Biomedical subjects

Mary Beth Ofstedal

Publications and source records attributed to Mary Beth Ofstedal.

10 recordsLinked to original sources

PubMed2007

Patterns and associations of body weight among older adults in two Asian societies.

Body weight has important health implications across the lifespan. Most recent attention has focused on the obesity epidemic that is occurring in many parts of the world. However, underweight is also a concern, particularly in less developed countries. For most health outcomes there is a curvilinear association with body weight, with underweight and overweight (compared to normal weight) being associated with a higher prevalence of chronic debilitating and life-threatening conditions and ultimately mortality. This paper uses data from two nationally-representative surveys of older adults (aged 60 and older) in the Philippines (1996) and Taiwan (1999) to assess the prevalence of underweight and overweight and examine associations between body weight and demographic, socioeconomic, and health characteristics in these populations. Older Filipinos have a modest prevalence of underweight (29.9%) and low prevalence of overweight (12.2%), whereas the reverse is observed in Taiwan (6.4 and 29.3%, respectively). Results show generally expected associations between body weight and demographic characteristics, health conditions and behaviors. We find little evidence of socioeconomic differences in body weight, except in the Philippines where higher SES is associated with a lower risk of being underweight. Implications of the results are discussed in terms of healthy weight maintenance among critical subgroups to potentially reduce the prevalence of disease and improve quality of life.

Age Factors↗

PubMed2005

The Aging, Demographics, and Memory Study: study design and methods.

OBJECTIVE: We describe the design and methods of the Aging, Demographics, and Memory Study (ADAMS), a new national study that will provide data on the antecedents, prevalence, outcomes, and costs of dementia and "cognitive impairment, not demented" (CIND) using a unique study design based on the nationally representative Health and Retirement Study (HRS). We also illustrate potential uses of the ADAMS data and provide information to interested researchers on obtaining ADAMS and HRS data. METHODS: The ADAMS is the first population-based study of dementia in the United States to include subjects from all regions of the country, while at the same time using a single standardized diagnostic protocol in a community-based sample. A sample of 856 individuals age 70 or older who were participants in the ongoing HRS received an extensive in-home clinical and neuropsychological assessment to determine a diagnosis of normal, CIND, or dementia. Within the CIND and dementia categories, subcategories (e.g. Alzheimer's disease, vascular dementia) were assigned to denote the etiology of cognitive impairment. CONCLUSION: Linking the ADAMS dementia clinical assessment data to the wealth of available longitudinal HRS data on health, health care utilization, informal care, and economic resources and behavior, will provide a unique opportunity to study the onset of CIND and dementia in a nationally representative population-based sample, as well as the risk factors, prevalence, outcomes, and costs of CIND and dementia.

Aging↗

PubMed2005

The effect of diabetes on disability in middle-aged and older adults.

BACKGROUND: Physical disability is increasingly recognized as an adverse health consequence of type 2 diabetes in older adults. We studied the effect of diabetes on disability in middle-aged and older adults to: 1) characterize the association of diabetes with physical disability in middle-aged adults, and 2) determine the extent to which the effect of diabetes is explained by related covariates in either or both age groups. METHODS: We used data from two parallel national panel studies of middle-aged and older adults to study the effect of self-reported diabetes at baseline on disability 2 years later, adjusting for baseline covariates. RESULTS: Diabetes was strongly associated with subsequent physical disability (measured by a composite variable combining activities of daily living, mobility, and strength tasks) in middle-aged and older adults. Controlling for socioeconomic characteristics and common diabetes-related and unrelated comorbidities and conditions reduced the diabetes effect substantially, but it remained a significant predictor of disability in both groups. CONCLUSIONS: Our analyses demonstrated that disability is an important diabetes-related health outcome in middle-aged and older adults that should be prevented or mitigated through appropriate diabetes management.

Activities of Daily Living↗

PubMed2005

Health and living arrangements among older Americans: does marriage matter?

