TRAJECTORIES OF HEALTH SYSTEM USE AND SURVIVAL FOR COMMUNITY-DWELLING PERSONS WITH DEMENTIA: AN INCEPTION COHORT STUDY

2019 ◽  
Vol 15 (7) ◽  
pp. P1635-P1636
Author(s):  
Susan E. Bronskill ◽  
Laura C. Maclagan ◽  
Jennifer Walker ◽  
Jun Guan ◽  
Xuesong Wang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Health System ◽  
Community Dwelling ◽  
Inception Cohort ◽  
System Use

scholarly journals Trajectories of health system use and survival for community-dwelling persons with dementia: a cohort study

BMJ Open ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. e037485
Author(s):  
Susan E Bronskill ◽  
Laura C Maclagan ◽  
Jennifer D Walker ◽  
Jun Guan ◽  
Xuesong Wang ◽  
...  
Keyword(s):  
Cohort Study ◽  
Home Care ◽  
Health System ◽  
Service Use ◽  
Long Term Care ◽  
Community Dwelling ◽  
Term Care ◽  
System Use ◽  
Over Time

ObjectivesTo determine the long-term trajectories of health system use by persons with dementia as they remain in the community over time.DesignPopulation-based cohort study using health administrative data.SettingOntario, Canada from 1 April 2007 to 31 March 2014.Participants62 622 community-dwelling adults aged 65+ years with prevalent dementia on 1 April 2007 matched 1:1 to persons without dementia based on age, sex and comorbidity.Main outcome measuresRates of health service use, long-term care placement and mortality over time.ResultsAfter 7 years, 49.0% of persons with dementia had spent time in long-term care (6.8% without) and 64.5% had died (30.0% without). Persons with dementia were more likely than those without to use home care (rate ratio (RR) 3.02, 95% CI 2.93 to 3.11) and experience hospitalisations with a discharge delay (RR 2.36, 95% CI 2.30 to 2.42). As they remained in the community, persons with dementia used home care at a growing rate (10.7%, 95% CI 10.0 to 11.3 increase per year vs 6.7%, 95% CI 4.3 to 9.0 per year among those without), but rates of acute care hospitalisation remained constant (0.6%, 95% CI −0.6 to 1.9 increase per year).ConclusionsWhile persons with dementia used more health services than those without dementia over time, the rate of change in use differed by service type. These results, particularly enumerating the increased intensity of home care service use, add value to capacity planning initiatives where limited budgets require balancing services.

scholarly journals TRAJECTORIES OF HEALTH SYSTEM USE AND TRANSITIONS IN OLDER ADULTS WITH DEMENTIA

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S15-S16
Author(s):  
Susan E Bronskill ◽  
Laura C Maclagan ◽  
Jennifer Walker ◽  
Jun Guan ◽  
Xuesong Wang ◽  
...  
Keyword(s):  
Older Adults ◽  
Home Care ◽  
Health System ◽  
Capacity Planning ◽  
Community Dwelling ◽  
Service Needs ◽  
Future Health ◽  
System Use ◽  
Community Dwelling Older Adults ◽  
Over Time

Abstract Health systems strive to enable persons with Alzheimer’s and related dementias to remain at home to maximize their quality of life. There is limited evidence describing long-term trajectories of health system use by persons with dementia as they remain in the community over time. A cohort of 62,622 community-dwelling older adults was followed for seven years and matched to persons without dementia (controls) based on age, sex and comorbidities. Overall, persons with dementia were more likely than controls to use health services, particularly home care and hospitalizations with discharge delay; and were more likely to be admitted to a nursing home. As they remained in the community over time, persons with dementia used home care at an increasingly intensive rate. Our approach to examine trajectories of health system use among persons with dementia is of particular value to capacity planning initiatives to anticipate future health service needs of this population.

O2-04-03: Health system use, transitions to long-term care, and survival among community-dwelling older adults with dementia in ontario, canada

2015 ◽  
Vol 11 (7S_Part_4) ◽  
pp. P180-P181
Author(s):  
Susan Bronskill ◽  
Jennifer Walker ◽  
Colleen Maxwell ◽  
Erika Yates ◽  
Nadia Gunraj
Keyword(s):  
Older Adults ◽  
Health System ◽  
Long Term Care ◽  
Community Dwelling ◽  
Term Care ◽  
System Use ◽  
Community Dwelling Older Adults

Leading Determinants of Healthy Ageing in Community-Dwelling Middle-Aged Men and Women: A Cohort Study

2018 ◽  
Author(s):  
Xianwen Shang ◽  
Wei Wang ◽  
Stuart Keel ◽  
Jinrong Wu ◽  
Mingguang He ◽  
...  
Keyword(s):  
Cohort Study ◽  
Community Dwelling ◽  
Healthy Ageing ◽  
Middle Aged ◽  
Men And Women

scholarly journals Functional Constipation and Anorexia in Community-Dwelling Older Adults: Korean Frailty and Aging Cohort Study (KFACS)

2021 ◽  
Vol 18 (11) ◽  
pp. 5754
Author(s):  
Eunjin Jeong ◽  
Jung A Kim ◽  
Byung Sung Kim ◽  
Chang Kyun Lee ◽  
Miji Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Depressed Mood ◽  
Mmse Score ◽  
Univariate Analysis ◽  
Functional Constipation ◽  
Community Dwelling ◽  
Geriatric Syndrome ◽  
Female Sex ◽  
Community Dwelling Older Adults

