Younger Older Americans and Sarcopenic Obesity: The Moderating Role of Living Alone.

OBJECTIVES: Previous studies have indicated that compared to older adults, younger older adults (e.g., baby boomers) are more susceptible to obesity, but their risk decreases as they age. However, there is a lack of research on how individuals experience sarcopenic obesity, which increases in later life and is a mortality risk factor. This study examined how younger cohorts of older Americans and their demographic traits are related to sarcopenic obesity. METHODS: Generalized estimating equations were used to analyze participants aged 65 years and older, stratified by sex using data from the 2006-2016 Health and Retirement Study, with survey weights (n = 2,896 men and n = 4,268 women). RESULTS: The findings indicate that the youngest cohort (born between 1948 and 1953) had greater odds of sarcopenic obesity than older cohorts (born before 1931). However, the youngest cohort did not have significantly different risks from those born between 1931 and 1947. Unexpectedly, the youngest cohort of older women living alone tended not to have sarcopenic obesity compared to the older cohorts living alone. These results remained significant even after adjusting for various covariates, including marital status, race, education level, wealth, and other factors. DISCUSSION: This paper contributes to the existing literature on population health and demographic change in 2 ways. First, the risk of sarcopenic obesity is higher among younger cohorts of older Americans relative to older cohorts (born before 1931). Second, living alone may not necessarily be considered a worse health condition, particularly for younger female cohorts.

Assessing Excess Mortality of Baby Boomers from the COVID-19 Pandemic: Taiwan Omicron-naïve Cohort.

BACKGROUND: Asia's elderly Baby Boomer demographic (born between 1946 and 1964) faced a huge problem during the COVID-19 pandemic due to increased all-cause mortality. We aimed to provide a unique Taiwan situation regarding the impact of Baby Boomers on excess mortalities from all causes relative to non-Baby Boomers throughout distinct times of SARS-CoV-2 mutations during the COVID-19 pandemic. METHODS: We used the Poisson time series design with a Bayesian directed acyclic graphic approach to build the background mortality prior to the COVID-19 pandemic between 2015 and 2019. It was then used for predicting the expected all-cause deaths compared to the reported figures during the COVID-19 pandemic period based on Taiwan residents, an Omicron-naïve cohort. RESULTS: Baby Boomers experienced a 2% negative excess mortality in 2020 (Wuhan/D614G) and a 4% excess mortality in 2021 (Alpha/Delta) with a rising background mortality trend whereas non-Baby Boomers showed the corresponding figures of 4% negative excess and 1% excess with a stable trend. Baby Boomer and non-Baby Boomer excess mortality soared to 9% (95% CI: 7-10%) and 10% (95% CI: 9-11%), respectively, during the epidemic Omicron period from January to June 2022. Surprisingly, Baby Boomers aged 58-76 experienced the same 9% excess mortality as non-Baby Boomers aged 77 and beyond. Non-COVID-19 deaths were more prevalent among Baby Boomers than non-Baby Boomers (33% vs. 29%). CONCLUSION: Baby Boomers were more likely to die from COVID-19 in early pandemic and had more non-COVID-19 deaths in late pandemic than older non-Baby Boomers demonstrated in Taiwan Omicron-naïve cohort. For this vulnerable population, adequate access to medical care and medical capacity require more consideration.

Higher adherence to a Mediterranean-type diet is associated with reduced psychosocial stress levels in baby boomers: a cross-sectional study.

