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Hansen RS, Scheel-Hincke LL, Jeune B, Ahrenfeldt LJ. Sex differences in vision and hearing impairments across age and European regions : Findings from SHARE. Wien Klin Wochenschr 2024; 136:55-63. [PMID: 37280394 DOI: 10.1007/s00508-023-02223-2] [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: 01/23/2023] [Accepted: 05/07/2023] [Indexed: 06/08/2023]
Abstract
AIM Although sensory impairments are common conditions among older people, research often fails to consider the role of sex. We examined sex differences in vision impairment and hearing impairment across age and European regions. METHODS We conducted a cross-sectional study based on a pooled sample of 65,656 females and 54,881 males aged 50 years and older participating in the Survey of Health, Ageing and Retirement in Europe (SHARE) from 2004-2020. Logistic regression models with robust standard errors providing odds ratios (OR) and 95% confidence intervals (CI) were used to examine associations. RESULTS European females had generally higher odds of vision impairment (OR 1.16, 95% CI 1.12-1.21) but lower odds of hearing impairment than European males (OR 0.70, 95% CI 0.67-0.73). The female disadvantage in vision increased with advancing age, whereas the female advantage in hearing decreased. No overall sex difference in vision was found in northern Europe, but females had more vision impairments than males in southern (OR 1.23, 95% CI 1.14-1.32), western (OR 1.14, 95% CI 1.08-1.21) and eastern (OR 1.10, 95% CI 1.02-1.20) Europe. Females were healthier than males in terms of hearing in all regions, with the largest female advantage in northern Europe (OR 0.58, 95% CI 0.53-0.64). CONCLUSION Our findings demonstrate an overall consistent pattern of sex differences in sensory impairments across Europe showing an increasing female disadvantage in vision and a decreasing female advantage in hearing with advancing age.
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Affiliation(s)
- Rikke Syrak Hansen
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark
| | - Lasse Lybecker Scheel-Hincke
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark
| | - Bernard Jeune
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark
| | - Linda Juel Ahrenfeldt
- Unit for Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000, Odense C, Denmark.
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Gajda M, Gajda P, Pac A, Gryglewska B, Wojnarski M, Różańska A, Lipińska-Tobiasz I, Wójkowska-Mach J. Post-discharge occurrence of surgical site infections after hip or knee arthroplasty surgery in Poland, a population-based study. Sci Rep 2023; 13:15940. [PMID: 37743386 PMCID: PMC10518305 DOI: 10.1038/s41598-023-43111-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 09/20/2023] [Indexed: 09/26/2023] Open
Abstract
Arthroplasty is a common procedure improving functioning of patients and their quality of life. Infection is a serious complication that determines subsequent management of the prosthesis and the patient. The aim of the study was to investigate the incidence of post-discharge surgical site infections (SSI) and their risk factors. A retrospective analysis of an anonymized database from the National Health Found for 2017 of 56,068 adult patients undergoing hip replacement surgery (HPRO) and 27,457 patients undergoing knee replacement surgery (KPRO). The cumulative incidence of post-discharge SSI was 0.92% for HPRO and 0.95% for KPRO. The main risk factors for hip SSI were male gender, diseases of hematopoietic, musculoskeletal and nervous system. The risk factor for knee SSI was male gender. All comorbidities significantly increased the risk of SSI. The ICU stay and antibiotics administered at discharge in studied population increased the risk of detection of SSI after HPRO and KPRO by up to four and seven times, respectively. For both procedures rehabilitation after surgery and total endoprosthesis decreased incidence of SSIs. The lower experience of the center was related to higher SSI incidence in HPRO in primary (1.5% vs. 0.9%) and in revision surgeries (3.8% vs. 2.1%), but in KPRO, lower experience only in primary surgeries was significantly associated with SSI. The cumulative incidence of post-discharge SSI in Poland is higher than in other European countries. Special attention should be paid to patients with chronic diseases.
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Affiliation(s)
- Mateusz Gajda
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Czysta 18 St., 31-121, Kraków, Poland.
