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01.03.2007 | Original Investigation

Association of unmet need with self-rated health in a community dwelling cohort of disabled seniors 75 years of age and over

verfasst von: Jacqueline M. Quail, Vittorio Addona, Christina Wolfson, John E. Podoba, Louise Y. Lévesque, Josette Dupuis

Erschienen in: European Journal of Ageing | Ausgabe 1/2007

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Abstract

Self-rated health (SRH) is a measure of perceived health that has been shown to predict use of community services, functional decline, pain, and mortality. Many factors associated with SRH have been identified, but unmet need for physical assistance with activities of daily living (ADL) has not yet been examined. The objective of this paper is to examine the association between unmet need and SRH while accounting for the effects of other, previously identified, correlates of SRH. We conducted a secondary analysis of a population-based study of 839 residents of Montréal, Québec who were 75 years of age or older, not cognitively impaired, and living in the community. Multivariable logistic regression was used to evaluate the association between met and unmet personal ADL (PADL) and instrumental ADL (IADL) need for physical assistance with SRH. Among 508 disabled community-dwelling elderly, for each additional unmet IADL need, subjects were 1.70 (95% CI: 1.11–2.61) times more likely to report poorer SRH. For each additional unmet PADL need, subjects were 2.26 (95% CI: 1.31–3.91) times more likely to report poorer SRH. Subjects at increased risk of malnutrition, with greater comorbidity and whose income was insufficient to meet their needs were also more likely to report poorer SRH. After adjustment for important correlates, unmet PADL and IADL needs retain a statistically significant association with poorer SRH, with nutritional status, comorbid conditions, and income satisfaction being important confounders of the relationship.

Allen SM, Mor V (1997) The prevalence and consequences of unmet need. Contrasts between older and younger adults with disability. Med Care 35:1132–1148PubMedCrossRef

Amador LF, Al SS, Markides KS, Goodwin JS (2006) Weight change and mortality among older Mexican Americans. Aging Clin Exp Res 18:196–204PubMed

Bardage C, Pluijm SMF, Pederson NL, Deeg DJH, Jylha M, Noale M, Blumstein T, Otero A (2005) Self rated health among older adults: a cross national comparison. Eur J Ageing 2:149–158CrossRef

Benyamini Y, Idler EL, Leventhal H, Leventhal EA (2000) Positive affect and function as influences on self-assessments of health: expanding our view beyond illness and disability. J Gerontol B Psychol Sci Soc Sci 55:107–116

Dening T, Chi LY, Brayne C, Huppert FA, Paykel ES, O’Connor DW (1998) Changes in self-rated health, disability and contact with services in a very elderly cohort: a 6 year follow-up study. Age Ageing 27:23–33PubMedCrossRef

Desai MM, Lentzner HR, Weeks JD (2001) Unmet need for personal assistance with activities of daily living among older adults. Gerontologist 41:82–88PubMed

DeSalvo KB, Bloser N, Reynolds K, He J, Muntner P (2006) Mortality prediction with a single general self-rated health question. A meta-analysis. J Gen Intern Med 21:267–275PubMedCrossRef

Ebly EM, Hogan DB, Fung TS (1996) Correlates of self-rated health in persons aged 85 and over: results from the Canadian study of health and aging. Can J Public Health 87:28–31PubMed

Eckersley R, Dixon J, Douglas B (2001) The social origins of health and well-being. Cambridge University Press, Cambridge, UK

Ferraro KF, Farmer MM, Wybraniec JA (1997) Health trajectories: long-term dynamics among black and white adults. J Health Soc Behav 38:38–54PubMedCrossRef

Ferrer RL, Palmer R (2004) Variations in health status within and between socioeconomic strata. J Epidemiol Community Health 58:381–387PubMedCrossRef

Fylkesnes K, Forde OH (1992) Determinants and dimensions involved in self-evaluation of health. Soc Sci Med 35:271–279PubMedCrossRef

Goldman N, Glei DA, Chang MC (2004) The role of clinical risk factors in understanding self-rated health. Ann Epidemiol 14:49–57PubMedCrossRef

Han B (2002) Depressive symptoms and self-rated health in community-dwelling older adults: a longitudinal study. J Am Geriatr Soc 50:1549–1556PubMedCrossRef

Han B, Small BJ, Haley WE (1999) The effects of race, gender, and education on the structure of self-rated health among community-dwelling older adults. Ann N Y Acad Sci 896:442–447PubMedCrossRef

Hattersley L (1999) Trends in life expectancy by social class—an update. Health Stat Q 2:16–24

Heistaro S, Jousilahti P, Lahelma E, Vartiainen E, Puska P (2001) Self rated health and mortality: a long term prospective study in eastern Finland. J Epidemiol Community Health 55:227–232PubMedCrossRef