BACKGROUND/OBJECTIVES: This study investigated the relationship between adherence to the Mediterranean diet among Korean baby boomers and their levels of psychosocial stress. SUBJECTS/METHODS: The study included 1,656 adults (889 men and 797 women) born between 1955 and 1963 who participated in the 2005-2006 survey of the community-based Korean Genome and Epidemiology Study (KoGES). The Mediterranean-type diet score (MTDS) was calculated from the semi-quantitative food frequency questionnaire (SQFFQ) data. The psychosocial stress levels were calculated using the psychosocial well-being index-short form (PWI-SF). Logistic regression analyses were performed to analyze the association between the MTDS (tertiles) and the prevalence of high psychosocial stress by gender. RESULTS: The ranges of the MTDS tertile groups were T1 (20-33 points), T2 (34-37 points), and T3 (38-39 points) for men, T1 (20-33 points), T2 (34-37 points), and T3 (38-48 points) for women. In both men and women, the consumption of whole grains, potatoes, fruits, vegetables, legumes, and fish increased with higher MTDS, while the consumption of red meat and dairy products decreased (P for trend < 0.05). As MTDS score increased the intake of energy, fiber, vitamins, and minerals (P for trend < 0.05). Men in the highest MTDS tertile had a 41% lower odds ratio (OR) of high psychosocial stress compared with those in the lowest tertile (OR, 0.59; 95% confidence interval [CI], 0.38-0.91). Similarly, women in the highest tertile of the MTDS had a 39% lower OR of high psychosocial stress compared with those in the lowest tertile (OR, 0.61; 95% CI, 0.40-0.95). CONCLUSION: Promoting adherence to the Mediterranean diet among baby boomers may have a positive impact on reducing their levels of psychosocial stress.

Pharmacy-based screening program to detect hepatitis C in 'baby-boomer' cohorts in western Canada.

Background: The estimated prevalence of hepatitis C virus (HCV) in Canada is approximately 1.0%. However, the number of individuals living with HCV but unaware of it is estimated to be 30%-44%. Increased screening programs that are accessible, effective, and feasible are important to ensure treatment and meet WHO elimination goals. We implemented an HCV point of care test (POCT) program in community pharmacies to examine the effectiveness and feasibility in screening. Methods: Twenty two London Drugs pharmacies in British Columbia and Alberta implemented an HCV POC screening program using OraQuick rapid antibody tests. Consenting patients filled out a 10-question screening questionnaire to examine risk factors. The participants then were tested using the POCT. While waiting for the test (20 minutes), patients were educated on HCV and treatment options. Results: Three hundred seventy-one participants underwent HCV screening. The most common HCV risk factor was being born between 1945 and 1975 (baby boomer) (93% of cohort), while the second most common was having a tattoo or body piercing (22%). Seven people (2%) tested positive; four were HCV-RNA PCR-positive and were treated, whereas the PCR status of three was unknown as they were lost to follow-up or not tested. Conclusions: Pharmacy-based POCT was shown to be effective and feasible in the western Canadian context, especially for baby boomers. Sustainable funding for pharmacy screening programs may be considered nationwide to identify HCV-infected persons and help meet elimination goals.

Stress and suicidal ideation in Korean baby boomers: the mediating effect of mindfulness and meaning in life.

Stress has been shown to enhance elderly suicidal ideation. However, the effect of mindfulness and meaning in life on the relationship between stress and suicidal ideation in Korean baby boomers are still unknown. This study investigated (a) a significant correlation between the stress, suicidal ideation, mindfulness, and meaning in life, (b) the mediating effect of mindfulness in the association between stress and suicidal ideation, and (c) the serial mediating effect of mindfulness and then meaning in life on the relationship between stress and suicidal ideation. Data were collected from 200 baby boomers (born between 1955-1963) concerning their stress, mindfulness, meaning in life, and suicidal ideation. These findings suggest that if interventions directed at baby boomers can successfully improve their mindfulness and by extension raise their meaning in life, suicidal ideation will decrease within their population.

Oral health issues of early baby boomers.

OBJECTIVES: The purpose of this article is to detail the oral health status of early baby boomers and how it is affected by the cultural influences after World War II. METHODS: National data on clinically and self-assessed oral conditions from the 2021 NIDCR Oral Health in America Report, National Health and Nutrition Examination Survey (2011-2014), Center for Disease Control and Prevention, National Cancer Institute (2018), the Indian Health Service (2022), and the Health and Retirement Study (2018) were tabulated and compared (where available) to similar data for older and younger cohorts. RESULTS: Data analyses show that there is more tooth retention overall. There are higher levels of tooth loss, unrestored caries, and periodontitis among Black, American Indian, Alaskan Native, and Hispanic baby boomers, and the poor. Smokers had higher rates of periodontitis. CONCLUSION: A life course approach to oral health care is warranted. Only by regular access and preventive care throughout life can avoidable, unnecessary, overly complex, and invasive procedures be prevented.

