Public Health Commons^™

Characterizing Multimorbidity Prevalence And Adverse Outcomes In Ethnically And Culturally Diverse Sub-Populations In India: Gaps, Opportunities, And Future Directions, Preeti Zanwar, Robyn Taylor, Tanisha Hill-Jarrett, Elena Tsoy, Jason Flatt, Zunera Mirza, Carl Hill, Arokiasamy Perianayagam

College of Population Health Faculty Papers

India is a large middle-income country and has surpassed China in overall population, comprising 20% of the global population (over 1.43 billion people). India is experiencing a major demographic shift in its aging population. Chronic diseases are common among older adults and can be persistent over the life course, lead to the onset of disability, and be costly. Among older adults in India, the existence of multiple comorbid chronic conditions (i.e., multimorbidity) is rapidly growing and represents a burgeoning public health burden. Prior research identified greater rates of multimorbidity (e.g., overweight/obesity diabetes, hypertension, cardiovascular disease, stroke, and malignancies) in minority …

Reimagining A Caregiver-Friendly Society, Jodi L. Southerland

Journal of Appalachian Health

Demographic aging is accelerating in the Appalachian Region, resulting in a growing proportion of caregivers living in areas that lack services to support their needs. Strategies are urgently needed in Appalachia to address deficiencies in the region’s long-term supports and services for older adults and their caregivers. Strengthening equitable access to care and community supports for family caregivers is a policy priority for state and community leaders in Appalachia.

Environmental Exposures And Aging., Daniel Chris Gomes

Electronic Theses and Dissertations

In recent years, research into air pollution has shown that exposure to certain components in air pollution, primarily PM2.5 can accelerate biological aging and thereby lead to increased susceptibility to multiple diseases. We hypothesize that prolonged exposure to air pollutants can result in premature aging leading to extensive tissue dysfunction and susceptibility to diseases. To examine this, we exposed mice to PM2.5 for 9, 15, and 21 days, then measured the telomere lengths, cellular senescence, and histone methylation patterns of multiple cell types. We found consistently increased telomere attrition, cellular senescence and advanced age-consistent histone methylation patterns in groups exposed …

Depression By Gender And Associated Factors Among Older Adults In India: Implications For Age-Friendly Policies, Ronak Paul, T. Muhammad, Rashmi Rashmi, Palak Sharma, Shobhit Srivastava, Preeti Zanwar

College of Population Health Faculty Papers

Inspite of implementing policies to control mental health problems, depression remains a severe health concern among older adults in India. We examined self-reported differences in the depression among older men and women in India and examined associated factors for gender differences in depression at the population level. We utilized nationally representative data from the Longitudinal Aging Study in India (LASI) wave I, for years 2017-2019. Our analytical sample comprised of 30,637 older adults ages 60 years and above (14,682 men and 15,655 women). We conducted descriptive statistics and Chi-Square tests followed by binary logistic regression and multivariate decomposition analyses to …

Longitudinal Associations Between Cognitive Functioning And Depressive Symptoms Among Couples In The Mexican Health And Aging Study, Joan K Monin, Gail Mcavay, Katie Newkirk, Rafael Samper-Ternent

Journal Articles

OBJECTIVE: To examine the bidirectional associations between older adult spouses' cognitive functioning and depressive symptoms over time and replicate previous findings from the United States (US) in Mexico.

DESIGN: Longitudinal, dyadic path analysis with the actor-partner interdependence model.

SETTING: Data were from the three most recent interview waves (2012, 2015, and 2018) of the Mexican Health and Aging Study (MHAS), a longitudinal national study of adults aged 50+ years in Mexico.

PARTICIPANTS: Husbands and wives from 905 community-dwelling married couples (N = 1,810).

