1
|
Shum ENY, Lau BHP, Cheung KSL, Chan CLW, Siu JCY, Luk JKH, Kwan JSK, Chan GMY, Pat LYC, Martin P. Multiple Roads to Success: A Latent Class Analysis on Successful Ageing Among Hong Kong Near-Centenarians and Centenarians (NCC). Int J Aging Hum Dev 2024; 99:152-178. [PMID: 37904549 DOI: 10.1177/00914150231208681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2023]
Abstract
Notwithstanding the oldest-old cohort being the fastest-growing population in most ageing societies, characterizing successful ageing in adults of advanced age, such as nonagenarians and centenarians, remains challenging. This study investigated the successful ageing subphenotypes using the data from Hong Kong Centenarian Study 2. Between April 2021 and September 2022, 146 family caregivers of community-dwelling older adults aged 95 or above were interviewed by phone. Latent class analysis identified three classes-Overall Frail (46.6%) with poor mobility, cognitive and functional health, Nonambulant (37.0%) but good functional health, and Robust (16.4%) with overall good health-from 11 indicators based on caregivers' reports. Although we found a low prevalence of fulfillment of all indicators of successful ageing, our findings will help care professionals appreciate the heterogeneity underlying partial successful ageing in this vulnerable cohort for segmented and targeted healthy longevity interventions.
Collapse
Affiliation(s)
- Eric Ngai-Yin Shum
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, China
| | - Bobo Hi-Po Lau
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, China
- Centre for Interdisciplinary Evidence-based Practice and Research (CIEBPR), Hong Kong Shue Yan University, Hong Kong, China
| | - Karen Siu-Lan Cheung
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
- Mindlink Research Centre, Hong Kong, China
| | - Cecilia Lai-Wan Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Joey Chung-Yue Siu
- Felizberta Lo Padilla Tong School of Social Sciences, Caritas Institute of Higher Education, Hong Kong, China
| | - James Ka-Hay Luk
- Department of Medicine and Geriatrics, Tung Wah Group of Hospitals Fung Yiu King Hospital, Hong Kong, China
| | | | | | - Lian Ying-Chun Pat
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, China
| | - Peter Martin
- Human Development and Family Studies, Iowa State University, Ames, Iowa, USA
| |
Collapse
|
2
|
Gago C, O’Neill HJ, Tamez M, López-Cepero A, Rodríguez-Orengo JF, Mattei J. Self-Rated Health and Medically Diagnosed Chronic Disease Association among Adults in Puerto Rico. Ethn Dis 2023; 33:140-149. [PMID: 38854413 PMCID: PMC11155621 DOI: 10.18865/ed.33.4.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024] Open
Abstract
Introduction Latinos report lower self-rated health (SRH) than non-Hispanic White persons. However, the association between SRH and medically diagnosed chronic diseases (MDCDs) remains understudied in Latino populations. This study assessed the relationship between a single-item SRH indicator and MDCD status among predominantly Latino adults in Puerto Rico. Methods Participants (30-75 years; n=965) of the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT) reported SRH (excellent/very good, good, or fair/poor) and MDCD (ever vs never). We performed multivariate logistic regressions to evaluate the association between SRH and MDCD, which adjusted for key socioeconomic, demographic, and behavioral confounders. Results Twenty-seven percent of participants reported excellent/very good SRH, 39% good, and 34% fair/poor. Participants with fair/poor SRH (vs excellent/very good) were more likely to report MDCD for painful inflammation (odds ratio [OR]=4.95 [95% CI, 3.27-7.48]), kidney disease (4.64 [2.16-9.97]), sleep disorder (4.47 [2.83-7.05]), migraine headaches (4.07 [2.52-6.58]), overweight/obesity (3.84 [2.51-5.88]), depression (3.61 [2.28-5.74]), hypertension (3.59 [2.43-5.32]), high blood sugar (3.43 [2.00-5.89]), cardiovascular disease (3.13 [2.01-4.87]), anxiety (2.87 [1.85-4.44]), arthritis (2.80 [1.83-4.30]), diabetes (2.46 [1.57-3.83]), respiratory problems (2.45 [1.59-3.79]), stomach problems (2.44 [1.57-3.81]), eye disease (2.42 [1.44-4.06]), gallbladder disease (2.34 [1.35-4.05]), liver disease (2.26 [1.38-3.70]), heartburn (2.25 [1.55-3.26]), hyperlipidemia (2.10 [1.44-3.06]), and thyroid conditions (2.04 [1.30-3.21]). Conclusions SRH may reflect MDCD burden and serve as a valid screener to efficiently identify Latino individuals in high need of clinical services. This is relevant in Puerto Rico, where chronic disease rates remain high amid limited, disparate access to health care.
Collapse
Affiliation(s)
- Cristina Gago
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
- Department of Community Health Sciences, Boston University, Boston, MA
| | - H. June O’Neill
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
| | - Martha Tamez
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
| | - Andrea López-Cepero
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - José F. Rodríguez-Orengo
- School of Medicine, University of Puerto Rico, Medical Sciences Campus, San Juan, Puerto Rico
- FDI Clinical Research, San Juan, Puerto Rico
| | - Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA
| |
Collapse
|
3
|
Sperlich S, Beller J, Epping J, Geyer S, Tetzlaff J. Trends of healthy and unhealthy working life expectancy in Germany between 2001 and 2020 at ages 50 and 60: a question of educational level? J Epidemiol Community Health 2023; 77:430-439. [PMID: 37193584 PMCID: PMC10314014 DOI: 10.1136/jech-2023-220345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/29/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND Extending the number of active working years is an important goal both for maintaining individual quality of life and safeguarding social security systems. Against this background, we examined the development of healthy and unhealthy working life expectancy (HWLE/UHWLE) in the general population and for different educational groups. METHODS The study is based on data from the German Socio-Economic Panel study, including 88 966 women and 85 585 men aged 50-64 years and covering four time periods (2001-05, 2006-2010, 2011-2015 and 2016-2020). Estimates of HWLE and UHWLE in terms of self-rated health (SRH) were calculated using the Sullivan's method. We adjusted for hours worked and stratified by gender and educational level. RESULTS Working-hours adjusted HWLE at age 50 increased in women and men from 4.52 years (95% CI 4.42 to 4.62) in 2001-2005 to 6.88 years (95% CI 6.78 to 6.98) in 2016-2020 and from 7.54 years (95% CI 7.43 to 7.65) to 9.36 years (95% CI 9.25 to 9.46), respectively. Moreover, UHWLE also rose with the proportion of working life spent in good SRH (health ratio) remaining largely stable. At age 50, educational differences in HWLE between the lowest and highest educational groups increased over time in women and in men from 3.72 to 4.99 years and from 4.06 to 4.40 years, respectively. CONCLUSIONS We found evidence for an overall increase but also for substantial educational differences in working-hours adjusted HWLE, which widened between the lowest and highest educational group over time. Our findings suggest that policies and health prevention measures at workplace should be more focused on workers with low levels of education in order to extend their HWLE.
Collapse
Affiliation(s)
| | - Johannes Beller
- Medical Sociology, Hannover Medical School, Hannover, Germany
| | - Jelena Epping
- Medical Sociology, Hannover Medical School, Hannover, Germany
| | - Siegfried Geyer
- Medical Sociology, Hannover Medical School, Hannover, Germany
| | | |
Collapse
|
4
|
Alhalal E, Alkhair Z, Alghazal F, Halabi R, Muhaimeed F. Psychological elder abuse among older Saudi adults: A cross-sectional study. J Elder Abuse Negl 2022; 34:349-368. [PMID: 36597203 DOI: 10.1080/08946566.2023.2164880] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The research examining elder abuse in diverse cultural contexts, such as in Saudi Arabia, remains limited. This study examined the extent of psychological elder abuse among older Saudi adults and investigated the characteristics of the victims that increase the risk of such abuse and its impact on older adults' self-rated health. Between December 2021 and April 2022, a sample of 444 older adults were recruited from 25 primary health care centers in Saudi Arabia and completed a structured interview. Of those surveyed, 88.3% reported at least one symptom or suspected symptom of psychological elder abuse. Age, gender, income, living arrangements, functioning, and social networking predicted vulnerability psychological elder abuse. Self-rated health was negatively impacted by psychological elder abuse, and this relationship is not moderated by social networking. These findings can provide insights about psychological elder abuse in Saudi Arabia and increase awareness of its impact.
Collapse
Affiliation(s)
- Eman Alhalal
- Community and Mental Health Nursing Department, Nursing College, King Saud University, Riyadh, Saudi Arabia
| | - Zainab Alkhair
- Qatif Health Centers Administration, Qatif Health Network, Eastern Region, Saudi Arabia
| | | | - Rehab Halabi
- The Administration of School Health Affairs in Makkah Health Care Cluster, Makkah, Saudi Arabia
| | - Fatema Muhaimeed
- Hematology/ Oncology unit, King Saud Medical City, Riyadh, Saudi Arabia
| |
Collapse
|
5
|
Deeg DJH, Blekesaune M, de Wind A. Employment trends at older ages: policy impact or secular change? Eur J Ageing 2022; 19:689-698. [PMID: 36052188 PMCID: PMC9424366 DOI: 10.1007/s10433-021-00664-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 11/26/2022] Open
Abstract
Observed increases in retirement age are generally attributed to policies to extend working lives (PEW). In a quasi-experimental design, we examine to what extent increases in employment of older workers can be attributed to secular changes in individual characteristics as opposed to PEW. We compare two countries: one with clear PEW (the Netherlands) and one without PEW (Norway). Data come from the Dutch Longitudinal Aging Study Amsterdam and the NORwegian Longitudinal study on Aging and Generations. From each study, two same-age (55-64 years) samples are selected, one recruited in 2002-03, and one recruited after five (Norway) and ten years (Netherlands). In pooled regression analysis, paid work is the outcome variable, and time of measurement, the main independent variable. Individual characteristics include age, sex, educational level, self-perceived health, functional limitations, sense of mastery, and work status of partner. Employment rose in both countries, faster in the Netherlands than in Norway. Of the rise in employment, individual characteristics explained less in the Netherlands than in Norway. Accounting for these, the interaction country*time was significant, indicating an extra rise in employment of 5.2 and 7.5% points for Dutch men and women, net of individual characteristics and unobserved factors that are assumed to be similar in both countries. The extra rise in the Netherlands represents 57% of the total rise for both sexes. Thus, secular change in individual characteristics explains part of the rise in employment in both countries. In the Netherlands, other factors such as PEW may additionally explain the rise in employment. Supplementary Information The online version contains supplementary material available at 10.1007/s10433-021-00664-0.
