The use of chiropractors by older adults in the United States.
BACKGROUND
In a nationally representative sample of United States Medicare beneficiaries, we examined the extent of chiropractic use, factors associated with seeing a chiropractor, and predictors of the volume of chiropractic use among those having seen one.


METHODS
We performed secondary analyses of baseline interview data on 4,310 self-respondents who were 70 years old or older when they first participated in the Survey on Assets and Health Dynamics Among the Oldest Old (AHEAD). The interview data were then linked to their Medicare claims. Multiple logistic and negative binomial regressions were used.


RESULTS
The average annual rate of chiropractic use was 4.6%. During the four-year period (two years before and two years after each respondent's baseline interview), 10.3% had one or more visits to a chiropractor. African Americans and Hispanics, as well as those with multiple depressive symptoms and those who lived in counties with lower than average supplies of chiropractors were much less likely to use them. The use of chiropractors was much more likely among those who drank alcohol, had arthritis, reported pain, and were able to drive. Chiropractic services did not substitute for physician visits. Among those who had seen a chiropractor, the volume of chiropractic visits was lower for those who lived alone, had lower incomes, and poorer cognitive abilities, while it was greater for the overweight and those with lower body limitations.


CONCLUSIONS
Chiropractic use among older adults is less prevalent than has been consistently reported for the United States as a whole, and is most common among Whites, those reporting pain, and those with geographic, financial, and transportation access.
Wolinsky
Fredric D
FD
College of Public Health, The University of Iowa, Iowa City, Iowa, USA. fredric-wolinsky@uiowa.edu
Liu
Li
L
Miller
Thomas R
TR
Geweke
John F
JF
Cook
Elizabeth A
EA
Greene
Barry R
BR
Wright
Kara B
KB
Chrischilles
Elizabeth A
EA
Pavlik
Claire E
CE
An
Hyonggin
H
Ohsfeldt
Robert L
RL
Richardson
Kelly K
KK
Rosenthal
Gary E
GE
Wallace
Robert B
RB