Frailty and Autonomy among the Oldest Old: Evidence from the Multicenter Prospective AgeCoDe-AgeQualiDe Study

Gerontology ◽  
2021 ◽  
pp. 1-8
Author(s):  
André Hajek ◽  
Christian Brettschneider ◽  
Tina Mallon ◽  
Hanna Kaduszkiewicz ◽  
Birgitt Wiese ◽  
...  
Keyword(s):  
Old Age ◽  
Service Use ◽  
Oldest Old ◽  
Strong Association ◽  
Total Sample ◽  
Sociodemographic Factors ◽  
Related Factors ◽  
Clinical Frailty Scale ◽  
Related Quality ◽  
Health Related

Introduction: There is a lack of studies examining the link between perceived autonomy and frailty among the oldest old. Therefore, our objective was to fill this gap. Methods: Data were used from the multicenter prospective cohort study “Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)” (AgeQualiDe; follow-up [FU] wave 9; n = 510 observations in the analytical sample). The average age was 90.3 years (SD: 2.7 years). The Canadian Study of Health and Aging (CSHA) Clinical Frailty Scale (CFS) was used to assess frailty. Socioeconomic and health-related covariates were included in our regression model. The autonomy scale developed by Schwarzer was used to assess perceived autonomy in old age. Results: Adjusting for various confounders, multiple linear regressions showed that lower perceived autonomy was associated with increased levels of frailty (total sample: β = −0.13, p < 0.001; women: β = −0.14, p < 0.001; and men: β = −0.12, p < 0.001). Furthermore, lower perceived autonomy was associated with more depressive symptoms, higher cognitive impairment, and being institutionalized (except for men) in the total sample and in both sexes, but it was not significantly associated with age, sex, marital status, educational level, and social support. Conclusion: Findings indicate that frailty is associated with lower autonomy among the oldest old. More generally, while health-related factors were consistently associated with autonomy, sociodemographic factors (except for being institutionalized) were not associated with autonomy among the oldest old. We should be aware of the strong association between autonomy and physical as well as mental health in very old age.

Factors Leading to Institutionalization among the Oldest Old: Longitudinal Findings from the AgeCoDe-AgeQualiDe Study

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
André Hajek ◽  
Elżbieta Buczak-Stec ◽  
Hendrik van den Bussche ◽  
Marion Eisele ◽  
Anke Oey ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Assisted Living ◽  
Service Use ◽  
Oldest Old ◽  
Strong Association ◽  
Functional Decline ◽  
Term Care ◽  
Random Effects Models ◽  
Related Quality ◽  
Health Related

<b><i>Introduction:</i></b> Due to the strong association between old age and the need for long-term care, the number of individuals in need for care is projected to increase noticeably. The aim of this study was to examine the determinants of institutionalization among the <i>oldest old</i> longitudinally. <b><i>Methods:</i></b> Longitudinal data (follow-up [FU] wave 7–9) were gathered from a multicenter prospective cohort study (“Study on needs, health service use, costs and health-related quality of life in a large sample of oldest old primary care patients [85+],” AgeQualiDe). At FU wave 7, in 2014, complete measures were available for 763 individuals. The average age was 88.9 (standard deviation 2.9) years (range 85–100), and 68% were female. Sociodemographic and health-related independent variables (e.g., depressive symptoms or functioning) were included in the regression model. Institutionalization (admission to assisted living home or nursing home) was used as an outcome measure. Logistic random-effects models were used. <b><i>Results:</i></b> Regressions revealed that among oldest old, the odds of being institutionalized were lower for men (odds ratio [OR] = 0.03; 95% confidence interval [CI] 0.00–0.16). Institutionalization was associated with an increased age (OR = 1.27; 95% CI 1.04–1.55). Additionally, widowed individuals (ref. non-widowed) had higher odds of being institutionalized (OR = 8.95; 95% CI 1.61–49.81). Institutionalization was also associated with functional decline (OR = 0.16; 95% CI 0.11–0.23), whereas it was not significantly associated with cognitive decline, depressive symptoms, and social support. <b><i>Conclusion:</i></b> Our findings stress the importance of gender, age, widowhood, and functional decline for institutionalization among the oldest old. Preventing or at least postponing functional decline might help to delay institutionalization as far as possible.

scholarly journals 1428Factors leading to institutionalization among the oldest old. Longitudinal findings from the AgeCoDe-AgeQualiDe study

2021 ◽  
Vol 50 (Supplement_1) ◽  
Author(s):  
Elzbieta Buczak-Stec ◽  
André Hajek ◽  
Michael Wagner ◽  
Martin Scherer ◽  
Wolfgang Maier ◽  
...  
Keyword(s):  
Nursing Home ◽  
Cognitive Decline ◽  
Service Use ◽  
Oldest Old ◽  
Strong Association ◽  
Functional Decline ◽  
Nursing Home Admission ◽  
Term Care ◽  
Increased Risk ◽  
Health Related