MEASUREMENTS: The MHAS cognitive battery measured cognitive function. Depressive symptoms were assessed using a modified nine-item Center …

The Impact Of Access To Oral Health Care On Inadequate Oral Health And Multimorbidity, Luis Limo

Electronic Thesis and Dissertation Repository

The connection between oral health and other non-communicable chronic conditions—commonly referred in the dental literature as the oral-systemic health connection—emphasizes the role of oral health care on both oral diseases and chronic conditions, particularly in vulnerable populations like the elderly. This thesis comprises 2 studies: the first is a systematic review on the impact of oral health care interventions, as an indicator of access to oral health care, on chronic conditions of which their co-existence would result in multimorbidity; the second study is a cross-sectional investigation of the associations between oral health, access to oral health care, and multimorbidity among …

Abstracts From The 2023 Health Care Systems Research Network (Hcsrn) Annual Conference, Denver, Colorado

Journal of Patient-Centered Research and Reviews

The Health Care Systems Research Network (HCSRN) is comprised of 20 learning health systems with embedded population-based research units. The network’s annual conference serves as a forum for research teams from member institutions to disseminate project findings, explore scientific collaborations, and share insights about conducting research in real-world care delivery settings. Abstracts presented at HCSRN 2023 are published in this issue supplement of Journal of Patient-Centered Research and Reviews, the journal of record for HCSRN’s annual conference proceedings.

Shared Care Networks Assisting Older Adults: New Insights From The National Health And Aging Trends Study, Mengyao Hu, Vicki A Freedman, Sarah E Patterson, Nora Lewis

Journal Articles

BACKGROUND AND OBJECTIVES: Caregiving research often assumes older adults receiving care have a primary caregiver who provides the bulk of care. Consequently, little is known about the extent to which care responsibilities are shared more evenly within a care network, the characteristics associated with sharing, or the consequences for meeting older adults' care needs.

RESEARCH DESIGN AND METHODS: We analyze a sample of U.S. older adults receiving care from the 2011 National Health and Aging Trends Study (n = 2,398). Based on variables reflecting differences in care hours, activities, and care provided by the whole network, we create network typologies …

Assessing The Correlation Between The Socioeconomic Level And Cognitive Function Among Older Adults In Egypt, Macy Abougabal

Theses and Dissertations

The number of older adults is increasing worldwide at an unprecedented rate. Some countries began to understand the challenges of aging, while others are still at the stage of comprehending the true dimensions of the situation. There is a global focus on aging research to appropriately mitigate the negative impact of aging and cognitive decline. Not only that dementia add economic pressure on governments, it also increase the psychological and physical burden of the caregivers. Scholars have previously studied socioeconomic level in three variables, namely work, education, and income, and their relationship with cognitive function. It was concluded that the …

Oral Health Considerations For Aging Patients Living With Hiv/Aids, Madeleine Daily Dds, Susan Liu Dds, Yuna Park Dds, Mph, Ms, Emily Byington Msw, Ivette Estrada Ma, Mphil, Sunil Wadhwa Dds, Carol Kunzel Phd

The New York State Dental Journal

People living with HIV/AIDS (PLWH) have an increased life expectancy due to advances in antiretroviral therapy. In 1996, the life expectancy for a 20-year old living with HIV was 39-years old; today, it is >70-years old. As life expectancy increases, PLWH are burdened with age-associated comorbidities. This paper reviews the interaction between aging and HIV and how it affects social, physical, and oral health issues. The shift in demographics presents new challenges for clinicians in how to identify, address, and manage these complex manifestations. This review summarizes how to approach HIV-related changes when providing care as a dental clinician.

Drivesafe Driveaware: A Systematic Review, Erin Vito, Anna Barkla, Linda Coventry

Research outputs 2022 to 2026

Objectives: Driving is an activity of daily living that significantly affects independence, and driving cessation is associated with poor health, lower quality of life, cognitive decline and early entry into care facilities. There is no consensus regarding the best off-road tool to assess driving safety. Therefore, this review explored the diagnostic accuracy, reliability and clinical utility of DriveSafe DriveAware (DSDA) compared with an on-road driving assessment. Methods: This review adhered to the PRISMA guidelines. Electronic databases for all English language articles published prior to December 2021 were searched. Studies were assessed for methodological quality and results were synthesised using a …

Neighborhood Factors, Cardiovascular Illness, Mental Health, And Aging In The United States, Brenda Billings

