TY - JOUR T1 - Chronic disease burden predicts food insecurity among older adults. JF - Public Health Nutrition Y1 - 2018 A1 - Jih, Jane A1 - Stijacic-Cenzer, Irena A1 - Hilary K Seligman A1 - W John Boscardin A1 - Thu T Nguyen A1 - Christine S Ritchie KW - Chronic conditions KW - Comorbidity KW - Food insecurity AB -

OBJECTIVE: Increased out-of-pocket health-care expenditures may exert budget pressure on low-income households that leads to food insecurity. The objective of the present study was to examine whether older adults with higher chronic disease burden are at increased risk of food insecurity.

DESIGN: Secondary analysis of the 2013 Health and Retirement Study (HRS) Health Care and Nutrition Study (HCNS) linked to the 2012 nationally representative HRS.

SETTING: USA.

SUBJECTS: Respondents of the 2013 HRS HCNS with household incomes <300 % of the federal poverty line (n 3552). Chronic disease burden was categorized by number of concurrent chronic conditions (0-1, 2-4, ≥5 conditions), with multiple chronic conditions (MCC) defined as ≥2 conditions.

RESULTS: The prevalence of food insecurity was 27·8 %. Compared with those having 0-1 conditions, respondents with MCC were significantly more likely to report food insecurity, with the adjusted odds ratio for those with 2-4 conditions being 2·12 (95 % CI 1·45, 3·09) and for those with ≥5 conditions being 3·64 (95 % CI 2·47, 5·37).

CONCLUSIONS: A heavy chronic disease burden likely exerts substantial pressure on the household budgets of older adults, creating an increased risk for food insecurity. Given the high prevalence of food insecurity among older adults, screening those with MCC for food insecurity in the clinical setting may be warranted in order to refer to community food resources.

VL - 21 IS - 9 U1 - http://www.ncbi.nlm.nih.gov/pubmed/29388533?dopt=Abstract ER - TY - JOUR T1 - Older adults in jail: high rates and early onset of geriatric conditions. JF - Health Justice Y1 - 2018 A1 - Greene, Meredith A1 - Cyrus Ahalt A1 - Stijacic-Cenzer, Irena A1 - Metzger, Lia A1 - Brie A Williams KW - Criminal justice KW - Health Conditions and Status KW - Public Health AB -

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.

VL - 6 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/29455436?dopt=Abstract ER - TY - JOUR T1 - Desire for predictive testing for Alzheimer's disease and impact on advance care planning: a cross-sectional study. JF - Alzheimers Res Ther Y1 - 2016 A1 - Sheffrin, Meera A1 - Stijacic-Cenzer, Irena A1 - Michael A Steinman KW - Advance care planning KW - Aged KW - Aged, 80 and over KW - Alzheimer disease KW - Cross-Sectional Studies KW - Female KW - Health Knowledge, Attitudes, Practice KW - Humans KW - Male KW - Patient Acceptance of Health Care AB -

BACKGROUND: It is unknown whether older adults in the United States would be willing to take a test predictive of future Alzheimer's disease, or whether testing would change behavior. Using a nationally representative sample, we explored who would take a free and definitive test predictive of Alzheimer's disease, and examined how using such a test may impact advance care planning.

METHODS: A cross-sectional study within the 2012 Health and Retirement Study of adults aged 65 years or older asked questions about a test predictive of Alzheimer's disease (N = 874). Subjects were asked whether they would want to take a hypothetical free and definitive test predictive of future Alzheimer's disease. Then, imagining they knew they would develop Alzheimer's disease, subjects rated the chance of completing advance care planning activities from 0 to 100. We classified a score > 50 as being likely to complete that activity. We evaluated characteristics associated with willingness to take a test for Alzheimer's disease, and how such a test would impact completing an advance directive and discussing health plans with loved ones.

RESULTS: Overall, 75% (N = 648) of the sample would take a free and definitive test predictive of Alzheimer's disease. Older adults willing to take the test had similar race and educational levels to those who would not, but were more likely to be ≤75 years old (odds ratio 0.71 (95% CI 0.53-0.94)). Imagining they knew they would develop Alzheimer's, 81% would be likely to complete an advance directive, although only 15% had done so already.

CONCLUSIONS: In this nationally representative sample, 75% of older adults would take a free and definitive test predictive of Alzheimer's disease. Many participants expressed intent to increase activities of advance care planning with this knowledge. This confirms high public interest in predictive testing for Alzheimer's disease and suggests this may be an opportunity to engage patients in advance care planning discussions.

VL - 8 UR - http://alzres.biomedcentral.com/articles/10.1186/s13195-016-0223-9http://link.springer.com/content/pdf/10.1186/s13195-016-0223-9.pdf IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/27955707?dopt=Abstract JO - Alz Res Therapy ER - TY - JOUR T1 - Predicting 10-year mortality for older adults. JF - JAMA Y1 - 2013 A1 - Cruz, Marisa A1 - Kenneth E Covinsky A1 - Eric W Widera A1 - Stijacic-Cenzer, Irena A1 - Sei J. Lee KW - Aged KW - Aged, 80 and over KW - Cohort Studies KW - Female KW - Forecasting KW - Humans KW - Kaplan-Meier Estimate KW - Life Expectancy KW - Male KW - Middle Aged KW - Mortality KW - Risk Assessment KW - United States PB - 309 VL - 309 IS - 9 U1 - http://www.ncbi.nlm.nih.gov/pubmed/23462780?dopt=Abstract U2 - PMC3760279 U4 - mortality/cancer screening/Diabetes/glycemic control/glycemic control/preventive interventions ER -