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Łazarza 16 St., 31-530, Kraków, Poland.
| | - Paulina Gajda
- Chair of Epidemiology and Preventive Medicine, Department of Epidemiology, Jagiellonian University Medical College, Kopernika 7 St., 31-034, Kraków, Poland
| | - Agnieszka Pac
- Chair of Epidemiology and Preventive Medicine, Department of Epidemiology, Jagiellonian University Medical College, Kopernika 7 St., 31-034, Kraków, Poland
| | - Barbara Gryglewska
- Department of Internal Medicine and Gerontology, Jagiellonian University Medical College, Jakubowskiego 2 St., 30-886, Kraków, Poland
| | - Marcin Wojnarski
- Faculty of Medicine, Jagiellonian University Medical College, St. Anna 12 St., 33-332, Kraków, Poland
| | - Anna Różańska
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Czysta 18 St., 31-121, Kraków, Poland
| | - Inga Lipińska-Tobiasz
- Department of Orthopedics and Traumatology, Hospital in Proszowice, Kopernika 13 St, 32-100, Proszowice, Poland
| | - Jadwiga Wójkowska-Mach
- Department of Microbiology, Faculty of Medicine, Jagiellonian University Medical College, Czysta 18 St., 31-121, Kraków, Poland
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Forster GK, Aarø LE, Alme MN, Hansen T, Nilsen TS, Vedaa Ø. Built Environment Accessibility and Disability as Predictors of Well-Being among Older Adults: A Norwegian Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20105898. [PMID: 37239625 DOI: 10.3390/ijerph20105898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/05/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023]
Abstract
Knowledge about the influence environmental factors have on well-being is important to deliver policies supporting healthy ageing and sustainable health equity. An under-researched question is whether and how the built environment plays a role on well-being among older adults with disabilities. This study explores the relationship between built environment accessibility and disability on psychosocial well-being among older adults. Data were used from the Norwegian Counties Public Health Survey collected during February 2021 in Møre and Romsdal county (N = 8274; age = 60-97, mean = 68.6). General linear modelling was performed to examine the relationship and interaction between built environment accessibility (services, transportation, and nature) and disability on psychosocial well-being (quality of life, thriving, loneliness, and psychological distress). Higher levels of disability and poorer accessibility were each significantly related to lower psychosocial well-being across all variables (p < 0.001). Significant interaction effects were observed between disability and built environment accessibility on thriving (F(8, 5936) = 4.97, p < 0.001, η2 = 0.006) and psychological distress (F(8, 5957) = 3.09, p = 0.002, η2 = 0.004). No significant interaction effects were found for quality of life and loneliness. These findings indicate good built environment accessibility is associated with thriving and reduces psychological distress among older adults with disabilities. This study supports and extends previous findings on the importance of accessible and equipped environments for well-being and may aid policy makers when planning built environments to foster healthy ageing among this population group.
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Affiliation(s)
- Grace Katharine Forster
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, NTNU, NO-7047 Trondheim, Norway
- Department of Health Promotion, Norwegian Institute of Public Health, NIPH, NO-5015 Bergen, Norway
- Department of Health and Functioning, Western Norway University of Applied Sciences, HVL, NO-5063 Bergen, Norway
| | - Leif Edvard Aarø
- Department of Health Promotion, Norwegian Institute of Public Health, NIPH, NO-5015 Bergen, Norway
| | - Maria Nordheim Alme
- Department of Health and Functioning, Western Norway University of Applied Sciences, HVL, NO-5063 Bergen, Norway
| | - Thomas Hansen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, NIPH, NO-0456 Oslo, Norway
- Centre for Welfare and Labour Research, Oslo Metropolitan University, NO-0170 Oslo, Norway
- Promenta Research Center, University of Oslo, NO-0317 Oslo, Norway
| | - Thomas Sevenius Nilsen
- Department of Mental Health and Suicide, Norwegian Institute of Public Health, NIPH, NO-0456 Oslo, Norway
- Promenta Research Center, University of Oslo, NO-0317 Oslo, Norway
| | - Øystein Vedaa
- Department of Health Promotion, Norwegian Institute of Public Health, NIPH, NO-5015 Bergen, Norway
- Department of Psychosocial Science, University of Bergen, UiB, NO-5015 Bergen, Norway
- Voss District Psychiatric Hospital NKS Bjørkeli, NO-5705 Voss, Norway
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Marroig A. Transitions across states with and without difficulties in performing activities of daily living and death: a longitudinal comparison of ten European countries. Eur J Ageing 2023; 20:18. [PMID: 37202643 DOI: 10.1007/s10433-023-00763-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 05/20/2023] Open
Abstract
Ageing has been related to the onset of disability and dependency in older adults. There is a need to better understand the disability and dependency trajectories of older adults and their relationship with socio-demographic characteristics and institutional or cultural context. This study analyses the role of age, sex, education and self-perceived health in disability, dependency and death transitions, addressing the heterogeneity across European countries and inconsistencies when using different measures of disability. Multi-state models were adjusted to evaluate the role of risk and protective factors in the transitions to disability, dependency and death. Difficulties in performing activities of daily living (ADLs) assess disability and dependency states. Data were from the Survey of Health, Ageing and Retirement in Europe conducted in 2004-2013, considering individuals aged 65 and older at baseline from Austria, Belgium, Denmark, France, Germany, Italy, the Netherlands, Spain, Sweden and Switzerland. The results showed that transitions to disability and dependency varied with age, sex, education and self-perceived health. The probability of transition to disability and dependency states increases until the age of 70 for all countries. However, there was heterogeneity in the disability and dependency trajectories with ageing between men and women. In most countries, women live with difficulties and may need help for longer than men. Care policies should consider sex differences to decrease the burden of care of informal caregivers, particularly in countries where care systems are absent or partially developed and a high level of family obligations to care needs exist.
