Food Insecurity Among Medicare Beneficiaries With Type 2 Diabetes: Implications for Diabetes Care and Education Specialists.

PURPOSE: The purpose of the study was to examine factors associated with food insecurity among Medicare beneficiaries with type 2 diabetes. METHODS: The 2019 Medicare Current Beneficiary Survey Public Use File of beneficiaries ≥65 years old with type 2 diabetes (n = 1343) was analyzed. A binary variable was created to represent food insecurity (1 = food insecurity, 0 = without food insecurity) with ≥2 affirmative responses adapting an established algorithm of the United States Department of Agriculture food insecurity questionnaire. A survey-weighted logistic model was performed to examine factors (ie, sociodemographic characteristics, health status, and insurance coverage) associated with food insecurity. RESULTS: Approximately 11.6% of study Medicare beneficiaries with type 2 diabetes reported food insecurity. Non-Hispanic Black beneficiaries were more likely to report food insecurity than non-Hispanic White beneficiaries. Beneficiaries with incomes < $25 000 were more likely to report food insecurity than those with higher incomes. Beneficiaries enrolled in Medicare Advantage programs (vs traditional Medicare), having Medicare-Medicaid dual eligibility (vs nondual), and living with instrumental activities of daily living or activities of daily living limitations (vs without) were also more likely to report food insecurity than their respective counterparts. CONCLUSIONS: Sociodemographic disparities in food insecurity were observed among Medicare beneficiaries with type 2 diabetes. Implementation of screening protocols, interventions related to social determinants of health, and the diabetes care continuum may mitigate the prevalence of food insecurity in this demographic.

Bathroom modifications among community-dwelling older adults who experience falls in the United States: A cross-sectional study.

Falls impose substantial health and economic burdens on older adults. Over half of falls in older adults occur at home, with many involving bathroom areas. Limited information is available on the presence of bathroom modifications for those who experience them. Therefore, we examined factors associated with bathroom modifications among older adults with at least one fall in the United States. We analysed the nationally representative 2016 Medicare Current Beneficiary Survey Public Use File of Medicare beneficiaries aged ≥65 years with ≥1 fall (n = 2,404). A survey-weighted logistic model was used to examine associations between bathroom modifications and factors including socio-demographic characteristics, health-related conditions, and fear of falling. Among Medicare beneficiaries with ≥1 fall, 55.5% had bathroom modifications and 50.1% had repeated falls (≥2 falls). Approximately 40.2% of those with repeated falls had no bathroom modifications. In the adjusted model, non-Hispanic Blacks (odds ratio [OR] = 0.38; p < 0.001) and Hispanics (OR = 0.64; p = 0.039) had lower odds of having bathroom modifications than non-Hispanic Whites. Fear of falling and activities of daily living limitations had incremental impacts on having bathroom modifications. This study highlights the need to improve disparities in bathroom modifications for non-Hispanic Black and Hispanic Medicare beneficiaries, including those with repeated falls. With the aging population and growing number of older minorities in the United States, reducing these disparities is vital for fall prevention efforts and aging-in-place.

MicroRNA-101 inhibits cell migration and invasion in bladder cancer via targeting FZD4.

Dysfunction of microRNAs (miRs) has been implicated in the development and progression of various human cancers. Our previous study demonstrated that miR-101 inhibited bladder cancer cell proliferation and invasion through inhibition of c-FOS expression. As an miR generally has many targets, other targets of miR-101 may also serve important roles in bladder cancer progression. Reverse transcription-quantitative polymerase chain reaction and western blot analyses were used to examine mRNA and protein expression, respectively. Wound healing and Transwell assays were conducted to study cell migration and invasion, respectively. The luciferase reporter gene assay was performed to verify one of the targets of miR-101. The data in the present study indicate that the expression of miR-101 is significantly reduced in bladder cancer tissues compared with that in adjacent non-tumour tissues. In addition, miR-101 expression is also downregulated in bladder cancer cell lines compared with that in normal bladder epithelial cells. Furthermore, low expression of miR-101 was significantly associated with tumour metastasis, advanced clinical stage, and poor prognosis in bladder cancer. Frizzled class receptor 4 (FZD4) was identified as a novel target of miR-101 in bladder cancer cells. The expression of FZD4 was significantly upregulated in bladder cancer tissues and cell lines. Both miR-101 overexpression and FZD4 inhibition caused a significant reduction of the migration and invasion of bladder cancer cells, whereas overexpression of FZD4 reversed the suppressive effects of miR-101 on bladder cancer cell migration and invasion. In conclusion, it was demonstrated that miR-101 downregulation is associated with bladder cancer progression and that miR-101 can inhibit bladder cancer cell migration and invasion via directly targeting FZD4. The present study expands the understanding of the molecular mechanisms underlying bladder cancer progression.