Idler EL, Kasl SV (1995) Self-ratings of health: do they also predict change in functional ability? J Gerontol B Psychol Sci Soc Sci 50:S344–S353PubMed

Ilfeld FW (1976) Further validation of a psychiatric symptoms index in a normal population. Psychol Rep 39:1215–1228

Jylha M, Volpato S, Guralnik JM (2006) Self-rated health showed a graded association with frequently used biomarkers in a large population sample. J Clin Epidemiol 59:465–471PubMedCrossRef

Kaplan L, Boss P (1999) Depressive symptoms among spousal caregivers of institutionalized mates with Alzheimer’s: boundary ambiguity and mastery as predictors. Fam Process 38:85–103PubMedCrossRef

Kennedy J (2001) Unmet and undermet need for activities of daily living and instrumental activities of daily living assistance among adults with disabilities: estimates from the 1994 and 1995 disability follow-back surveys. Med Care 39:1305–1312PubMedCrossRef

Lee Y (2000) The predictive value of self-assessed general, physical, and mental health on functional decline and mortality in older adults. J Epidemiol Community Health 54:123–129PubMedCrossRef

Lee Y, Shinkai S (2003) A comparison of correlates of self-rated health and functional disability of older persons in the far East: Japan and Korea. Arch Gerontol Geriatr 37:63–76PubMedCrossRef

Leger Marketing. Leger Marketing Home Page. http://www.legermarketing.com/eng/ 2006. 12-21-2006. Ref type: electronic citation

Leibson CL, Garrard J, Nitz N, Waller L, Indritz M, Jackson J, Rolnick SJ, Luepke L (1999) The role of depression in the association between self-rated physical health and clinically defined illness. Gerontologist 39:291–298PubMed

Lorraine PJ, Hammock RL, Blanton JM (2005) Predictors of self-rated health status among Texas residents. Prev Chronic Dis 2:A12PubMed

Mackenbach JP, Kunst AE, Cavelaars AE, Groenhof F, Geurts JJ (1997) Socioeconomic inequalities in morbidity and mortality in western Europe. The EU working group on socioeconomic inequalities in health. Lancet 349:1655–1659PubMedCrossRef

Moller L, Kristensen TS, Hollnagel H (1996) Self rated health as a predictor of coronary heart disease in Copenhagen, Denmark. J Epidemiol Community Health 50:423–428PubMed

Mor V (1998) A modern lexicon of disability. In: Allen SM, Mor V (eds) Living in the community with disability: service needs, use, systems. Springer, New York, pp 353–371

Mor V, Wilcox V, Rakowski W, Hiris J (1994) Functional transitions among the elderly: patterns, predictors, and related hospital use. Am J Public Health 84:1274–1280PubMedCrossRef

Mulsant BH, Ganguli M, Seaberg EC (1997) The relationship between self-rated health and depressive symptoms in an epidemiological sample of community-dwelling older adults. J Am Geriatr Soc 45:954–958PubMed

Newcomer R, Kang T, Laplante M, Kaye S (2005) Living quarters and unmet need for personal care assistance among adults with disabilities. J Gerontol B Psychol Sci Soc Sci 60:S205–S213PubMed

Newman AB, Yanez D, Harris T, Duxbury A, Enright PL, Fried LP (2001) Weight change in old age and its association with mortality. J Am Geriatr Soc 49:1309–1318PubMedCrossRef

Ng TP, Niti M, Chiam PC, Kua EH (2006) Prevalence and correlates of functional disability in multiethnic elderly Singaporeans. J Am Geriatr Soc 54:21–29PubMedCrossRef

Nourhashemi F, Andrieu S, Gillette-Guyonnet S, Vellas B, Albarede JL, Grandjean H (2001) Instrumental activities of daily living as a potential marker of frailty: a study of 7,364 community-dwelling elderly women (the EPIDOS study). J Gerontol 56A:M448–M453

Orfila F, Ferrer M, Lamarca R, Alonso J (2000) Evolution of self-rated health status in the elderly: cross sectional versus longitudinal estimates. Clin Epidemiol 53:563–570CrossRef

Otero A, de Yebenes MJ, Rodriguez-Laso A, Zunzunegui MV (2003) Unmet home care needs among community-dwelling elderly people in Spain. Aging Clin Exp Res 15:234–242PubMed

Payette H (1999) Development, validation and evaluation of a nutrition screening program in a functionally-dependent community-living elderly population. Ref type: unpublished work

Payette H, Boutier V, Coulombe C, Gray-Donald K (2002) Benefits of nutritional supplementation in free-living, frail, undernourished elderly people: a prospective randomized community trial. J Am Diet Assoc 102:1088–1095PubMed

Payette H, Coulombe C, Boutier V, Gray-Donald K (1999a) Weight loss and mortality among free-living frail elders: a prospective study. J Gerontol A Biol Sci Med Sci 54:M440–M445

