Racial and ethnic variances in preparedness for aging in place among US adults ages 50-80.

OBJECTIVES: To investigate the preparations made by adults to age in place and identify disparities. METHODS: A cross-sectional survey was conducted among U.S. adults ages 50-80 years old (n = 2277). Individual, environmental, social, and community factors influencing readiness for aging in place were examined using chi-square tests and logistic regression. RESULTS: Income, disability status, and household composition, emerged as influential factors, often negatively affecting minority aging. Participants' consideration of aging in place was related to their disability status (OR 1.80 [1.32, 2.45]) and age (OR age 60-69 2.06 [1.54, 2.74], age 70-80 (OR 1.98 [1.46,2.67]), compared with age 50-59). Indigenous and Black older adults reported significantly higher levels of consideration for aging in place than White older adults (Indigenous OR 7.89 [2.35, 26.42], Black OR 1.71 [1.11, 2.64]). CONCLUSION: Aging in place is best facilitated by inclusive communities that prioritize adaptive homes and accessible community services.

Perceptions of Overall Mental Health and Barriers to Mental Health Treatment Among US Older Adults.

OBJECTIVES: We surveyed older adults about their perceived mental health and their comfort discussing and engaging in mental health treatment. METHODS: A nationally representative survey of community-dwelling older adults aged 50-80 (N = 2,021), with respondents asked to rate their current mental health as compared to 20 years ago, comfort discussing their mental health, and potential hesitations to seeking treatment in the future. RESULTS: About 79.6% reported their mental health as the same or better than 20 years ago; 18.6% reported their mental health to be worse. Most respondents reported that they were comfortable (87.3%) discussing their mental health, preferring to discuss such concerns with their primary care provider (30.6%). About 28.5% of respondents did endorse some hesitation seeking mental health care in the future. CONCLUSIONS: Most older adults reported that their mental health was as good if not better than it was 20 years ago and felt comfortable discussing mental health concerns.

Firearm ownership, attitudes, and safe storage practices among a nationally representative sample of older U.S. adults age 50 to 80.

Firearms are a leading cause of injury mortality across the lifespan, with elevated risks for older adult populations. To inform prevention efforts, we conducted a probability-based web survey (12/1/2019-12/23/2019) of 2048 older adults (age 50-80) to characterize national estimates of firearm ownership, safety practices, and attitudes about health screening, counseling, and policy initiatives. Among older U.S. adults, 26.7% [95%CI = 24.8%-28.8%] report owning one or more firearms. The primary motivation for ownership was protection (69.5%), with 90.4% highlighting a fear of criminal assault. 39.4% of firearm owners reported regularly storing firearm(s) unloaded and locked, with 24.2% regularly storing at least one loaded and unlocked. While most firearm owners found healthcare screening (69.2% [95%CI: 64.9-73.1]) and safety counseling (63.2% [95%CI = 58.8-67.3]) acceptable, only 3.7% of older adults reported being asked about firearm safety by a healthcare provider in the past year. Among firearm owners, there was support for state-level policy interventions, including allowing family/police to petition courts to restrict access when someone is a danger to self/others (78.9% [95%CI = 75.1-82.3]), comprehensive background checks (85.0% [95%CI = 81.5-87.9]), restricting access/ownership under domestic violence restraining orders (88.1%; 95%CI = 84.9-90.7], and removing firearms from older adults with dementia/confusion (80.6%; 95%CI = 76.8-84.0]. Healthcare and policy-level interventions maintained higher support among non-owners than owners (p's < 0.001). Overall, data highlights opportunities exist for more robust firearm safety prevention efforts among older adults, particularly healthcare-based counseling and state/federal policies that focus on addressing lethal means access among at-risk individuals.

Interest in Sex and Conversations About Sexual Health with Health Care Providers Among Older U.S. Adults.

Objectives: Sexual health is an important component of overall health and well-being for older adults. Despite this, little is known about the importance of sex to quality of life, as part of romantic relationships for older adults, and potential drivers of interactions between healthcare providers and older adults about sexual health. In this study using a nationally representative population, we describe perceptions and experiences of sex among older adults.Methods: A nationally representative, cross-sectional sample of community-dwelling U.S. adults aged 65-80 was surveyed about their sexual health and interaction with their health care providers about sexual health.Results: The survey completion rate was 75% (N = 1,002). Overall, 50.9% of men and 30.8% of women reported being sexually active. In all, 17.3% of adults aged 65-80 reported speaking to their health care provider about sexual health in the past two years and of those, 60.5% of patients initiated the conversation. Multivariable logistic regression demonstrated that sexual activity (yes/no), interest in sex, and satisfaction with sex life are major drivers of sexual health conversations between patients and healthcare providers.Conclusions: Many adults aged 65-80 are interested in and engage in sexual activity. While the majority of older adults reported a willingness to discuss their sexual health with their health care providers, few had done so, and most conversations were initiated by patients. Iterest in sex and satisfaction with sex life may be targets for intervention and offer a segue for providers as they begin the conversation to engage with older adults about their sexual health.Clinical Implications: Providers may have conversations with older adults about sexual health and may need sexual health training to have effective discussions; age nor chronic conditions should preclude this essential conversation. Clinical gerontologists may be helpful in this training and in encouraging patients to bring up sexual health concerns during their medical appointments.

