Recurrent Falls over Three Years among Older Adults Age 70+: Associations with Physical and Mental Health Status, Exercise, and Hospital Stay.

We used the 2019-2021 U.S. National Health and Aging Trend Study (N = 3,063, age 70+) and multinomial logistic regression and generalized linear models with Poisson and log link to identify correlates of (1) recurrent falls (2 + falls) over 3 years (2019-2021); and (2) any subsequent fall among those who had a fall in 2019. We also examined the associations between falls and hospitalization in 2021. Results show that those with recurrent falls had greater physical/functional and psychological health problems in 2019, while single fallers over the 3 years were not significantly different from those without a fall. Exercise was associated with a lower likelihood of a subsequent fall among those who fell in 2019. Both a single fall and recurrent falls over the 3 years were associated with a higher risk of hospitalization in 2021. Multifactorial fall preventions including exercise and depression/anxiety treatment are needed to mitigate recurrent fall risks.

Changes in Older Adults' Frequency of Going Outside between 2020 and 2021: Associations with Health Status and Environmental Factors.

OBJECTIVES: To examine the changes in the frequency of going outside among U.S. older adults between 2020 and 2021 (post-COVID vaccine) and correlates of those changes. METHODS: We used the 2019-2021 National Health and Aging Trend Study (NHATS) (N = 3,063, age 70+) and multinomial logistic regression to analyze associations of increased and decreased frequencies in going outside with physical, psychosocial, and cognitive health, environmental (COVID concerns and transportation) factors, and social media use as the independent variables. RESULTS: In 2021 compared to 2020, 13% and 16% of those age 70+ reported increased and decreased frequencies, respectively. Increased frequency was associated with social media use. Decreased frequency was associated with poor physical health, depression/anxiety, and perceived memory decline. COVID concerns and transportation problems, as well as female gender, age 90+, and being non-Hispanic Black, were also significant correlates of decreased frequency. CONCLUSIONS: Most U.S. adults age 70+ appear to have resumed their 2019 level of frequency of going outside in 2021 after the COVID vaccines became available; however, 16% reported decreased frequency of going outside in 2021 compared to 2020. CLINICAL IMPLICATIONS: Older adults with physical, mental, and cognitive health challenges need help to increase their frequency of going outside.

Older Adults' Frequency of Going Outside during the COVID-19 Pandemic: Associations with Physical Distancing, Health Status, and Fall Risk Factors.

Research shows significant health benefits of going outside in late life. Using the 2019 and 2020 National Health and Aging Trend Study and its 2020 COVID-19 supplemental survey (N = 3,857, age 70+), we examined changes in the past-month frequency of going outside one's home/building during the COVID-19 pandemic in 2020 compared to the same time in 2019. We found that 57.0% reported no change in the frequency of going outside, 32.0% went out less frequently, and 11.0% went out more frequently. Logistic regression models showed that decreased frequency was associated with higher frequency of going outside in 2019, avoidance of contact with those outside their household (AOR = 1.51, 95% CI = 1.10, 2.06), dementia diagnosis, mobility device use, self-rated health (AOR = .85, 95% CI = .75-.97), and being 90+ years of age, female, non-Hispanic Black or Hispanic, divorced/separated. Older adults are likely to benefit from going outside more often when they can safely do so.

Heroin and fentanyl overdose deaths among cases age 50+ in the National Poison Data System, 2015-2020.

CONTEXT: Illicit opioid use and heroin treatment admissions among individuals age 50+ have increased. Little research has, however, examined correlates of illicit opioid overdose deaths in this age group before or during the COVID-19 pandemic or the healthcare services used in these cases. METHODS: The sample included illicit opioid (heroin, fentanyl, or other synthetic, nonpharmaceutical opioids) poisoning cases age 50+ (N = 5576) in the National Poison Data System (NPDS), 2015-2020. Using descriptive statistics and logistic regression models, we report changes in overdose death rates during the study period and associations of death with healthcare service use, naloxone administration, and clinical and demographic characteristics. RESULTS: The 6-year average overdose death rate from illicit opioids among those age 50+ was 2.9%, increasing from 1.4% in 2015 to 4.0% in 2019 and 3.6% in 2020. Logistic regression results showed that exposure year was not a significant factor in the odds of overdose death; however, odds were significantly higher among cases that were not managed at any healthcare facility (HCF) (adjusted odds ratio [AOR] = 4.60, 95% confidence interval [CI] = 3.19-6.63) and lower among those who received naloxone therapy (AOR = 0.64, 95% CI = 0.45-0.92). The odds of death were also higher among cases involving exposure at own or another's home and co-use of prescription opioids, alcohol, and other illicit drugs. CONCLUSIONS: Although the NPDS did not show increases in illicit opioid overdose death rates among cases age 50+ in 2020 compared to 2019, overdose deaths were greater among cases that were not managed at HCF and did not receive naloxone therapy. Many appear to have died before they received any intervention to prevent death. Improved access to healthcare services and social support and access to naloxone therapy for older adults with opioid use problems are needed.

COVID-19 and Loneliness among Older Adults: Associations with Mode of Family/Friend Contacts and Social Participation.

OBJECTIVES: Given physical/social distancing due to COVID-19, we examined associations between self-reported loneliness and changes in contact with family/friends and mode of social participation among older adults. METHODS: Data came from the 2020 National Health and Aging Trend Study (NHATS) and its supplemental mail COVID-19 survey (N = 2,910 respondents who reported changes in loneliness during the COVID-19 outbreak). We fit a generalized linear model (GLM) with Poisson and log link using increased versus the same/decreased loneliness as the dependent variable and changes in frequencies of four modalities of contact with family/friends and social participation mode during COVID-19 as the independent variables. RESULTS: Approximately 19% of respondents reported feeling lonely on more days during COVID-19. GLM results showed that decreased in-person contact (AOR = 1.42, 95% CI = 1.17-1.73) and increased video call contact (AOR = 1.30, 95% CI = 1.01-1.66) with family/friends and on-line participation in clubs, classes, and other organized activities (AOR = 1.36, 95% CI = 1.04-1.77) were associated with higher odds of increased loneliness. CONCLUSIONS: Virtual interaction is not an effective substitute for in-person interaction for older adults and is associated with increased loneliness. CLINICAL IMPLICATIONS: : Innovative means of making virtual contacts more similar to in-person contacts are needed to decrease older adults' loneliness during COVID-19.

Telehealth Use Among Older Adults During COVID-19: Associations With Sociodemographic and Health Characteristics, Technology Device Ownership, and Technology Learning.

The COVID-19 pandemic ushered in rapid telehealth/telemedicine adoption. In this study, we (1) examined rates and correlates of telehealth (video call) use among those aged 70+, and (2) tested the significance of access to information and communication technology (ICT) device ownership and knowledge of how to use the internet and devices as telehealth-enabling factors. The Behavioral Model of Health Services Use served as the conceptual framework, and data came from the COVID-19 supplemental survey of the National Health and Aging Trend Study. Results show that telehealth use increased to 21.1% from 4.6% pre-pandemic. In logistic regression models without technology-enabling factors, older age and lower income were negatively associated with telehealth use; however, when technology-enabling factors were included, they were significant while age and income were no longer significant. Insuring that older adults have ICT devices and internet access may reduce health disparities and improve telehealth care delivery.