A. Regula Herzog

Age, Socioeconomic Status, and Health

Analysts dispute what roles biomedical, psychosocial, and other factors play in determining the duration of morbidity and disability over the life course. Cross-sectional data from two national surveys of adults aged 25 years and over not only show, however, that age and socioeconomic status (SES) are significant predictors of self-reported physical health; they also demonstrate that the relation of age to health varies with SES features. Longitudinal research is needed to test the finding that enduring functional limitations in terms of time are actually compressed in higher SES groups. To improve well-being in our society, moreover, requires specifying why SES differences occur, and perhaps ultimately reducing socioeconomic inequality itself.

Prevalence of Urinary Incontinence and Other Urological Symptoms in the Noninstitutionalized Elderly

The prevalences of urinary incontinence, difficulty in bladder emptying and irritative bladder symptoms are not known in the noninstitutionalized elderly in this country. A survey, consisting of a multi-stage probability sample of 13,912 households, was done in Washtenaw County, Michigan to estimate these prevalences. A total of 1,955 senior citizens 60 or more years old was interviewed. The prevalences of urinary incontinence, difficult bladder emptying and irritative bladder symptoms were 18.9, 22.1 and 11.8 per cent, respectively, in men, and 37.7, 10.8 and 17.4 per cent, respectively, in women. Urinary incontinence was significantly more prevalent among all respondents with bladder emptying and irritative symptoms than those without such symptoms (p less than 0.001). The frequency of voiding was significantly increased among respondents with incontinence, or emptying or irritative symptoms compared to asymptomatic respondents (p less than 0.001). These survey data are of importance to senior citizens, care providers and governmental agencies.

National Estimates of the Quantity and Cost of Informal Caregiving for the Elderly with Dementia

AbstractOBJECTIVE: Caring for the elderly with dementia imposes a substantial burden on family members and likely accounts for more than half of the total cost of dementia for those living in the community. However, most past estimates of this cost were derived from small, nonrepresentative samples. We sought to obtain nationally representative estimates of the time and associated cost of informal caregiving for the elderly with mild, moderate, and severe dementia. DESIGN: Multivariable regression models using data from the 1993 Asset and Health Dynamics Study, a nationally representative survey of people age 70 years or older (N=7,443). SETTING: National population-based sample of the community-dwelling elderly. MAIN OUTCOME MEASURES: Incremental weekly hours of informal caregiving and incremental cost of caregiver time for those with mild dementia, moderate dementia, and severe dementia, as compared to elderly individuals with normal cognition. Dementia severity was defined using the Telephone Interview for Cognitive Status. RESULTS: After adjusting for sociodemographics, comorbidities, and potential caregiving network, those with normal cognition received an average of 4.6 hours per week of informal care. Those with mild dementia received an additional 8.5 hours per week of informal care compared to those with normal cognition (P<.001), while those with moderate and severe dementia received an additional 17.4 and 41.5 hours (P<.001), respectively. The associated additional yearly cost of informal care per case was

Prevalence and Incidence of Urinary Incontinence in Community-Dwelling Populations

3,630 for mild dementia,

Epidemiology and natural history of urinary incontinence in women

7,420 for moderate dementia, and

Individual consequences of volunteer and paid work in old age: health and mortality.

17,700 for severe dementia. This represents a national annual cost of more than

Health-related quality of life among adults with symptoms of overactive bladder: results from a U.S. community-based survey

18 billion. CONCLUSION: The quantity and associated economic cost of informal caregiving for the elderly with dementia are substantial and increase sharply as cognitive impairment worsens. Physicians caring for elderly individuals with dementia should be mindful of the importance of informal care for the well-being of their patients, as well as the potential for significant burden on those (often elderly) individuals providing the care.

Activities and well-being in older age: Effects of self-concept and educational attainment.

revalence and incidence represent important characteristics of urinary incontinence as it appears in the population. Prevalence estimates P provide an indication of how widespread involuntary urine loss is and have important implications for the level of medical and self-care that is needed. Incidence estimates provide an indication of the onset of the condition and are critical when studying its development, risk factors, and sequelae. Early estimates of prevalence of incontinence in the community came almost exclusively from European studies. Several reviews of these studies are The reviews point out that prevalence estimates vary, and they suggest that differences in the definition of incontinence and in the sample account for much of the variability. More recently, several prevalence estimates have become available from regional or national US samples that had not been previously reviewed nor, in several instances, been formally published. This article complles prevalence and incidence estimates from American and non-American studies published or conducted since 1970. These studies used survey respondents’ reports of involuntary urine loss to measure prevalence and, in some cases, incidence and symptoms of types of urinary incontinence. Some estimates had to be calculated from reported or computerized data. Because information regarding study design and measurement was incomplete for some of the studies, the estimates must be taken as close approximations only. Further details about the reestimation procedures are given in the Appendix.

Overview of the Health Measures in the Health and Retirement Study

Understanding the epidemiology (distribution and determinants) of urinary incontinence (UI), as well as its natural history is a very important issue. In this article, we discuss prevalence, incidence, natural history, and the variations that may be related to race and ethnicity. We focus on epidemiologic population comprising community-dwelling women who are not institutionalized. Our review clearly shows that there is a lack of advanced epidemiologic analyses. Variables that better characterize UI include frequency measure, quantity of urine loss, duration, type, and severity. These factors should be incorporated into basic study design so that more advanced and informative analyses may be conducted.

Self-Reported Social and Emotional Impact of Urinary Incontinence

The impacts of the productive social activities of volunteer and paid work on health have rarely been investigated among the oldest Americans despite a recent claim for their beneficial effect (Rowe and Kahn 1998). This paper used data from Waves 3 and 4 of the Asset and Health Dynamics among the Oldest Old (AHEAD) Study to (1) investigate the impact of these activities on health measured as self-reported health and activities of daily living (ADL) functioning limitations and to (2) explore possible causal mechanisms. Using multinomial logistic regression analysis, amounts of volunteer and paid work over a minimum of 100 annual hours self-reported at Wave 3 were related to poor health and death as competing risks measured at Wave 4, controlling for health measured at Wave 2 and for other predictors of poor health and death. Findings suggest that performing more than 100 annual hours of volunteer work and of paid work have independent and significant protective effects against subsequent poor health and death. Additional analyses suggest that the quantity of volunteer and paid work beyond 100 annual hours is not related to health outcomes and that physical exercise and mental health measured as cognitive functioning and depressive symptoms explain not entirely overlapping parts of the relationship between productive activities and health.