The choice of self-rated health measures matter when predicting mortality: evidence from 10 years follow-up of the Australian longitudinal study of ageing

BACKGROUND Self-rated health (SRH) measures with different wording and reference points are often used as equivalent health indicators in public health surveys estimating health outcomes such as healthy life expectancies and mortality for older adults. Whilst the robust relationship between SRH and mortality is well established, it is not known how comparable different SRH items are in their relationship to mortality over time. We used a dynamic evaluation model to investigate the sensitivity of time-varying SRH measures with different reference points to predict mortality in older adults over time. METHODS We used seven waves of data from the Australian Longitudinal Study of Ageing (1992 to 2004; N = 1733, 52.6% males). Cox regression analysis was used to evaluate the relationship between three time-varying SRH measures (global, age-comparative and self-comparative reference point) with mortality in older adults (65+ years). RESULTS After accounting for other mortality risk factors, poor global SRH ratings increased mortality risk by 2.83 times compared to excellent ratings. In contrast, the mortality relationship with age-comparative and self-comparative SRH was moderated by age, revealing that these comparative SRH measures did not independently predict mortality for adults over 75 years of age in adjusted models. CONCLUSIONS We found that a global measure of SRH not referenced to age or self is the best predictor of mortality, and is the most reliable measure of self-perceived health for longitudinal research and population health estimates of healthy life expectancy in older adults. Findings emphasize that the SRH measures are not equivalent measures of health status.This study was funded by the South Australian Health Commission, the Australian Rotary Health Research Fund, the US National Institute of Health (Grant No. AG 08523-02) and the National Health and Medical Research Council (NHMRC; Grant No.229936). KJA is supported by NHMRC Fellowship No.366756

The relationship between age-stereotypes and health locus of control across adult age-groups

OBJECTIVE: This study integrates healthy ageing and health psychology theories to explore the mechanisms underlying the relationship between health control expectancies and age-attitudes on the process of ageing well. Specifically, the aim of this study is to investigate the relationship between age-stereotypes and health locus of control. DESIGN: A population-based survey of 739 adults aged 20 to 97 years (mean=57.3 years, SD=13.66; 42% female) explored attitudes towards ageing and health attitudes. A path-analytical approach was used to investigate moderating effects of age and gender. RESULTS: Higher age-stereotype endorsement was associated with higher chance (β=2.91, p<.001) and powerful other (β=1.07, p=.012) health expectancies, after controlling for age, gender, education and self-rated health. Significant age and gender interactions were found to influence the relationship between age-stereotypes and internal health locus of control. CONCLUSION: Our findings suggest that the relationship between age-stereotypes and health locus of control dimensions must be considered within the context of age and gender. The findings point to the importance of targeting health promotion and interventions through addressing negative age-attitudes

An Australian survey of cognitive health beliefs, intentions, and behaviours through the adult life course

Objective: Information is required regarding cognitive health beliefs and behaviours from across the life in order to inform the design of interventions to optimise cognitive health and reduce the risk of cognitive impairment. Methods: A survey of Australian adults aged 20-89 was administered via Computer Assisted Telephone Interviewing (CATI) software to respondents recruited by random digit dialling (N = 900). Socio-demographic and self-reported health information was collected to investigate associations with cognitive health responses. Results: Alcohol abuse was nominated by the highest proportion of respondents (34.3%) as detrimental for brain health. Fewer than 5% nominated elevated cholesterol, blood pressure, obesity, poor education, or ageing. The most frequently endorsed protective activity was socialising (70%). Socio-demographic factors predicted responses. Age-group differences were apparent in the proportions nominating alcohol (X2=24.2; p<.001), drugs (X2=56.8; p<.001), smoking (X2=13.1; p=.001), nutrition (X2=20.4; p<.001), and mental activity (X2=12.8; p=.002) as relevant to brain health. Activities undertaken for cognitive benefit also differed by age. Across all ages the perceived benefit of activities was not supported by intentions to undertake activities. Conclusions: Interventions are needed to inform and motivate people across the life-course to undertake behaviours specifically to optimise their cognitive health

Development of the motivation to change lifestyle and health behaviours for dementia risk reduction scale

Background and Aims: It is not yet understood how attitudes concerning dementia risk may affect motivation to change health behaviours and lifestyle. This study was designed to develop a reliable and valid theory-based measure to understand beliefs underpinning the lifestyle and health behavioural changes needed for dementia risk reduction. Methods: 617 participants aged ≥ 50 years completed a theory-based questionnaire, namely, the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction (MCLHB-DRR) scale. The MCLHB-DRR consists of 53 items, reflecting seven subscales of the Health Belief Model. Results: Confirmatory factor analysis was performed and revealed that a seven-factor solution with 27 items fitted the data (comparative fit index = 0.920, root-mean-square error of approximation = 0.047) better than the original 53 items. Internal reliability (α = 0.608–0.864) and test-retest reliability (α = 0.552–0.776) were moderate to high. Measurement of invariance across gender and age was also demonstrated. Conclusions: These results propose that the MCLHB-DRR is a useful tool in assessing the beliefs and attitudes of males and females aged ≥ 50 years towards dementia risk reduction. This measure can be used in the development and evaluation of interventions aimed at dementia prevention