Walden Dissertations and Doctoral Studies

The inability to age in place among people 65 years old and older is a public health problem in the United States. However, it is unknown what neighborhood factors (i.e., trust, safety, shared values) impact the communities that are struggling to support individuals looking to stay in their homes as they age. The purpose of this quantitative correlational study was to examine the relationship between neighborhood factors (i.e., trust, safety, and shared values), cardiovascular illness (i.e., heart attack and stroke), mental health (i.e., depression), and aging in place, controlling for sex, age, marital status, educational level, employment status, and race. …

Neighborhood Factors, Cardiovascular Illness, Mental Health, And Aging In The United States, Brenda Billings

Walden Dissertations and Doctoral Studies

The inability to age in place among people 65 years old and older is a public health problem in the United States. However, it is unknown what neighborhood factors (i.e., trust, safety, shared values) impact the communities that are struggling to support individuals looking to stay in their homes as they age. The purpose of this quantitative correlational study was to examine the relationship between neighborhood factors (i.e., trust, safety, and shared values), cardiovascular illness (i.e., heart attack and stroke), mental health (i.e., depression), and aging in place, controlling for sex, age, marital status, educational level, employment status, and race. …

Epigenomic And Other Evidence For Cannabis-Induced Aging Contextualized In A Synthetic Epidemiologic Overview Of Cannabinoid-Related Teratogenesis And Cannabinoid-Related Carcinogenesis, Albert Stuart Reece, Gary Kenneth Hulse

Research outputs 2022 to 2026

Background: Twelve separate streams of empirical data make a strong case for cannabis-induced accelerated aging including hormonal, mitochondriopathic, cardiovascular, hepatotoxic, immunological, genotoxic, epigenotoxic, disruption of chromosomal physiology, congenital anomalies, cancers including inheritable tumorigenesis, telomerase inhibition and elevated mortality. Methods: Results from a recently published longitudinal epigenomic screen were analyzed with regard to the results of recent large epidemiological studies of the causal impacts of cannabis. We also integrate theoretical syntheses with prior studies into these combined epigenomic and epidemiological results. Results: Cannabis dependence not only recapitulates many of the key features of aging, but is characterized by both age-defining and …

Impact Of Sociodemographic Features And Lifestyle On Cognitive Performance Of Peruvian Adults, Brenda Chino, Jonathan Zegarra-Valdivia, Jaisalmer De Frutos-Lucas, Carmen Paredes-Manrique, Nilton Custodio

Research outputs 2022 to 2026

Background:

Cognitive impairment and dementia may result from a combination of modifiable and nonmodifiable risk and protective factors, such as the environment, educational attainment, time devoted to cognitively stimulating activities, and physical activity.

Objective:

This study aimed to investigate the mediating role of sociodemographic characteristics and lifestyle factors in the years of education and cognitive performance in Peruvian adults.

Methods:

This cross-sectional study included 1,478 subjects assessed by Addenbrooke’s Cognitive Examination Revised (ACE-R). Using mediation models, we evaluated the mediation role of parents’ educational level, reading time (RT), and physical activity time (PAT) in the years of education (IYE) and …

Commentary: Examining Contextual Factors Contributing To Differentials In Covid-19 Mortality In U.S. Vs. India., Preeti Zanwar, Katrine L Wallace, Christopher Soria, Arokiasamy Perianayagam

College of Population Health Faculty Papers

No abstract provided.

Functional Neuroimaging Techniques To Examine Falls And Cognition In Older Adults: A Systematic Review, Tia M. Seleem, Raphael Gabiazon

Undergraduate Student Research Internships Conference

Falls in older adults have been attributed to impaired cognition. There is potential for neuroimaging techniques to understand the biological components that are involved in the cognitive processes pertaining to falls. Therefore, the purpose of this systematic review was to analyze how functional neuroimaging can be used to examine the relationship between falls and cognition among older adults. The following five electronic databases were selected to identify peer-reviewed articles in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: 1) Medline (via OVID), 2) PsycINFO (via OVID), 3) CINAHL (via EBSCO), 4) EMBASE (via OVID), and 5) Pubmed. …

The Coping Strategies Of Older Adults With Age Related Vision Loss (Arvl) – A Narrative Account, Zakara J. Stampp