Collapse
Affiliation(s)
- Dorly J. H. Deeg
- Department of Epidemiology and Data Science, Amsterdam University Medical Centers, Vrije Universiteit Amsterdam, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Morten Blekesaune
- Department of Sociology and Social Work, University of Agder, Kristiansand, Norway
| | - Astrid de Wind
- Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
6
|
Tübbecke FM, Epping J, Safieddine B, Sperlich S. Development of gender inequality in self-rated health in the life-phase of raising children in Germany from 1994 to 2018 – A decomposition analysis of socioeconomic, psychosocial and family-related influencing factors. SSM Popul Health 2022; 19:101183. [PMID: 36046064 PMCID: PMC9421283 DOI: 10.1016/j.ssmph.2022.101183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 07/08/2022] [Accepted: 07/21/2022] [Indexed: 11/27/2022] Open
|
7
|
Viana RT, de Freitas Araújo É, Lima LAO, Teixeira-Salmela LF, de Morais Faria CDC. General and comparative self-rated health in chronic stroke: an important outcome measure for health professionals. BMC Neurol 2022; 22:78. [PMID: 35255837 PMCID: PMC8900340 DOI: 10.1186/s12883-022-02592-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 02/07/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND After a stroke, several aspects of health and function may influence how individuals perceive their own health. However, self-rated health (SRH), as well as its relationship with functioning, has been little explored in individuals with stroke. The aims of this study were to determine how individuals with chronic post-stroke disabilities evaluate their health, considering general, time- and age-comparative SRH questions and to investigate whether SRH measures would be influenced by the following health and functioning domains: mental/physical functions and personal factors. METHODS Sixty-nine individuals with chronic post-stroke disabilities answered the three types of SRH questions and were assessed regarding depressive symptoms (emotional function domain), physical activity levels (physical function domain), and engagement in physical activity practice (personal factor domain). Subjects were divided into the following groups: good/poor for the general SRH question; better, similar, and "worse" for both time- and age-comparative questions. Between-group differences in the three domains for each SRH question were investigated (α = 5%). RESULTS General SRH was rated as good by 73% of the participants. Time- and age-comparative SRH was rated as better by 36% and 47% and as similar by 31% and 28% of the subjects, respectively. Significant between-group differences in emotional function were found for both the general and age-comparative questions. For the time-comparative question, significant differences were only observed for physical function. CONCLUSION SRH evaluation differed in individuals with chronic post-stroke disabilities according to the types of questions and health/functioning domains.
Collapse
Affiliation(s)
- Ramon Távora Viana
- Department of Physical Therapy, Faculty of Medicine, Universidade Federal Do Ceará, Fortaleza, Brazil
| | - Érika de Freitas Araújo
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Campus Pampulha, 1270-901, MG, Belo Horizonte, Brazil
| | | | - Luci Fuscaldi Teixeira-Salmela
- Department of Physical Therapy, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, Campus Pampulha, 1270-901, MG, Belo Horizonte, Brazil
| | | |
Collapse
|
8
|
Steinman BA, Tabler J, Mittlieder CM, Whitlock B, Goodman CE. Self-Reported Sensory Impairments in Older Adults and their Association with Self-Rated Health and Mortality Outcomes. J Aging Health 2021; 34:693-704. [PMID: 34939470 DOI: 10.1177/08982643211059133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES This study assessed the relationship between self-reported impairments of vision, hearing, and dual sensory impairment, and change in self-rated health/mortality status over a 5-year period. METHODS Data came from the National Health and Aging Trends Study, a nationally representative survey of Medicare beneficiaries ages 65 and older. Analyses consisted of a series of ordinal logistic regressions stratified by sex. RESULTS For both women and men, self-reported sensory impairments were not statistical predictors of self-rated health/mortality, when other dimensions of health, such as physical functioning, participation, and activities of daily living functioning were included in models. DISCUSSION Understanding how self-reported sensory impairments impact self-rated health could assist in targeting rehabilitation strategies to older adults who experience sensory impairments.
Collapse
|
9
|
Thygesen LC, Christensen K, Rørth M, Sørensen HT, Vandenbroucke JP, Westendorp RGJ. Tipping Points - Do the Prognostic Values of Multimorbidity and Functional Status Vary with Age? Clin Epidemiol 2021; 13:853-857. [PMID: 34588816 PMCID: PMC8473562 DOI: 10.2147/clep.s325348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/23/2021] [Indexed: 12/24/2022] Open
Abstract
Aging of the population is a pressing challenge for healthcare systems and knowledge of a patient’s prognosis is a key to shaping effective interventions. As the prevalence of multimorbidity strongly increases with age, the prognostic value of multiple disease diagnoses for survival among older people may diminish, whereas other measures of health, such as functional status (defined as a measure of an individual’s ability to perform activities of daily living), may become more important. In this commentary, the impact of age on the prognostic value of multimorbidity is discussed, with the aim of identifying relevant alternative risk indicators for different age groups. The key question is to determine at what age the prognostic value of multimorbidity for meaningful clinical outcomes decreases and is overridden by the prognostic value of functional status. This tipping point likely depends on age, calendar time, and birth cohort. The public health and clinical implications of these tipping points are important. Among younger and middle-aged persons, interventions could be directed towards prevention and treatment of specific diseases, while among older persons efforts should focus more on improving functional levels that include physical, emotional, and social dimensions.
Collapse
Affiliation(s)
- Lau Caspar Thygesen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Kaare Christensen
- The Danish Aging Research Center, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Mikael Rørth
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.,Aarhus University Hospital, Aarhus, Denmark
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.,Aarhus University Hospital, Aarhus, Denmark
| | - Jan P Vandenbroucke
- Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.,Department of Medical Statistics and Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.,Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Rudi G J Westendorp
- Department of Public Health and Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
10
|
Vafaei A, Yu J, Phillips SP. The intersectional impact of sex and social factors on subjective health: analysis of the Canadian longitudinal study on aging (CLSA). BMC Geriatr 2021; 21:473. [PMID: 34454440 PMCID: PMC8399822 DOI: 10.1186/s12877-021-02412-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 08/03/2021] [Indexed: 12/17/2022] Open
Abstract
Background Self-rated health (SRH) is a widely validated measure of the general health of older adults. Our aim was to understand what factors shape individual perceptions of health and, in particular, whether those perceptions vary for men and women and across social locations. Methods We used data from the Canadian Longitudinal Study on Aging (CLSA) of community-dwelling adults aged 45 to 85. SRH was measured via a standard single question. Multiple Poisson regression identified individual, behavioural, and social factors related to SRH. Intersections between sex, education, wealth, and rural/urban status, and individual and joint cluster effects on SRH were quantified using multilevel models. Results After adjustment for relevant confounders, women were 43% less likely to report poor SRH. The strongest cluster effect was for groupings by wealth (21%). When wealth clusters were subdivided by sex or education the overall effect on SRH reduced to 15%. The largest variation in SRH (13.6%) was observed for intersections of sex, wealth, and rural/urban status. In contrast, interactions between sex and social factors were not significant, demonstrating that the complex interplay of sex and social location was only revealed when intersectional methods were employed. Conclusions Sex and social factors affected older adults’ perceptions of health in complex ways that only became apparent when multilevel analyses were carried out. Utilizing intersectionality analysis is a novel and nuanced approach for disentangling explanations for subjective health outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02412-6.
Collapse
Affiliation(s)
- Afshin Vafaei
- Department of Family Medicine, Queen's University, Kingston, ON, Canada. .,Department of Public Health Sciences, Queen's University, Centre for Studies in Primary Care, 220 Bagot St, Kingston, ON, K7L 5E9, Canada.
| | - Janelle Yu
- Department of Family Medicine, Queen's University, Kingston, ON, Canada
| | - Susan P Phillips
- Department of Family Medicine, Queen's University, Kingston, ON, Canada.,Department of Public Health Sciences, Queen's University, Centre for Studies in Primary Care, 220 Bagot St, Kingston, ON, K7L 5E9, Canada
| |
Collapse
|
11
|
Bozick R. The utility of self-rated health in population surveys: the role of bodyweight. Popul Health Metr 2021; 19:23. [PMID: 33941193 PMCID: PMC8091531 DOI: 10.1186/s12963-021-00255-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background Self-rated health (SRH) is one of the most commonly used summary measures of overall health and well-being available to population scientists due to its ease of administration in large-scale surveys and to its efficacy in predicting mortality. This paper assesses the extent to which SRH is affected by its placement before or after questions about bodyweight on a survey, and whether differences in placement on the questionnaire affects SRH’s predictive validity. Methods I assessed the validity of SRH in predicting the risk of mortality by comparing outcomes of sample members who were asked to rate their health before reporting on their bodyweight (the control group) and sample members who were asked to rate their health after reporting on their bodyweight (the treatment group). Both the control and treatment group were randomly assigned via an experiment administered as a module in a nationally representative sample of adults in the USA in 2019 (N = 2523). Results The odds of reporting a more favorable appraisal of health are 30% lower for sample members who were in the treatment group when compared with the control group. Additionally, the SRH of treatment group members is significantly associated with their risk of mortality, while the SRH of control group members is not. Conclusion The findings from this study suggest that for researchers to maximize the utility of SRH, closer attention needs to be paid to the context of the survey within which it asked. SRH is highly sensitive to the questions that precede it, and this sensitivity may in turn mischaracterize the true health of the population that the survey is intending to measure.
Collapse
Affiliation(s)
- Robert Bozick
- Kinder Institute for Urban Research, Rice University, Kraft Hall, 6100 Main Street, Suite 305, Houston, TX, 77005-1892, USA.
| |
Collapse
|
12
|
Sperlich S, Klar MK, Safieddine B, Tetzlaff F, Tetzlaff J, Geyer S. Life stage-specific trends in educational inequalities in health-related quality of life and self-rated health between 2002 and 2016 in Germany: findings from the German Socio-Economic Panel Study (GSOEP). BMJ Open 2021; 11:e042017. [PMID: 33664070 PMCID: PMC7934728 DOI: 10.1136/bmjopen-2020-042017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 12/30/2020] [Accepted: 01/21/2021] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES While evidence suggests persisting health inequalities, research on whether these trends may vary according to different stages of life has rarely been considered. Against this backdrop, we analysed life stage-specific trends in educational inequalities in health-related quality of life (HRQOL) and poor self-rated health (SRH) for individuals in 'later working life' (50-64 years), 'young seniors' (65-79 years) and persons of 'old age' (80+ years). METHODS We used survey data from the German Socio-Economic Panel Study comprising the period from 2002 to 2016. The sample consists of 26 074 respondents (160 888 person-years) aged 50 years and older. Health was assessed using the mental and physical component summary scale (MCS/PCS) of the HRQOL questionnaire (12-Item Short Form Health Survey V.2) and the single item SRH. To estimate educational health inequalities, we calculated the regression-based Slope Index of Inequality (SII) and Relative Index of Inequality (RII). Time trends in inequalities were assessed by the inclusion of a two-way interaction term between school education and time. RESULTS With increasing age, educational inequalities in PCS and poor SRH decreased whereas they rose in MCS. Over time, health inequalities decreased in men aged 65-79 years (MCSSII=2.76, 95% CI 0.41 to 5.11; MCSRII=1.05, 95% CI 1.01 to 1.10; PCSSII=2.12, 95% CI -0.27to 4.51; PCSRII=1.05, 95% CI 1.00 to 1.11; poor SRHSII=-0.10, 95% CI -0.19 to 0.01; poor SRHRII=0.73, 95% CI 0.48 to 1.13) and among women of that age for MCS (MCSSII=2.82, 95% CI 0.16 to 5.50; MCSRII=1.06, 95% CI 1.01 to 1.12). In contrast, health inequalities widened in the 'later working life' among women (PCSSII=-2.98, 95% CI -4.86 to -1.11; PCSRII=0.94, 95% CI 0.90 to 0.98; poor SRHSII=0.07, 95% CI 0.00 to 0.14) while remained largely stable at old age for both genders. CONCLUSIONS We found distinctive patterns of health inequality trends depending on gender and life stage. Our findings suggest to adopt a differentiated view on health inequality trends and to pursue research that explores their underlying determinants.
