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Determinants of Health Services Utilization By Elderly Patients In Rural And Urban Areas In Saudi Arabia
2013 AAGP Annual Meeting Conclusions: Findings from this study should help service providers working with older adults receiving home-based services to identify clients who are at an increased risk for poor outcomes related to nutrition, disability, health and mental health. Additionally, the findings should help identify if there are significant disparities among recipients receiving home-based services so that support services can be targeted to those specific at-risk groups. Poster Number: EI 56
The future of successful aging in Alaska. Advice to ensure a healthy future Jordan P. Lewis, PhD, MSW University of Washington, Seattle, WA Introduction: We are all aging as individuals, and we are also aging as a society. While it is clear that we are living longer, it is not clear that our lives are healthier (Verbrugge, 1984). As our communities change and people live longer, we need to understand how to live out our older years in a good way, at both the individual and societal levels, and to identify factors that can help us to do so (Herzog & House, 1991). For Alaska Natives this is important because it will enable us to get the most out of our lives, feel good about ourselves, as well as preserve our culture and traditions while honoring our Elders who share their knowledge and wisdom on healthy living. Rowe and Kahn’s (1987) biomedical definition of successful aging, which emphasizes physical health and absence of disease, does not fit the holistic approach to aging that is common among Alaska Natives. Very little research has been conducted with younger generations to explore whether or not they believe they will age well and why or why not. This study hopes to address this gap in the literature and serve as an example of why we need to explore healthy aging among our youth to develop programs and services to ensure a long and healthy life. Methods: A purposive sampling procedure was used in this study to interview seven individuals who were not Elders. Among the participants, five Alaska Native tribal groups (Aleut, Gwich’in Athabascan, Inupiaq, Tlingit, and Yup’ik Eskimo) were represented who were residents of seven different urban communities and self-identified as Alaska Native (N¼7). A grounded theory (Glaser & Strauss, 2006) approach was used to gain a sense of the experiences of aging in Alaska. The experiences of the participants were most important and not the researchers understanding, or interpretation, of successful aging. Rather than bringing ideas and thoughts to the article, this article provides insight on successful aging among the participants, using their words. Results: Aging successfully is making the conscious decision to live a clean and healthy life, abstaining from drugs and alcohol, but many of younger Alaska Natives do not feel they will age well due to lifestyle factors. Young Alaska Natives see the inability to age well as primarily due to the decrease in physical activity, lack of availability of subsistence foods and activities, and the difficulty of living a balanced life in urban settings. Conclusions: Based on the results of the interviews with the younger participants, they all have a desire to live a healthy and balanced life, but the demands of living in urban settings and working to provide for their families prevents them from activities they believe will help them age well. Each younger participant understood the value and importance of aging well and looked up to family and community members who served as examples, but found it challenging to engage in the same activities and behaviors because of constraints and demands in their current work and home environment. The findings in this study lead to future research to explore how Alaska Natives living in urban settings maintain a connection to their natal community and continue traditional, or cultural, practices. As more Alaska Natives relocate to urban communities for various reasons, it will be important to determine how they maintain cultural connections, access to their Native foods, and maintain family and community connections. Future research will need to explore the notion of urban successful aging among Alaska Natives and what can be done to ensure healthy living for this population. As the Alaska Native population continues to live longer with more chronic illnesses, it will be important to address the issues facing Alaska Natives and determine what they need to live healthily in their own communities. Insight into how successful aging is defined by Alaska Natives will inform the factors that determine whether or not communities are able to meet their needs and enable them to achieve a healthy old age. Poster Number: EI 57
Determinants of Health Services Utilization By Elderly Patients In Rural And Urban Areas In Saudi Arabia Saad A. Alghanim, PhD King Saud University, Riyadh, Saudi Arabia Introduction: This research aims to explore the utilization of health services by rural and urban elderly patients in Saudi Arabia.