Electronic Thesis and Dissertation Repository

The goal of this study was to share the stories of older adults with age-related vision loss (ARVL) and how they have coped to maintain meaningful occupational engagement. Grounded in a constructivist paradigm, data collection and analysis were guided by the narrative inquiry methodology. The participants consisted of six older adults aged 60 or older, diagnosed with one of the following ARVL conditions: macular degeneration, diabetic retinopathy, and/or glaucoma. Participants were recruited from vision loss non-profit organizations such as the Canadian National Institute for the Blind (CNIB) and the Alliance for Equity of Blind Canadians (AEBC). One older adult was …

Midlife Determinants Of Healthy Cardiovascular Aging: The Atherosclerosis Risk In Communities (Aric) Study, Xiaoming Jia, Caroline Sun, Vijay Nambi, Salim S Virani, George Taffet, Eric Boerwinkle, Jan Bressler, Chiadi Ndumele, B Gwen Windham, James A De Lemos, Kunihiro Matsushita, John William Mcevoy, Ron C Hoogeveen, Elizabeth Selvin, Christie M Ballantyne

Journal Articles

BACKGROUND AND AIMS: Risk factor cutoffs are derived from associations with clinical cardiovascular disease (CVD), but how these risk factors associate with preserved cardiovascular health into old age is not well studied. We investigated midlife determinants of healthy versus nonhealthy cardiovascular aging in the Atherosclerosis Risk in Communities (ARIC) study.

METHODS: ARIC participants were categorized by cardiovascular status in older age (mean age 75.8 ± 5.3 years, range 66-90): healthy, subclinical disease (assessed by biomarkers and left ventricular function), clinical CVD (coronary heart disease, stroke, or heart failure), or prior death. We examined associations of midlife (mean age 52.1 ± …

The Role Of Physical Activity And Gender As Moderators For The Relationship Between Insomnia And Depression, Claire E. Wickersham

Graduate Doctoral Dissertations

Objective: The aim of this study was to examine the association between insomnia and depressive symptoms among middle-aged and older adults and to investigate whether gender or physical activity moderates this relationship. Method: This study used nationally representative data from the 2016 and 2018 waves of the Health and Retirement Study (HRS) and binomial logistic regression was used to estimate models. Regression models for risk of depressive symptoms (2018) were based on a longitudinal model with time-lagged indicators of insomnia, levels of physical activity, and covariates (2016). Results: Analyses showed that participants who reported having insomnia in 2016 were more …

Age-Associated Gut Dysbiosis, Marked By Loss Of Butyrogenic Potential, Correlates With Altered Plasma Tryptophan Metabolites In Older People Living With Hiv., Smita Ghare, Richa Singhal, Vaughn Bryant, Sabina Gautam, Chanakya Charan Tirumala, Praneet Kumar Srisailam, Andrea Reyes-Vega, Dushan Ghooray, Craig J. Mcclain, Kristi Hoffman, Joseph Petrosino, Kendall Bryant, Varand Govind, Ronald Cohen, Robert L. Cook, Shirish Barve

Faculty Scholarship

Background:

Imbalance in tryptophan (TRP) metabolism and its neuroactive metabolites, serotonin and kynurenine (KYN), is a known pathogenic mechanism underlying neurocognitive impairment. Gut microbiota plays an important role in TRP metabolism, and the production of these neuroactive molecules affects neurocognitive function. Although both HIV infection and normal aging independently induce gut dysbiosis and influence TRP metabolism, their interactive effects on compositional/functional changes in gut microbiota and consequent alterations in TRP metabolites remain largely undetermined.

