Gary Andrews

Effect of social networks on 10 year survival in very old Australians: the Australian longitudinal study of aging

Study objectives: To examine if social networks with children, relatives, friends, and confidants predict survival in older Australians over 10 years after controlling for a range of demographic, health, and lifestyle variables. Design: Prospective longitudinal cohort study (the Australian longitudinal study of aging) Setting: Adelaide, South Australia. Participants: 1477 persons aged 70 years or more living in the community and residential care facilities. Main results: After controlling for a range of demographic, health, and lifestyle variables, greater networks with friends were protective against mortality in the 10 year follow up period. The hazard ratio for participants in the highest tertile of friends networks compared with participants in the lowest group was 0.78 (95%CI 0.65 to 0.92). A smaller effect of greater networks with confidants (hazard ratio = 0.84; 95%CI  = 0.71 to 0.98) was seen. The effects of social networks with children and relatives were not significant with respect to survival over the following decade. Conclusions: Survival time may be enhanced by strong social networks. Among older Australians, these may be important in lengthening survival.

Demographic, health, cognitive, and sensory variables as predictors of mortality in very old adults.

Cognitive and sensorimotor predictors of mortality were examined in the Australian Longitudinal Study of Ageing, controlling for demographic and health variables. A stratified random sample of 1,947 males and females aged 70 and older were interviewed, and 1,500 were assessed on measures of health, memory. verbal ability, processing speed, vision, hearing, and grip strength in 1992 and 1994. Analyses of incident rate ratios for mortality over 4- and 6-year periods were conducted using Cox hierarchical regression analyses. Results showed that poor performance on nearly all cognitive variables was associated with mortality, but many of these effects were explained by measures of self-rated health and disease. Significant decline in hearing and cognitive performance also predicted mortality as did incomplete data at Wave 1. Results suggest that poor cognitive performance and cognitive decline in very old adults reflect both biological aging and disease processes.

Successful Aging in the Australian Longitudinal Study of Aging: Applying the MacArthur Model Cross–Nationally

Wide variation in the experience of aging is increasingly recognized and models for identifying groups based on how “successfully” individuals are aging have taken many forms. This study used the criteria developed in the MacArthur studies on successful aging to identify subgroups with higher, intermediate, or lower levels of function, and to compare them across a range of other domains. Data were drawn from the Australian Longitudinal Study of Aging (ALSA) in Adelaide, Australia, which is a population–based, bio–psycho–social study of a cohort of 1947 adults aged 70 years or more. Six waves have been conducted, between 1992 and 2000. At waves 1 and 3, an extensive personal interview and self–complete questionnaires were administered and objective physical and psychological functioning assessed. Eight–year mortality was also examined. Results showed risk and protective effects of successful aging for physical functioning and performance, lifestyle, cognition, affect, and personality. The findings confirm that people age with differing degrees of success and those aging most successfully not only live longer, but also experience a better quality of life. The MacArthur model proved useful for this cross–national comparison of determinants and outcomes of “successful” aging.

Corrected Arm Muscle Area: An Independent Predictor of Long-Term Mortality in Community-Dwelling Older Adults?

OBJECTIVES: Older people are at risk of undernutrition because of a number of physiological conditions and lifestyle factors. The purpose of this study was to explore the predictive relationship of corrected arm muscle area (CAMA) with 8‐year mortality in a representative sample of older Australians.

Factors associated with falling in older Adelaide residents

Abstract: The aim of this study was to identify characteristics that predispose older residents of Adelaide to falling. Information collected in the baseline phase of the Australian Longitudinal Study of Ageing was used to draw cross–sectional comparisons between participants who reported having fallen on at least one occasion in the previous 12 months and those participants who reported not having fallen. The baseline cohort consisted of 1947 participants aged 70 years or more, of whom 550 (28 per cent) reported having fallen at least once in the previous year. Independent risk factors for falling were: age; having left school at an early age; a worsening of vision in recent years; and histories of Parkinsons disease, fractured hip, glaucoma, stroke (including transient ischaemic attack), corns or bunions, or arthritis. The findings regarding medical histories suggest some possible opportunities for reducing the risk of falls in the elderly by managing the symptoms and risk factors of underlying conditions such as stroke and loss of vision. (Aust N Z J Public Health 1997; 21: 462–8)

