An analysis of elder abuse rates in Milwaukee County.

INTRODUCTION: The elder abuse and neglect burden in Milwaukee County, Wisconsin, is substantial, with 3384 reports made from 2006 to 2009. Current prevalence estimates are determined from reported cases only and are likely underestimated. Provider awareness of victim and perpetrator characteristics is necessary to increase recognition and response. METHODS: A cross-sectional analysis of elder abuse and neglect cases reported to the Milwaukee County Department on Aging (MCDA) from 2006 to 2009 was performed to provide a profile of the county's elder abuse burden by victim, perpetrator, and reporter characteristics. Annual reporting trends were identified using Poisson regression analysis. RESULTS: Fifty-eight percent of MCDA reports of abuse were substantiated after investigation. Victims in Milwaukee County tended to be older than 75 (64%), female (64%), and white (62%). Reporting rates to the MCDA were significantly lower in 2009 than 2006. Perpetrators were often adult children (48%) or a spouse (14%). Forty percent of life-threatening cases of self-neglect were due to unfulfilled medical needs. Most reports were made by medical professionals (23%), relatives of the victim (21%), and community agencies (18%). Only 13% of elder abuse victims were placed in nursing homes and assisted living centers; many received services to assist independent living. DISCUSSION: Although this study is limited to reported cases only, it provides a valuable profile of pertinent elder abuse characteristics in Milwaukee County. CONCLUSION: Characteristics of vulnerable elders, potential abusers, and investigation outcomes are described to inform clinical practice about this important social issue.

Ambulatory activity and body mass index in white and non-white older adults.

BACKGROUND: The purpose of this study was to examine the extent to which physical activity (PA) is related to obesity in older adults when accounting for race/ethnicity. METHODS: Cross-sectional data were collected on 214 older adults (72.3 +/- 8.9 y; body mass index [BMI] 28.9 +/- 6.0; 151 females; 96 non-White). Measures of body height and mass were collected; BMI was calculated. PA was assessed via an electronic pedometer worn for seven consecutive days. RESULTS: "White" subjects accumulated 5036 +/- 286 steps/d. "Non-White" subjects accumulated significantly fewer steps/d (3671 +/- 253 steps/d; z = -3.45, P = 0.001). Race/ethnicity, income, age, gender, and steps/d accounted for 27.4% (P < 0.001) of the variance in BMI, with steps/d accounting for 21.2% (P < 0.001). The most influential factor in this model was PA level (beta = -0.510), followed by age (beta = -0.220), and finally gender being the least influential, but still a significant factor (beta = 0.168). CONCLUSION: Although race/ethnicity and income have been associated with obesity levels, this study shows that older adults who accumulate more ambulatory activity tend to have healthier levels of BMI irrespective of race/ethnicity or income.

Glucose control and walking in a multiethnic sample of older adults.

BACKGROUND: Although walking is the most commonly reported physical activity by older adults, there is a paucity of data determining the relationship between objectively determined walking behavior and glucose dynamics in older adults. OBJECTIVE: This study was designed to investigate the relationship between objectively determined walking behavior and glucose control in a multiethnic sample of older adults. METHODS: Data were collected on 142 older adults (age 72.1 +/- 9.2 years; body mass index (BMI) 29.4 +/- 6.3; 37 males, 105 females). Anthropometric measures, fasting plasma glucose (FG), and glycosylated hemoglobin A(1c) (HbA(1c)) were assessed; race/ethnicity was self-reported. The study participants wore a pedometer for 7 consecutive days. RESULTS: The average number of steps/day reported by the entire group was 3,939 +/- 232. White participants (n = 48) were older (p = 0.019), taller (p = 0.002), had lower waist circumference (WC) (p = 0.021), HbA(1c) (p = 0.001) and FG (p = 0.007), and did not differ in average steps/day (p = 0.162) or BMI (p = 0.280) as compared with nonwhite participants (n = 94). Individuals with HbA(1c) values <7% and those with FG <100 mg/dl walked about 1,343 more steps/day than those with unfavorable HbA(1c) and/or FG values. Age, race/ethnicity, WC, BMI, log base 10 of steps/days, and type 1 and 2 diabetes medications accounted for 37.5% of the variance in inverse HbA(1c) (p < 0.001), with significant or near significant individual model contributions consisting of WC (beta = -0.316, B = -0.001, SE = 0.000, p = 0.047), BMI (beta = 0.310, B = 0.001, SE = 0.001, p = 0.050), diabetic medication (beta = -0.473, B = -0.035, SE = 0.006, p < 0.001), and log base 10 of steps/day (beta = 0.198, B = 0.019, SE = 0.010, p = 0.056). Interpretations of transformed data illustrate that greater WC and being on diabetic medications are associated with higher HbA(1c) levels. Further, there is a trend to suggest that fewer accumulated steps/day and lower BMI are associated with higher HbA(1c) concentrations. CONCLUSIONS: This study demonstrated that objectively determined walking behavior and indicators of obesity were modest predictors of chronic glucose control, after accounting for glucose-altering medications, in this multicultural sample of older adults. Further, when comparing individuals with good glucose control to those with less favorable glucose control, walking an additional 0.5-0.75 miles was associated with better glucose control.

Walking and metabolic syndrome in older adults.

BACKGROUND: Little data exists describing the impact that walking has on metabolic syndrome (MetS) in a multicultural sample of older adults. METHODS: Walking was measured via pedometer in 150 older adults from 4 different ethnic categories. Steps per day were classified as low (< 3100 steps/d) or high (> or = 3100 steps/d) for statistical analyses. RESULTS: Occurrence of MetS was lower in the white (33%) versus non-white population (50%). Low steps/d were related to an increase in MetS for both white (OR = 96.8, 95% CI 12.3-764.6) and non-white individuals (OR = 4.5, 95% CI 1.8-11.3). Low steps/d also increased the odds for selected components of MetS in both the white and non-white groups. CONCLUSION: Low levels of walking increase the likelihood of having MetS in both white and nonwhite older adults. Efforts to increase walking in older adults may decrease the likelihood of developing this clustering of disease risk factors.