Anorexia is a relevant geriatric syndrome because it accounts for most malnutrition in older adults. Constipation has been suggested as a risk factor for anorexia. This study aimed to examine the association between anorexia and functional constipation in community-dwelling older adults. Data on 899 subjects aged 72–86 years were obtained from a follow-up survey of the Korean Frailty and Aging Cohort Study in 2018. Anorexia was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ), while functional constipation was diagnosed based on Rome IV criteria. Anorexia and functional constipation were present in 30.9% and 19.6% of the participants, respectively. Age, female sex, chewing problems, malnutrition, polypharmacy, low Mini-Mental Status Examination (MMSE) score, depressed mood, low serum albumin, and functional constipation were associated with anorexia in the univariate analysis. In the multivariate logistic regression, functional constipation was associated with anorexia (OR 1.478, 95% CI 1.038–2.104) after adjusting for age, female sex, and MMSE score. However, after further adjusting for depressed mood (OR 2.568) and chewing problems (OR 2.196), the relationship was no longer significant. This study showed that functional constipation is associated with anorexia in community-dwelling older adults, but this association is confounded by depressed mood and chewing problems.

scholarly journals Prediction of 11-year incidence of psychophysically dependent status or death among community-dwelling younger elderlies: from an age-specified community-based cohort study (the NISSIN project)

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Satoe Okabayashi ◽  
Takashi Kawamura ◽  
Hisashi Noma ◽  
Kenji Wakai ◽  
Masahiko Ando ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Cohort Study ◽  
Prediction Model ◽  
Nursing Care ◽  
Family Members ◽  
Limited Resource ◽  
Community Dwelling ◽  
Older Individuals ◽  
Regression Analyses

Abstract Background Predicting adverse health events and implementing preventative measures are a necessary challenge. It is important for healthcare planners and policymakers to allocate the limited resource to high-risk persons. Prediction is also important for older individuals, their family members, and clinicians to prepare mentally and financially. The aim of this study is to develop a prediction model for within 11-year dependent status requiring long-term nursing care or death in older adults for each sex. Methods We carried out age-specified cohort study of community dwellers in Nisshin City, Japan. The older adults aged 64 years who underwent medical check-up between 1996 and 2005 were included in the study. The primary outcome was the incidence of the psychophysically dependent status or death or by the end of the year of age 75 years. Univariable logistic regression analyses were performed to assess the associations between candidate predictors and the outcome. Using the variables with p-values less than 0.1, multivariable logistic regression analyses were then performed with backward stepwise elimination to determine the final predictors for the model. Results Of the 1525 female participants at baseline, 105 had an incidence of the study outcome. The final prediction model consisted of 15 variables, and the c-statistics for predicting the outcome was 0.763 (95% confidence interval [CI] 0.714–0.813). Of the 1548 male participants at baseline, 211 had incidence of the study outcome. The final prediction model consisted of 16 variables, and the c-statistics for predicting the outcome was 0.735 (95% CI 0.699–0.771). Conclusions We developed a prediction model for older adults to forecast 11-year incidence of dependent status requiring nursing care or death in each sex. The predictability was fair, but we could not evaluate the external validity of this model. It could be of some help for healthcare planners, policy makers, clinicians, older individuals, and their family members to weigh the priority of support.

Prospective Associations of Physical Frailty With Future Falls and Fear of Falling: A 48-Month Cohort Study

2021 ◽  
Author(s):  
K Makino ◽  
S Lee ◽  
S Bae ◽  
I Chiba ◽  
K Harada ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Fear Of Falling ◽  
Community Dwelling ◽  
Cardiovascular Health Study ◽  
Physical Frailty ◽  
Frailty Status ◽  
Community Dwelling Older Adults ◽  
The Relationship

Abstract Objective The present study aimed to examine the prospective associations of physical frailty with future falls and fear of falling (FOF) among community-dwelling older adults. Methods A prospective cohort study with a 48-month follow-up was conducted in a Japanese community. Participants were 2469 community-dwelling older adults aged 65 years or older who completed baseline and follow-up assessments at intervals of 48±2 months. Primary outcomes were recent falls (defined as at least one fall within the past year) and FOF (determined by response to “Are you afraid of falling?”) at follow-up survey. Physical frailty, operationalized by the frailty phenotype (slowness, weakness, exhaustion, weight loss, and low activity) based on the criteria of the Japanese version of the Cardiovascular Health Study (J-CHS), was also assessed as a predictor of future falls and FOF. Results Multivariate logistic regression showed that pre-frailty or frailty increase the risk of not only future falls (OR: 1.57; 95%CI = 1.20-2.05) but also FOF (OR: 1.33; 95%CI = 1.05-1.69). In addition, the relationship between baseline frailty status and future falls remained significant after adjusting for baseline FOF (OR: 1.55; 95%CI = 1.19-2.02), and the relationship between baseline frailty status and future FOF also remained significant after adjusting for baseline falls (OR: 1.32; 95%CI = 1.04-1.68). Conclusions Frailty status may predict future falls and FOF among community-dwelling older adults. Strategies to prevent frailty may be beneficial to prevent not only future falls but also future FOF in a community setting. Impact Falls and FOF have a close relationship but a different clinical meaning. Older adults with physical frailty may require monitoring as high-risk not only for falls but also for FOF.

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