Biomedical subjects

J E Lubben

Publications and source records attributed to J E Lubben.

At least 19 recordsLinked to original sources

PubMed2005

Determinants of psychological distress over time among older Korean immigrants and Non-Hispanic White elders: evidence from a two-wave panel study.

The purpose of this study is to examine racial/ethnic differences in the change of psychological distress as measured by CES-D over time and its associated factors between older Korean immigrants and non-Hispanic White elders, based on a social stress perspective. Data come from a two-wave panel survey of 172 older Korean immigrants and 157 non-Hispanic White elders, with a follow-up period of 12 to 15 months. The sample was drawn from a three-stage probability sampling method. Ordinary least square regressions in a hierarchical process and change score method were used to analyze the two-wave panel data. Older Korean immigrants reported higher levels of psychological distress than the non-Hispanic White elderly at both Time 1 and Time 2. Changes in self-assessed health status and functional limitations were significantly associated with change in psychological distress for both ethnic groups. Increased social support significantly decreased psychological distress at Time 2, for older Korean immigrants only. This study discusses practice and policy implications for service and interventions for older immigrants to assist their adjustment to a host society.

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PubMed1998

Awareness and utilization of community long-term care services by elderly Korean and non-Hispanic white Americans.

This article presents a comparative analysis of the level of awareness and utilization of 15 community-based long-term care services by 213 elderly Korean and 201 non-Hispanic White Americans. We found extremely low levels of awareness and utilization of long-term health and social services among Korean Americans, in both absolute and relative terms. This finding challenges the success of the Older Americans Act, an important funding source of those services, in meeting its stated objectives to increase service availability and delivery to minority elders and socioeconomically disadvantaged elders. Strategies for effective outreach and public education efforts are also discussed.

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PubMed1997

Sexual activity and satisfaction among very old adults: results from a community-dwelling Medicare population survey.

This article explores the relationship between sociopsychological factors, sexual activity, and sexual satisfaction in a sample of 1,216 elderly people (mean age = 77.3). Almost 30% had participated in sexual activity in the past month and 67% were satisfied with current level of sexual activity. Men are more likely to be sexually active, but less apt than women to be satisfied with their level of sexual activity. Regarding predictors of sexual activity, for men the strongest predictors were being younger and having more education. For women, the strongest predictor by far was being married. For both men and women the strongest predictors for satisfaction were being sexually active and having positive mental health scores. In summary, the main variables predicting sexual activity were being married, having more education, being younger, being male, and having good social networks. The main predictors for satisfaction with sexual activity were, in addition to being sexually active, being female, having good mental health, and better functional status.

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PubMed1996

Expansion of formalized in-home services for Japan's aged.

This article analyzes the social and political forces in Japan that led to the creation of the Gold Plan, a comprehensive national plan for formalized in-home services for the aged. The political strategies of the Gold Plan are examined from the following perspectives: (1) shifts from institutional to in-home services, (2) decentralization of in-home services policy, and (3) needs for expanding the number of in-home service workers. New nonprofit organizations called Resident-Participation Types (RPTs) are identified, which are self-help organizations to augment the delivery of in-home services to the aged. The current status of these new models for the aged are examined, using data from two different surveys conducted by the Japanese National Council of Social Welfare in 1992 and 1993. Finally, future issues regarding RTPs and in-home services for the aged and some policy recommendations are discussed.

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PubMed1995

Factors affecting self-ratings of oral health.

OBJECTIVES: The purpose of this study is to determine the relationship of self-rated oral health to a comprehensive battery of clinical, sociodemographic, physical health, and mental health measures in a well-elderly urban population. METHODS: Results are based on telephone interviews and clinical assessments of 550 subjects over 65 years of age participating in a Los Angeles-based Medicare project during 1990. Subjects were mostly female, white (89%), with above-average income. RESULTS: Findings show that: (1) the DMF measure is not as strongly related to self-rated oral health as was a single measure of missing teeth; (2) the major predictors of self-rated oral health were "worry about teeth" and "appearance of teeth" followed by total missing teeth, race, education, and depression scores; and (3) self-rated general health is related to self-rated oral health. CONCLUSION: Self-rated oral health may be, for older adults, a better measure of "health" than of "morbidity".