Abstract Background Due to the strong association between old age and the need for long-term care, the number of individuals in need for care is projected to increase noticeably. The aim of this study is to examine determinants of institutionalization nursing home admission among the oldest old longitudinally. Methods Longitudinal data were gathered from a multicenter prospective cohort study (“Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)”; AgeQualiDe). At baseline (2014), complete measures were available for 684 individuals. The average age was 88.9ys (85-100), 68% were female. Sociodemographic and health-related variables (e.g., depressive symptoms, functioning) were included in the regression model. Institutionalization was defined as a date of admission to a nursing home. Competing risk survival analysis was performed using death as a competing event (Fine and Gray model). Results During the follow-up of the study, altogether 104 individuals were institutionalized, 81 died. Based on the estimated subhazard ratios, the risk of institutionalization increased with functional decline sHR=0.62, 95% CI [0.56-0.69] in total sample. Moreover, cognitive decline was associated with an increased risk of institutionalization only in men (sHR=1.73, 95%CI [1.05-2.87]). Conclusions Our findings stress the importance of functional decline (for both sexes) and cognitive decline (only for men) for institutionalization among the oldest old. Key messages Preventing or at least postponing functional decline might help to delay as far as possible institutionalization.

scholarly journals Morale in Old Age and Its Association with Sociodemographic, Social, and Health-Related Factors in Different Age Groups

2020 ◽  
Vol 2020 ◽  
pp. 1-13
Author(s):  
Marina Näsman ◽  
Johan Niklasson ◽  
Jan Saarela ◽  
Mikael Nygård ◽  
Birgitta Olofsson ◽  
...  
Keyword(s):  
Old Age ◽  
Oldest Old ◽  
Age Groups ◽  
Well Being ◽  
Subjective Well Being ◽  
Old People ◽  
Related Factors ◽  
Aging Well ◽  
Health Related ◽  
Geriatric Center

Morale can be viewed as a future-oriented optimism or pessimism regarding challenges associated with aging and is closely related to subjective well-being. Promoting morale in old age could be considered to have important implications for aging well, and increased knowledge about morale in different stages of old age is needed. Hence, the aim of this study was to investigate factors associated with morale in different age groups among old people. Data were derived from a survey conducted in 2016, as a part of the Gerontological Regional Database (GERDA). The sample consisted of 9,047 individuals aged between 65 and 86 years from Ostrobothnia and Southern Ostrobothnia in Finland, and Västerbotten in Sweden. Morale was measured with the Philadelphia Geriatric Center Morale Scale (PGCMS) and regressed upon a number of sociodemographic, social, and health-related factors using linear regression analyses. The results showed that older age was an independent factor explaining lower level of morale. Additionally, the sociodemographic, social, and health-related variables could explain a large proportion of the variance in morale. Perceived loneliness, having gone through a crisis in life, poor self-rated health, and depression were associated with lower morale, and sleeping well with higher morale, in all age groups. Furthermore, the oldest age groups seem to be more exposed to several risk factors of lower morale identified in this study. Multidimensional interventions targeting especially social and mental health and the oldest-old could therefore be recommended.

scholarly journals Social support and health-related quality of life among the oldest old — longitudinal evidence from the multicenter prospective AgeCoDe-AgeQualiDe study

2021 ◽  
Author(s):  
André Hajek ◽  
Christian Brettschneider ◽  
Tina Mallon ◽  
Hanna Kaduszkiewicz ◽  
Anke Oey ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Support ◽  
Fixed Effects ◽  
Service Use ◽  
Oldest Old ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
Eq Vas

Abstract Purpose The aim of this study was to examine the longitudinal within-association between social support and health-related quality of life among the oldest old. Methods Longitudinal data (follow-up waves 7 to 9) were used from the multicenter prospective cohort study “Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85 +)” (AgeQualiDe). n = 648 individuals were included in the analytical sample. At FU wave 7, mean age was 88.8 years (SD: 2.9 years, from 85 to 99 years). Social support was quantified using the Lubben Social Network Scale (6-item version). Health-related quality of life was assessed using the EQ-5D-3L including problems in five health dimensions, and its visual analogue scale (EQ VAS). It was adjusted for several covariates in conditional logistic and linear fixed effects regressions. Results Intraindividual decreases in social support were associated with an increased likelihood of developing problems in ‘self-care’, ‘usual activities’, ‘pain/discomfort’ and ‘anxiety/depression’ (within individuals over time). In contrast, intraindividual changes in social support were not associated with intraindividual changes in the EQ VAS score. Conclusion Findings indicate a longitudinal intraindividual association between social support and problems, but only in some health dimensions. Further research in this area based on longitudinal studies among the oldest old (from different countries) is required.