OBJECTIVE: This research examines how physical and mental health influence living arrangements among older Americans and whether these effects differ for married and unmarried persons. METHODS: Data came from the Asset and Health Dynamics Among the Oldest Old study. These two intervals were pooled, and hierarchical multinomial logistic regressions were used to analyze pooled time lags. RESULTS: Functional status and cognitive functioning are significantly associated with living arrangements among those not married. Health conditions exert no significant effects among those married. Given the same functional status, unmarried elders are significantly more likely than their married counterparts to reside with their children or with others. DISCUSSION: These results underscore the critical role of the spouse in influencing living arrangements, providing new evidence supporting the assertion that a spouse is the greatest guarantee of support in old age and the importance of the marriage institution.

Adult Children↗

PubMed2004

Gender differences in economic support and well-being of older Asians.

This report provides a comprehensive analysis of gender differences in economic support and well-being in eight countries in Southern and Eastern Asia (Bangladesh, Malaysia, Indonesia, Singapore, Thailand, Vietnam, Philippines, and Taiwan). We examine multiple economic indicators, including sources of income, receipt of financial and material support, income levels, ownership of assets, and subjective well-being. Results show substantial variation in gender differences across indicators and provide an important qualification to widely held views concerning the globally disadvantaged position of older women. Whereas men tend to report higher levels of income than women, there is generally little gender difference in housing characteristics, asset ownership, or reports of subjective economic well-being. Unmarried women are economically advantaged compared to unmarried men in some respects, in part because they are more likely to be embedded in multigenerational households and receive both direct and indirect forms of support from family members.

Aged↗

PubMed2003

Functional status and health outcomes in older americans with diabetes mellitus.

OBJECTIVES: To determine how baseline functional status affects health outcomes in older adults with diabetes mellitus (DM). DESIGN: Nationally representative cross-sectional and longitudinal health interview survey. SETTING: Waves I (1993) and II (1995) of the Assets and Health Dynamics of the Oldest Old Survey (AHEAD) in the United States. PARTICIPANTS: AHEAD respondents aged 70 and older (n = 7,447, including 995 with DM). MEASUREMENTS: At baseline, the entire sample was divided into three groups: high-functioning group, defined as having no physical limitations or instrumental activities of daily living/activities of daily living (IADL/ADL) disabilities (39%); low-functioning group, having three or more limitations or IADL/ADL disabilities (24%); and intermediate-functioning group, those in the middle (36%). Older adults with and without DM, within each of the functioning groups, were compared at 2-year follow-up with respect to demographic characteristics, weight/body mass index, baseline and incident chronic diseases and conditions, and follow-up functioning. RESULTS: Of people aged 70 and older, 28% with DM and 41% without were high functioning; 38% with DM and 22% without were low functioning (both P <.001). High-functioning people with DM remained high functioning at 2 years but had a significantly higher incidence of heart disease and mortality than high-functioning people without DM. Low-functioning people with DM were significantly more likely to have vascular comorbidities at baseline than low-functioning people without DM, but their 2-year outcomes were similar. The intermediate-functioning group showed the most differences between those with and without DM; those with DM were significantly (P <.01) more likely to have baseline vascular disease, low cognitive performance, increased incident vascular disease, and significantly worse 2-year functioning and to have experienced falls (P <.001). CONCLUSION: Differences in baseline functional status in older adults with DM were associated with outcome differences. High-functioning older people with DM tended to remain high functioning but demonstrated significantly higher incidence of heart disease and mortality than those without DM, whereas low-functioning people with and without DM had similar outcomes. However, intermediate-functioning older diabetics had worse health and functioning outcomes than a similarly impaired group without DM. DM management adjusted to functional status can potentially address the most-relevant outcomes in the heterogeneous older population with DM.

Aged↗

PubMed2003

Trends in scores on tests of cognitive ability in the elderly U.S. population, 1993-2000.

