Use of Complementary Medicine in Older Americans: Results From the Health and Retirement Study

Department of Internal Medicine, University of Iowa Carver College of Medicine, SE624GH, 200 Hawkins Drive, Iowa City, IA 52242, USA.
The Gerontologist (Impact Factor: 3.21). 09/2005; 45(4):516-24. DOI: 10.1093/geront/45.4.516
Source: PubMed


The correlates of complementary and alternative medicine (CAM) utilization among elders have not been fully investigated. This study was designed to identify such correlates in a large sample of older adults, thus generating new data relevant to consumer education, medical training, and health practice and policy.
A subsample from the 2000 Wave of the Health and Retirement Study (n = 1,099) aged 52 or older were surveyed regarding use of CAM (chiropractic, alternative practitioners, dietary and herbal supplements, and personal practices).
Of respondents over 65 years of age, 88% used CAM, with dietary supplements and chiropractic most commonly reported (65% and 46%, respectively). Users of alternate practitioners and dietary supplements reported having more out-of-pocket expenses on health than nonusers of these modalities. Age correlated positively with use of dietary supplements and personal practices and inversely with alternative practitioner use. Men reported less CAM use than women, except for chiropractic and personal practices. Blacks and Hispanics used fewer dietary supplements and less chiropractic, but they reported more personal practices than Whites. Advanced education correlated with fewer chiropractic visits and more dietary and herbal supplement and personal practices use. Higher income, functional impairment, alcohol use, and frequent physician visits correlated with more alternative practitioner use. There was no association between CAM and number of chronic diseases.
The magnitude and patterns of CAM use among elders lend considerable importance to this field in public health policy making and suggest a need for further epidemiological research and ongoing awareness efforts for both patients and providers.