Body Satisfaction and Associated Predictors Among Baby Boomer Women in Rural and Urban Manitoba.

Purpose: This study examines body satisfaction, weight attitudes, dieting behaviours, and aging concerns of baby boomer women (BBW; born 1946-1965) from rural and urban Manitoba.Methods: Primary data collection occurred November 2015, and 1083 participants completed the Body Image and Food Choice Survey. Four strata of BBW were represented to examine differences between older and younger BBW and location of residence. Multinomial logistic regression models were fit to determine predictors of weight and appearance satisfaction. Odds ratios and 95% confidence intervals were considered significant at p ≤ 0.05.Results: Fifty-three percent of participants were satisfied with their appearance, whereas only 34% were satisfied with their weight. Ninety-one percent desired to lose weight (29.9 ± 29.3 lbs). Aging anxiety was evident for 46% of participants and associated with appearance satisfaction (χ2 = 27.46, df = 4, p < 0.001). Body work and dieting behaviours were used to mitigate body dissatisfaction, and media influence was associated with both appearance (χ2 = 76.17, df = 6, p < 0.001) and weight satisfaction (χ2 = 67.90, df = 6, p < 0.001). Desired weight change, appearance stress, appearance importance, and self-rated health predicted both weight and appearance satisfaction.Conclusions: There is a need for greater awareness of aging women's body image concerns and the need for age-appropriate tools/resources to help dietitians support women achieve a healthy body image.

The Double Mediating Effect of Family Support and Family Relationship Satisfaction on Self-Compassion and Meaning in Life among Korean Baby Boomers.

This study identified the relationship between self-compassion and meaning in life among Korean baby boomers and examined the double mediating effect of family support and family relationship satisfaction on this relationship. For this purpose, data were collected from 400 baby boomers (born between 1955-1963) using the self-compassion, meaning in life, family support, and family relationship satisfaction scales. PROCESS Macro 3.5 Model 6 was used to analyze the double mediating effects. The results revealed that first, there was a significant correlation between the self-compassion, meaning in life, family support, and family relationship satisfaction of this study. Second, in the relationship between self-compassion and the meaning in life, family support, and family relationship satisfaction were found to have a partial mediating effect and a double mediating effect. The implications and limitations of these findings are also discussed.

Identifying baby boomer service expectations for future aged care community services in Australia.

Baby Boomers are ageing, yet little is known as to what their expectations are likely to be for the community health service sector or what the challenges this cohort might create. Interviews were conducted with 11 experienced Australian baby boomer carers to identify the key characteristics that might influence their future community aged care service expectations. Qualitative analysis of the data revealed five characteristics that could influence participant expectations for future services: Independent; Astute; Resourceful; Forthright and Exacting. As octogenarians this group plan to independently self-determine what support services they receive and from whom without any outside influence, using their well-developed skills and knowledge, by drawing on their own resourcefulness. They will most likely create significant pressure for industry change. To accommodate this group, a new service industry model will most likely be needed. One that empowers older people to completely self-manage and take control of their services as true consumers rather than a model, which designates older people as passive recipients of provider offered and driven services. For this to be achieved, a considerable philosophical shift is required on how ageing is viewed by society, including health professionals and government.

Religious Transitions Among Baby Boomers From Young Adulthood to Later Life: Associations with Psychological Well-Being Over 45 Years.

We used classification analysis to examine change in religiosity among baby boomers from young adulthood to early old age and how religiosity transition patterns are associated with psychological well-being in later life. In addition, we tested the gender difference in the above association. We applied latent class and latent transition analysis to 392 baby boomers who participated in the Longitudinal Study of Generations in Wave-1 (1971) and Wave-9 (2016). We identified three classes describing religiosity at each wave (strongly religious, doctrinally religious, and weakly religious), and considered five types of change or stability in religious class membership from Wave-1 to Wave-9. Multiple regression with gender interactions revealed that men who stayed strongly religious over the period reported better psychological well-being compared to men who declined in their religiosity; no such pattern was found for women. Our findings suggest that maintaining strong religiosity over the life course was beneficial for baby boom men in later life.