Prospectus, September 5, 2019

SUCCEED WITH STUDENT LEADERSHIP ACADEMY; Queens Club Makes Debut; Humans of Parkland: Brian Walker; Water + Color: A Tribute to Jamie Kruidenier; Kruidenier is Remembered By Her Artwork and the People She Influenced; Brian Walker is More Than Meets the Eye; The Student Leadership Academy Benefits Students in Different Ways; The Queens Club is a New Organization with a Positive Message; Cobra Sportshttps://spark.parkland.edu/prospectus_2019/1039/thumbnail.jp

Correlates of subjective health across the aging lifespan: understanding self-rated health in the oldest old

OBJECTIVES: To examine the determinants of self-rated health (SRH) in different age groups of older adults, including the oldest-old. METHODS: Variables assessing physical health, difficulty with self-care, depressive symptoms and cognitive impairment were pooled and harmonised from three Australian longitudinal studies of ageing (n=5,222). The association of these with SRH was examined in older adults aged 60-64 years, 65-74 years, 75-84 years and 85 years and older. RESULTS: SRH was not associated with cognitive impairment or difficulty with self-care in the oldest-old, and its association with physical health was diminished compared with younger groups. Depression showed a significant relationship in all age groups, conferring an approximately fourfold increase in the likelihood of poorer SRH. DISCUSSION: As old age progresses, self-reports of poor health become most closely related to psychological symptoms. This explains some of the paradoxes of past literature and offers important insights for health professionals working with the oldest-old.National Health and Medical Research Council (NHMRC); Australian Research Council Centre of Excellence in Population Ageing Research (CEPAR

Using Learning Collaboratives to Improve Public Health Emergency Preparedness Systems

The U.S. National Health Security Strategy calls for the development and wide-spread implementation of quality improvement (QI) tools in public health emergency preparedness (PHEP), including the development of “learning collaboratives,” a structured way for organizations with common interests to close the gap between potential and practice by learning from each other. To test this approach, we developed and assessed separate learning collaboratives focused on PHEP emergency communications and on the use of Medical Reserve Corps (MRC) volunteers. Although participants carried out improvement projects that they felt were useful, each collaborative struggled to identify a common theme, participation was limited, and leadership buy-in was not strong. This suggests that the learning collaborative model may not be appropriate in this context. Because some of the factors that limited their success are inherent (the lack of an established evidence base and agreed upon outcome and performance measures and the difficulty of carrying out rapid Plan-Do-Study-Act (PDSA) cycles and measuring the results), this suggests that the learning collaborative model may not be appropriate in this context

Prospectus, September 12, 2019

PARKLAND REMOVES PRAIRIE PLOT; Opinion: Trump offends Denmark; Student Life hosts Leadership Summit; Perimeter Road: Setting the bar high; Parkland hosts health clinics at Wellness Center; Plants picked: new plot pending; Trump offends Denmark after cancelling state visit; Leadership Summit inspire students to succeed; Perimeter Road is taking over the music scene with their art.; Cobra Sportshttps://spark.parkland.edu/prospectus_2019/1040/thumbnail.jp

Cross-national insights into the relationship between wealth and wellbeing: a comparison between Australia, the United States of America and South Korea

The positive relationship between wealth and wellbeing has received considerable attention over the last three decades. However, little is known about how the significance of wealth for the health and wellbeing of older adults may vary across societies. Furthermore, researchers tend to focus mainly on income rather than other aspects of financial resources even though older adults often rely on fixed income, particularly after retirement. Using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey (N=1,431), the Health and Retirement Study (HRS, N=4,687), and the Korean Longitudinal Study of Ageing (KLoSA, N=5,447), this exploratory cross-national study examined the relationship between wealth satisfaction and objective wealth and wellbeing (measured as self-rated health and life satisfaction) among older Australians, Americans and Koreans (50+ years). Regression analyses showed that wealth satisfaction was associated with wellbeing over and above monetary wealth in all three countries. The relationship between monetary wealth and self-rated health was larger for the United States of America (USA) than Australian and Korean samples, while the additional contribution of wealth satisfaction to life satisfaction was larger for the Korean than the Australian and USA samples. These findings are discussed in terms of the cultural and economic differences between these countries, particularly as they affect older persons.This research was funded through a grant. - Sarang Kim was supported by ARC/NHMRC Research Network in Ageing Well, Davina French by NHMRC Project Grant No. 410215 and Kaarin Anstey by NHMRC Research Fellowship No. 366756