Collapse
Affiliation(s)
| | | | | | - Fabian Tetzlaff
- Medical Sociology, Hannover Medical School, Hannover, Germany
| | | | - Siegfried Geyer
- Medical Sociology, Hannover Medical School, Hannover, Germany
| |
Collapse
|
13
|
Implications of response shift for micro-, meso-, and macro-level healthcare decision-making using results of patient-reported outcome measures. Qual Life Res 2021; 30:3343-3357. [PMID: 33651278 PMCID: PMC8602130 DOI: 10.1007/s11136-021-02766-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE Results of patient-reported outcome measures (PROMs) are increasingly used to inform healthcare decision-making. Research has shown that response shift can impact PROM results. As part of an international collaboration, our goal is to provide a framework regarding the implications of response shift at the level of patient care (micro), healthcare institute (meso), and healthcare policy (macro). METHODS Empirical evidence of response shift that can influence patients' self-reported health and preferences provided the foundation for development of the framework. Measurement validity theory, hermeneutic philosophy, and micro-, meso-, and macro-level healthcare decision-making informed our theoretical analysis. RESULTS At the micro-level, patients' self-reported health needs to be interpreted via dialogue with the clinician to avoid misinterpretation of PROM data due to response shift. It is also important to consider the potential impact of response shift on study results, when these are used to support decisions. At the meso-level, individual-level data should be examined for response shift before aggregating PROM data for decision-making related to quality improvement, performance monitoring, and accreditation. At the macro-level, critical reflection on the conceptualization of health is required to know whether response shift needs to be controlled for when PROM data are used to inform healthcare coverage. CONCLUSION Given empirical evidence of response shift, there is a critical need for guidelines and knowledge translation to avoid potential misinterpretations of PROM results and consequential biases in decision-making. Our framework with guiding questions provides a structure for developing strategies to address potential impacts of response shift at micro-, meso-, and macro-levels.
Collapse
|
14
|
Klar MK, Geyer S, Safieddine B, Tetzlaff F, Tetzlaff J, Sperlich S. Trends in healthy life expectancy between 2002 and 2018 in Germany - Compression or expansion of health-related quality of life (HRQOL)? SSM Popul Health 2021; 13:100758. [PMID: 33732863 PMCID: PMC7937823 DOI: 10.1016/j.ssmph.2021.100758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 01/29/2021] [Accepted: 02/13/2021] [Indexed: 12/29/2022] Open
Abstract
The question of whether rising life expectancy has led to additional life years spent in good health or poor health is of major public health relevance. We tested the theories of compression or expansion of morbidity for Germany with respect to the mental and physical component summary scales (MCS/PCS) of the health-related quality of life (HRQOL) questionnaire (SF-12). Data of 90,758 women and 81,400 men were obtained from the German Socio-Economic Panel between 2002 and 2018. Linear and logistic regression analyses were applied to estimate temporal changes in MCS and PCS in different life stages. The development of healthy life expectancy (H-LE) expressed by life years without severe functional limitations was calculated by applying the Sullivan method. Overall, a significant increase of MCS and PCS was found in both genders. The rise was mainly due to declining proportions of severe limitations (norm values < 40 points) while the proportions of norm values > 60 points did not change substantially. Improvements were most apparent for the 'young seniors' (65-79 years) and at 'old age' (80 years +). In contrast, no improvements in PCS were found for 'later working life' (50-64 years) and decreasing levels were observed for persons of 'middle working age' (30-49 years). During the study period, H-LE at age 50 increased in women/men by 2.93/2.90 years (MCS) and 1.92/2.53 years (PCS), respectively. Our results support the hypothesis of absolute compression of morbidity. However, since consistent improvements were not found for ages below 65 years, it remains open to debate whether the positive health trend will also persist in the future. Our findings suggest that health promotion efforts should be strengthened for people of middle and later working age to support healthy aging.
Collapse
Affiliation(s)
| | - Siegfried Geyer
- Hannover Medical School, Medical Sociology, Hannover, Germany
| | | | - Fabian Tetzlaff
- Hannover Medical School, Medical Sociology, Hannover, Germany
| | | | | |
Collapse
|
15
|
Fjell A, Cronfalk Seiger B, Hermann M, Rongve A, Aßmus J, Kvinge L, Seiger Å, Skaug K, Boström AM. Factors associated with self-rated health in a Norwegian population of older people participating in a preventive home visit program: a cross-sectional study. BMC Geriatr 2020; 20:323. [PMID: 32887555 PMCID: PMC7650279 DOI: 10.1186/s12877-020-01733-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 08/24/2020] [Indexed: 11/22/2022] Open
Abstract
Background Assessing self-rated health by preventive home visits of older people can provide information about the person’s well-being, quality of life and risk of developing illness. The aim of this study was to examine associations between self-rated health and factors related to demographics, lifestyle, health conditions and medical diagnoses by older people participating in a preventive home visit program. Methods A cross-sectional study including 233 participants (age 75–79) from three municipalities of Western Norway was conducted. Data were collected through preventive home visits performed by six nurses, using a questionnaire including self-rated health assessment and questions and tests related to demographics (e.g. education and housing), lifestyle (e.g. social activities, alcohol and smoking), health conditions (e.g. sensory impairment, pain and limited by disease) and medical diagnoses. Descriptive and inferential statistics including linear block-wise regression model were applied. Results The block-wise regression model showed that the variables Limited by disease and Pain were negatively associated with self-rated health and Use internet was positively associated. The model had a R2 0.432. The variable that contributed to largest change in the model was Limited by disease (R2 Change; 0.297, p-value< 0.001). Conclusions In the present study, being limited by disease and pain were strongly associated with poor self-rated health, indicating that these are important factors to assess during a preventive home visit. Also, digital competence (Use internet) was associated with a better self-rated health, suggesting that it could be useful to ask, inform and motivate for the use of digital tools that may compensate for or improve social support, social contact and access to health -related information.
Collapse
Affiliation(s)
- Astrid Fjell
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden. .,Department of health and caring sciences, Western Norway University of Applied Sciences, Bjørnsonsgate 45, 5528, Haugesund, Norway.
| | - Berit Cronfalk Seiger
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.,Department of Nursing Science, Ersta Sköndal Bräcke University College, Huddinge, Sweden
| | - Monica Hermann
- Department of health and caring sciences, Western Norway University of Applied Sciences, Stord, Norway
| | - Arvid Rongve
- Department of Research and Innovation, Helse Fonna, Haugesund Hospital, Haugesund, Norway.,Inst. of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Jörg Aßmus
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway
| | - Lars Kvinge
- Department of health and caring sciences, Western Norway University of Applied Sciences, Stord, Norway
| | - Åke Seiger
- Department of Neurobiology, Care Sciences and Society, Division of Clinical geriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Knut Skaug
- Department of Research and Innovation, Helse Fonna HF, Haugesund, Norway
| | - Anne-Marie Boström
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.,Department of health and caring sciences, Western Norway University of Applied Sciences, Bjørnsonsgate 45, 5528, Haugesund, Norway.,Theme Aging, Karolinska University Hospital, Huddinge, Sweden
| |
Collapse
|
16
|
Suanet B, Huxhold O. Cohort Difference in Age-Related Trajectories in Network Size in Old Age: Are Networks Expanding? J Gerontol B Psychol Sci Soc Sci 2020; 75:137-147. [PMID: 29304239 DOI: 10.1093/geronb/gbx166] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 11/22/2017] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Contemporary societal views on old age as well as a rise in retirement age raise the question whether patterns of stability and/or decline in network size as found in earlier studies similarly apply to later birth cohorts of older adults. METHODS Change score models are estimated to determine cohort differences in age-related trajectories in network size. Two birth cohorts (1928-37 and 1938-47, 55-64 at baseline in 1992 and 2002) of the Longitudinal Aging Study Amsterdam are followed across 4 observations over a time span of 9 years. RESULTS Age-related trajectories in network size differ between the early and late birth cohort. The late birth cohort makes large gains in network size around retirement age, but this increase does not hold over time. Increased educational level and larger diversity in social roles relate to the cohort difference. Nonetheless, cohort difference prevails even after adjusting for these factors. DISCUSSION The peak level in the network size in the late birth cohort hints at stronger preference and more opportunities to gain and maintain social relationships around retirement age in the current societal structure and culture. The subsequent drop-off in network size suggests that these ties are mostly used to adapt to the retirement transition.
Collapse
Affiliation(s)
- Bianca Suanet
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit Amsterdam, HV Amsterdam, Netherlands
| | - Oliver Huxhold
- German Centre of Gerontology, Manfred-von-Richthofen-Straße, Berlin, Germany
| |
Collapse
|
17
|
Disease or function? What matters most for self-rated health in older people depends on age. Aging Clin Exp Res 2020; 32:1591-1594. [PMID: 32130715 PMCID: PMC7452924 DOI: 10.1007/s40520-020-01507-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/08/2020] [Indexed: 10/26/2022]
Abstract
BACKGROUND Self-rated health (SRH) holistically captures older adults' health status from the perspective of the individual. AIMS To explore the accuracy of five objective health indicators related to diseases, physical function, cognition and disability in discriminating SRH among the youngest and oldest old. METHODS We used baseline data from 2196 participants of the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K), Sweden (years 2001-2004). Area under the receiver operating characteristic curves (AUROC) were obtained from logistic regressions adjusted by sex, age and education. RESULTS Among the youngest old, having ≥ 4 chronic diseases showed the highest discriminatory capacity of poor versus good SRH (AUROC: 0.714). Among the oldest old, a walking speed < 1.0 m/s showed the highest discriminatory capacity of poor versus good SRH (AUROC: 0.683), followed by ≥ 1 limitations in IADL (AUROC: 0.664). CONCLUSION What matters most for SRH in older people depends on age, with walking speed playing a major role among the oldest old.
Collapse
|
18
|
Self-Rated Health: When and How to Use It in Studies Among Older People? INTERNATIONAL HANDBOOK OF HEALTH EXPECTANCIES 2020. [DOI: 10.1007/978-3-030-37668-0_12] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
19
|
Choi JW, Kim J, Han E, Kim TH. Association of employment status and income with self-rated health among waged workers with disabilities in South Korea: population-based panel study. BMJ Open 2019; 9:e032174. [PMID: 31772097 PMCID: PMC6887090 DOI: 10.1136/bmjopen-2019-032174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE This study aimed to examine the association of employment status and income with self-rated health among waged workers with disabilities in South Korea. METHODS This study used the Panel Survey of Employment for the Disabled from 2011 to 2015. A total of 951 waged workers with disabilities were selected as baseline subjects in 2011 and were followed up for 5 years. This study used a generalised linear mixed model after adjusting for covariates. RESULTS Among 951 waged workers with disabilities, the results showed that 39.3% of workers with disabilities reported poor self-rated health. Workers with disabilities with a precarious employment status and lower income were 1.22 (95% CI 1.21 to 1.23) and 1.81 (95% CI 1.80 to 1.83) times more likely to have poor self-rated health than those with permanent employment and higher income, respectively. A subgroup analysis found that precarious workers with disabilities in lower income households had higher possibilities of poor self-rated health. CONCLUSION This study suggests that precarious employment and lower income of waged workers with disabilities are significantly associated with poor self-rated health compared with those with permanent jobs or higher income.