S102
Am J Geriatr Psychiatry 21:3, Supplement 1
2013 AAGP Annual Meeting Methods: Four hundred questionnaires were distributed to collect data randomly from elderly patients in rural and urban areas during March 2012. The data were collected on sets of variables which were thought to have an influence on the utilization of health services. Descriptive statistics (frequencies and percentages) were used for presenting the results. Chi-square test was used to determine differences in the utilization of health services between respondents in rural and urban areas according to the selected independent variables. Results: The findings revealed that elderly patients in urban areas were more likely to use health services than respondents in rural areas. Elderly patients in rural areas made a significantly higher percentage of use of primary health care services than elderly patients in urban areas. On the contrary, respondents in urban areas made significantly higher percentages of visits to emergency departments and specialty clinics than their counterparts in rural areas. Conclusions: The study highlighted some of the significant differences between rural and urban residents in the utilization of health facilities by elderly patients. Understanding these factors by health practitioners, policy makers and researchers should precede any intervention which attempts to provide elderly population in rural and urban areas with equitable and necessary health services. Poster Number: EI 58
Prevalence and Associations of Sleep Treatment Use in Community Dwelling Older Adults Nicolas Badre, MD1; Colin Depp, PhD1,2; Dilip V. Jeste, MD1,2 1 2
UC San Diego, La Jolla, CA Sam and Rose Stein Institute for Research on Aging, San Diego, CA
Introduction: Over 50% of older adults have complaints of insomnia. Multiple factors have been suspected to impact older adults’ ability to obtain sufficient sleep including medical illness and polypharmacy, psychiatric disorders, psychosocial changes and environmental changes associated with age. Use of sleep treatments is common and may have deleterious effects. In this study we examined the prevalence and associations between self-reported sleep treatments: over the counter medications, prescription medications, alternative medications, behavioral techniques, and alcohol for sleep. Methods: Data was utilized from the Successful AGing Evaluation (SAGE) study, a structured multi-cohort population based study designed to assess successful aging in 1,006 community-dwelling men and women in San Diego County, aged 50-99 years (with an over-sampling of people in the 80s and 90s). A modified version of random digit dialing was used to recruit subjects. Evaluation included a 25-minute phone interview followed by a self-report survey of various domains of functioning. Sleep and its treatment were measured using questions on numbers of hours slept per night, use of over the counter, prescription, alternative, behavioral, and alcohol as treatment for sleep. Other measured outcomes included physician visits, self-reporting of successful aging, cognitive assessment (TICS), and PHQ-9. Results: Of the respondents (n¼799), the mean age was 77.0%, and 48.7% female. Overall, 57.9% (n¼463) used some form of treatment for sleep. A total of 22.9% (n¼183) used OTC treatments, 15.4% (n ¼123) used prescription medications, 40.9% (n¼327) used behavioral techniques, 8.6% (n¼69) used complementary or alternative treatments, 10.4% (n¼83) used alcohol. Female participants used more treatments for sleep except alcohol. The number of doctor visits in the past year correlated with all treatments of sleep except alcohol use. Lower reports of successful aging were noted in users of prescriptions, over the counter medications, and alcohol used for sleep but not with behavioral and alternative medicine management of sleep. Daily use of prescription medication was negatively associated with cognitive performance. Regular use of alcohol significantly correlated with PHQ-9 scores. Conclusions: The SAGE study highlights that the majority of older adults used some kind of treatment for sleep disturbance in older adults. Physicians may have an important role in reducing alcohol use for sleep, as well as in providing education in behavioral sleep treatments. Poster Number: EI 59
Home healthcare utilization among older adults
Yolonda R. Pickett, MD, MS1,2; Martha L. Bruce, PhD, MPH1 1 2
Weill Cornell Medical Collge, White Plains, NY Albert Einstein College of Medicine, Bronx, NY
Introduction: Depression has been documented to cause an increase in healthcare utilization in medical inpatient and outpatient settings, but little is known of the use of services of older adults in home healthcare agencies. The objective for this study is to determine the home healthcare utilization of older adults who screen positive for depression compared to those who screen negative.