Chest Wall Swelling in a Baby Boomer: An Unusual Presentation of Primary Hepatocellular Carcinoma.

Primary hepatocellular carcinoma (HCC) is one of the most frequently diagnosed cancers in adult men and a leading cause of cancer-related deaths worldwide. It also has an association with patients with hepatitis C-related cirrhosis. HCC usually metastasizes within the liver as well as to the lungs, regional lymph nodes, and adrenal glands, whereas the involvement of the chest wall and thoracic musculoskeletal system are more unusual. Herein, we report the case of a 58-year-old man who presented with swelling of the right anterolateral lower chest wall. The final diagnosis was primary HCC with distant metastases involving the right anterolateral ribs and left scapula. Such a presentation of extrahepatic HCC of this size and at this site is unique and has never before been reported in the literature. It reinforces the urgency and importance of screening all adults (18 years and above), particularly baby boomers, because three out of 100 have been infected with hepatitis C, at least once in their lifetime. It is also a wake-up call, as the incidence of primary HCC secondary to hepatitis C-associated cirrhosis has doubled, with a resultant increase in mortality. This HCC-related death might have been prevented if the patient had been screened for hepatitis C virus in his lifetime, as recommended by the American Association for the Study of Liver Diseases. We also discuss the latest developments in the diagnosis and management of HCC.

Differences in inpatient and outpatient hepatitis C virus prevalence and linkage to care rates in a safety net hospital hepatitis C screening program.

BACKGROUND AND AIM: Routine screening for hepatitis C virus (HCV) infection is crucial in identifying the 50% of infected persons unaware of their infection. We added an inpatient screening initiative to our successful outpatient HCV screening program in an urban, safety-net hospital. METHODS: From March 2017 to December 2019, HCV screening was performed in inpatient and outpatient settings at Grady Health System. We compared care cascade outcomes, including anti-HCV testing, RNA testing, and linkage to care (LTC) between these settings. RESULTS: A total of 29 751 patients were tested for anti-HCV: 8883 inpatients and 20 868 outpatients. The anti-HCV population was predominantly Black (76.2%) and male (67.9%). The total anti-HCV prevalence was 8.9%, with 14% of inpatients and 6.7% of outpatients testing positive. RNA testing was performed on 86%. The prevalence of active HCV infection was 59.3% in those that were anti-HCV positive; inpatient prevalence was 66%, and outpatient was 53.8%. Of those with active infection, 67.5% were linked to care (57.3% of inpatients and 77.8% of outpatients). CONCLUSION: We found significant differences in prevalence of anti-HCV and LTC rates between inpatients and outpatients during an HCV screening program. Higher anti-HCV prevalence among inpatients may be due a higher prevalence of non-birth year HCV risk factors. LTC rates were lower in the inpatient setting despite a robust linkage strategy. The striking prevalence of HCV in both settings warrants continued screening, expansion to additional settings, and novel strategies to improve inpatient linkage rates, especially in the setting of new universal HCV screening guidelines.

Gender, education, and digital generations as determinants of attitudes toward health information for health workers in West Java, Indonesia.

Health information is a commodity heavily sought by Indonesians because of the increasing consciousness of a healthy lifestyle. However, the circulation of health information is consistently disrupted by misinformation and disinformation, particularly on social media and chatting platforms such as WhatsApp. Identified misinformation and disinformation can be found on the official web page run by the Ministry of Communication and Information (https://trustpositif.kominfo.go.id/). Digital information exchange often involves health care workers; they are considered a credible source of health information. The purpose of this study was to delineate the attitudes of health care workers toward health information, determined by gender, educational attainment, and age differences. Health information in this study was information circulated on WhatsApp. We divided the age differences into four digital generations: baby boomers and Generations X, Y, and Z. We used the t-test and analysis of education and age differences when using the analysis of variance to demonstrate the differences among determinants factors of respondents-617 health care workers in West Java-in using WhatsApp when receiving and sharing health information. The results support that attitudes toward health information are determined by education attainment and differences in generation and that gender differences have no effect.

Dyadic Profiles of Health Behaviors Among Korean Baby Boomer Couples.