Collapse
Affiliation(s)
- Jae Woo Choi
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Yeonsu-gu, Incheon, South Korea
| | - Juyeong Kim
- Department of Health and Human Performance, Sahmyook University, Nowon-gu, Seoul, South Korea
| | - Euna Han
- College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, Yeonsu-gu, Incheon, South Korea
| | - Tae Hyun Kim
- Department of Hospital Administration, Yonsei University, Seodaemun-gu, Seoul, South Korea
| |
Collapse
|
20
|
Trends in good self-rated health in Germany between 1995 and 2014: do age and gender matter? Int J Public Health 2019; 64:921-933. [PMID: 30918976 DOI: 10.1007/s00038-019-01235-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 03/12/2019] [Accepted: 03/14/2019] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES This study analyzes longitudinal trends in self-rated health (SRH) by taking age- and gender-specific differences into account. METHODS Data of 29,251 women and 26,967 men were obtained from the German Socio-Economic Panel between 1995 and 2014. Generalized Estimation Equation analysis for logistic regression was used to estimate changes in odds of (very) good SRH over time. Development of (un)healthy life expectancy was calculated by applying the Sullivan method. RESULTS While in women, the odds of good SRH increased significantly over time for the ages 41-50 to 71-80 years, improvements among men were most apparent for the ages 61-70 and 71-80 years. By contrast, for both genders, no improvements in SRH were found in the youngest (31-40 years) and eldest age group (81-90 years) and in men aging 51-60 years. Over time, healthy life expectancy at age 31 increased by 3 years in women and 2 years in men, leading to a reduced but not eliminated gender gap in SRH. CONCLUSIONS Our findings support the hypothesis of relative compression of morbidity. However, trends in SRH differed according to age and gender, calling for health promotion efforts that meet diverse needs at different stages of life.
Collapse
|
21
|
Alders P, Deeg DJ, Schut FT. Who will become my co-residents? The role of attractiveness of institutional care in the changing demand for long-term care institutions. Arch Gerontol Geriatr 2019; 81:91-97. [DOI: 10.1016/j.archger.2018.11.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2018] [Revised: 11/29/2018] [Accepted: 11/30/2018] [Indexed: 11/28/2022]
|
22
|
Scharn M, van der Beek AJ, Suanet B, Huisman M, Boot CRL. Societal participation of individuals aged 55-64 years with and without chronic disease. Eur J Public Health 2019; 29:93-98. [PMID: 30020455 DOI: 10.1093/eurpub/cky122] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background It is unknown whether an increase in societal participation is important for individuals with a chronic disease. This study explores whether having paid work, volunteer activities or informal care giving differs for individuals with a chronic disease and those without. Methods Respondents (n = 1779) aged 55-64 years who participated in the Longitudinal Ageing Study Amsterdam in 2002/2003 or 2012/2013 were included. We tested differences in (combinations of) performing paid work, volunteer activities or informal care giving between participants with and without a chronic disease by regression analyses, while taking into account sociodemographic confounders and effect modification by year. Results Having a chronic disease was associated with having paid work in 2002/2003 (OR: 0.5; 95% CI: 04-0.7), but not in 2012/2013 (OR: 0.7; 95% CI: 0.4-1.1). Work participation of participants with (OR: 1.5; 95% CI: 1.0-2.2) and without a chronic disease (OR: 2.3; 95% CI: 1.3-3.9) increased in 2012/2013. Participants with a chronic disease are more likely to participate in volunteer activities than paid work. No statistically significant associations were found between having a chronic disease and informal care giving. Conclusion Participation in paid work differs between individuals aged 55-64 years with a chronic disease and those without, but participation in informal care giving did not. Individuals with a chronic disease are more likely to participate in volunteer activities than paid work. Future research should focus on differences in societal participation within heterogeneous group of individuals with a chronic disease, since differences may be present in subgroups with specific chronic diseases.
Collapse
Affiliation(s)
- Micky Scharn
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Bianca Suanet
- Department of Sociology, VU University, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Sociology, VU University, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Cécile R L Boot
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
23
|
Aaltonen MS, Forma LP, Pulkki JM, Raitanen JA, Rissanen P, Jylhä MK. The Joint Impact of Age at Death and Dementia on Long-Term Care Use in the Last Years of Life: Changes From 1996 to 2013 in Finland. Gerontol Geriatr Med 2019; 5:2333721419870629. [PMID: 31489341 PMCID: PMC6709434 DOI: 10.1177/2333721419870629] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 07/19/2019] [Accepted: 07/29/2019] [Indexed: 11/16/2022] Open
Abstract
Welfare states increasingly rely on aging in place policies and have cut back on institutional long-term care (LTC) provision. Simultaneously, the major determinants of LTC use, that is, dementia and living to very old age, are increasing. We investigated how increasing longevity and concomitant dementia were associated with changes in round-the-clock LTC use in the last 5 years of life between 1996 and 2013. Retrospective data drawn from national registers included all those who died aged 70+ in 2007 and 2013, plus a 40% random sample from 2001 (N = 86,554). A generalized estimating equations (GEE) were used to estimate the association of dementia and age with LTC use during three study periods 1996-2001, 2002-2007, and 2008-2013. Between the study periods, the total number of days spent in LTC increased by around 2 months. Higher ages at death and the increased number of persons with dementia contributed to this increase. The group of the most frequent LTC users, that is, people aged 90+ with or without dementia, grew the most in size, yet their LTC use decreased. The implications of very old age and concomitant dementia for care needs must be acknowledged to guarantee an adequate quantity and quality of care.
Collapse
Affiliation(s)
- Mari S. Aaltonen
- Faculty of Social Sciences and
Gerontology Research Center, Tampere University, Finland
- The University of British Columbia,
Vancouver, Canada
| | - Leena P. Forma
- Faculty of Social Sciences and
Gerontology Research Center, Tampere University, Finland
| | - Jutta M. Pulkki
- Faculty of Social Sciences and
Gerontology Research Center, Tampere University, Finland
| | - Jani A. Raitanen
- Faculty of Social Sciences and
Gerontology Research Center, Tampere University, Finland
- UKK Institute for Health Promotion
Research, Tampere, Finland
| | - Pekka Rissanen
- Faculty of Social Sciences and
Gerontology Research Center, Tampere University, Finland
- National Institute for Health and
Welfare, Helsinki, Finland
| | - Marja K. Jylhä
- Faculty of Social Sciences and
Gerontology Research Center, Tampere University, Finland
| |
Collapse
|
24
|
Deeg DJH, Comijs HC, Hoogendijk EO, van der Noordt M, Huisman M. 23-Year Trends in Life Expectancy in Good and Poor Physical and Cognitive Health at Age 65 Years in the Netherlands, 1993-2016. Am J Public Health 2018; 108:1652-1658. [PMID: 30359113 PMCID: PMC6236728 DOI: 10.2105/ajph.2018.304685] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/18/2018] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine 23-year trends in both physically and cognitively healthy life expectancy from age 65 years in the Netherlands. METHODS We used 8 waves between 1993 and 2016 from the nationally representative Longitudinal Aging Study Amsterdam (12 948 observations). We calculated physically and cognitively healthy life expectancies by using the Sullivan life table method and tested prevalence trends over time by using generalized estimating equations. RESULTS Total life expectancy at age 65 years rose from 14.7 to 18.7 years (men) and from 19.2 to 21.4 years (women). Life expectancy in poor physical health increased nonlinearly from 1.8 to 2.9 years for men; for women it fluctuated around 5.7 years. Meanwhile, life expectancy in good cognitive health increased linearly from 11.0 to 15.7 years (men) and from 13.4 to 18.0 years (women). The proportion of people with poor physical and poor cognitive health combined did not increase, averaging 5.9% (men) and 8.7% (women). CONCLUSIONS This multiwave study shows that a negative trend in physically healthy life expectancy is accompanied by a positive trend in cognitively healthy life expectancy.
Collapse
Affiliation(s)
- Dorly J H Deeg
- Dorly J. H. Deeg, Emiel O. Hoogendijk, Maaike van der Noordt, and Martijn Huisman are with the Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, the Netherlands. Hannie C. Comijs is with the Department of Psychiatry, GGZinGeest, Amsterdam. Martijn Huisman is also with the Department of Sociology, Faculty of Social Sciences, VU University. All of the authors are with the VU University Medical Center and the Amsterdam Public Health Research Institute, Amsterdam
| | - Hannie C Comijs
- Dorly J. H. Deeg, Emiel O. Hoogendijk, Maaike van der Noordt, and Martijn Huisman are with the Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, the Netherlands. Hannie C. Comijs is with the Department of Psychiatry, GGZinGeest, Amsterdam. Martijn Huisman is also with the Department of Sociology, Faculty of Social Sciences, VU University. All of the authors are with the VU University Medical Center and the Amsterdam Public Health Research Institute, Amsterdam
| | - Emiel O Hoogendijk
- Dorly J. H. Deeg, Emiel O. Hoogendijk, Maaike van der Noordt, and Martijn Huisman are with the Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, the Netherlands. Hannie C. Comijs is with the Department of Psychiatry, GGZinGeest, Amsterdam. Martijn Huisman is also with the Department of Sociology, Faculty of Social Sciences, VU University. All of the authors are with the VU University Medical Center and the Amsterdam Public Health Research Institute, Amsterdam
| | - Maaike van der Noordt
- Dorly J. H. Deeg, Emiel O. Hoogendijk, Maaike van der Noordt, and Martijn Huisman are with the Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, the Netherlands. Hannie C. Comijs is with the Department of Psychiatry, GGZinGeest, Amsterdam. Martijn Huisman is also with the Department of Sociology, Faculty of Social Sciences, VU University. All of the authors are with the VU University Medical Center and the Amsterdam Public Health Research Institute, Amsterdam
| | - Martijn Huisman
- Dorly J. H. Deeg, Emiel O. Hoogendijk, Maaike van der Noordt, and Martijn Huisman are with the Department of Epidemiology and Biostatistics, VU University Medical Centre, Amsterdam, the Netherlands. Hannie C. Comijs is with the Department of Psychiatry, GGZinGeest, Amsterdam. Martijn Huisman is also with the Department of Sociology, Faculty of Social Sciences, VU University. All of the authors are with the VU University Medical Center and the Amsterdam Public Health Research Institute, Amsterdam
| |
Collapse
|
25
|
de Wind A, van der Noordt M, Deeg DJH, Boot CRL. Working life expectancy in good and poor self-perceived health among Dutch workers aged 55–65 years with a chronic disease over the period 1992–2016. Occup Environ Med 2018; 75:792-797. [DOI: 10.1136/oemed-2018-105243] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 08/08/2018] [Accepted: 08/17/2018] [Indexed: 12/14/2022]
Abstract
ObjectivesSeveral governments have taken measures to encourage prolonged working. It is therefore likely that older adults with a chronic disease are required to work longer in poor self-perceived health (SPH) than before. This study examines to what extent working life expectancy (WLE) in good and poor SPH changed between 1992 and 2016 in workers with a chronic disease from age 55 years onwards.MethodsThree cohorts (1992, 2002 and 2012) of workers with a chronic disease aged 55–65 years were selected from the Longitudinal Aging Study Amsterdam with a 3-year follow-up each (n=705). A three-state survival model was estimated, modelling transitions between states ‘working with good SPH’, ‘working with poor SPH’ and ‘exit from work’. WLEs were estimated using Multistate Modelling and Estimating Life Expectancies using Continuous Time in R.ResultsOf the workers with a chronic disease, total WLEs at age 55 years were 5.2, 5.7 and 6.8 years in cohorts 1992, 2002 and 2012, respectively. Workers initially having poor SPH, had total WLE of 4.7 years of which 2.4 years in poor SPH in cohort 1992. These workers had total WLE of 5.2 years of which 3.3 years in poor SPH in cohort 2002, and total WLE of 6.5 years of which 3.6 years in poor SPH in cohort 2012.ConclusionsWorkers with a chronic disease extended their working lives by approximately 18 months from 1992 to 2016. In the first decade, unhealthy WLE increased, whereas in the second decade, healthy WLE increased, among both workers in general and workers initially having poor SPH.
