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Cheraghi P, Delbari A, Cheraghi Z, Karimi-Shahanjarini A, Zanjari N. Assessment of Met and Unmet Care Needs in Older Adults without Mental Disorders using the Camberwell Assessment of Need for the Elderly: A Systematic Review and Meta-analysis. J Res Health Sci 2021; 21:e00530. [PMID: 36511226 PMCID: PMC8957665 DOI: 10.34172/jrhs.2021.64] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/02/2021] [Accepted: 10/02/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Physical, psychological, and social changes in the aging lead to new needs in the care of the elderly. The Camberwell Assessment of Need for the Elderly (CANE) evaluates older adults' care needs. This study aimed to assess the types of needs of the elderly using the CANE questionnaire. STUDY DESIGN A systematic review. METHODS This systematic review included all cross-sectional studies. International databases, including Web of Sciences, Medline, Scopus, and ProQuest were searched up to June 2021. Such keywords as aged OR ageing OR "older adults" OR "older people" OR "older person" OR elderly, AND need OR "needs assessment" OR "met needs" OR "unmet needs" were used to design the search strategy. A 95% CI was calculated using the exact method, and the meta-analysis of proportion (metaprob) module was used for data analysis. RESULTS In total, 769 studies were retrieved in this review. At the following stages, 760 articles were excluded upon checking the duplicates; moreover, the titles and abstracts did not meet the eligibility criteria. Finally, nine studies remained. The mean±SD age of 2200 participants was obtained at 78.4±5.9 years. The highest and lowest met needs were related to the physical (45%) and social (21%) dimensions, respectively. Furthermore, the highest unmet needs were observed in the physical and social dimensions (0.07%), and the lowest unmet needs were related to the psychological and environmental dimensions (0.04%). CONCLUSIONS The CANE is sensitive enough to identify unmet needs in different samples and settings. Therefore, a new care model and appropriate interventions for the elderly can be designed based on the CANE results.
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Affiliation(s)
- Parvin Cheraghi
- Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ahmad Delbari
- Iranian Research Centre on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Zahra Cheraghi
- Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
,Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Akram Karimi-Shahanjarini
- Department of Public Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nasibeh Zanjari
- Department of Gerontology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
,Correspondence: Nasibeh Zanjari (PhD) Tel: +98 21 22180154 E-mail:
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Tobis S, Wieczorowska-Tobis K, Talarska D, Pawlaczyk M, Suwalska A. Needs of older adults living in long-term care institutions: an observational study using Camberwell Assessment of Need for the Elderly. Clin Interv Aging 2018; 13:2389-2395. [PMID: 30538435 PMCID: PMC6254588 DOI: 10.2147/cia.s145937] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction No comprehensive needs assessment is performed routinely in Poland. Purpose The goal of the study was to investigate the patterns of needs in older individuals living in long-term care institutions (LTCIs) using the Camberwell Assessment of Need for the Elderly (CANE) questionnaire, based on a previously published study protocol. Participants and methods The study included 306 LTCI residents (age: ≥75 years) with the a Mini-Mental State Examination (MMSE) score of at least 10 points. The dependence in basic activities of daily living was measured using the Barthel index (BI). A screening for depression was performed using the Geriatric Depression Scale (GDS) in subjects with an MMSE score of ≥15 points. Thereafter, CANE was used to analyze needs receiving adequate support (met needs) and those without appropriate interventions (unmet needs). Results The mean age of studied individuals was 83.2±6.0 years. They had 10.4±3.2 met needs and 0.8±1.2 unmet needs. Unmet needs were reported most commonly in the following areas: company (15.9%), psychological distress (14.0%), intimate relationship (11.4%), eyesight/hearing/communication (11.4%), and daytime activities (11.0%). The OR of having a large number of met needs (ie, above the median) was almost eight times higher in residents with a BI score of 0–49 points versus those with ≥80 points. The group between (with 50–79 points) had this parameter almost four times higher. The OR of having a large number of unmet needs depended neither on BI nor on GDS and was more than four times higher in the group of 10–19 MMSE points (ie, with symptoms of moderate dementia) versus subjects with 24–30 MMSE points (ie, without symptoms of dementia). Conclusion We defined the target group with high probability of unmet needs and the areas in which resources and efforts should be concentrated. We believe that the results can be used to optimize care in LTCIs.
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Affiliation(s)
- Sławomir Tobis
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznan, Poland,
| | | | - Dorota Talarska
- Department of Preventive Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Mariola Pawlaczyk
- Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznan, Poland,
| | - Aleksandra Suwalska
- Laboratory of Neuropsychobiology, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
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Hallgren J, Fransson EI, Kåreholt I, Reynolds CA, Pedersen NL, Dahl Aslan AK. Factors associated with hospitalization risk among community living middle aged and older persons: Results from the Swedish Adoption/Twin Study of Aging (SATSA). Arch Gerontol Geriatr 2016; 66:102-8. [PMID: 27281475 DOI: 10.1016/j.archger.2016.05.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 04/01/2016] [Accepted: 05/12/2016] [Indexed: 11/30/2022]
Abstract
The aims of the present study were to: (1) describe and compare individual characteristics of hospitalized and not hospitalized community living persons, and (2) to determine factors that are associated with hospitalization risk over time. We conducted a prospective study with a multifactorial approach based on the population-based longitudinal Swedish Adoption/Twin Study of Aging (SATSA). A total of 772 Swedes (mean age at baseline 69.7 years, range 46-103, 59.8% females) answered a postal questionnaire about physical and psychological health, personality and socioeconomic factors. During nine years of follow-up, information on hospitalizations and associated diagnoses were obtained from national registers. Results show that 484 persons (63%) had at least one hospital admission during the follow-up period. The most common causes of admission were cardiovascular diseases (25%) and tumors (22%). Cox proportional hazard regression models controlling for age, sex and dependency within twin pairs, showed that higher age (HR=1.02, p<0.001) and more support from relatives (HR=1.09, p=0.028) were associated with increased risk of hospitalization, while marital status (unmarried (HR=0.75, p=0.033) and widow/widower (HR=0.69, p<0.001)) and support from friends (HR=0.93, p=0.029) were associated with lower risk of hospitalization. Social factors were important for hospitalization risk even when medical factors were controlled for in the analyses. Number of diseases was not a risk in the final regression model. Hospitalization risk was also different for women and men and within different age groups. We believe that these results might be used in future interventions targeting health care utilization.