Objectives: To address the issue of whether health behaviors are concordant within couples, this study identified dyadic profiles of health behaviors among Korean baby boomer couples (born 1955-1963). Methods: We analyzed a sample of 1,092 middle-aged couples from the Korean Baby Boomer Panel Study (2014). Latent class analysis and multinomial regression models were conducted to describe underlying health behavior profiles. Results: Four dyadic profiles of health behaviors emerged: (a) concordant-high health-promoting (26%), (b) moderate concordant-compensating (21%), (c) moderate concordant-low engaging (22%), and (d) less concordant-high health-promoting (31%). In addition, couples with higher levels of education, worse health, or better marital quality were more likely to belong to two high health-promoting profiles. Discussion: Encouraging husbands to engage in fewer health-compromising behaviors and acknowledging barriers to health-promoting behaviors for both spouses may contribute to healthier lifestyles among Korean couples.

Age- and risk factor-based serologic screening for Hepatitis C virus among an Urban, high-risk population.

Hepatitis C virus (HCV) screening among individuals born between 1945 and 1965 (ie birth cohort) may augment risk factor-based screening. We assessed HCV seropositivity among injection drug users (IDUs) and birth cohort members from New York City. We assessed HCV risk factors and seropositivity in 7722 participants from community health, HIV prevention, syringe exchange and drug treatment programmes. A total of 26.6% were HCV seropositive, 55.8% were born between 1945 and 1965, and 82.2% had ever injected drugs. Among all participants, HCV seropositivity was higher among IDUs compared to non-IDUs (60.5% versus 7.7%, odds ratio (OR) = 18.5, 95% confidence interval (CI) [16.2, 21.1], P < .0001) and among birth cohort members compared to non-birth cohort members (31.3% versus 22.3%, OR = 1.6, 95%CI [1.4, 1.8], P < .0001). Within the birth cohort, HCV seroprevalence among IDUs was 68.5% versus 11.8%, OR = 16.2, 95%CI [13.7, 19.3]. After adjustment, HCV seroprevalence was higher in IDUs, previously incarcerated, whites (<42 years) and 'other races' (versus blacks), HIV-infected, those who snorted heroin, those with liver disease history, and those who had sex with an HCV-seropositive partner. HCV seroprevalence among IDU, birth cohort members, was considerably higher than among the general population. In this high-risk, urban population, the association between IDU and HCV seropositivity was approximately ten times that between birth cohort membership and HCV seropositivity.

A Digital Health Coach for Younger Seniors - User Centred Requirements Collection.

BACKGROUND: Based on socio-economic and medical improvements as well as healthier lifestyles, a majority of baby boomer pensioners still feel fit and active and thus may struggle with transitioning into retirement. They could benefit from an ICT system to ease their transition into retirement and support general well- being. OBJECTIVES: The aim of this paper was to gain insights into the requirements for a digital coach to support their transition into retirement. METHODS: Two rounds of focus groups with older employees close to retirement, people just retired and relatives of retired were conducted. Outcomes were then identified through a framework analysis and integrated into the design of a digital coach. RESULTS: Four functional groups (i) physical activity, (ii) cognitive support, (iii) emotional support and (iv) social support were identified.

"It's Luck as to What Sort of Family You're Born Into" Cumulative Dis/advantage Generative Systemic Processes Across the Life Course of a Baby-Boom Birth Cohort.

OBJECTIVES: While a large body of evidence exists in support of outcomes associated with cumulative dis/advantage (CAD), individual-level experiences of the systemic processes that generate unequal outcomes have received far less attention. This study explored experiences, among members of an early baby-boom birth cohort, of CAD-generative processes within the education and housing systems and the mechanisms by which they interacted with initial social position to perpetuate inequalities. METHODS: The author conducted in-depth interviews (n = 27) with members of the Newcastle Thousand Families Study, a UK 1947 birth cohort. Longitudinal survey data enabled participant sampling on the basis of gender, occupational social class at birth and age 50, educational attainment and homeownership status at age 60. Qualitative data were analyzed using thematic analysis. RESULTS: Analysis identified two themes: Firstly, the sorting and funneling mechanisms by which the "meritocratic" education system interacted with initial social position, progressively narrowing aspirations and opportunities; and secondly, the creation in later life of winners and losers in the property market, resulting in legitimization of inequalities through a deservingness narrative. DISCUSSION: CAD has proved persistent, even among the supposedly "lucky" early baby-boom cohort. Policies to ameliorate CAD generation through education and property systems act instead to entrench advantaged social positions. Later-life outcomes can be naturalized as the product of effort-plus-ability if not seen in a whole-life context. Disruption of CAD processes requires challenging vested interest inherent in social systems.