Collapse
|
26
|
Trends in the use of care among people aged 65–85 with cognitive impairment in the Netherlands. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000752] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractObservation of long-term trends within countries is needed to increase insight into how policy initiatives are reflected in the use of care over time in addition to individual determinants of care use. In the past decades, Dutch care policies have favoured homecare and reduced the availability of institutional care which extended the care responsibilities of formal and informal care-givers at home. This study investigates the changes in the use of informal and formal homecare, community services and residential care among cognitively impaired older adults over time in the Netherlands. In addition, of special interest here are the associations of the presence of a spouse, other family members or social network with care use, and the interdependency between the use of different types of care. The study employs the Longitudinal Aging Study Amsterdam (LASA) covering the years 1992–2012, analysed with generalised estimating equations. The data consisted of 1,022 observations gathered from 813 respondents aged 65–85. The respondents were cognitively impaired according to the age- and education-standardised Mini-Mental State Examination score. The analyses took into account several individual determinants of care use. The use of informal care and residential care decreased while the use of formal homecare and community services remained the same. Simultaneously, the proportion of those who did not use the studied care types increased. The contribution of partners in informal care decreased. Informal care and formal homecare use increasingly became complementary services. The findings suggest that the decreases in informal care and residential care have not been replaced by other types of care, as reflected in the increased number of persons receiving no care. Care policies should not rely excessively on the availability of informal help and should guarantee adequate formal help, especially for those in high need.
Collapse
|
27
|
Trends in ageing and ageing-in-place and the future market for institutional care: scenarios and policy implications. HEALTH ECONOMICS POLICY AND LAW 2018; 14:82-100. [PMID: 29779497 DOI: 10.1017/s1744133118000129] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
In several OECD countries the percentage of elderly in long-term care institutions has been declining as a result of ageing-in-place. However, due to the rapid ageing of population in the next decades future demand for institutional care is likely to increase. In this paper we perform a scenario analysis to examine the potential impact of these two opposite trends on the demand for institutional elderly care in the Netherlands. We find that the demand for institutional care first declines as a result of the expected increase in the number of low-need elderly that age-in-place. This effect is strong at first but then peters out. After this first period the effect of the demographic trend takes over, resulting in an increase in demand for institutional care. We argue that the observed trends are likely to result in a growing mismatch between demand and supply of institutional care. Whereas the current stock of institutional care is primarily focussed on low-need (residential) care, future demand will increasingly consist of high-need (nursing home) care for people with cognitive as well as somatic disabilities. We discuss several policy options to reduce the expected mismatch between supply and demand for institutional care.
Collapse
|
28
|
Córdoba-Doña JA, Escolar-Pujolar A, San Sebastián M, Gustafsson PE. Withstanding austerity: Equity in health services utilisation in the first stage of the economic recession in Southern Spain. PLoS One 2018; 13:e0195293. [PMID: 29601609 PMCID: PMC5877882 DOI: 10.1371/journal.pone.0195293] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 03/20/2018] [Indexed: 12/30/2022] Open
Abstract
Scant research is available on the impact of the current economic crisis and austerity policies on inequality in health services utilisation in Europe. This study aimed to describe the trends in horizontal inequity in the use of health services in Andalusia, Spain, during the early years of the Great Recession, and the contribution of demographic, economic and social factors. Consultation with a general practitioner (GP) and specialist, hospitalisation and emergency care were studied through the Andalusian Health Survey 2007 (pre-crisis) and 2011–2012 (crisis), using a composite income index as socioeconomic status (SES) indicator. Horizontal inequity indices (HII) were calculated to take differential healthcare needs into account, and a decomposition analysis of change in inequality between periods was performed. Results showed that before the crisis, the HII was positive (greater access for people with higher SES) for specialist visits but negative (greater access for people with lower SES) in the other three utilisation models. During the crisis no change was observed in inequalities in GP visits, but a pro-poor development was seen for the other types of utilisation, with hospital and emergency care showing significant inequality in favour of low income groups. Overall, the main contributors to pro-poor changes in utilisation were socio-economic variables and poor mental health, due to changes in their elasticities. Our findings show that inequalities in healthcare utilisation largely remained in favour of the less well-off, despite the cuts in welfare benefits and health services provision during the early years of the recession in Andalusia. Further research is needed to monitor the potential impact of such measures in subsequent years.
Collapse
Affiliation(s)
- Juan Antonio Córdoba-Doña
- Delegación Territorial de la Consejería de Salud de la Junta de Andalucía, Cádiz, Spain
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
- * E-mail:
| | | | - Miguel San Sebastián
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Per E. Gustafsson
- Department of Public Health and Clinical Medicine, Epidemiology and Global Health, Umeå University, Umeå, Sweden
| |
Collapse
|
29
|
Botes R, Vermeulen KM, Gerber AM, Ranchor AV, Buskens E. Functioning and quality of life in Dutch oldest old with diverse levels of dependency. Patient Prefer Adherence 2018; 12:2187-2196. [PMID: 30410314 PMCID: PMC6199227 DOI: 10.2147/ppa.s175388] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Frequently, a questionnaire like the EQ-5D is applied to investigate elderly health-related quality of life (HRQoL), but current literature suggests that inputs that go beyond these traditional health aspects might be of importance. The capability approach is a different method, which integrates several non-health-related factors to define the well-being of the oldest old. OBJECTIVE We propose to investigate the differences in oldest old functionings and quality of life (QoL), given different levels of dependency, using both a utility-based (EQ-5D+C) and capability-based (Currently Achieved Functioning) questionnaire. METHODS We interviewed 99 Dutch elderly, living in the Groningen, Veendam, and Hoogeveen areas. The average age of the elderly was 80 years, who were living independently, still looking after themselves; living semi-dependently with moderate care; or living in a nursing home requiring consistent care. RESULTS The utility score for the dependent group is the lowest of all three groups, across the diseases investigated in this study. The respective average utility scores calculated for the dependent, semi-dependent, and independent subgroups were 0.56 (SD ±0.10); 0.84 (SD ±0.11), and 0.69 (SD ±0.13). Mobility and pain were reported to be the major domains where problems appeared across the three groups. Additionally, dependent elderly experience deficits in the role and control functionings while the other two subgroups experience deficits in pleasure and security. CONCLUSION The results suggest that it is important to take note of the achievability of functionings and HRQoL, in addition to care dependency, to obtain QoL and well-being outcomes of the oldest old.
Collapse
Affiliation(s)
- Riaan Botes
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands,
| | - Karin M Vermeulen
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands,
| | - Antonie M Gerber
- Department of Basic Medical Sciences (G25), University of the Free State, Basic Medical Sciences, Bloemfontein, South Africa
| | - Adelita V Ranchor
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Erik Buskens
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands,
| |
Collapse
|
30
|
Karppinen H, Pitkälä KH, Kautiainen H, Tilvis RS, Valvanne J, Yoder K, Strandberg TE. Changes in disability, self-rated health, comorbidities and psychological wellbeing in community-dwelling 75-95-year-old cohorts over two decades in Helsinki. Scand J Prim Health Care 2017; 35:279-285. [PMID: 28784018 PMCID: PMC5592355 DOI: 10.1080/02813432.2017.1358855] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To explore changes in self-reported disabilities, health, comorbidities and psychological wellbeing (PWB) in aged cohorts over two decades. DESIGN, SETTING AND SUBJECTS Cross-sectional cohort studies with postal surveys were conducted among community-dwelling people aged 75, 80, 85, 90 and 95 years in 1989 (n = 660), 1999 (n = 2598) and 2009 (n = 1637) in Helsinki, Finland. MAIN OUTCOME MEASURES Self-reported items on disability, self-rated health (SRH), diagnoses and PWB were compared between cohorts of the same age. Standardized mortality ratios (SMRs) were calculated for each study year to explore the representativeness of the samples compared to general population of same age. RESULTS A significantly lower proportion of the 75-85-year-olds of the later study years reported going outdoors daily, although this group had improvements in both SRH and PWB scores. The number of comorbidities increased over time among 75-85-year-olds. The only significant change that could be verified among 90- and 95-year-olds between 1999 and 2009, was the lower proportion of participants going outdoors daily. The trend of leveling-off in disabilities was not explained by the SMRs (0.90, 0.71 and 0.60 for 1989, 1999 and 2009). CONCLUSIONS The latest older people's cohorts showed an end to previously reported improvements in disabilities, despite having favorable trends in SRH and PWB. Primary care may be faced with increasing need of appropriate services for their senior members.
Collapse
Affiliation(s)
- Helena Karppinen
- General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- CONTACT Helena Karppinen General Practice and Primary Health Care, P.O. Box 20, 00014 University of Helsinki, Finland
| | - Kaisu H. Pitkälä
- General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Hannu Kautiainen
- General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
| | - Reijo S. Tilvis
- Geriatrics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaakko Valvanne
- School of Medicine, University of Tampere, Tampere University Hospital, Tampere, Finland
- Gerontology Research Center, Universities of Jyväskylä and Tampere, Tampere, Finland
| | - Käthe Yoder
- General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Timo E. Strandberg
- Geriatrics, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Institute of Health Sciences/Geriatrics, University of Oulu, Oulu University Hospital, Oulu, Finland
| |
Collapse
|
31
|
Nosraty L, Pulkki J, Raitanen J, Enroth L, Jylhä M. Successful Aging as a Predictor of Long-Term Care Among Oldest Old: The Vitality 90+ Study. J Appl Gerontol 2017; 38:553-571. [PMID: 28671023 DOI: 10.1177/0733464817716968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AIM The aim of the study was to investigate whether successful aging (SA) predicts entering long-term care (LTC) among nonagenarians. METHODS Data originated from the linkage of the Vitality 90+ Study surveys with register data from Finnish Population Register and Care Registers. Altogether 1,966 community-dwelling individuals were followed for 2 years and 1,354 individuals for 5 years. Four models of SA were constructed by varying combinations of physical, psychological, and social components. Competing risk regression analysis was used. FINDINGS The incidence rate for entering LTC was lower for successful agers. Three models of SA presented a significantly decreased risk for entering LTC in the whole group and in women. The impact of SA was attenuated when living alone, needing help, and the year of participation were adjusted for, but was still significant for Model 3. CONCLUSION Nonagenarians who meet the multidimensional criteria of SA are less likely to enter LTC than those aging less successfully.
