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  • Steiner, John F.  (2)
  • 1
    In: Journal of the American Geriatrics Society, Wiley, Vol. 70, No. 12 ( 2022-12), p. 3458-3468
    Abstract: Changes in loneliness are associated with corresponding changes in depression, anxiety, and general health in population surveys, but few studies have assessed these associations through repeated screening in clinical settings. Methods Retrospective cohort study among individuals ≥age 65 in an integrated health care system who completed loneliness screening before two annual wellness visits, separated by a mean of 12.9 (SD 2.0) months, between 2013 and 2018. Their responses identified four subgroups: individuals who were persistently lonely; not lonely; experienced an increase (recently lonely); or decrease (previously lonely) in loneliness. Loneliness was assessed with a single item. Depression was assessed with the Patient Health Questionnaire‐2. Anxiety was assessed with the Generalized Anxiety Disorder‐2. Fair/poor general health was assessed by a single item. Linear mixed effects models assessed changes in outcomes after covariate adjustment. Results The cohort comprised 24,666 individuals (19.2% of older adults in the system). Mean age was 73.7 years (SD 6.4); 54.6% were female, and 11.6% were members of racial and ethnic minority groups. Of these individuals, 1936 (7.8%) were persistently lonely, 1687 (6.8%) were recently lonely, 1551 (6.3%) were previously lonely, and 19,492 (79.0%) were not lonely at either time point. After adjustment for sociodemographic, clinical and social variables, recent loneliness was associated with increases in depression (adjusted odds ratio [aOR] 1.76, 95% confidence interval [CI] 1.41–2.19) and anxiety (aOR 1.67, 95% CI 1.32–2.10). Previous loneliness was associated with decreases in depression (aOR, 0.46, 95% CI 0.36–0.58) and anxiety (aOR 0.69, 95% CI 0.54–0.90). Changes in loneliness were not associated with changes in general health. Conclusions Changes in loneliness identified through screening were associated with corresponding changes in depression and anxiety. These findings support the potential value of identifying social risk factors in clinical settings among older adults.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2040494-3
    Library Location Call Number Volume/Issue/Year Availability
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  • 2
    Online Resource
    Online Resource
    Wiley ; 2018
    In:  Journal of the American Geriatrics Society Vol. 66, No. 5 ( 2018-05), p. 1017-1024
    In: Journal of the American Geriatrics Society, Wiley, Vol. 66, No. 5 ( 2018-05), p. 1017-1024
    Abstract: To estimate food insecurity prevalence and develop a statistical prediction model for food insecurity. Design Retrospective cohort study. Setting Kaiser Permanente Colorado. Participants Adult members who completed a pre‐Medicare Annual Wellness Visit survey. Measurements Food insecurity was assessed using a single screening question. Sociodemographic and clinical characteristics from electronic health records and self‐reported characteristics from the survey were used to develop the prediction model. Results Of 130,208 older adult members between January 2012 and December 2015, 50,097 (38.5%) completed food insecurity screening, 2,859 of whom (5.7% of respondents) reported food insecurity. The prevalence of food insecurity was 10.0% or greater among individuals who were black or Hispanic, had less than high school education, had Medicaid insurance, were extremely obese, had poor health status or quality of life, had depression or anxiety, had impairments in specific activities of daily living, had other nutritional risk factors, or were socially isolated (all p 〈 .001). A multivariable model based on these and other characteristics showed moderate discrimination (c‐statistic = 0.74) between individuals with food insecurity and those without and 14.3% of individuals in the highest quintile of risk reported food insecurity. Conclusion Food insecurity is prevalent even in older adults with private‐sector healthcare coverage. Specific individual characteristics, and a model based on those characteristics, can identify older adults at higher risk of food insecurity. System‐level interventions will be necessary to connect older adults with community‐based food resources.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2018
    detail.hit.zdb_id: 2040494-3
    Library Location Call Number Volume/Issue/Year Availability
    BibTip Others were also interested in ...
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