Nonalcoholic Steatohepatitis Becomes the Leading Indication for Liver Transplant Registrants Among US Adults Born Between 1945 and 1965.

BACKGROUND: Improved efforts in screening and treating chronic hepatitis C virus (HCV) infection are expected to reduce its burden among adults on the liver transplantation (LT) waitlist (WL). We aim to evaluate birth cohort-specific liver disease etiology trends in US adults listed for and receiving LT. METHODS: We evaluated 2005-2016 United Network for Organ Sharing LT registry data to evaluate birth cohort-specific trends in LT WL registrants and recipients in the US. Annual trends in etiology of liver disease at listing were compared between the 1945-1965 birth cohort and the non-1945-1965 birth cohort, were stratified by presence of hepatocellular carcinoma (HCC vs. non-HCC), and were focused on the four leading indications for LT in the US, nonalcoholic steatohepatitis (NASH), HCV infection, alcoholic liver disease (ALD), and those with combined alcoholic cirrhosis with HCV (HCV/ALD). RESULTS: From 2005 to 2016, although HCV infection was a leading indication for LT WL registration among the 1945-1965 birth cohort patients until 2015, NASH overtook HCV infection as the leading indication in 2016. When stratified by HCC status, both ALD and NASH surpassed HCV infection as the leading indication among 1945-1965 birth cohort WL registrants without HCC, whereas HCV infection remained the leading indication among patients with HCC. When evaluating trends in patients who received LT, HCV infection remained the leading indication among the 1945-1965 birth cohort patients. CONCLUSION: In 2016, NASH surpassed HCV infection as the leading indication for WL registration among the 1945-1965 birth cohort patients. Improved HCV screening, increased availability of effective HCV infection treatment, and rising prevalence of nonalcoholic fatty liver disease may explain changes in LT indication among this group.

Improved Hepatitis C Cure Cascade Outcomes Among Urban Baby Boomers in the Direct-Acting Antiviral Era.

OBJECTIVES: We compared outcomes of the hepatitis C virus (HCV) cure cascade (ie, the path a patient follows from diagnosis to cure), including antiviral treatment outcomes, from 2 HCV screening programs. Our objective was to assess whether treatment uptake and HCV cure rates improved in the cohort screened after the release of all-oral HCV direct-acting antiviral therapies. METHODS: We retrospectively compared outcomes of the HCV cure cascade from a cohort of newly diagnosed patients screened during 2012-2014 (period 1) with outcomes from a cohort of newly diagnosed patients screened during 2015-2016 (period 2) at Grady Health System in Atlanta, Georgia. Cure cascade outcomes included HCV antibody (anti-HCV) and RNA testing, linkage to care, antiviral treatment, and sustained virologic response. RESULTS: During period 1, 412 of 5274 (7.8%) persons screened were anti-HCV positive, and 264 (69.3%) of those tested were RNA positive. During period 2, 462 of 7137 (6.5%) persons screened were anti-HCV positive, and 240 (59.3%) of those tested were RNA positive (P = .003). The percentage of newly diagnosed patients who were treated during period 2 (64.0%) was 3 times that of newly diagnosed patients treated during period 1 (21.2%; P < .001). Both cohorts had similarly high levels of linkage to care (95.8% during period 1, 95.4% during period 2) and cure (92.6% during period 1, 95.5% during period 2). CONCLUSIONS: Over time, the prevalence of anti-HCV and HCV RNA positivity declined substantially, and linkage-to-care and cure rates remained high. Treatment uptake increased significantly after the introduction of all-oral direct-acting antiviral therapy. These findings suggest that combining large-scale screening initiatives with treatment programs can speed progress toward HCV elimination.