Collapse
Affiliation(s)
| | | | - Jani Raitanen
- 1 University of Tampere, Finland.,2 UKK Institute, Tampere, Finland
| | | | | |
Collapse
|
32
|
Klokgieters SS, van Tilburg TG, Deeg DJH, Huisman M. Resilience in the Disabling Effect of Gait Speed Among Older Turkish and Moroccan Immigrants and Native Dutch. J Aging Health 2017; 30:711-737. [PMID: 28553804 DOI: 10.1177/0898264316689324] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the factors that inhibit the disabling effect of impairments among citizens who have migrated from Turkey and Morocco and native Dutch according to a resilience perspective. METHOD Using data from the Longitudinal Aging Study Amsterdam with 928 native Dutch, 255 Turks, and 199 Moroccans aged 55 to 65, linear regression analysis assessed whether country of origin, mastery, income, and contact frequency modified the relationship between gait speed and activity limitations. RESULTS Turks, but not Moroccans, demonstrated stronger associations between gait speed and activity limitations than the Dutch. Mastery modified the association among the Dutch and the Turks. Income modified the association only among the Dutch. Effect modification by contact frequency was not observed. DISCUSSION Moroccans and Dutch appeared to be more resilient against impairments than Turks. As none of the resilience factors buffered in all three populations, we conclude that resilience mechanisms are not universal across populations.
Collapse
Affiliation(s)
- Silvia S Klokgieters
- 1 Department of Sociology, Faculty of Social sciences, Vrije Universiteit Amsterdam, The Netherlands
| | - Theo G van Tilburg
- 1 Department of Sociology, Faculty of Social sciences, Vrije Universiteit Amsterdam, The Netherlands
| | - Dorly J H Deeg
- 2 Amsterdam Public Health Research Institute, Department of Epidemiology and Biostatistics, VU University Medical Centre Amsterdam
| | - Martijn Huisman
- 1 Department of Sociology, Faculty of Social sciences, Vrije Universiteit Amsterdam, The Netherlands.,2 Amsterdam Public Health Research Institute, Department of Epidemiology and Biostatistics, VU University Medical Centre Amsterdam
| |
Collapse
|
33
|
Buttery AK, Du Y, Busch MA, Fuchs J, Gaertner B, Knopf H, Scheidt-Nave C. Changes in physical functioning among men and women aged 50-79 years in Germany: an analysis of National Health Interview and Examination Surveys, 1997-1999 and 2008-2011. BMC Geriatr 2016; 16:205. [PMID: 27908276 PMCID: PMC5134286 DOI: 10.1186/s12877-016-0377-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 11/23/2016] [Indexed: 11/22/2022] Open
Abstract
Background This study examines changes in physical functioning among adults aged 50-79 years in Germany based on data from two German National Health Interview and Examination Surveys conducted in 1997–1999 (GNHIES98) and 2008–2011 (DEGS1). Methods Using cross-sectional data from the two surveys (GNHIES98, n = 2884 and DEGS1, n = 3732), we examined changes in self-reported physical functioning scores (Short Form-36 physical functioning subscale (SF-36 PF)) by sex and age groups (50–64 and 65–79 years). Covariables included educational level, living alone, nine chronic diseases, polypharmacy (≥5 prescribed medicines), body mass index, sports activity, smoking and alcohol consumption. Multimorbidity was defined as ≥2 chronic diseases. Multivariable models were fitted to examine consistency of changes in physical functioning among certain subgroups and to assess changes in mean SF-36 PF scores, adjusting for changes in covariables between surveys. Results Mean physical functioning increased among adults aged 50–79 years between surveys in unadjusted analyses, but this change was not as marked among men aged 65–79 years who experienced rising obesity (20.6 to 31.5%, p = 0.004) and diabetes (13.0 to 20.0%, p = 0.014). Prevalence of multimorbidity and polypharmacy use increased among men and women aged 65–79 years. In sex and age specific multivariable analyses, changes in physical functioning over time were consistent across subgroups. Gains in physical functioning were explained by improved education, lower body mass index and improved health-related behaviours (smoking, alcohol consumption, sports activity) in women, but less so among men. Conclusions Physical functioning improved in Germany among adults aged 50–79 years. Improvements in the population 65–79 years were less evident among men than women, despite increases in multimorbidity prevalence among both sexes. Changes in health behaviours over time differed between sexes and help explain variations in physical functioning. Targeted health behaviour interventions are indicated from this study. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0377-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- A K Buttery
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany.,Faculty of Life Sciences and Medicine, King's College London, Guy's Campus, London, SE1 1UL, UK
| | - Y Du
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany
| | - M A Busch
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany
| | - J Fuchs
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany
| | - B Gaertner
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany
| | - H Knopf
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany
| | - C Scheidt-Nave
- Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 64, 12101, Berlin, Germany.
| |
Collapse
|
34
|
Hoogendijk EO, Deeg DJH, Poppelaars J, van der Horst M, Broese van Groenou MI, Comijs HC, Pasman HRW, van Schoor NM, Suanet B, Thomése F, van Tilburg TG, Visser M, Huisman M. The Longitudinal Aging Study Amsterdam: cohort update 2016 and major findings. Eur J Epidemiol 2016; 31:927-45. [PMID: 27544533 PMCID: PMC5010587 DOI: 10.1007/s10654-016-0192-0] [Citation(s) in RCA: 147] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 08/13/2016] [Indexed: 12/14/2022]
Abstract
The Longitudinal Aging Study Amsterdam (LASA) is an ongoing longitudinal study of older adults in the Netherlands, which started in 1992. LASA is focused on the determinants, trajectories and consequences of physical, cognitive, emotional and social functioning. The study is based on a nationally representative sample of older adults aged 55 years and over. The findings of the LASA study have been reported in over 450 publications so far (see www.lasa-vu.nl ). In this article we describe the background and the design of the LASA study, and provide an update of the methods. In addition, we provide a summary of the major findings from the period 2011-2015.
Collapse
Affiliation(s)
- Emiel O Hoogendijk
- Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| | - Dorly J H Deeg
- Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Jan Poppelaars
- Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Sociology, VU University, Amsterdam, The Netherlands
| | - Marleen van der Horst
- Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Hannie C Comijs
- Department of Psychiatry, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - H Roeline W Pasman
- Department of Public and Occupational Health, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Natasja M van Schoor
- Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Bianca Suanet
- Department of Sociology, VU University, Amsterdam, The Netherlands
| | - Fleur Thomése
- Department of Sociology, VU University, Amsterdam, The Netherlands
| | | | - Marjolein Visser
- Department of Health Sciences, Faculty of Earth and Life Sciences, EMGO + Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
- Department of Internal Medicine, Nutrition and Dietetics, VU University Medical Center, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics, EMGO + Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Sociology, VU University, Amsterdam, The Netherlands
| |
Collapse
|
35
|
Galenkamp H, Deeg DJH, de Jongh RT, Kardaun JWPF, Huisman M. Trend study on the association between hospital admissions and the health of Dutch older adults (1995-2009). BMJ Open 2016; 6:e011967. [PMID: 27531734 PMCID: PMC5013367 DOI: 10.1136/bmjopen-2016-011967] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 07/14/2016] [Accepted: 07/22/2016] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES An increase in hospital admission rates in older people may reflect improved access to healthcare, but also declining health trends in the older population. Owing to a lack of individual-level data, the latter possibility has received little attention. The current study examines associations between health status and hospitalisation rates of older adults in the Netherlands. DESIGN Observational individual-level data linked to hospital register data. SETTING Data from 1995 to 2009 from the nationally representative Longitudinal Aging Study Amsterdam were linked to the Dutch Hospital Discharge Register. PARTICIPANTS A total of 5681 observations of 2520 respondents across 4 measurement points (each with a follow-up of 36 months; ages 65-88 years). OUTCOME MEASURES The contribution of health, demographic, psychosocial and lifestyle characteristics to time trends in hospitalisation was assessed in multivariate models. RESULTS Between 1995 and 2009, the percentage with 1 or more overnight admissions (planned or acute) increased slightly from 38.1% to 39.7%. This was due to an increase in acute admission only (22.2-27.0%). Increased prevalences of chronic diseases, functional limitations and polypharmacy accounted for part of the observed increase in acute admissions. In addition, a more than doubled prevalence of day admissions over time was observed (12.3-28.3%), a trend that was unrelated to changes in individual characteristics. CONCLUSIONS This trend study showed a contribution of declines in population health to increases in acute hospital admissions. Since these declines did not provide a full explanation, healthcare reforms and increases in treatment possibilities in this period are likely to have contributed as well.
Collapse
Affiliation(s)
- Henrike Galenkamp
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Dorly J H Deeg
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Renate T de Jongh
- Department of Internal Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Jan W P F Kardaun
- Statistics Netherlands, The Hague, The Netherlands
- Department of Public Health, Academic Medical Center, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology and Biostatistics and the EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
- Department of Sociology, VU University, Amsterdam, The Netherlands
| |
Collapse
|
36
|
Alders P, Comijs HC, Deeg DJH. Changes in admission to long-term care institutions in the Netherlands: comparing two cohorts over the period 1996-1999 and 2006-2009. Eur J Ageing 2016; 14:123-131. [PMID: 28579933 PMCID: PMC5435789 DOI: 10.1007/s10433-016-0393-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Using data from two cohorts, we examine to what extent a decline in institutional care in the Netherlands is associated with changes in the need for care and/or societal factors. We compared older adults, aged 65–89, who were admitted to a long-term care (LTC) institution in the period 1996–1999 and 2006–2009. Using the Andersen model, we tested per block of predisposing, enabling and need factors, which factors were significant predictors of admission to institutional care. With a Blinder–Oaxaca decomposition regression, we decomposed the difference in admission to an LTC institution between the period 1996–1999 and 2006–2009 into a part that is due to differences in health needs and other factors such as effect of policy, social values, and technology. Between 1996 and 2006, the percentage of co-residing partners and income increased and the average level of loneliness decreased significantly. The prevalence of disability, chronic diseases, however, increased. Whereas the care by partners declined, the formal care by professionals increased. Although the observed decline in the admission rate to institutional care was relatively small across the 10 years (from 5.3 % in 1996–1999 to 4.5 % in 2006–2009, a 15 % decrease), the probability of admission in 2006–2009 was relatively much lower when accounting for changes in the health and social conditions of the participants: the probability was 1.7–2.1 % point lower for adults in the period 2006–2009 compared to 1996–1999, a 32–40 % decrease. Our results show that the decline in the admission rate to LTC institutions is not the result of changes in need. The decline is suggested to be the combined effect of changes in policy, technological advances and changes in social norms.