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PubMed1995

Screening for depression among a well elderly population.

This article describes a geriatric wellness program in which social work practitioners played a major role. The focus of this article is twofold: to examine the use of a telephone screening test for depression among a well elderly population and to compare the results of that screening with the clinical judgment of social workers. Overall findings indicated that a telephone screening instrument incorporating the Rand Mental Health Inventory and the Center for Epidemiological Studies Depression Scale was an efficient tool for assessing a population with a higher rate of major depression. Furthermore, the social workers identified many previously undetected cases of major depression, and a majority of people referred for treatment completed those referrals.

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PubMed1994

The physical, mental, and social health status of older Chinese: a cross-national study.

This article reports data on 16 indicators of the physical, mental, and social health status of older Chinese living in Beijing, Guangzhou, and Los Angeles. Both the frequency distributions of these indicators and their factor structures are different among the three cities. These differences may have implications for the planning of public health services. Either they are the result of differences in the way in which people in each of these cities think about illness or they are the result of differential experiences with disease. Although these data cannot resolve this issue, both the frequency distributions and the severity ratings for nine chronic diseases also differed markedly among the three cities.

Activities of Daily Living↗

PubMed1993

The relationship between dental utilization and preventive participation among a well-elderly sample.

Previous studies have shown that dental utilization by older people is lower than for the general population. This study hypothesizes that an elder's tendency toward participating in preventive health activities may be an important factor in explaining the likelihood of accessing the dentist. Subjects included 1,911 older individuals who enrolled in the UCLA Medicare Screening and Health Promotion Trial. All were interviewed about their utilization of preventive health services and participation in preventive behaviors. A recent dental visit was positively associated with all sociodemographic variables examined except age and sex. It was also related to health status questions and utilization of the preventive health services and health behaviors studied. Logistic regression analysis showed that both summary preventive health behavior and preventive service utilization variables were important factors in explaining a recent dental visit (model chi-square = 221.4, P = .001) along with income, not having a removable prosthesis, and perceiving the need for dental care. This study showed that dental utilization is related to older people's participation in other preventive activities. When in contact with older people, health care professionals should consider current oral and general preventive health status and encourage appropriate referral for preventive activities.

Age Factors↗

PubMed1993

Comparison of oral health ratings by dentists and dentate elders.

Previous studies suggest a discrepancy between the way dentists and patients measure oral health. The purpose of this study was to determine the relationship between a dentist's rating of an older dentate person's oral health and the patient self-rating using a single-item indicator, and to compare the clinical (i.e., number of teeth, caries, etc.) and subjective (problems with function, pain, etc.) factors that influence the rating. The study sample consisted of 776 older dentate people. Results showed that dentists judged subjects' oral health significantly more positively than the self-ratings. Approximately 30 percent of the elders rated their oral health identically to the dentist and half rated their oral health lower than the dentist. Bivariate comparisons showed that similar clinical and subjective variables were associated with the dentist and patient ratings. Multiple regression findings, however, highlighted differences in the factors that influenced the ratings. In addition, the proportion of variance accounted for by the clinical factors as opposed to the subjective factors was greater for the dentist rating (R2 = .28 of .33) than the subject self-rating (R2 = .18 of .43).

Age Factors↗

PubMed1993

Benzodiazepine use in older, community-dwelling southern Californians: prevalence and clinical correlates.

