探索不同老年人群体中医疗保健的社会决定因素和认知水平。
Exploring social determinants of healthcare and cognition levels among diverse older adults.
作者信息
Rahemi Zahra, Bacsu Juanita-Dawne R, Shalhout Sophia Z, Sadafipoor Maryam S, Smith Matthew Lee, Adams Swann Arp
机构信息
School of Nursing, The Clemson University, Clemson, SC, United States.
School of Nursing, Thompson Rivers University, Kamloops, Canada.
出版信息
Geriatr Nurs. 2025 Jan-Feb;61:614-621. doi: 10.1016/j.gerinurse.2024.12.037. Epub 2025 Jan 7.
BACKGROUND
The purpose was to investigate the impact of social determinants of health on healthcare utilization among older adults in two cognition groups: normal and dementia/impaired cognition.
METHODS
We used cross-sectional data from the Health and Retirement Study (N = 16,339) to assess healthcare utilization: hospital stay, nursing home stay, hospice care, and doctor visits. The respondents were classified into two cognition groups using the Langa-Weir approach.
RESULTS
A cohort comparison between normal (mean age = 66.1) and dementia/impaired cognition (mean age = 71.9) groups revealed dementia/impaired group included more individuals from racial and ethnic minorities (42.7 % Black/Other, 20.8 % Hispanic) compared to the normal cognition (24.7 % Black/Other, 12.1 % Hispanic). They experienced longer hospital, nursing home, and hospice stays and varied doctor visit frequencies. These differences were influenced by race, age, marital status, education, and rurality.
CONCLUSION
Social determinants of health play an important role in predicting disparities in healthcare utilization among older adults across cognition levels.
背景
本研究旨在调查健康的社会决定因素对两个认知组（正常认知组和痴呆/认知受损组）老年人医疗保健利用情况的影响。
方法
我们使用了健康与退休研究的横断面数据（N = 16339）来评估医疗保健利用情况，包括住院、入住养老院、临终关怀和看医生。采用兰加 - 韦尔方法将受访者分为两个认知组。
结果
正常认知组（平均年龄 = 66.1岁）和痴呆/认知受损组（平均年龄 = 71.9岁）的队列比较显示，与正常认知组（24.7%为黑人/其他种族，12.1%为西班牙裔）相比，痴呆/认知受损组中来自少数种族和族裔的个体更多（42.7%为黑人/其他种族，20.8%为西班牙裔）。他们的住院、入住养老院和临终关怀时间更长，看医生的频率也有所不同。这些差异受到种族、年龄、婚姻状况、教育程度和农村地区等因素的影响。
结论
健康的社会决定因素在预测不同认知水平老年人医疗保健利用差异方面起着重要作用。
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