Am J Geriatr Psychiatry 21:3, Supplement 1
S103
The future of successful aging in Alaska. Advice to ensure a healthy future Jordan P. Lewis, PhD, MSW University of Washington, Seattle, WA Introduction: We are all aging as individuals, and we are also aging as a society. While it is clear that we are living longer, it is not clear that our lives are healthier (Verbrugge, 1984). As our communities change and people live longer, we need to understand how to live out our older years in a good way, at both the individual and societal levels, and to identify factors that can help us to do so (Herzog & House, 1991). For Alaska Natives this is important because it will enable us to get the most out of our lives, feel good about ourselves, as well as preserve our culture and traditions while honoring our Elders who share their knowledge and wisdom on healthy living. Rowe and Kahn’s (1987) biomedical definition of successful aging, which emphasizes physical health and absence of disease, does not fit the holistic approach to aging that is common among Alaska Natives. Very little research has been conducted with younger generations to explore whether or not they believe they will age well and why or why not. This study hopes to address this gap in the literature and serve as an example of why we need to explore healthy aging among our youth to develop programs and services to ensure a long and healthy life. Methods: A purposive sampling procedure was used in this study to interview seven individuals who were not Elders. Among the participants, five Alaska Native tribal groups (Aleut, Gwich’in Athabascan, Inupiaq, Tlingit, and Yup’ik Eskimo) were represented who were residents of seven different urban communities and self-identified as Alaska Native (N¼7). A grounded theory (Glaser & Strauss, 2006) approach was used to gain a sense of the experiences of aging in Alaska. The experiences of the participants were most important and not the researchers understanding, or interpretation, of successful aging. Rather than bringing ideas and thoughts to the article, this article provides insight on successful aging among the participants, using their words. Results: Aging successfully is making the conscious decision to live a clean and healthy life, abstaining from drugs and alcohol, but many of younger Alaska Natives do not feel they will age well due to lifestyle factors. Young Alaska Natives see the inability to age well as primarily due to the decrease in physical activity, lack of availability of subsistence foods and activities, and the difficulty of living a balanced life in urban settings. Conclusions: Based on the results of the interviews with the younger participants, they all have a desire to live a healthy and balanced life, but the demands of living in urban settings and working to provide for their families prevents them from activities they believe will help them age well. Each younger participant understood the value and importance of aging well and looked up to family and community members who served as examples, but found it challenging to engage in the same activities and behaviors because of constraints and demands in their current work and home environment. The findings in this study lead to future research to explore how Alaska Natives living in urban settings maintain a connection to their natal community and continue traditional, or cultural, practices. As more Alaska Natives relocate to urban communities for various reasons, it will be important to determine how they maintain cultural connections, access to their Native foods, and maintain family and community connections. Future research will need to explore the notion of urban successful aging among Alaska Natives and what can be done to ensure healthy living for this population. As the Alaska Native population continues to live longer with more chronic illnesses, it will be important to address the issues facing Alaska Natives and determine what they need to live healthily in their own communities. Insight into how successful aging is defined by Alaska Natives will inform the factors that determine whether or not communities are able to meet their needs and enable them to achieve a healthy old age. Poster Number: EI 57
Determinants of Health Services Utilization By Elderly Patients In Rural And Urban Areas In Saudi Arabia Saad A. Alghanim, PhD King Saud University, Riyadh, Saudi Arabia Introduction: This research aims to explore the utilization of health services by rural and urban elderly patients in Saudi Arabia.