OBJECTIVE: To determine the use of benzodiazepines (BZDs) in an older, community-dwelling sample and to examine the sociodemographic and clinical correlates of BZD use. DESIGN: A cross-sectional study of 1752 elderly people (aged > or = 65 y) who completed a mailed medication survey and a telephone health status survey. PARTICIPANTS: Participants were invited to participate in a large Medicare demonstration project on prevention by their private physicians, who were also enrolled in the larger study. Participants had to be English-speaking, could not have dementia or a terminal illness, and had to give informed consent to participate in the study. MAIN OUTCOME MEASURES: Sociodemographic and health status variables that predicted BZD use were examined. Sociodemographic variables included age, gender, ethnicity, education, and income. Health status variables included functional status, with measures of mental, social, and physical health. Influenza immunization status was used as an indicator for preventive health services use and self-reported chronic illness was used as a measure of comorbidity. RESULTS: Twenty percent of the participants used BZDs at least twice in the past year. We found that those who used BZDs were more than twice as likely to take ten or more drugs, two-and-a-half times more likely to have difficulty falling asleep, and over twice as likely to be depressed. BZD users were also more likely to be white, to have a college education, and to have received a recent influenza shot, but were not more likely to be women when controlled for health status. CONCLUSIONS: Further clinical research should explore the relationship between BZD use among older patients and the BZD-associated adverse clinical factors we observed, as well as the association between multiple drug use and potential adverse outcomes in older BZD users.

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PubMed1992

Patient-related predictors of rehabilitation use for community-dwelling older Americans.

OBJECTIVE: To determine patient factors that predict use of physical or occupational therapy (PT/OT) services by elderly people. DESIGN: Time-series study of the relationship of PT/OT use to a variety of characteristics present at baseline. PARTICIPANTS: Eight-hundred nine community-dwelling men and women aged 65 and older. SETTING: The Medicare Screening and Health Promotion Trial at UCLA. MAIN OUTCOME MEASURES: Use of PT/OT services, as reported in a telephone survey 1 year after initial information was obtained on the same subjects by the baseline telephonic survey. RESULTS: Fifteen percent of the sample used PT/OT within 12 months of baseline. In multiple logistic regression analysis, PT/OT use was significantly less frequent among racial minorities, less well educated groups, and the oldest age group. PT/OT use was higher among those who had both functional disability and the presence of arthritis, heart or lung disease, or a prior history of stroke. However, neither functional disability alone nor the presence of arthritis, cardiovascular or lung disease, in the absence of limited functioning, was associated with PT/OT use. Patients who had obtained a pneumococcal vaccination or used transportation services were also more likely to receive PT/OT. CONCLUSIONS: Our findings suggest that there may be important sociodemographic inequalities in the use of rehabilitation services and raise the possibility of inappropriate underuse in certain subgroups. Additional studies are needed to determine whether similar inequalities of PT/OT use are found in other populations and whether rehabilitation is effective in various subgroups.

Activities of Daily Living↗

PubMed1992

Norms and alcohol consumption: Japanese in Japan, Hawaii and California.

The study compared age/sex norms and alcohol consumption of a sample of Japanese from Japan and Japanese Americans in Hawaii and California. Age norms included acceptable drinking levels for the following age groups: 16, 21, 40 and 60, both male and female. There were significant differences in norms across the sites with the Japanese in Japan holding the most tolerant views of heavier drinking for men, followed by California and Hawaii. The Japanese-American samples were more tolerant of female drinking than were the Japanese. There was a high degree of similarity between Hawaii and California, whereas Japanese respondents in Japan differed in their responses. A correlation between drinking and norms by site indicated a high degree of congruence between drinking and more tolerant norms for drinking in all of the samples: Those who drank the most also had the most permissive norms toward drinking. The differences in norms between Japanese in Japan and Japanese Americans were explained in terms of enculturation and acculturation.

Acculturation↗

PubMed1991

Cognitive impairment and hospital use.

