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This study examined negative life changes due to coronavirus disease of 2019 (COVID-19) and its correlates in a sample of community-dwelling older adults from a low-income urban city in Korea, focusing on gendered differences. Negative life changes due to COVID-19 were categorized into four domains: behavioral/physical, psychosocial, goal-seeking, and control/freedom. Being female, not receiving basic livelihood security, and dissatisfaction with housing situation were significantly associated with negative life changes during the pandemic. Gender-stratified analyses revealed that most within-gender social disparities associated with changes due to COVID-19 occurred in older women. The odds of experiencing negative changes were higher among working women and those receiving security income aid. In low-income urban communities, those who were previously socially and economically active perceived more negative changes owing to the pandemic. The contribution of gender to negative life changes should be considered to effectively alleviate concerns among older adults during pandemics. [ABSTRACT FROM AUTHOR]

Background: Previous epidemiological studies have suggested that phthalate exposure may contribute to neurocognitive and neurobehavioral disorders and decreased muscle strength and bone mass, all of which may be associated with reduced physical performance. Walking speed is a reliable assessment tool for measuring physical performance in adults age 60 y and older. Objective: We investigated associations between urinary phthalate metabolites and slowness of walking speed in community-dwelling adults ages 60-98 y. Methods: We analyzed 1,190 older adults [range, 60-98 y of age; mean [+ or -] standard deviation (SD), 74.81 [+ or -] 5.99] from the Korean Elderly Environmental Panel II study and measured repeatedly up to three times between 2012 and 2014. Phthalate exposure was estimated using the following phthalate metabolites in urine samples: mono-(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono-(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono-n-butyl phthalate (MnBP), mono-(2-ethyl-5-carboxypentyl) phthalate (MECPP), and mono-benzyl phthalate (MBzP). Slowness was defined as a walking speed of Results: At enrollment, MBzP levels were associated with an increased odds of slowness [odds ratio (OR) per doubling increase: 1.15, 95% confidence interval (CI): 1.02, 1.30; OR for the highest vs. lowest quartile: 2.20 (95% CI: 1.12, 4.35) with p-trend across quartiles = 0.031]. In longitudinal analyses, MEHHP levels showed an increased risk of slowness [OR per doubling increase: 1.15 (95% CI: 1.02, 1.29), OR for the highest vs. lowest quartile: 1.47 (95% CI: 1.04, 2.06), p- trend = 0.035]; whereas those with higher MnBP showed a reduced risk of slowness [OR per doubling increase: 0.84 (95% CI: 0.74, 0.96), OR in the highest (vs. lowest) quartile: 0.64 (95% CI: 0.47, 0.87), p-trend = 0.006]. For linear regression models, MBzP quartiles were associated with slower walking speed (p-trend = 0.048) at enrollment, whereas MEHHP quartiles were associated with slower walking speed, and MnBP quartiles were associated with faster walking speed in longitudinal analysis (p-trend = 0.026 and Discussion: Urinary concentrations of prevalent phthalates exhibited significant associations with slow walking speed in adults ages 60-98 y. https://doi.org/10.1289/EHP10549, Introduction Walking speed is one of the quickest, most reliable, and simple measurements for monitoring the mobility and physical function of older adults. (1) Along with blood pressure, pulse rate, [...]

Purpose of the Study: To examine the effects of the present on admission (POA) indicator on the prevalence of and factors associated with postsurgical adverse events in older patients. Design and Methods: This is a secondary data analysis of 82,898 surgical patients aged 65 years or older in 252 acute care hospitals in California in 2004. Four adverse events were counted using the Agency for Healthcare Research and Quality's Patient Safety Indicator (PSI) definitions with and without using the POA indicator. We also examined the effects of the POA indicator on the relationships between patient- and hospital-level factors and adverse events, using generalized linear mixed models. Results: The use of the POA indicator resulted in a marked reduction in the estimated rates of all 4 adverse event rates. Adjustment for POA conditions also influenced factors associated with adverse events. Compared with those with newly occurring adverse events only, admissions with only POA conditions were more likely to be admitted through the emergency department, be unplanned, and belong to patients with one or more preceding admissions or those with multiple admissions within the same year. Implications: Adverse event rates estimated from discharge abstracts using PSI methodology could be overstated when the POA indicator was not used. The POA indicator could influence predictors of adverse events. Studies on geriatric safety and outcomes using large administrative data sets should consider using the POA indicator. Further studies are needed on how to determine POA conditions.

Purpose: To examine the relationship between registered nurse (RN) staffing mix and quality of nursing home care measured by regulatory violations. Design and Methods: A retrospective panel data study (1999-2003) of 2 groups of California freestanding nursing homes. One group was 201 nursing homes that consistently met the state's minimum standard for total nurse staffing level over the 5-year period. The other was 210 nursing homes that consistently failed to meet the standard over the period. All facility and market variables were drawn from California's cost report data and state licensing and certification data, as well as 3 other databases. Results: The RN to total nurse staffing ratio was negatively related to serious deficiencies in nursing homes that consistently met the staffing standard, whereas the ratio was negatively associated with total deficiencies in nursing homes that consistently failed to meet the standard over the 5-year period. As the RN to licensed vocational nurse ratios increased, total deficiencies and serious deficiencies decreased in both groups of nursing homes. Implications: A higher RN mix is positively related to quality of care, but the relationship is affected by overall nurse staffing levels in nursing homes. Further studies are necessary for a better understanding of RNs' unique contributions to the quality of care in nursing homes.