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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.

Educational level is most strongly associated with predicting active life expectancy of blacks and whites 65 years old and older. It is a more significant predictor of active life and total life expectancy than race. A study of 2,219 blacks and 1,838 whites found that men and women who were 65 years old and who had 12 or more years of education had a two-to-four year longer active life expectancy than participants with less education. Measurements of active life expectancy included assessing participants' abilities to dress, wash and eat by themselves, as well as their ability to use the toilet without assistance and their ability to walk across a room unassisted. Study participants were initially interviewed in 1986 and 1987 and contacted yearly thereafter. Those who were classified as disabled during the first interview had a mortality rate two-to-three times higher than those who were not initially classified as disabled.

Reports on Part A of the Older Americans' Resources and Services Multidimensional Functional Assessment Questionnaire. Content and consensual validity were ensured by construction method. Information on criterion validity was obtained for all dimensions except social. (Author)

Purpose of Study: To maximize respondent participation in a study of the prevalence, incidence, and natural history of dementia. Design and Methods: Clinical research nurses were trained to carry out evaluations for dementia in the home. We describe the assessment and training procedures used and note the advantages and drawbacks of this approach. Results: Nurse identification of the presence of dementia agreed well with that of medical specialists (kappa = 0.84), but was slightly poorer regarding type of dementia (kappa = 0.71). Implications: Use of nurses for such activity need not be limited to epidemiological studies, but is relevant also in clinical practice. Key Words: Diagnosis, Dementia, In-home evaluation

Background. Comorbidity is common in elderly persons. Its extent, correlates, and life-threatening impact in representative community residents are unclear. Methods. Self-reported information of physician-diagnosed coronary artery disease (CAD), cerebrovascular disease (CVD), diabetes, and cancer was obtained annually between 1986-87 and 1992-93, and hypertension was obtained triennially from the participants of the Duke Established Populations for Epidemiologic Studies of the Elderly, a stratified multistage sample of 4126 Black and White community residents aged 65-100, living in a five-county area of North Carolina. Date of death was obtained from death certificates identified through search of the National Death Index. Statistical procedures included descriptive statistics, logistic regression, and survival analysis. Results. Of this sample, 57% reported hypertension, 20% diabetes, 15% CAD, 9% cancer, and 9% CVD; 29% reported none of these conditions, whereas 29% reported two or more. Demographic characteristics were not related to comorbidity with CVD or cancer. Increased education tended to be protective. The effect of age, gender, and race varied with condition. At baseline there was substantial comorbidity among hypertension, CAD, CVD, and diabetes, but not with cancer. Hypertension, CVD, and diabetes were risk factors for CAD, whereas diabetes was a risk factor for CVD. After controlling for demographic characteristics, all health conditions except hypertension were predictive of 6-year mortality, as was the presence of comorbidity. Conclusion. We found significant comorbidity in older persons who have hypertension, CAD, CVD, or diabetes; particular risk of developing comorbidity, particularly CAD, among those with hypertension, CVD, and diabetes; and risk of CVD in those with diabetes. With the exception of hypertension, these conditions, and comorbidity per se, are life-threatening.

Background: A number of large-scale population studies have provided valuable information about physical performance in aged individuals; however, there is little information about trajectories of function and associations with age across the adult life span. We developed a mobility-focused physical performance screener designed to be appropriate for the adult life span.Methods: The physical performance battery includes measures of mobility, strength, endurance, and balance. Physical activity (PA) was assessed with accelerometry. We examined age-related trends in physical performance and PA, and the relationship between physical performance and PA across the age range (30-90+), by decade, in 775 participants enrolled in the study 2012-2014.Results: Physical performance was worse with increasing age decade. Although men performed better than women across all ages, the decrement by age group was similar between genders. Worsening physical performance was observed as early as the fifth decade for chair stands and balance and in the sixth decade for gait speed and aerobic endurance. The number and strength of significant associations between physical performance and PA increased with greater age: the greatest number of significant associations was seen in the 60-79 age groups, with fewer reported in the 30-59 and 80-90+ age groups. More PA was associated with better physical function.Conclusion: These results emphasize the importance of a life span approach to studies of function and aging. This work points to the need for a physical performance screener that spans across adulthood as a clinical tool for identifying functional decline. [ABSTRACT FROM AUTHOR]