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Affiliation(s)
- Alejandra Marroig
- Instituto de Estadística, Universidad de la República, Montevideo, Uruguay.
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Kekäläinen T, Luchetti M, Sutin A, Terracciano A. Functional Capacity and Difficulties in Activities of Daily Living From a Cross-National Perspective. J Aging Health 2022; 35:356-369. [PMID: 36245236 PMCID: PMC10104963 DOI: 10.1177/08982643221128929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objectives: This study investigated whether physical and cognitive functioning predicts developing difficulties in basic or instrumental activities of daily living (ADL/IADL), and whether country-level factors moderated the associations. Methods: 69,227 adults aged 50+ from 19 countries were followed for up to 14 years. Cox regression and meta-regression analyses were used. Results: Higher grip strength was associated with a 45% lower risk of developing ADL limitations and a 47% lower risk of IADL limitations. The corresponding values were 22% and 23% for peak flow, 20% and 23% for word recall, and 20% and 24% for temporal orientation. The associations were similar and statistically significant in most countries, but some associations were weaker in countries with lower GDP and lower service coverage. Discussion: Good physical and cognitive functional capacity protects from ADL and IADL limitations consistently across Western countries. The associations may be stronger in countries with more resources.
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Affiliation(s)
- Tiia Kekäläinen
- Gerontology Research Center, Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | - Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Angelina Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, FL, USA
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Bonsang E, Skirbekk V. Does Childbearing Affect Cognitive Health in Later Life? Evidence From an Instrumental Variable Approach. Demography 2022; 59:975-994. [PMID: 35471229 PMCID: PMC10539463 DOI: 10.1215/00703370-9930490] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Cognitive decline is a widespread concern as populations grow older. However, population aging is partly driven by a decrease in fertility, and family size may influence cognitive functioning in later life. Prior studies have shown that fertility history is associated with late-life cognition, but whether the relationship is causal remains unclear. We use an instrumental variable approach and data from the Survey of Health, Ageing, and Retirement in Europe to examine whether having three or more versus two children affects late-life cognition. Parents often prefer to have at least one son and one daughter. We thus exploit the sex composition of the first two children as a source of exogenous variation in the probability of having three or more children. Results indicate that having three or more versus two children has a negative effect on late-life cognition. This effect is strongest in Northern Europe, perhaps because higher fertility decreases financial resources yet does not improve social resources in this region. Future studies should address the potential effects of childlessness or having one child on late-life cognition and explore the mediating mechanisms.
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Affiliation(s)
- Eric Bonsang
- LEDA, CNRS, IRD, Université Paris-Dauphine, Université PSL, Paris, France
- Netspar, Tilburg, the Netherlands
| | - Vegard Skirbekk
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Columbia Aging Centre, Columbia University, New York, NY, USA
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Fuchs J, Gaertner B, Prütz F. Limitations in activities of daily living and support needs - Analysis of GEDA 2019/2020-EHIS. JOURNAL OF HEALTH MONITORING 2022; 7:6-25. [PMID: 35434501 PMCID: PMC9009067 DOI: 10.25646/9570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 03/04/2022] [Indexed: 11/16/2022]
Abstract
Being able to perform activities of daily living is an important component of a person's ability to function. If these activities are impaired, support is needed. Using data from GEDA 2019/2020-EHIS, we present how many people aged 55 and older living in private households in Germany experience limitations in activities of daily living. Severe limitations in basic (fundamental) activities (e.g. food intake) are reported by 5.8% of women and 3.7% of men. The proportion increases with age as 13.4% of women and 9.0% of men aged 80 and older experience limitations. Severe limitations of instrumental activities of daily living (e.g. grocery shopping) are rather rare in participants less than 80 years of age. But at age 80 and older the proportion rises to 35.9% of women and 21.0% of men. A total of 68.1% of afflicted women and 57.5% of men receive help and support related to limitations of basic activities. Women are also more likely to report a lack of support (48.8% vs. 43.2%). The situation is slightly better with regard to instrumental activities. The results of GEDA 2019/2020-EHIS show in which areas of daily life older and very old people are impaired, give an impression of who is affected particularly strongly and indicate where support services are insufficient. As such, these results provide clues as to where support can be provided to enable older people to keep living in their own homes for a long time.