Payette H, Guigoz Y, Vellas BJ (1999b) Study design for nutritional assessments in the elderly. In: Yu BP (eds) Methods in aging research, CRC Press, Boca Raton, pp 301–320

Pearlin LI, Lieberman MA, Menaghan EG, Mullan JT (1981) The stress process. J Health Soc Behav 22:337–356PubMedCrossRef

Pearlin LI, Schooler C (1978) The structure of coping. J Health Soc Behav 19:2–21PubMedCrossRef

Podoba JE (2004) Unmet needs for community services among the elderly: impact on health services utilization. 1-288. McGill University. Ref type: thesis/dissertation

Préville M, Boyer R, Potvin L, Perrault C, Légaré G (1992) La détresse psychologique: détermination de la fiabilité et de la validité de la mesure utilisée dans l’enquête Santé Québec. Tremblay D, Lavallière J, Jobin J ISBN-2-550-22725-5, 1-60. 1992. Québec, Ministère de la Santé et des Services Sociaux. Ref type: report

Reyes-Gibby CC, Aday L, Cleeland C (2002) Impact of pain on self-rated health in the community-dwelling older adults. Pain 95:75–82PubMedCrossRef

Roccaforte WH, Burke WJ, Bayer BL, Wengel SP (1992) Validation of a telephone version of the mini-mental state examination. J Am Geriatr Soc 40:697–702PubMed

Sands LP, Wang Y, McCabe GP, Jennings K, Eng C, Covinsky KE (2006) Rates of acute care admissions for frail older people living with met versus unmet activity of daily living needs. J Am Geriatr Soc 54:339–344PubMedCrossRef

SAS Institute Inc. SAS. http://www.sas.com/, 2005. 8-19-2005. Ref type: electronic citation

Simonsick EM, Kasper JD, Phillips CL (1998) Physical disability and social interaction: factors associated with low social contact and home confinement in disabled older women (The women’s health and aging study). J Gerontol B Psychol Sci Soc Sci 53:S209–S217PubMed

Sonn U (1996) Longitudinal studies of dependence in daily life activities among elderly persons. Scand J Rehabil Med Suppl 34:1–35PubMed

Sullivan DH, Patch GA, Walls RC, Lipschitz DA (1990) Impact of nutrition status on morbidity and mortality in a select population of geriatric rehabilitation patients. Am J Clin Nutr 51:749–758PubMed

van den Brink CL, Tijhuis M, van den Bos GA, Giampaoli S, Nissinen A, Kromhout D (2005) The contribution of self-rated health and depressive symptoms to disability severity as a predictor of 10 year mortality in European elderly men. Am J Public Health 95:2029–2034PubMedCrossRef

van Rossum CT, Shipley MJ, van de MH, Grobbee DE, Marmot MG (2000) Employment grade differences in cause specific mortality. A 25 year follow up of civil servants from the first Whitehall study. J Epidemiol Community Health 54:178–184PubMedCrossRef

von Korff M, Wagner EH, Saunders K (1992) A chronic disease score from automated pharmacy data. J Clin Epidemiol 45:197–203CrossRef

Wolinsky FD, Stump TE, Johnson RJ (1995) Hospital utilization profiles among older adults over time: consistency and volume among survivors and decedents. J Gerontol B Psychol Sci Soc Sci 50:S88–S100PubMed

Xi G, McDowell I, Nair R, Spasoff R (2005) Income inequality and health in Ontario: a multilevel analysis. Can J Public Health 96:206–211PubMed

Zuliani G, Romagnoni F, Volpato S, Soattin L, Leoci V, Bollini MC, Buttarello M, Lotto D, Fellin R (2001) Nutritional parameters, body composition, and progression of disability in older disabled residents living in nursing homes. J Gerontol A Biol Sci Med Sci 56:M212–M216PubMed

Zunzunegui MV, Kone A, Johri M, Beland F, Wolfson C, Bergman H (2004) Social networks and self-rated health in two French-speaking Canadian community dwelling populations over 65. Soc Sci Med 58:2069–2081PubMedCrossRef

Titel: Association of unmet need with self-rated health in a community dwelling cohort of disabled seniors 75 years of age and over
verfasst von: Jacqueline M. Quail
Vittorio Addona
Christina Wolfson
John E. Podoba
Louise Y. Lévesque
Josette Dupuis
Publikationsdatum: 01.03.2007
Verlag: Springer-Verlag
Erschienen in: European Journal of Ageing / Ausgabe 1/2007
Print ISSN: 1613-9372
Elektronische ISSN: 1613-9380
DOI: https://doi.org/10.1007/s10433-007-0042-8

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Association of unmet need with self-rated health in a community dwelling cohort of disabled seniors 75 years of age and over

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