents with "below average" self-assessed school performance were four times more likely to have AD compared with those of "average" performance (odds ratio, 4.0; 95% confidence interval, 1.2-14). "Above average" and "average" self-assessed school performance did not increase or decrease the odds of having AD (odds ratio, 0.9; 95% confidence interval, 0.5-1.7).

CONCLUSIONS: We suggest an association between "below average" self-assessed school performance and AD beyond the known association with formal education. Efforts to increase cognitive reserve through better school performance, in addition to increasing the number of years of formal education in early life, may be important in reducing vulnerability throughout the life course.

%B Alzheimers Dement %I 5 %V 5 %P 380-7 %8 2009 Sep %G eng %U http://www.sciencedirect.com/science?_ob=ArticleURLand_udi=B7W6D-4X6VH7W-7and_user=99318and_coverDate=09 2F30 2F2009and_rdoc=1and_fmt=highand_orig=searchand_origin=searchand_sort=dand_docanchor=andview=cand_acct=C000007678and_version=1and_urlVersion=0and_ %N 5 %L newpubs20101112_Mehta.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/19751917?dopt=Abstract %2 PMC2787515 %4 alzheimer disease/cognition Disorders/educational Status/Geriatric Assessment/neuropsychological Tests/risk Factors %$ 23670 %R 10.1016/j.jalz.2009.07.039 %0 Journal Article %J J Am Geriatr Soc %D 2006 %T Functional impairment, race, and family expectations of death. %A Brie A Williams %A Lindquist, Karla %A Sandra Y. Moody-Ayers %A Louise C Walter %A Kenneth E Covinsky %K Activities of Daily Living %K Aged %K Attitude to Death %K Black or African American %K Cross-Sectional Studies %K Disabled Persons %K Family %K Female %K Hispanic or Latino %K Humans %K Male %K White People %X

OBJECTIVES: To assess the effect of functional impairment on family expectations of death and to examine how this association varies by race.

DESIGN: Cross-sectional.

SETTING: Community based.

PARTICIPANTS: Two thousand two hundred thirty-seven family members of decedents from the Health and Retirement Survey (HRS), a national study of persons aged 50 and older.

MEASUREMENTS: Families were interviewed within 2 years of the HRS participant's death. The primary outcome was whether death was expected. The primary predictors were the decedent's functional status (impairment in any activity of daily living (ADL; eating, dressing, transferring, toileting, or bathing) during the last 3 months of life and the decedent's race.

RESULTS: Overall, 58% of families reported that their family member's death was expected. Expecting death was strongly associated with functional impairment; 71% of families of decedents with ADL disability expected death, compared with 24% of those without ADL disability (P < .01). Death was expected more often in families of white decedents (60%) than African Americans (49%) (P < .01), although the effect of ADL disability was similar in both groups. After adjustment for potentially confounding factors, there were still significant associations between expecting death and functional impairment (odds ratio (OR) = 3.58, 95% confidence interval (CI) 2.73-4.70), and families of African Americans expected death less often than families of white decedents (OR = 0.63, 95% CI = 0.46-0.86).

CONCLUSION: Family members of older adults expected death only 58% of the time. Families of functionally impaired older people were more likely to expect death when it occurred than were families of older people who were not functionally impaired, and the expectation of death was lower for families of African Americans than for whites.

%B J Am Geriatr Soc %I 54 %V 54 %P 1682-7 %8 2006 Nov %G eng %N 11 %L newpubs20101112_Willams2.pdf %1 http://www.ncbi.nlm.nih.gov/pubmed/17087694?dopt=Abstract %4 Activities of Daily Living/Minorities/Hispanic/African Americans/functional impairment/expectations/death %$ 23640 %R 10.1111/j.1532-5415.2006.00941.x