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Affiliation(s)
- Judith Fuchs
- Corresponding author Dr Judith Fuchs, Robert Koch Institute, Department of Epidemiology and Health Monitoring, General-Pape-Str. 62–66, 12101 Berlin, Germany, E-mail:
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Macinko J, Vaz de Melo Mambrini J, Bof de Andrade F, Drumond Andrade FC, Lazalde GE, Lima-Costa MF. Life-course risk factors are associated with activity of daily living disability in older adults. Eur J Public Health 2021; 31:520-527. [PMID: 33128061 PMCID: PMC8485733 DOI: 10.1093/eurpub/ckaa156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Multiple risk factors accumulate over the life-course and contribute to higher rates of disability at older ages. This study investigates whether three life-course risk factors (low educational attainment, poor health in childhood and multimorbidity) are associated with increased risk of disability [defined as any limitation in basic activities of daily living (BADL)] in older adults and whether this relationship is moderated by the national socioeconomic context, measured by the Human Development Index (HDI). METHODS Data include 100 062 adults (aged 50 and over) participating in longitudinal studies of aging conducted in 19 countries. Analyses include multivariable Poisson models with robust standard errors to assess the associations between HDI, life-course risk factors and other individual-level control variables (sex and age) with any BADL disability. RESULTS In country-specific analyses, both educational attainment and multimorbidity are independently associated with disability in nearly every country. The interaction between these risk factors further increases the magnitude of this association. In pooled regression analyses, the relationship between life-course risk factors and disability is moderated by a country's HDI. For individuals with all three life-course risk factors, the predicted probability of disability ranged from 36.7% in the lowest HDI country to 21.8% in the highest HDI country. CONCLUSIONS Social and health system policies directed toward reducing the development of life-course risk factors are essential to reduce disability in all countries, but are even more urgently needed in those with lower levels of socioeconomic development.
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Affiliation(s)
- James Macinko
- Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
- Correspondence: M. Fernanda Lima-Costa, Instituto de Pesquisas René Rachou, Fundação Oswaldo Cruz, Av. Augusto de Lima 1715, Belo Horizonte 30190002, Brazil, e-mail:
| | | | | | | | - Gabriela E Lazalde
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, CA, USA
| | - Maria Fernanda Lima-Costa
- Fundação Oswaldo Cruz, Instituto de Pesquisas René Rachou, Belo Horizonte, Brazil
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Barbosa F, Voss G, Delerue Matos A. Do European co-residential caregivers aged 50+ have an increased risk of frailty? HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:2418-2430. [PMID: 32557977 PMCID: PMC7818189 DOI: 10.1111/hsc.13064] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 05/04/2020] [Accepted: 05/26/2020] [Indexed: 06/11/2023]
Abstract
One important health challenge associated with ageing is frailty, which has been acknowledged as a new public health priority. However, only a few studies have explored the relationship between providing care at older ages and frailty. The main objective of this study is to assess whether there is an association between providing co-residential care and frailty, according to gender and from a European cross-sectional perspective, among the population aged 50+. Data from 17 European countries that participated in wave 6 of the Survey of Health, Ageing and Retirement in Europe (SHARE) is used (N = 52,073). Multinomial logistic regressions were used to estimate caregivers' chances of frailty. The results show that the prevalence of pre-frailty and frailty differs according to the caregiver's status, gender and the European region. The highest prevalence of pre-frailty was found in the group of female caregivers from Northern countries (57.3%), and the highest prevalence of frailty was found in the group of female caregivers from Southern countries (29.3%). Providing co-residential care is positively associated with the risk of being pre-frail in women, in all European regions (Northern: OR 1.724, 95% CI 1.190-2.496; Central: OR 1.213, 95% CI 1.010-1.456; Eastern: OR 1.227, 95% CI 1.031-1.460; Southern: OR 1.343, 95% CI 1.103-1.634), and with being frail for both genders in the Southern region (female: OR 1.527, 95% CI 1.060-2.200; male: OR 1.644, 95% CI 1.250-2.164). The results of this study suggest that female co-residential caregivers are a greater risk of being pre-frail in all European regions except Southern Europe, where male and female co-residential caregivers are a greater risk of being frail, compared with non-caregivers. European policy makers should create political measures to prevent and reverse frailty among European co-residential caregivers.