BACKGROUND: An increasing number of older people are at higher risk of developing Alzheimer's Disease or another dementias. The resultant cognitive impairment has been well identified as one of the risk factors for nursing home placement but it has not been well studied as a risk for hospitalization. METHODS: To study the association between cognitive impairment and hospital use, this study examined data from a randomly selected cohort of community dwelling California elderly (California Senior Survey). The cohort was followed for one year (N = 940). RESULTS: Only about 17 percent of the study population was in the mildly or moderately/severe impaired category. Those participants with cognitive impairment were almost twice as likely as those without any impairment to be hospitalized and to be hospitalized for six days or more. CONCLUSIONS: Although the cause of the cognitive impairment and hospitalization was not determined in this study, the data support the importance of cognitive impairment as a risk factor for hospital use even after controlling for age, ADL, IADL, and prior hospitalizations. The causes for this need to be further examined so the burden of such care can be reduced.

Activities of Daily Living↗

PubMed1989

Gender and ethnic differences in the health practices of the elderly poor.

Gender and ethnic differences in personal health practices were examined with a sample of 1021 Medicaid recipients aged 65 years and older. Six different health practices were examined including smoking, drinking, weight control, exercise, and social networks. Although gender differences were noted with respect to all of the health practices examined, neither men nor women were consistently favored in adhering to desired health practices. Perhaps most importantly, women were more apt than men to refrain from smoking and drinking which have been strongly linked to major health consequences. Ethnicity was also a factor in all of the health practices examined. Whereas Hispanic and Black elderly were very similar to White elderly, Asian elderly generally adhered to more desired health practices than did either Whites, Blacks, or Hispanics. The implications of these findings could benefit health promotion programs for the elderly.

Black or African American↗

PubMed1989

Differential health screening of the well elderly by gender and age; appropriate care or bias?

We use data from a random sample of 5,454 elderly participants in the California Preventive Health Care for the Aging Program to identify gender and age differences in health screening practices. We present a framework to facilitate an evaluation of current targeting of services by gender and age. This framework clarifies where targeting based on age and gender is appropriate or inappropriate and where more or less targeting might be needed. With use of this framework, some inappropriate age bias is indicated. The oldest-old often receive less health screening than their younger counterparts. Gender-based targeting is less frequent and is usually appropriate when it occurs. We discuss implications for practice and future program evaluations.

Age Factors↗

PubMed1989

The relative influence of selected social factors on Korean drinking behavior in Los Angeles.

The purpose of this study was twofold: to identify characteristics distinguishing Korean-American drinkers from abstainers and to clarify differences between those who drink smaller versus larger amounts of alcohol. A random sample of 280 Korean adults was interviewed using a schedule based on Cahalan's national study of drinking behavior and attitudes. Approximately 58% of the sample were abstainers while only about 14% were heavy drinkers. Logistic regression was used to determine the relative influence of various social factors on drinking behavior. The logistic model identified five characteristics which differentiated abstainers from drinkers: gender (male), college education, parental opposition, playing indoor games (e.g., cards) and going to bars, and/or nightclubs. A second logistic model clarified the influence of similar characteristics on the level of drinking. Males and those who went to bars and/or nightclubs were most apt to be heavy drinkers whereas participants in sports and Protestants were aligned with more moderate drinking.

Acculturation↗

PubMed1989

Differences in drinking behavior among three Asian-American groups.

This article challenges the commonly held beliefs that there are few if any heavy drinkers among Asian-Americans and that different groups of Asians exhibit similar patterns of drinking. To explore these stereotypes, alcohol consumption patterns were compared in a survey of 298 Chinese, 295 Japanese and 280 Koreans in Los Angeles. Heavy drinking was found in each of the Asian groups. Gender specific logistic regression models were used to illustrate the differences in the drinking patterns of the Asian-American groups and to clarify the determinants of drinking. The greatest proportion of heavy drinking was found among the Japanese and the lowest among the Chinese. Having friends who drank was the only social factor consistently related to Asian drinking behavior.

Adult↗

PubMed1989

Health practices of the elderly poor.

The purpose of the present study was to describe the health practices of the elderly poor and to examine the association between specific health practices and subsequent hospital use. Data came from a sample of 931 Medicaid elderly living in California. Smoking, limited social networks, and lack of regular exercise significantly increased the odds of subsequent hospital utilization. Implications of these findings, which could benefit health promotion intervention and treatment programs for the elderly, were discussed.

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