The Effects of Social Networks on Disability in Older Australians

Objective: To investigate the effects of total social networks and specific social net-works with children, relatives, friends, and confidants on disability in mobility and Nagi functional tasks. Methods: Six waves of data from the Australian Longitudinal Study of Ageing were used. Data came from 1,477 participants aged 70 years or older. The effects of total social networks and those with children, relatives, friends, and confidants on transitions in disability status were analyzed using binary and multinomial logistic regression. Results: After controlling for a range of health, environmental, and personal factors, social networks with relatives were protective against developing mobility disability (OR = 0.89; 95% CI = 0.79 to 1.00) and Nagi disability (OR = 0.85; 95% CI = 0.74 to 0.96). Other social subnetworks did not have a consistent effect on the development of disability. Discussion: The effects of social relationships extend beyond disability in activities of daily living. Networks with relatives protect against disability in mobility and Nagi tasks.

Exercise profile and subsequent mortality in an elderly Australian population

Abstract: Although the importance of exercise as a public health issue is increasingly recognised, little attention has been paid to exercise in very old people. We examined exercise patterns in 1788 subjects aged 70 years and over who were participating in the Australian Longitudinal Study of Ageing. In the two weeks before interview, 39 per cent of subjects had taken no exercise and only four per cent had exercised vigorously. When compared with those who took no exercise, exercisers were more likely to be male and younger, to self–report better health, to be former smokers and regular alcohol users. Mortality rates at two years follow–up were inversely related to the level of exercise at baseline. This research indicates that exercise is important for the very old as well as younger groups.

Falls: A comparison of trends in community, hospital and mortality data in older Australians

Background and aims: Falls are major contributors to disability, morbidity and death for older people. Frequently, falls-related data for each of these areas is viewed in isolation. The aim of this study was to establish trends in incidence of falls-related events including: community reporting of falls and falls-related injuries, hospitalizations as a result of accidental falls, and mortality related to accidental falls for older people in two states of Australia (Victoria and South Australia). Methods: We analysed data sets for falls hospitalizations and mortality rates for the period 1988 to 1997, and from two longitudinal population-based proportional samples during the same time period. Results: Age-standardised falls mortality rates have steadily declined in Victoria, and remained unchanged between 1988 and 1997 in South Australia. In both states, age-standardised falls hospitalization rates have increased significantly (in Victoria, RR=1.32, 95% CI: 1.30–1.34; and South Australia, RR=1.05, 95% CI: 1.03–1.06). In both states, there was a clear age-related effect, with those in the 85-year and older age group having a falls-related mortality rate approximately 40 times that of those aged 65–69 years, and a hospitalization rate 9 times that of those in the 65–69 age group. The community studies indicated that falls rates remain high among older Australians, and that injurious falls occurred in 10% in the first wave of data collection in each of these studies. Conclusions: The results highlight that various indicators related to falls trends taken in isolation may yield differing conclusions. For a true reflection of the effectiveness of falls prevention programs, falls-related mortality, hospitalization and community data need to be integrated. Increased focus on falls prevention activity in Australia during the 1990’s has not reduced the magnitude of this major public health problem.

Do social networks affect the use of residential aged care among older Australians

BackgroundOlder peoples social networks with family and friends can affect residential aged care use. It remains unclear if there are differences in the effects of specific (with children, other relatives, friends and confidants) and total social networks upon use of low-level residential care and nursing homes.MethodsData were drawn from the Australian Longitudinal Study of Ageing. Six waves of data from 1477 people aged ≥ 70 collected over nine years of follow-up were used. Multinomial logistic regressions of the effects of specific and total social networks on residential care use were carried out. Propensity scores were used in the analyses to adjust for differences in participants health, demographic and lifestyle characteristics with respect to social networks.ResultsHigher scores for confidant networks were protective against nursing home use (odds ratio [OR] upper versus lower tertile of confidant networks = 0.50; 95%CI 0.33–0.75). Similarly, a significant effect of upper versus lower total network tertile on nursing home use was observed (OR = 0.62; 95%CI 0.43–0.90). Evidence of an effect of children networks on nursing home use was equivocal. Nursing home use was not predicted by other relatives or friends social networks. Use of lower-level residential care was unrelated to social networks of any type. Social networks of any type did not have a significant effect upon low-level residential care use.DiscussionBetter confidant and total social networks predict nursing home use in a large cohort of older Australians. Policy needs to reflect the importance of these particular relationships in considering where older people want to live in the later years of life.

Ageing and the economy: costs and benefits

Objectives: The purpose of this study was to estimate the financial value of the productive contributions that older adults make to South Australian society and to compare this to the cost of maintaining them in good health and well‐being.