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Affiliation(s)
- Fátima Barbosa
- Centro de Estudos de Comunicação e SociedadeInstituto de Ciências SociaisUniversidade do MinhoBragaPortugal
| | - Gina Voss
- Centro de Estudos de Comunicação e SociedadeInstituto de Ciências SociaisUniversidade do MinhoBragaPortugal
| | - Alice Delerue Matos
- Centro de Estudos de Comunicação e SociedadeInstituto de Ciências SociaisUniversidade do MinhoBragaPortugal
- Departamento de SociologiaInstituto de Ciências SociaisUniversidade do MinhoBragaPortugal
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Ćwirlej-Sozańska A, Wiśniowska-Szurlej A, Wilmowska-Pietruszyńska A, Sozański B. Determinants of ADL and IADL disability in older adults in southeastern Poland. BMC Geriatr 2019; 19:297. [PMID: 31672121 PMCID: PMC6824102 DOI: 10.1186/s12877-019-1319-4] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 10/15/2019] [Indexed: 11/26/2022] Open
Abstract
Background The extension of the life span has led to an increase in the number of older people and an increase in the prevalence of disability in people over 60 years of age. The aim of this study was to assess the prevalence of ADL and IADL disability and to analyze its determinants among people aged 60 and older living in southeastern Poland. Methods This cross-sectional study was carried out among a randomly selected, representative population of people aged 60 and older living in southeastern Poland. Disability was assessed using the Katz Index of Independence in Basic Activities of Daily Living and Instrumental Activities of Daily Living. Logistic regression models were used to identify the factors related to ADLs and IADLs. For the variables that were included in the above models, their clustered influence on the increase in the odds ratio for the occurrence of an ADL or IADL limitation was also examined. Results The research results show that 35.75% of the participants reported at least one problem with IADLs. At least one problem with ADLs was reported by 17.13% of the participants. The most significant modifiable factors influencing the occurrence of disability were the presence of barriers in the participant’s environment, poor relations with relatives, a lack of social contacts, multimorbidity and pain. A multiple increase in the odds ratio of disability was found with the presence of pairs of analyzed factors. The highest odds ratio of at least one ADL limitation was observed for the combination of barriers in the participant’s environment with multimorbidity (OR 74.07). With regard to IADL disability, the highest odds ratio was observed for the combination of pain on the VAS scale ≥3 points with older age (OR 19.47). Conclusions The study showed a high prevalence of ADL and IADL disability in older people living in southeastern Poland. It also indicated the extent to which modifiable factors influenced the occurrence of disability and the extent to which the risk of disability increased with the presence of pairs of factors, especially those that included environmental barriers in the participant’s environment.
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Affiliation(s)
| | | | | | - Bernard Sozański
- Center for Innovative Research in Medical and Natural Sciences, University of Rzeszow, Rzeszow, Poland
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Scheel-Hincke LL, Möller S, Lindahl-Jacobsen R, Jeune B, Ahrenfeldt LJ. Cross-national comparison of sex differences in ADL and IADL in Europe: findings from SHARE. Eur J Ageing 2019; 17:69-79. [PMID: 32158373 DOI: 10.1007/s10433-019-00524-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Women experience greater longevity than men, but have poorer health, although sex differences vary across health measures and geographical regions. We aim to examine sex differences in Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) over age across European regions in a cross-sectional setting including 51,292 men and 62,007 women aged 50+ from a pooled sample of waves 1 (2004-2005) to 6 (2015) in the Survey of Health, Ageing and Retirement in Europe. ADL and IADL were dichotomised into no limitations and at least one limitation. Binomial regression models were used to estimate absolute and relative sex differences. Women had higher risk than men of ADL limitations (RR = 1.21, 95% CI 1.16; 1.27) and IADL limitations (RR = 1.54, 95% CI 1.48; 1.60), corresponding to risk differences of 1.3% and 5.7%, respectively. When we stratified by age groups and regions, sex differences in ADL were found in all age groups in Southern Europe, in the age groups 65-79 years and 80+ years in Western and Eastern Europe, and from the age of 80 in Northern Europe. For IADL, sex differences were found in all age groups in the four European regions, except from ages 50-64 in Eastern Europe. The absolute sex differences increased with age in all European regions. In conclusion, our results lend support for the male-female health survival paradox by showing that European women have higher risk of ADL and IADL limitations than European men and that sex differences increase with advancing age.