Collapse
Affiliation(s)
- Peter Alders
- Institute of Health Policy and Management, Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands
| | - Hannie C Comijs
- Department of Psychiatry, EMGO Institute for Health and Care Research, VU University Medical Center and GGZ inGeest, Amsterdam, The Netherlands
| | - Dorly J H Deeg
- Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| |
Collapse
|
37
|
Increasing social participation of older people: are there different barriers for those in poor health? Introduction to the special section. Eur J Ageing 2016; 13:87-90. [PMID: 28804373 DOI: 10.1007/s10433-016-0379-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
|
38
|
Rooth V, van Oostrom SH, Deeg DJH, Verschuren WMM, Picavet HSJ. Common trajectories of physical functioning in the Doetinchem Cohort Study. Age Ageing 2016; 45:382-8. [PMID: 26892339 DOI: 10.1093/ageing/afw018] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2015] [Accepted: 10/21/2015] [Indexed: 11/14/2022] Open
Abstract
PURPOSE to describe common trajectories of physical functioning and their determinants among an adult cohort, followed over a period of 15 years. METHODS the study sample consisted of 4,123 participants (initial ages 26-70 years) from the Doetinchem Cohort Study, who participated in three or four measurement cycles. Physical functioning was measured with the Dutch version of the SF-36. Using a group-based modelling strategy, trajectories of physical functioning were determined. Weighted multinomial logistic regression analyses were performed to identify socio-demographic, lifestyle and health characteristics that differentiate between the trajectories at baseline. RESULTS five common physical functioning trajectories were distinguished, labelled as 'stable not limited' (27% of the population), 'stable slightly limited' (54%), 'slightly limited substantial deterioration' (7%), 'moderately limited gradual improvement' (9%) and 'stable severely limited' (3%). The characteristics that differentiate between the trajectories with limitations and the trajectory 'stable not limited' were being female, older, physically inactive, overweight or obese, having one or more chronic conditions, poor mental health and poor self-perceived health at baseline. Being younger, physically active, less obese, living with a partner and a good perceived health were characteristics of the trajectory 'moderately limited gradual improvement' compared with 'stable severely limited'. CONCLUSION five common trajectories of physical functioning were distinguished in an adult cohort, with most individuals following a stable but slightly limited course of physical functioning. Some early risk indicators were found that in the future might be used to early identify those with limitations in physical functioning.
Collapse
Affiliation(s)
- Vera Rooth
- National Institute for Public Health and the Environment-Centre for Nutrition, Prevention and Health Services, Bilthoven, The Netherlands
| | - Sandra H van Oostrom
- National Institute for Public Health and the Environment-Centre for Nutrition, Prevention and Health Services, Bilthoven, The Netherlands
| | - Dorly J H Deeg
- VU University Medical Centre-Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - W M Monique Verschuren
- National Institute for Public Health and the Environment-Centre for Nutrition, Prevention and Health Services, Bilthoven, The Netherlands Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - H Susan J Picavet
- National Institute for Public Health and the Environment-Centre for Nutrition, Prevention and Health Services, Bilthoven, The Netherlands
| |
Collapse
|
39
|
Modig K, Virtanen S, Ahlbom A, Agahi N. Stable or improved health status in the population 65 years and older in Stockholm, Sweden – an 8-year follow-up of self-reported health items. Scand J Public Health 2016; 44:480-9. [DOI: 10.1177/1403494816636248] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Karin Modig
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Suvi Virtanen
- Department of Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anders Ahlbom
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet & Stockholm University, Stockholm, Sweden
| |
Collapse
|
40
|
Upmeier E, Vire J, Korhonen MJ, Isoaho H, Lehtonen A, Arve S, Wuorela M, Viitanen M. Cardiovascular risk profile and use of statins at the age of 70 years: a comparison of two Finnish birth cohorts born 20 years apart. Age Ageing 2016; 45:84-90. [PMID: 26764397 DOI: 10.1093/ageing/afv187] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE to compare cardiovascular morbidity and risk factor profiles of two 70-year-old cohorts of Finns examined in 1991 and 2011 and to describe prevalence of statin use according to cardiovascular risk in the later cohort. METHODS 1920-born cohort of community-dwelling 70-year-old persons (n = 1032) participated in comprehensive health surveys, physical and laboratory examinations in the Turku Elderly Study (TUVA) during 1991-92. In 2011, identical examination pattern was performed, in a 1940-born cohort of 70-year-old persons (n = 956) from the same area. Prevalence of cardiovascular diseases (CVD) and risk factors in the two cohorts was compared. Further, each cohort was divided into three cardiovascular risk groups (high, moderate and low) based on their estimated risk. Prevalence of statin use was calculated among each risk group in the 1940 cohort. RESULTS coronary heart disease (25 versus 11%) and peripheral artery disease (9 versus 2%) were more common in the 1920 than 1940 cohort, respectively. Lipid profile was worse and blood pressure higher in the earlier cohort, whereas use of statins and antihypertensives was more common in the later cohort. Forty-two per cent of the 1920 cohort and 29% of the 1940 cohort were estimated to have high cardiovascular risk. In the 1940 cohort, a total of 36% used statins. Statin use was most common among high-risk persons. CONCLUSIONS seventy-year olds examined in 2011 had less CVD morbidity than their counterparts 20 years earlier, and their cardiovascular risk factors were better controlled which is reflected in higher use of preventive medications, such as statins and antihypertensives.
Collapse
Affiliation(s)
- Eveliina Upmeier
- Department of Geriatrics, Turku City Hospital and University of Turku, Turku FIN-20700, Finland
| | - Jenni Vire
- Department of Geriatrics, Turku City Hospital and University of Turku, Turku FIN-20700, Finland
| | - Maarit Jaana Korhonen
- Department of Pharmacology, Drug Development and Therapeutics, University of Turku, Finland
| | | | - Aapo Lehtonen
- Department of Geriatrics, Turku City Hospital and University of Turku, Turku FIN-20700, Finland
| | - Seija Arve
- Department of Nursing Science, Turku City Hospital and University of Turku, Turku, Finland
| | - Maarit Wuorela
- Department of Geriatrics, Turku City Hospital and University of Turku, Turku FIN-20700, Finland
| | - Matti Viitanen
- Statcon Ltd, Salo, Finland Division of Clinical Geriatrics, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden
| |
Collapse
|
41
|
|
42
|
Choi NG, DiNitto DM, Marti CN. Social participation and self-rated health among older male veterans and non-veterans. Geriatr Gerontol Int 2015; 16:920-7. [PMID: 26338088 DOI: 10.1111/ggi.12577] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2015] [Indexed: 11/25/2022]
Abstract
AIM To examine self-rated health (SRH) and its association with social participation, along with physical and mental health indicators, among USA male veterans and non-veterans aged ≥65 years. METHODS The two waves of the National Health and Aging Trend Study provided data (n = 2845 at wave 1; n = 2235 at wave 2). Multilevel mixed effects generalized linear models were fit to test the hypotheses. RESULTS Despite their older age, veterans did not differ from non-veterans in their physical, mental and cognitive health, and they had better SRH. However, black and Hispanic veterans had lower SRH than non-Hispanic white veterans. Formal group activities and outings for enjoyment were positively associated with better SRH for veterans, non-veterans and all veteran cohorts. CONCLUSIONS Aging veterans, especially black and Hispanic veterans, require programs and services that will help increase their social connectedness. Geriatr Gerontol Int 2016; 16: 920-927.
Collapse
Affiliation(s)
- Namkee G Choi
- The University of Texas at Austin, Austin, Texas, USA
| | | | | |
Collapse
|
43
|
Kara B. Self-Rated Health and Associated Factors in Older Turkish Adults With Type 2 Diabetes: A Pilot Study. J Transcult Nurs 2015; 28:40-47. [PMID: 26303253 DOI: 10.1177/1043659615601484] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To evaluate self-rated health (SRH) and determine its associations with participant characteristics, glycemic control, family support, and health-related quality of life in older Turkish adults with type 2 diabetes. METHOD This cross-sectional study included 113 adults aged 60 years or older with type 2 diabetes. Data were collected by using an information form, the Perceived Social Support From Family Scale, and the Nottingham Health Profile. SRH was assessed by a single-item question. Glycemic control was measured by glycosylated hemoglobin levels. RESULTS Ninety-seven patients (85.8%) evaluated their health as fair or poor. The glycemic target level (glycosylated hemoglobin <7.5%) was achieved in 47.8% of the patients. Female gender, a low or moderate family income, and lower levels of family support were associated with poorer SRH. CONCLUSIONS/IMPLICATIONS The majority of the participants considered their health to be fair or poor. Better understanding of risk factors associated with SRH may provide more effective interventions to improve health outcomes.
Collapse
|
44
|
Complex health problems among the oldest old in Sweden: increased prevalence rates between 1992 and 2002 and stable rates thereafter. Eur J Ageing 2015; 12:285-297. [PMID: 28804361 DOI: 10.1007/s10433-015-0351-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Studies of health trends in older populations usually focus on single health indicators. We include multiple medical and functional indicators, which together indicate the broader impact of health problems experienced by individuals and the need for integrated care from several providers of medical and long-term care. The study identified severe problems in three health domains (diseases/symptoms, mobility, and cognition/communication) in three nationally representative samples of the Swedish population aged 77+ in 1992, 2002, and 2011 (n ≈ 1900; response rate >85 %). Institutionalized people and proxy interviews were included. People with severe problems in two or three domains were considered to have complex health problems. Results showed a significant increase of older adults with complex health problems from 19 % in 1992 to 26 % in 2002 and no change thereafter. Changes over time remained when controlling for age and sex. When stratified by education, complex health problems increased significantly for people with lower education between 1992 and 2002 and did not change significantly between 2002 and 2011. For higher-educated people, there was no significant change over time. Among the people with severe problems in the symptoms/disease domain, about half had no severe problems in the other domains. People with severe mobility problems, on the other hand, were more likely to also have severe problems in other domains. Even stable rates may imply an increasing number of very old people with complex health problems, resulting in a need for improved coordination between providers of medical care and social services.
Collapse
|
45
|
Trends in the informal and formal home-care use of older adults in the Netherlands between 1992 and 2012. AGEING & SOCIETY 2015. [DOI: 10.1017/s0144686x1500077x] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
ABSTRACTThis study investigates trends in, and the interdependence of, the use of informal and formal home care of community-dwelling older people over the last two decades in the context of governmental reform of long-term care services and modernisation of informal relationships. Seven observations of the Longitudinal Aging Study Amsterdam covering the time span between 1992 and 2012 were analysed using multi-level logistic regression analysis. The sample entailed 9,585 observations from 3,574 respondents, aged between 65 and 85 years and living independently at each time of measurement. Measures included formal and informal care use, health, physical and cognitive limitations, socio-demographics, partner status, social network, privately paid help and sense of mastery. Results showed that between 1992 and 2012, formal home-care use increased slightly while there was a large decrease in the use of informal care. Multivariate multi-level logistic regression analyses showed a substitution effect between formal and informal care use which decreased over time. Analyses also showed improved cognitive functioning, increased partner availability and social network size, as well as increased use of privately paid care over time. Nevertheless, these positive trends did not explain the large decrease in informal care use. The results regarding informal care use suggest a societal trend of weakened informal solidarity, reflecting increased individualisation and increased availability of formal home care. The decreased substitution effect suggests that, in agreement with current reforms of long-term care, complementary or supplementary forms of care use may be more common in the near future.
