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      Daily Routine: Associations With Health Status and Urgent Health Care Utilization Among Older Adults

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          Abstract

          Background and Objectives

          Chronically ill older adults must integrate self-care behaviors into their daily routine to promote health and reduce urgent health care utilization. Individuals of lower socioeconomic position (SEP) experience a disproportionate burden of stressors that challenge the formation of regular routines. We examined associations between the presence of a daily routine and older adults’ health status and urgent health care utilization, to determine whether higher levels of daily routine mediates associations between SEP and health outcomes.

          Research Design and Methods

          We used data from a cohort of older adult primary care patients in Chicago. Daily routine was measured using a brief, validated scale. A single factor score of SEP was created with measures of education, income, homeownership, and insurance status. Health status was assessed by Patient Reported Outcomes Measurement Information Service physical function, depression, and anxiety. Urgent health care utilization was patient reported. Multivariable models were used to assess the effect of routine and SEP on health status and urgent health care utilization.

          Results

          Individuals reporting low levels of daily routine reported worse physical function (β = −2.34; 95% CI −4.18, −0.50), more anxiety (β = 2.73; 95% CI 0.68, 4.78) and depressive symptoms (β = 2.83; 95% CI 0.94, 4.74) than those with greater daily routine. No differences in urgent health care utilization were observed by daily routine. Daily routine varied by SEP ( p < .001); routine partially mediated the relationship between SEP and physical function and anxiety symptoms ( ps < .05).

          Discussion and Implications

          A daily routine may be an under recognized modifiable factor that could promote health outcomes among older adults.

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          Author and article information

          Contributors
          Role: Decision Editor
          Journal
          Gerontologist
          Gerontologist
          geront
          The Gerontologist
          Oxford University Press (US )
          0016-9013
          1758-5341
          September 2019
          22 September 2018
          17 September 2020
          : 59
          : 5
          : 947-955
          Affiliations
          [1 ] Division of General Internal Medicine and Geriatrics, Northwestern University , Chicago, IL
          [2 ] Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University , Chicago, IL
          [3 ] College of Nursing, University of Illinois at Chicago , Chicago, IL
          [4 ] Office of Research, Denver Health and Hospital Authority , Denver, Colorado
          [5 ] Division of General Internal Medicine, Icahn School of Medicine at Mount Sinai , New York
          [6 ] Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago , Chicago, IL
          Author notes
          Address correspondence to: Rachel O’Conor, PhD, MPH, Division of General Internal Medicine and Geriatrics, Feinberg School of Medicine, Northwestern University, 750 N. Lake Shore Drive, 10th Floor, Chicago, IL 60611. E-mail: r-oconor@ 123456northwestern.edu
          Article
          PMC6857682 PMC6857682 6857682 gny117
          10.1093/geront/gny117
          6857682
          30247549
          7a364eb1-9253-4f27-aab1-ca5d108370a5
          © The Author(s) 2018. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

          This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model ( https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

          History
          : 12 July 2018
          : 06 August 2018
          Page count
          Pages: 9
          Funding
          Funded by: National Institute on Aging 10.13039/100000049
          Award ID: R01AG030611
          Categories
          Access to Healthcare

          Socioeconomic position,Analysis—regression models,Health,Chronic illness

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