Methods:

Older people living with HIV infection (PLWH, aged 50–70 years, n = 22) were enrolled in this cross-sectional pilot study. Metagenomic analysis of fecal microbiome …

Effects Of Metal And Polychlorinated Biphenyls Exposures And Fish Consumption On Cognitive Function In Adults, Nozomi Sasaki

Legacy Theses & Dissertations (2009 - 2024)

Cognitive decline often occurs with aging, independent of development of neurodegenerative diseases. Little is known about how to prevent cognitive decline or what cofactors, hereditary or environmental, may accelerate or protect against it. In young people, metals, including lead, cadmium, arsenic, methylmercury, and some organic compounds such as polychlorinated biphenyls (PCBs), are known to decrease cognitive function. Consumption of fish is a route of exposure to methylmercury and PCBs, but fish also contain omega-3 fatty acids that are reported to enhance infant neurodevelopment and postnatal cognitive performance. Yet, a recent systematic review concluded that there was inconclusive evidence the omega-3 …

Effect Of Living Arrangements On Cognitive Function In Chinese Elders: A Longitudinal Observational Study, Yanwei Lin, Qi Zhang, Tingxian Wang, Zhirong Zeng

Community & Environmental Health Faculty Publications

Objective To examine how living arrangement as a social contextual factor can affect Chinese elders’ cognitive function.

Setting and participants Our sample consists of 2486 Chinese elders from two waves (2014 and 2018) of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) that was administered in 22 of China’s 31 provinces using a multi-stage, disproportionate, purposive random sampling method. The CLHLS aims to better understand the determinants of healthy longevity in China and collects extensive data on a large population of fragile elders aged 80–112 in China.

Outcome measures Cognitive function was measured by the Mini-Mental State Examination (MMSE). Living arrangement …

Persistent Polypharmacy And Fall Injury Risk: The Health, Aging And Body Composition Study, Lingshu Xue, Robert M. Boudreau, Julie M. Donohue, Janice C. Zgibor, Zachary A. Marcum, Tina Costacou, Anne B. Newman, Teresa M. Waters, Elsa S. Strotmeyer

Health Management and Policy Faculty Publications

Background

Older adults receive treatment for fall injuries in both inpatient and outpatient settings. The effect of persistent polypharmacy (i.e. using multiple medications over a long period) on fall injuries is understudied, particularly for outpatient injuries. We examined the association between persistent polypharmacy and treated fall injury risk from inpatient and outpatient settings in community-dwelling older adults.

Methods

The Health, Aging and Body Composition Study included 1764 community-dwelling adults (age 73.6 ± 2.9 years; 52% women; 38% black) with Medicare Fee-For-Service (FFS) claims at or within 6 months after 1998/99 clinic visit. Incident fall injuries (N = 545 in …

Association Of Low-Frequency And Rare Coding Variants With Information Processing Speed, Jan Bressler, Gail Davies, Albert V Smith, Yasaman Saba, Joshua C Bis, Xueqiu Jian, Caroline Hayward, Lisa Yanek, Jennifer A Smith, Saira S Mirza, Ruiqi Wang, Hieab H H Adams, Diane Becker, Eric Boerwinkle, Archie Campbell, Simon R Cox, Gudny Eiriksdottir, Chloe Fawns-Ritchie, Rebecca F Gottesman, Megan L Grove, Xiuqing Guo, Edith Hofer, Sharon L R Kardia, Maria J Knol, Marisa Koini, Oscar L Lopez, Riccardo E Marioni, Paul Nyquist, Alison Pattie, Ozren Polasek, David J Porteous, Igor Rudan, Claudia L Satizabal, Helena Schmidt, Reinhold Schmidt, Stephen Sidney, Jeannette Simino, Blair H Smith, Stephen T Turner, Sven J Van Der Lee, Erin B Ware, Rachel A Whitmer, Kristine Yaffe, Qiong Yang, Wei Zhao, Vilmundur Gudnason, Lenore J Launer, Annette L Fitzpatrick, Bruce M Psaty, Myriam Fornage, M Arfan Ikram, Cornelia M Van Duijn, Sudha Seshadri, Thomas H Mosley, Ian J Deary

Journal Articles

Measures of information processing speed vary between individuals and decline with age. Studies of aging twins suggest heritability may be as high as 67%. The Illumina HumanExome Bead Chip genotyping array was used to examine the association of rare coding variants with performance on the Digit-Symbol Substitution Test (DSST) in community-dwelling adults participating in the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE) Consortium. DSST scores were available for 30,576 individuals of European ancestry from nine cohorts and for 5758 individuals of African ancestry from four cohorts who were older than 45 years and free of dementia and …

Community-Dwelling Older Adult Fall Prevention Improvement Project, Evan Edminster Bsn, Rn, Cfrn, Tcrn, Cen, Nhdp-Bc

Master's Projects and Capstones

Abstract

Problem: Ground-level falls among community-dwelling adults 60 years and older are significant and contribute to adverse health outcomes such as fractures, functional decline, disability, and death. Additionally, falls among community-dwelling older adults are the number one mechanism of injury seen at a Northern California Level II trauma center. Falls often lead to post-fall fear, activity restriction, and physical deconditioning, further compounding fall risk.