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Affiliation(s)
- Jenny Hallgren
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Eleonor I Fransson
- Department of Natural Science and Biomedicine, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Institute of Environmental Medicine, Karolinska Institutet, Stockholm 551 11, Sweden
| | - Ingemar Kåreholt
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Chandra A Reynolds
- Department of Psychology, University of Southern California, Riverside, USA
| | - Nancy L Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna K Dahl Aslan
- Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Kettaneh AA, Umeasiegbu VI. Specialized housing adaptation in multiple sclerosis: Relationships to demographic variables. JOURNAL OF VOCATIONAL REHABILITATION 2016. [DOI: 10.3233/jvr-150790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Woo J, Leung J. Multi-morbidity, dependency, and frailty singly or in combination have different impact on health outcomes. AGE (DORDRECHT, NETHERLANDS) 2014; 36:923-931. [PMID: 24091565 PMCID: PMC4039270 DOI: 10.1007/s11357-013-9590-3] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2013] [Accepted: 09/23/2013] [Indexed: 06/01/2023]
Abstract
Multi-morbidity, dependency, and frailty were studied simultaneously in a community-living cohort of 4,000 men and women aged 65 years and over to examine the independent and combined effects on four health outcomes (mortality, decline in physical function, depression, and polypharmacy). The influence of socioeconomic status on these relationships is also examined. Mortality data was documented after a mean follow-up period of 9 years, while other health outcomes were documented after 4 years of follow-up. Fifteen percent of the cohort did not have any of these syndromes. Of the remaining participants, nearly one third had multi-morbidity and frailty (pre-frail and frail), while all three syndromes were present in 11 %. All syndromes as well as socioeconomic status were significantly associated with all health outcomes. Mortality was only increased for age, being male, frailty status, and combinations of syndromes that included frailty. Both multi-morbidity and frailtymale was protective. Only a combination of all three syndromes, and age per se, increased the risk of depressive symptoms at 4 years while being male conferred reduced risk. Multi-morbidity, but not frailty status or dependency, and all syndrome combinations that included multi-morbidity were associated with use of ≥ four medications. Decline in homeostatic function with age may thus be quantified and taken into account in prediction of various health outcomes, with a view to prevention, management, formulation of guidelines, service planning, and the conduct of randomized controlled trials of interventions or treatment.
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Affiliation(s)
- Jean Woo
- Department of Medicine & Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Shatin, N.T, Hong Kong,
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Brothers TD, Theou O, Rockwood K. Frailty and migration in middle-aged and older Europeans. Arch Gerontol Geriatr 2013; 58:63-8. [PMID: 23993266 DOI: 10.1016/j.archger.2013.07.008] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 06/28/2013] [Accepted: 07/30/2013] [Indexed: 01/10/2023]
Abstract
We evaluated life course influences on health by investigating potential differences in levels of frailty between middle-aged and older European immigrants born in low- and middle-income countries (LMICs), immigrants born in high income countries (HICs), and their native-born European peers. Using data from the Survey of Health, Ageing, and Retirement in Europe (SHARE), we constructed a frailty index from 70 age-related health measures for 33,745 participants aged 50+ (mean=64.9 ± 10.2 years; 54% women) in 14 European countries. Participants were grouped as native-born or as immigrants born in LMICs or in HICs, and further by current residence in Northern/Western or Southern/Eastern Europe. Seven percent of participants (n=2369) were immigrants (mean=64.4 ± 10.2 years; 56% women; LMIC-born=3.4%, HIC-born=3.6%). In Northern/Western Europe, after adjustment for age, gender, and education, LMIC-born immigrants demonstrated higher frailty index scores (mean=0.18, 95% confidence interval=0.17-0.19) than both HIC-born immigrants (0.16, 0.16-0.17) and native-born participants (0.15, 0.14-0.15 both p<0.001). In Southern/Eastern Europe, frailty index scores did not differ between groups (p=0.2). Time since migration explained significant variance in frailty index scores only in HIC-born immigrants to Southern/Eastern Europe (4.3%, p=0.03). Despite differences in frailty, survival did not differ between groups (p=0.2). LMIC-born immigrants demonstrated higher levels of frailty in Northern/Western Europe, but not Southern/Eastern Europe. Country of birth and current country of residence were each associated with frailty. Life course influences are demonstrable, but complex.
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Affiliation(s)
- Thomas D Brothers
- Geriatric Medicine Research, Dalhousie University, 1315-5955 Veterans' Memorial Lane, Halifax, Nova Scotia B3H 2E1, Canada.
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