S102
Am J Geriatr Psychiatry 21:3, Supplement 1
2013 AAGP Annual Meeting Methods: Four hundred questionnaires were distributed to collect data randomly from elderly patients in rural and urban areas during March 2012. The data were collected on sets of variables which were thought to have an influence on the utilization of health services. Descriptive statistics (frequencies and percentages) were used for presenting the results. Chi-square test was used to determine differences in the utilization of health services between respondents in rural and urban areas according to the selected independent variables. Results: The findings revealed that elderly patients in urban areas were more likely to use health services than respondents in rural areas. Elderly patients in rural areas made a significantly higher percentage of use of primary health care services than elderly patients in urban areas. On the contrary, respondents in urban areas made significantly higher percentages of visits to emergency departments and specialty clinics than their counterparts in rural areas. Conclusions: The study highlighted some of the significant differences between rural and urban residents in the utilization of health facilities by elderly patients. Understanding these factors by health practitioners, policy makers and researchers should precede any intervention which attempts to provide elderly population in rural and urban areas with equitable and necessary health services. Poster Number: EI 58
Prevalence and Associations of Sleep Treatment Use in Community Dwelling Older Adults Nicolas Badre, MD1; Colin Depp, PhD1,2; Dilip V. Jeste, MD1,2 1 2
UC San Diego, La Jolla, CA Sam and Rose Stein Institute for Research on Aging, San Diego, CA
Introduction: Over 50% of older adults have complaints of insomnia. Multiple factors have been suspected to impact older adults’ ability to obtain sufficient sleep including medical illness and polypharmacy, psychiatric disorders, psychosocial changes and environmental changes associated with age. Use of sleep treatments is common and may have deleterious effects. In this study we examined the prevalence and associations between self-reported sleep treatments: over the counter medications, prescription medications, alternative medications, behavioral techniques, and alcohol for sleep. Methods: Data was utilized from the Successful AGing Evaluation (SAGE) study, a structured multi-cohort population based study designed to assess successful aging in 1,006 community-dwelling men and women in San Diego County, aged 50-99 years (with an over-sampling of people in the 80s and 90s). A modified version of random digit dialing was used to recruit subjects. Evaluation included a 25-minute phone interview followed by a self-report survey of various domains of functioning. Sleep and its treatment were measured using questions on numbers of hours slept per night, use of over the counter, prescription, alternative, behavioral, and alcohol as treatment for sleep. Other measured outcomes included physician visits, self-reporting of successful aging, cognitive assessment (TICS), and PHQ-9. Results: Of the respondents (n¼799), the mean age was 77.0%, and 48.7% female. Overall, 57.9% (n¼463) used some form of treatment for sleep. A total of 22.9% (n¼183) used OTC treatments, 15.4% (n ¼123) used prescription medications, 40.9% (n¼327) used behavioral techniques, 8.6% (n¼69) used complementary or alternative treatments, 10.4% (n¼83) used alcohol. Female participants used more treatments for sleep except alcohol. The number of doctor visits in the past year correlated with all treatments of sleep except alcohol use. Lower reports of successful aging were noted in users of prescriptions, over the counter medications, and alcohol used for sleep but not with behavioral and alternative medicine management of sleep. Daily use of prescription medication was negatively associated with cognitive performance. Regular use of alcohol significantly correlated with PHQ-9 scores. Conclusions: The SAGE study highlights that the majority of older adults used some kind of treatment for sleep disturbance in older adults. Physicians may have an important role in reducing alcohol use for sleep, as well as in providing education in behavioral sleep treatments. Poster Number: EI 59
Home healthcare utilization among older adults
Yolonda R. Pickett, MD, MS1,2; Martha L. Bruce, PhD, MPH1 1 2
Weill Cornell Medical Collge, White Plains, NY Albert Einstein College of Medicine, Bronx, NY
Introduction: Depression has been documented to cause an increase in healthcare utilization in medical inpatient and outpatient settings, but little is known of the use of services of older adults in home healthcare agencies. The objective for this study is to determine the home healthcare utilization of older adults who screen positive for depression compared to those who screen negative.
Am J Geriatr Psychiatry 21:3, Supplement 1
S103