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Affiliation(s)
- Lasse Lybecker Scheel-Hincke
- 1Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000 Odense, Denmark
| | - Sören Möller
- 2OPEN - Odense Patient data Explorative Network, Odense University Hospital, 5000 Odense, Denmark.,3Department of Clinical Research, University of Southern Denmark, 5000 Odense, Denmark
| | - Rune Lindahl-Jacobsen
- 1Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000 Odense, Denmark
| | - Bernard Jeune
- 1Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000 Odense, Denmark
| | - Linda Juel Ahrenfeldt
- 1Unit of Epidemiology, Biostatistics and Biodemography, Department of Public Health, University of Southern Denmark, J. B. Winsløws Vej 9B, 5000 Odense, Denmark
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van der Roest HG, van Eenoo L, van Lier LI, Onder G, Garms-Homolová V, Smit JH, Finne-Soveri H, Jónsson PV, Draisma S, Declercq A, Bosmans JE, van Hout HPJ. Development of a novel benchmark method to identify and characterize best practices in home care across six European countries: design, baseline, and rationale of the IBenC project. BMC Health Serv Res 2019; 19:310. [PMID: 31092244 PMCID: PMC6521361 DOI: 10.1186/s12913-019-4109-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 04/17/2019] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Europe's ageing society leads to an increased demand for long-term care, thereby putting a strain on the sustainability of health care systems. The 'Identifying best practices for care-dependent elderly by Benchmarking Costs and outcomes of Community Care' (IBenC) project aims to develop a new benchmark methodology based on quality of care and cost of care utilization to identify best practices in home care. The study's baseline data, methodology, and rationale are reported. METHODS Home care organizations in Belgium, Finland, Germany, Iceland, Italy, and the Netherlands, home care clients of 65 years and over receiving home care, and professionals working in these organizations were included. Client data were collected according to a prospective longitudinal design with the interRAI Home Care instrument. Assessments were performed at baseline, after six and 12 months by trained (research) nurses. Characteristics of home care organizations and professionals were collected cross-sectionally with online surveys. RESULTS Thirty-eight home care organizations, 2884 home care clients, and 1067 professionals were enrolled. Home care clients were mainly female (66.9%), on average 82.9 years (± 7.3). Extensive support in activities of daily living was needed for 41.6% of the sample, and 17.6% suffered cognitive decline. Care professionals were mainly female (93.4%), and over 45 years (52.8%). Considerable country differences were found. CONCLUSION A unique, international, comprehensive database is established, containing in-depth information on home care organizations, their clients and staff members. The variety of data enables the development of a novel cost-quality benchmark method, based on interRAI-HC data. This benchmark can be used to explore relevant links between organizational efficiency and organizational and staff characteristics.
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Affiliation(s)
- Henriëtte G. van der Roest
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam UMC, VU University medical center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Liza van Eenoo
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Lisanne I. van Lier
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam UMC, VU University medical center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Graziano Onder
- Department of Geriatrics, Neuroscience and Orthopedics, Agostino Gemelli University Hospital, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Vjenka Garms-Homolová
- Department of Economics and Law, HTW Berlin, University of Applied Sciences, Berlin, Germany
| | - Johannes H. Smit
- Department of Psychiatry, Amsterdam Public Health research institute, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands & GGZ inGeest Specialized Mental Health Care, Research and Innovation, Amsterdam, The Netherlands
| | - Harriet Finne-Soveri
- Department of Wellbeing, National Institute for Health and Welfare, Helsinki, Finland
| | - Pálmi V. Jónsson
- Department of Geriatrics, Landspitali University Hospital, and Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Stasja Draisma
- Department of Wellbeing, National Institute for Health and Welfare, Helsinki, Finland
| | - Anja Declercq
- LUCAS Centre for Care Research and Consultancy, KU Leuven, Leuven, Belgium
| | - Judith E. Bosmans
- Department of Health Sciences, Faculty of Science, Amsterdam Public Health research institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Hein P. J. van Hout
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, Amsterdam UMC, VU University medical center, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
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