Search

Introduction Investigation of medication use patterns in a population (or pharmaco-epidemiology) is useful for describing variations in medication use and potentially detecting overuse or underuse of medications [1]. Pharmaco-epidemiological studies [...]

Introduction Elderly people are substantial consumers of medications [1-7]. Community-based surveys reveal that they take an average of 2.7 to 3.9 prescription and nonprescription medications [3, 5-7]. While medications can [...]

This study examines the prevalence of functional disability (limitation in at least one basic activity of daily living) among elderly Black and White community residents in the New Haven (n = 2812) and North Carolina (n = 4162) sites of the Established Populations for Epidemiologic Studies of the Elderly (EPESE). In New Haven, elderly Blacks, particularly women below age 75, had a higher prevalence of disability compared with Whites, which was partially attributable to a higher prevalence of chronic conditions. In North Carolina, Blacks had only a slightly higher risk of being disabled than Whites, and this was fully accounted for by differences in socioeconomic status. Black-White differences in the prevalence of functional disability reveal geographic variation. (Am J Public Health. 1995; 85:994-998), Elderly blacks are more likely to have functional disabilities than whites. Researchers compared data on elderly living in two different geographic areas. One group consisted of 2748 people aged 65 and over living in New Haven and the other group consisted of 4162 elderly persons living in North Carolina, half in an urban county. Interviews were conducted in 1982 and 1986, respectively. Blacks were more likely to have difficulty with daily living than whites, but the gap was smaller in North Carolina than in New Haven. In both areas disabled elderly blacks tended to be younger, less educated, poorer, and have more mental disability. Elderly black women tended to weigh more and were more likely to have two or more chronic conditions. Socioeconomic factors accounted completely for the increased likelihood of disability among North Carolina blacks but not among New Haven blacks. The discrepancy between whites and blacks tended to increase with age, especially among women.

Objectives. To examine and compare concomitants of prescription and nonprescription drug use of Black and White community-dwelling elderly. Methods. Information on prescription and nonprescription drug use, demographic and health characteristics, and use of health services was obtained from a probability-based sample of Black (n = 2152) and White (n = 1821) community-resident elderly in the Piedmont area of North Carolina. Descriptive statistics were calculated. Linear regression, in which sample weights and design effects were taken into account, was used for the final models. Results. For prescription drug use, 37% and 32% of the variance was explained for Whites and Blacks, respectively (6% and 5% for nonprescription drugs). Health status and use of medical services were the strongest predictors of prescription drug use for both races (with Medigap insurance also important for Whites and Medicaid important for Blacks). Demographic characteristics and self-assessed health were significant factors in the use of nonprescription drugs. Race independently predicted use of both types of drugs but explained only a small proportion of the variance. Conclusions. Health status and use of health services are importantly related to prescription drug use. Nonprescription drug use is difficult to explain., Prescription drug use is related strongly to health status and utilization of health services. No such connection can be made for nonprescription drug use. Using data on prescription and nonprescription drug use, as well as demographics, health status and overall use of health services, researchers derived statistics for elderly residents of a North Carolina community. Factors related to the use of prescription and nonprescription drugs among elderly blacks and whites were analyzed. Among blacks and whites in the same state of health, blacks tended to use fewer prescription and nonprescription drugs. Coverage by Medigap insurance was an important factor in prescription drug use by whites, as was Medicaid coverage for blacks. Use of nonprescription drugs was influenced by demographics and subjective assessment of health status. When all other factors were taken into account, some difference remained between the drug use of older blacks and whites.

This study compared the odds of becoming disabled and recovering from disability among blacks and whites aged 65 years and over in two sites of the Established Populations for Epidemiologic Studies of the Elderly (EPESE) project. The authors examined the influence of mortality differences, socioeconomic status, and health-related factors on racial differences in risk of disability and recovery. A Markov model was employed using nine waves of data from the New Haven, Connecticut, site (529 blacks, 2,219 whites) and seven waves of the North Carolina (Piedmont) site (2,260 blacks, 1,876 whites), collected between 1982 and 1992. Blacks below age 75 years had an increased risk of developing disability relative to whites in New Haven (odds ratio (OR) at age 65 years = 3.33,95% confidence interval (CI) 2.13–5.22) as well as in North Carolina (OR at age 65 years = 1.58,95% CI 1.25–1.99). This excess risk diminished with increasing age, and crossed over in New Haven (OR at age 85 years = 0.45,95% CI 0.22–0.95), but not in North Carolina (OR at age 85 years = 1.22,95% CI 0.98–1.51). Adjustment for socioeconomic and health-related factors only partially reduced the excess disability risk among blacks below age 75 years in New Haven, but eliminated the difference in disability risk between blacks and whites in North Carolina. Blacks below age 75 years also had higher mortality risks at both sites. There were no consistent racial differences in recovery from disability. Am J Epidemiol 1997;145:488–97. [ABSTRACT FROM AUTHOR]

Change in self-reported physical function was examined using baseline and 5 years of follow-up data between 1982 and 1991 from the four Established Populations for Epidemiologic Studies of the Elderly studies. In East Boston, Massachusetts (n = 3, 809), lowa and Washington Counties, lowa (n = 3, 673), New Haven, Connecticut (n = 2, 812), and North Carolina (n = 4, 163), noninstitutionalized persons aged 65 years and older were asked a series of questions to assess their physical function: a modified Katz Activities of Daily Living (ADL) scale, three items from the Rosow-Breslau Functional Health Scale, and questions on physical performance, adapted from Nagi, as well as information on demographic, social, and health characteristics. Longitudinal statistical analyses (random effects and Markov transition models) were used to evaluate improvement, stability, and deterioration in functional ability at both an individual and a population level over multiple years of data. The average decline in physical function associated with age was found to be greater than previous cross-sectional studies have suggested, and the rate of decline increased with increasing age. Considerable individual variation was evident. Although many people experienced declines, a smaller but substantial portion experienced recovery. Women reported a greater rate of decline in physical function and were less likely to recover from disability. Am J Epidemiol 1996; 143: 766–78. [ABSTRACT FROM AUTHOR]