Correlates of Formal Support Service Use among Dementia Caregivers.

Informal caregivers for persons with dementia frequently report needing assistance, yet formal support service use has been low. To better understand factors associated with service use, correlates of self-reported service use (e.g., support groups, family mediation, family leave, classes/trainings, and respite care) among dementia caregivers were assessed. The National Poll on Healthy Aging conducted a nationally representative web-based survey of adults aged 50-80 (N = 2,131) using Ispos' KnowledgePanel®; 148 reported caregiving for an adult with memory loss [61.5% female; 25% nonwhite, 54.1% aged 50-64]. Multivariable logistic regression analyzes assessed caregiver and care recipient characteristics associated with service use within the prior year. Nearly 25% of caregivers used at least one service. Caregiver characteristics associated with greater likelihood of service use included not working [7.5 OR; 2.73, 20.62 CI]; income <$30,000/year [5.9 OR; 1.27, 27.17 CI]; and residing in Western US [7.5 OR; 2.73, 20.62 CI]. Ability of care recipient to be left alone safely for only three hours or less [5.1 OR; 1.66, 15.46 CI] was associated with greater likelihood of use. Support service use remains low. Findings suggest need to consider caregivers' employment status, income, and geographical location in service design and implementation.

Prescription and Nonprescription Sleep Product Use Among Older Adults in the United States.

OBJECTIVE: Older adults commonly use products that may be used to promote sleep, such as benzodiazepines and over-the-counter medications, but the current extent of use of both prescription and nonprescription products specifically for sleep in the United States is unknown. METHODS: Respondents in this cross-sectional, nationally representative survey (the National Poll on Healthy Aging) of community-dwelling older adults aged 65-80 (n = 1,065) reported difficulty initiating sleep or early awakening ("sleep symptoms") and use of prescription medication or nonprescription aids to promote sleep ("sleep product"), including prescription sleep medication, over-the-counter (OTC) sleep aids, prescription pain medication, and herbal/natural sleep aids. Logistic regression was used to determine the association of respondent sociodemographic and clinical characteristics with the use of sleep products. RESULTS: Sleep symptoms were endorsed by 67.7% of respondents (95% confidence interval [CI] 64.7%-70.7%). Use of a sleep product was reported by 35.4% (95% CI 32.4%-38.6%), with 21.9% (95% CI 19.4%-24.7%) using OTC sleep aids, 12.5% using herbal/natural aids (95% CI 10.6%-14.8%), 8.3% using prescription sleep medication (95% CI 6.7%-10.3%), and 5.0% using prescription pain medication (95% CI 3.8%-6.7%). Self-reported fair/poor mental health (relative to excellent/very good) was associated with increased odds of sleep product use (adjusted odds ratio 2.28, 95% CI 1.10-4.72, p = 0.03). CONCLUSION: More than a third of older adults use medications or aids to help with sleep-most commonly OTC aids. Clinicians should routinely ask older patients about sleep-related difficulties and the use of nonprescription sleep aids.

Poison Ivy, Poison Oak, and Poison Sumac.

This JAMA Patient Page describes allergic skin reactions from contact with poison ivy, poison oak, and poison sumac plants, and how to treat rashes caused by these plants.

What Is Dengue?

This JAMA Patient Page describes the viral infection dengue and its signs and symptoms, diagnosis, treatment, and prevention measures.

What Are E-Cigarettes?

This JAMA Patient Page describes e-cigarettes and the potential health effects of vaping.

Therapies to Decrease Severe Respiratory Syncytial Virus Illness.

This JAMA Insights discusses the use of monoclonal antibodies or protein-based vaccines to help prevent severe RSV infection in infants, children, and older adults.

Social Isolation and Loneliness in Older Adults.

This JAMA Patient Page discusses social isolation and loneliness as important public health concerns, especially among older adults.

Highlights From IDWeek 2023-New Vaccines, Artificial Intelligence, and Antimicrobial Resistance.

This Medical News article is an interview with infectious disease physician Heather Yun, MD, cochair of this year's Infectious Diseases Week meeting in Boston.

Artificial Intelligence, Emerging Threats, and Diagnostic Advances-Highlights From ECCMID, Europe's Largest Infectious Disease Conference.

This Medical News article is an interview with ECCMID program director Jacob Moran-Gilad, MD, MPH.

Public Health Experts Advise Clinicians to Be on the Lookout for New Mpox Cases.

This Medical News article discusses signs of an mpox resurgence and updated prevention and treatment information.