OBJECTIVE: This study investigates cohort differences in cognitive functioning among Americans aged 70 or older in 1993, 1995, 1998, and 2000. METHODS: The study draws on self-respondent data from four waves of the Asset and Health Dynamics Among the Oldest Old Study and the Health and Retirement Study surveys collected between 1993 and 2000. Cognitive performance scores for each of four components (immediate recall, delayed recall, serial 7s, and mental status) and their sum are compared across cohorts, unadjusted and with adjustments for survey design features and demographic characteristics. RESULTS: Unadjusted scores suggest cohort improvements in several components of cognitive functioning between 1993 and 1998, and little change between 1998 and 2000. However, these improvements largely disappear after confounding features of the survey design (changes in age distribution of the sample across waves and prior exposure to the cognitive tests) and changes in the demographic composition of the sample (race, ethnicity, and gender) are adjusted for. DISCUSSION: There appears to have been little improvement of cognitive functioning across recent cohorts of older Americans. However, the study points out the complexities of using panel data to study cohort differences, particularly when the measures of interest are likely influenced by prior wave participation. Future studies based on other data sources are needed.

Aged↗

PubMed2003

Additive and interactive effects of comorbid physical and mental conditions on functional health.

OBJECTIVE: To understand the role of cognitive impairment and depressive symptoms on functional outcomes of stroke and diabetes. Evaluation approaches to functional outcomes have rarely focused on the presence of specific comorbidities, particularly those involving mental health disorders. METHODS: Data are from the AHEAD cohort of the Health and Retirement Study (HRS), a nationally representative panel of persons 70+ years of age in 1993. Analyses are limited to 5,646 self-respondents for whom functional outcome data are available in 1995. Additive and interactive multiple regression models are compared for each outcome and focal condition combination. RESULTS: The additive model is sufficient for the majority of outcome and focal condition combinations. The interaction term is significant in 4 of 12 comparisons. DISCUSSION: Stroke, diabetes, cognitive impairment, and depressive symptoms exhibit strong independent effects on physical functioning. Support for the hypothesis that cognitive impairment and depression exacerbate the impact of stroke and diabetes is more limited.

Activities of Daily Living↗

PubMed2002

Social engagement and its relationship to health.

Older age is a time of life when major life tasks such as work and raising children have typically been completed. As a consequence, the daily demands for involvement in their social environment have lessened for older adults. It is believed that, because of their many possible benefits, social activities ultimately promote physical and mental health in older age. These propositions have captured the imagination of gerontologists and geriatricians for decades. Surprisingly, the body of relevant research is not plentiful. In this article we selectively review the theory and empirical support surrounding social engagement and its health consequences in older age.

Aged↗

PubMed2002

Low cognitive performance, comorbid disease, and task-specific disability: findings from a nationally representative survey.

BACKGROUND: This research evaluated the association of low cognitive performance with both chronic diseases and conditions, and with difficulties in a broad array of task-specific functioning and disability measures in older adults living in the community. METHODS: Data were from the first wave of the Assets and Health Dynamics Among the Oldest-Old Study, a national panel survey of individuals age 70 and older (n = 6600 age-eligible self-respondents). Low cognitive performance (LCP) was defined as scores in the lowest (poorest performing) 25th percentile of a cognitive performance scale. The associations of LCP with prevalent chronic diseases and conditions and with limitations in 14 tasks (strength and mobility, instrumental activities of daily living, and activities of daily living) were evaluated. Associations of LCP and task limitations were adjusted for potential modifiers and confounders, including demographic characteristics (age, gender, race), educational attainment, chronic diseases, depressive symptoms, and sensory impairments. Data were weighted to account for complex sample design and nonresponse. RESULTS: More than one third of people with LCP had three or more coexisting diseases and conditions. The unadjusted associations of LCP with task functioning were attenuated after covariate adjustment, but even after adjustment, LCP remained significantly and independently associated with functioning problems in 9 of 14 tasks (borderline with four more), including mobility tasks. CONCLUSIONS: Low cognitive performance, regardless of its relationship to clinical dementia, coexists with multiple chronic diseases and conditions. It is independently associated with a broad array of functioning difficulties, even after controlling for demographic characteristics, educational attainment, and chronic conditions. Chronic diseases and conditions, however, attenuate the relationship between LCP and some task difficulties. LCP should be considered an important comorbid condition associated with both chronic diseases and disability that substantially increases the health burden of many older adults who are poorly equipped to handle it.

Activities of Daily Living↗