Collapse
|
46
|
Nascimento CDM, Mambrini JVDM, de Oliveira CM, Giacomin KC, Peixoto SV. Diabetes, hypertension and mobility among Brazilian older adults: findings from the Brazilian National Household Sample Survey (1998, 2003 and 2008). BMC Public Health 2015; 15:591. [PMID: 26116434 PMCID: PMC4483209 DOI: 10.1186/s12889-015-1956-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Accepted: 06/19/2015] [Indexed: 12/02/2022] Open
Abstract
Background The rapid population ageing has been accompanied by a growing number of older adults experiencing chronic conditions, especially diabetes and hypertension, which are conditions associated to the decline in physical functioning. The aim of this study was to investigate changes in the strength of the association between mobility and two chronic conditions (hypertension and diabetes) in a large representative sample of Brazilian older adults over a ten year period. Methods The data came from the Brazilian National Household Sample Survey (PNAD) of 1998, 2003 and 2008. The sample comprised 28,943 participants aged 60 years and older investigated in 1998, 35,042 in 2003 and 41,269 in 2008, totalling 105,254 older adults. The dependent variable was the physical mobility index (PMI) constructed based on the Item Response Theory (IRT) using five physical mobility indicators. The chronic conditions were self-reported and the confounders included: age, sex, schooling, ethnicity, family income, household composition, other co-morbidities and use of health services. The association between physical mobility (three different groups) and chronic conditions (hypertension and diabetes) was performed using multinomial logistic regression. Results Over the ten year period the prevalence of hypertension increased from 44 % (1998), 49 % (2003) to 53 % (2008) (p < 0.001). Similar pattern was observed for the prevalence of diabetes: 10 % in 1998, 13 % in 2003 and 16 % in 2008 (p < 0.001). Overall, physical mobility showed a statistical significant association with both chronic diseases studied even after adjusting for potential confounders. The time-disease interaction term was significant (p < 0.05) for the two chronic conditions studied, and the strength of the associations decreased over the first five years, but it was not sustained between 2003 and 2008. Conclusions Despite the increases observed in the prevalence of the hypertension and diabetes over the ten year period, the decrease in strength of the association with physical mobility during the first period could be explained by improvements in health services and treatment of older adults. Special attention should be given to the treatment and management of diabetes in order to avoid declines in physical mobility levels.
Collapse
Affiliation(s)
| | | | | | - Karla Cristina Giacomin
- Rene Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil. .,Secretaria Municipal de Saúde de Belo Horizonte, Belo Horizonte, Minas Gerais, Brazil.
| | - Sérgio Viana Peixoto
- Rene Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil. .,Nursing School, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
| |
Collapse
|
47
|
Pu C. The Influence of the Common Cold on Self-Rated Health: A Population-Based Study. AIMS Public Health 2015; 2:247-256. [PMID: 29546109 PMCID: PMC5690234 DOI: 10.3934/publichealth.2015.3.247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 06/08/2015] [Indexed: 11/22/2022] Open
Abstract
Objective Studies on the association between self-rated health and acute conditions are sparse. The aim of this study was to examine whether individuals respond to acute conditions (such as the common cold) in health ratings as well as the effect of chronic conditions (using the Charlson comorbidity score) on self-rated health. Methods The national representative survey data was linked with the claims data from the Taiwan National Health Insurance for 13,723 adults ≥ 18 years. Ordered logistic regressions with fractional polynomials were estimated to determine the relationship between the frequency of common cold episodes and the Charlson comorbidity score on self-rated health. The interactions between these two variables and the baseline age were tested. Results Self-rated health worsens with the increased frequency of both common cold episodes and the Charlson comorbidity score. Both variables have a non-linear relationship with self-rated health. Younger individuals put heavier weight on acute health conditions than their older counterparts. Conclusion Individuals respond to questions regarding their self-rated health based on their acute health condition along with chronic condition. Thus the information on self-rated health depends on the timing the information is collected, and whether at that time the individual experienced acute health conditions or not.
Collapse
Affiliation(s)
- Christy Pu
- Institute of Hospital and Health Care Administration, School of Medicine, National Yang-Ming University, Taipei 112, Taiwan
| |
Collapse
|
48
|
Junius-Walker U, Wiese B, Klaaßen-Mielke R, Theile G, Müller CA, Hummers-Pradier E. Older patients' perceived burdens of their health problems: a cross-sectional analysis in 74 German general practices. Patient Prefer Adherence 2015; 9:811-20. [PMID: 26124648 PMCID: PMC4476476 DOI: 10.2147/ppa.s81348] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Older patients often experience the burden of multiple health problems. Physicians need to consider them to arrive at a holistic treatment plan. Yet, it has not been systematically investigated as to which personal burdens ensue from certain health conditions. OBJECTIVE The objective of this study is to examine older patients' perceived burden of their health problems. PATIENTS AND METHODS The study presents a cross-sectional analysis in 74 German general practices; 836 patients, 72 years and older (mean 79±4.4), rated the burden of each health problem disclosed by a comprehensive geriatric assessment. Patients rated each burden using three components: importance, emotional impact, and impact on daily activities. Cluster analyses were performed to define patterns in the rating of these components of burden. In a multilevel logistic regression analysis, independent factors that predict high and low burden were explored. RESULTS Patients had a median of eleven health problems and rated the burden of altogether 8,900 health problems. Four clusters provided a good clustering structure. Two clusters describe a high burden, and a further two, a low burden. Patients attributed a high burden to social and psychological health problems (especially being a caregiver: odds ratio [OR] 10.4, 95% confidence interval [CI] 4.4-24.4), to specific symptoms (eg, claudication: OR 2.3, 95% CI 1.3-4.0; pain: OR 2.3, 95% CI 1.6-3.1), and physical disabilities. Patients rated a comparatively low burden for most of their medical findings, for cognitive impairment, and lifestyle issues (eg, hypertension: OR 0.2, 95% CI 0.2-0.3). CONCLUSION The patients experienced a relatively greater burden for physical disabilities, mood, or social issues than for diseases themselves. Physicians should interpret these burdens in the individual context and consider them in their treatment planning.
Collapse
Affiliation(s)
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Renate Klaaßen-Mielke
- Department of Medical Informatics, Biometry and Epidemiology, Ruhr-University, Bochum, Germany
| | - Gudrun Theile
- Institute of General Practice, Hannover Medical School, Hannover, Germany
- Geriatric Clinic University Hospital, Zurich, Switzerland
| | - Christiane Annette Müller
- Department of General Practice/Family Medicine, University Medical Center Göttingen, Georg-August-University, Göttingen, Germany
| | - Eva Hummers-Pradier
- Department of General Practice/Family Medicine, University Medical Center Göttingen, Georg-August-University, Göttingen, Germany
| |
Collapse
|
49
|
Solé-Auró A, Alcañiz M. Are we living longer but less healthy? Trends in mortality and morbidity in Catalonia (Spain), 1994-2011. Eur J Ageing 2015; 12:61-70. [PMID: 28804346 PMCID: PMC5549217 DOI: 10.1007/s10433-014-0317-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Evidence on trends in prevalence of disease and disability can clarify whether countries are experiencing a compression or expansion of morbidity. An expansion of morbidity, as indicated by disease, has appeared in Europe and other developed regions. It is likely that better treatment, preventive measures, and increases in education levels have contributed to the declines in mortality and increments in life expectancy. This paper examines whether there has been an expansion of morbidity in Catalonia (Spain). It uses trends in mortality and morbidity and links these with survival to provide estimates of life expectancy with and without diseases and mobility limitations. We use a repeated cross-sectional health survey carried out in 1994 and 2011 for measures of morbidity, and information from the Spanish National Statistics Institute for mortality. Our findings show that at age 65 the percentage of life with disease increased from 52 to 70 % for men, and from 56 to 72 % for women; the expectation of life with mobility limitations increased from 24 to 30 % for men and from 40 to 47 % for women between 1994 and 2011. These changes were attributable to increases in the prevalence of diseases and moderate mobility limitation. Overall, we find an expansion of morbidity along the period. Increasing survival among people with diseases can lead to a higher prevalence of diseases in the older population. Higher prevalence of health problems can lead to greater pressure on the health care system and a growing burden of disease for individuals.
Collapse
Affiliation(s)
- Aïda Solé-Auró
- Mortality, Health and Epidiemology Unit, Institut National d’Études Démographiques INED, 133 Boulevard Davout, 75020 Paris, France
- Riskcenter, Department of Econometrics, Statistics and Spanish Economy, University of Barcelona, Av. Diagonal 690, 08034 Barcelona, Spain
| | - Manuela Alcañiz
- Riskcenter, Department of Econometrics, Statistics and Spanish Economy, University of Barcelona, Av. Diagonal 690, 08034 Barcelona, Spain
| |
Collapse
|
50
|
Levinson D, Kaplan G. What does Self Rated Mental Health Represent. J Public Health Res 2014; 3:287. [PMID: 25553310 PMCID: PMC4274494 DOI: 10.4081/jphr.2014.287] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2014] [Accepted: 11/21/2014] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Unlike the widely used self rated health, the self rated mental health was found unsuitable as a proxy for mental illness. This paper analyses the relationships between the self ratings of physical health, mental health and overall health, and their association of with the objective indicators for physical and mental health. DESIGN AND METHODS The study is a secondary analysis of data from a nationwide representative sample of the non-institutionalized adult residents of Israel in 2003 that was collected via computer-assisted personal interview methods [n=4859]. RESULTS The self rated physical health and the self rated mental health were strongly related to each other yet the self rated mental health was not related to chronic physical conditions and the self rated physical health was not related to mental disorders. In a multiple logistic regression analysis, those with positive self rated mental health had 93 times the odds of reporting positive overall health whereas those with positive self rated physical health had 40 times the odds of reporting positive overall health. CONCLUSIONS The self rating of mental health presents a qualitatively different dimension from mental illness. The self rated mental health is two times more important than the self rated physical health in predicting the self rated overall health Significance for public healthThe present study is an original study on the self rated physical, mental and overall health measures. Because of the wide range of associations with other health indicators, and the simplicity with which they are collected, self-rated health measures are widely used in large population surveys.The present study questions the automatic assumption that the self rated mental health functions as a proxy measure of psychiatric morbidity, and suggests that the self rated mental health is more closely related to subjective well-being. The results show that self rated mental health predicts self rated general health better than self rated physical health.
Collapse
Affiliation(s)
| | - Giora Kaplan
- Certner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Israel
| |
Collapse
|