Context: When trauma centers provide targeted outreach and screening for unmanaged health risks such as falls, they reduce unnecessary disability and premature death in the local population. Reducing total fall victim numbers and fall recidivism also …

Developmental Ethanol Exposure Causes Central Nervous System Dysfunction And May Slow The Aging Process In A Drosophila Model Of Fetal Alcohol Spectrum Disorder, Khaoula Belhorma, Nahed Darwish, Elizabeth Benn-Hirsch, Annalisa Duenas, Hillary Gates, Navneet Sanghera, Jodie Wu, Rachael L. French

Faculty Research, Scholarly, and Creative Activity

Alcohol is a known teratogen, and developmental exposure to ethanol results in fetal alcohol spectrum disorder (FASD). Children born with FASD can exhibit a range of symptoms including low birth weight, microcephaly, and neurobehavioral problems. Treatment of patients with FASD is estimated to cost 4 billion dollars per year in the United States alone, and 2 million dollars per affected individual's lifetime. We have established Drosophila melanogaster as a model organism for the study of FASD. Here we report that mutations in Dementin (Dmtn), the Drosophila ortholog of the Alzheimer's disease-associated protein TMCC2, convey sensitivity to developmental ethanol exposure, …

The Effects Of Sociodemographic Characteristics, Caregiving Practice Patterns, Coping Mechanisms, And Social Support On The Health Of Asian American Ethnic Groups And Asian American Caregivers, Suryadewi Edi Nugraheni

Legacy Theses & Dissertations (2009 - 2024)

Background: Asian American family caregivers came from various ethnic groups with different sociodemographic characteristics and culturally specific values. However, cultural practices were often overlooked because researchers often combined all Asian Americans under one umbrella. Objective: The purpose of the study was two-fold. First, the study investigated the study sample of Asian Americans participating in the California Health Interview Survey (CHIS) 2009 comprised of multiple Asian American ethnic groups. By utilizing the study sample, the research aimed to investigate 1) the associations between caregiving and self-rated health (SRH) and hypertension and 2) the associations between heterogeneity of Asian American ethnic groups …

Mitigating Isolation Of People Aging With Hiv During The Covid-19 Pandemic, Brandon Brown, Jeff Taylor, Celia B. Fisher

Covid-19 Digital Research

Before COVID-19, the HIV/AIDS pandemic had arguably been the worst public health crisis in the United States. Although an HIV diagnosis was previously regarded as a death sentence, the development of combination therapy in the 1990s transformed HIV into a largely manageable chronic condition.

Muscle Performance Changes With Age In Active Women, Ryan M. Miller, Eduardo D. S. Freitas, Aaron D. Heishman, Keldon M. Peak, Samuel R. Buchanan, J. Mikhail Kellawan, Hugo M. Pereira, Debra A. Bemben, Michael G. Bemben

Health & Human Performance Faculty Publications and Presentations

The purpose of this study was to examine age-related differences in muscle performance in women divided into young (YW, 20–39 years, n = 29) middle-aged (MAW, 40–59 years, n = 33), and older (OW, ≥60 years, n = 40) age groups. Methods: Hand grip strength, vertical jump performance, and knee extensor (KE) strength (0 deg/s, 60 deg/s, and 240 deg/s), speed of movement (SoM; at 1 Nm, 20%, 40%, and 60% isometric strength), and endurance (30-repetition test at 60 degs/s and 240 deg/s) were assessed. Computed tomography-acquired muscle cross-sectional area (mCSA) was measured and included to determine specific strength (KE …