Exploring social determinants of healthcare and cognition levels among diverse older adults

Zahra Rahemi, Juanita Dawne R. Bacsu, Sophia Z. Shalhout, Maryam S. Sadafipoor, Matthew Lee Smith, Swann Arp Adams

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The purpose was to investigate the impact of social determinants of health on healthcare utilization among older adults in two cognition groups: normal and dementia/impaired cognition. Methods: We used cross-sectional data from the Health and Retirement Study (N = 16,339) to assess healthcare utilization: hospital stay, nursing home stay, hospice care, and doctor visits. The respondents were classified into two cognition groups using the Langa-Weir approach. Results: A cohort comparison between normal (mean age = 66.1) and dementia/impaired cognition (mean age = 71.9) groups revealed dementia/impaired group included more individuals from racial and ethnic minorities (42.7 % Black/Other, 20.8 % Hispanic) compared to the normal cognition (24.7 % Black/Other, 12.1 % Hispanic). They experienced longer hospital, nursing home, and hospice stays and varied doctor visit frequencies. These differences were influenced by race, age, marital status, education, and rurality. Conclusion: Social determinants of health play an important role in predicting disparities in healthcare utilization among older adults across cognition levels.

Original languageEnglish (US)
Pages (from-to)614-621
Number of pages8
JournalGeriatric Nursing
Volume61
DOIs
StatePublished - Jan 1 2025

Keywords

  • Cognition
  • Doctor visits
  • Health and retirement study
  • Hospice
  • Hospital
  • Nursing home

ASJC Scopus subject areas

  • Gerontology

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