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Available from: Dominic Cirillo, Apr 03, 2014
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    • "A randomized subsample (n = 1099) of the 2000 wave of the Health and Retirement Study [25] answered questions about their CAM use. The evaluation included subgroups in the age ranges of 65–79 (43%) and 80 years or older (14%). "
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    ABSTRACT: Very little is known about complementary and alternative medicine (CAM) use by older adults in Germany. The aim of this study was to investigate the use of CAM and other health promoting substances (e.g., herbal teas) by older adults of at least 70 years of age. A cross-sectional questionnaire study was conducted among persons of >=70 years from metropolitan Berlin and rural parts of Brandenburg, Germany. Recorded were: demographics, current use of CAM, medical diagnoses, users' opinions and preferences. A total of 400 older adults, living as 'self-reliant' (n = 154), 'home care service user' (n = 97), or 'in nursing home' (n = 149), and with the legal status 'without guardian' (n = 355) or 'with guardian' (n = 45) were included (mean age 81.8 +/- 7.4 years, 78.5% female). Any type of CAM used 61.3% of respondents (dietary supplements 35.5%, herbal medicines 33.3%, and external preparations 26.8%); 3.0% used drug-interaction causing preparations. Usage was based on recommendations (total 30.3%; in 20.0% by friends or family and 10.4% by pharmacists), own initiative (27.3%), and doctors' prescription (25.8%). Participants with legal guardian took almost solely prescribed dietary supplements. Of the others, only half (58.7%) informed their general practitioner (GP) of their CAM use. Participants expected significant (44.9%) or moderate (37.1%) improvement; half of them perceived a good effect (58.7%) and two-thirds (64.9%) generally preferred a combination of CAM and conventional medicine. More than half (57.9%) stated that they could neither assess whether their CAM preparations have side effects, nor assess what the side effects might be. Strongest predictors for CAM use were two treatment preferences (vs. 'conventional only': 'CAM only', OR = 3.98, p = 0.0042 and 'CAM + conventional', 3.02, 0.0028) and the type of health insurance ('statutory' vs. 'private', 3.57, 0.0356); against CAM use two subjective assessments predicted (vs. 'CAM causes no harm': 'CAM causes harmful drug interactions', 0.25, 0.0536 and 'I cannot assess side effects', 0.28, 0.0010). Older German adults frequently use CAM. They perceived it as an effective complement to conventional medicine, but are not sufficiently informed about risks and benefits.
    BMC Geriatrics 03/2014; 14(1):38. DOI:10.1186/1471-2318-14-38 · 1.68 Impact Factor
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    • "CAM has caught the attention of many older adults and their caregivers as CAM often offers gentler and safer approaches to addressing common health conditions suffered by elderly.[2] A survey on community-dwelling older adults in Minnesota indicated that 62.7% of the respondents had used at least one CAM modalities.[3] Nearly 88% of older Americans were reported to be using CAM in an analysis of Health and Retirement Study.[4] With the ageing of the Baby-Boom population and increased life expectancy, the prevalence of CAM usage among the older population is somewhat expected to be increased.[5] "
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    ABSTRACT: Since time immemorial homo sapiens are subjected to both health and diseases states and seek treatment for succor and assuagement in compromised health states. Since last two decades the progressive rise in the alternative form of treatment cannot be ignored and population seems to be dissatisfied with the conventional treatment modalities and therefore, resort to other forms of treatment, mainly complementary and alternative medicine (CAM). The use of CAM is predominantly more popular in older adults and therefore, numerous research studies and clinical trials have been carried out to investigate the effectiveness of CAM in the management of both communicable and non-communicable disease. In this current mini review, we attempt to encompass the use of CAM in chronic non-communicable diseases that are most likely seen in geriatrics. The current review focuses not only on the reassurance of good health practices, emphasizing on the holistic development and strengthening the body's defense mechanisms, but also attempts to construct a pattern of self-care and patient empowerment in geriatrics. The issues of safety with CAM use cannot be sidelined and consultation with a health care professional is always advocated to the patient. Likewise, responsibility of the health care professional is to inform the patient about the safety and efficacy issues. In order to substantiate the efficacy and safety of CAMs, evidence-based studies and practices with consolidated standards should be planned and executed.
    Pharmacognosy Reviews 03/2014; DOI:10.4103/0973-7847.134230
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    • "Patients with unresolved pain may pair conventional healthcare with complementary and alternative medicine (CAM) [16-19]. Chiropractic is among the most widely used CAM therapies [16,17,20,21], including by older adults [22-26]. Patients who use medical care and chiropractic together believe the combination helps their condition more than either alone [21]. "
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    ABSTRACT: While older adults may seek care for low back pain (LBP) from both medical doctors (MDs) and doctors of chiropractic (DCs), co-management between these providers is uncommon. The purposes of this study were to describe the preferences of older adults for LBP co-management by MDs and DCs and to identify their concerns for receiving care under such a treatment model. We conducted 10 focus groups with 48 older adults who received LBP care in the past year. Interviews explored participants' care seeking experiences, co-management preferences, and perceived challenges to successful implementation of a MD-DC co-management model. We analyzed the qualitative data using thematic content analysis. Older adults considered LBP co-management by MDs and DCs a positive approach as the professions have complementary strengths. Participants wanted providers who worked in a co-management model to talk openly and honestly about LBP, offer clear and consistent recommendations about treatment, and provide individualized care. Facilitators of MD-DC co-management included collegial relationships between providers, arrangements between doctors to support interdisciplinary referral, computer systems that allowed exchange of health information between clinics, and practice settings where providers worked in one location. Perceived barriers to the co-management of LBP included the financial costs associated with receiving care from multiple providers concurrently, duplication of tests or imaging, scheduling and transportation problems, and potential side effects of medication and chiropractic care. A few participants expressed concern that some providers would not support a patient-preferred co-managed care model. Older adults are interested in receiving LBP treatment co-managed by MDs and DCs. Older adults considered patient-centered communication, collegial interdisciplinary interactions between these providers, and administrative supports such as scheduling systems and health record sharing as key components for successful LBP co-management.
    BMC Complementary and Alternative Medicine 09/2013; 13(1):225. DOI:10.1186/1472-6882-13-225 · 2.02 Impact Factor
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