Herbal supplements and retirement facility residents : factors that predict usage

Abstract

The prevalence of herbal supplement use by the elderly and factors that influence regular versus occasional use were investigated in a group of independent residents of a continuing care retirement community in Salem, Oregon. A nine-page questionnaire was delivered to 402 residents of Capital Manor; 318 questionnaires were usable (84% response rate). The majority of respondents were female (68%) and Caucasian (88%) with an age range of 65 to 100 (average 82.2 years). Twenty percent of all respondents (n=65) were herbal supplement users. Sixty-two percent of them were regular users and 39% were occasional users. The majority of users were female (68%), Caucasian (85%), and non-smokers (78%). Their age range was 65 to 91 years (mean of 79.6 years). Sixty-nine percent reported living with a spouse. They had more than a high school education (78%) and had annual household incomes above $50,000 (49%). "Books, newspapers, and magazines" (84%) were the information sources most frequently relied on for herbal supplement information, followed by "medical doctor/nurse" (72%). Forty-four percent of user households spent more than $10 per month on herbal supplements. Supermarkets (41%) and health food stores (41%) were the most popular places to purchase herbal supplements. The majority of herbal supplement users strongly agreed/agreed that taking herbal supplements would "make you feel less stress" (88%), "protect you from getting a cold" (81%), and "improve your memory" (81%). Fifty-two percent of users strongly agreed/agreed that "herbal supplements may cause side effects" and 24% strongly agreed/agreed that "herbal supplement shouldn't be taken with other medications". Gingko biloba was the most frequently used of eight herbal supplements (71% of respondents) followed by echinacea (39%) and ginseng (29%). Males were significantly more likely to use saw palmetto (claimed to prevent enlargement of the prostate gland). Eighty-three percent of herbal supplement users reported having some knowledge about possible benefits of ginkgo biloba (claimed to reduce memory loss). A belief that herbal supplements "improve your memory" was significantly associated with usage. Regular herbal supplement users were significantly more likely to agree that taking herbal supplements reduces severity of memory loss. Four factors were significantly related to herbal supplement use: age group (with age group of 75 to 84 years old more likely to be users than age groups of 65 to 74 years and age group of 85 years and over); living status (with those living with spouses being more likely to be users than those living alone), health status changes in the past year (with users being more likely to report their health status as "improved" than non-users); and physical exercise participation (with users being more likely to exercise than nonusers). The fundamental hypothesis of this study was that the frequency of use of herbal supplements among older adults would be mediated by several factors including: perceived susceptibility to and severity of chronic diseases (i.e., heart disease and cancer); perceived benefits of and barriers to herbal supplement usage; information sources; vitamin/mineral supplement usage; and perceived preventive lifestyle factors. Of these, only vitamin/mineral supplement usage was significantly associated with herbal supplement usage. Ninety-seven percent of herbal supplement users also used vitamin/mineral supplements. In addition, perception of control over health (a measure of self-efficacy) was significantly associated with herbal supplement use. The more control perceived, the more likely respondents were to be herbal supplement users. In general, the Health Belief Model did not predict frequency of herbal supplement usage (i.e., regular vs. occasional). Hence, further research is needed to focus on factors predicting herbal supplement use versus non-use. In addition, lack of awareness about risks and benefits of herbal supplement use suggests a need for education targeted at older adults.