scholarly journals Health-Related Quality of Life and Related Factors in Persons with Preserved Ratio Impaired Spirometry: Data from the Korea National Health and Nutrition Examination Surve

Medicina ◽  
2020 ◽  
Vol 57 (1) ◽  
pp. 4
Author(s):  
I Re Heo ◽  
Ho Cheol Kim ◽  
Tae Hoon Kim
Keyword(s):  
Quality Of Life ◽  
Low Income ◽  
Control Group ◽  
Poor Hrqol ◽  
Related Factors ◽  
Health And Nutrition ◽  
Prism Group ◽  
Related Quality ◽  
Health Related

Background and Objectives: preserved ratio impaired spirometry (PRISm) is a common spirometric pattern that causes respiratory symptoms, systemic inflammation, and mortality. However, its impact on health-related quality of life (HRQOL) and its associated factors remain unclear. We aimed to identify these HRQOL-related factors and investigate the differences in HROOL between persons with PRISm and those with normal lung function. Materials and Methods: we reviewed the Korea National Health and Nutrition Examination Survey data from 2008 to 2013 to evaluate the HRQOL of persons with PRISm, as measured while using the Euro Quality of Life-5D (EQ-5D) and identify any influencing factors. PRISm was defined as pre-bronchodilator forced expiratory volume in 1 s (FEV1) <80% predicted and FEV1 to forced vital capacity (FVC) ratio (FEV1/FVC) ≥0.7. Individuals with FEV1 ≥80% predicted and FEV1/FVC ≥0.7 were considered as Controls. Results: of the 27,824 participants over the age of 40 years, 1875 had PRISm. The age- and sex-adjusted EQ-5D index was lower in the PRISm group than in the control group (PRISm, 0.930; control, 0.941; p = 0.005). The participants with PRISm showed a significantly higher prevalence of hypertension (p < 0.001), diabetes (p < 0.001), obesity (p < 0.001), low physical activity (p = 0.001), ever-smoker (p < 0.001), and low income (p = 0.034) than those in the control group. In participants with PRISm, lower EQ-5D index scores were independently associated with old age (p = 0.002), low income (p < 0.001), low education level (p < 0.001), and no economic activity (p < 0.001). Three out of five EQ-5D dimensions (mobility, self-care, and usual activity) indicated a higher proportion of dissatisfied participants in the PRISm group than the control group. Conclusions: the participants with PRISm were identified to have poor HRQOL when compared to those without PRISm. Old age and low socioeconomic status play important roles in HRQOL deterioration in patients with PRISm. By analyzing risk factors that are associated with poor HRQOL, early detection and intervention of PRISm can be done in order to preserve patients’ quality of life.

Health-related quality of life and ego integrity among the oldest old – Evidence from the multicenter AgeCoDe-AgeQualiDe study

2021 ◽  
pp. 104408
Author(s):  
André Hajek ◽  
Simon Forstmeier ◽  
Christian Brettschneider ◽  
Dagmar Lühmann ◽  
Juliane Döhring ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oldest Old ◽  
Health Related Quality ◽  
Ego Integrity ◽  
Related Quality ◽  
Health Related ◽  
Old Evidence

Oral health related quality of life and it’s related factors of stroke patients at home in Korea

2015 ◽  
Vol 61 (3) ◽  
pp. 523-528 ◽  
Author(s):  
Eun-Jin Jang ◽  
Eun-Kyong Kim ◽  
Kyeong-Soo Lee ◽  
Hee-Kyung Lee ◽  
Youn-Hee Choi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Health Related Quality ◽  
Stroke Patients ◽  
Related Factors ◽  
Related Quality ◽  
Health Related ◽  
At Home

Complex coevolution of depression and health-related quality of life in old age

2015 ◽  
Vol 24 (11) ◽  
pp. 2713-2722 ◽  
Author(s):  
André Hajek ◽  
Christian Brettschneider ◽  
Annette Ernst ◽  
Carolin Lange ◽  
Birgitt Wiese ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Old Age ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

scholarly journals Benefits of Sustained Physical Activity From Middle-Age To Early Old Age On Quality Of Life In Early Old Age

2022 ◽  
Author(s):  
Mikyung Lee ◽  
Hyeonkyeong Lee ◽  
Ki Jun Song ◽  
Young-Me Lee
Keyword(s):  
Quality Of Life ◽  
Old Age ◽  
Secondary Data ◽  
Activity Levels ◽  
Related Quality ◽  
Health Related ◽  
Using Data ◽  
Middle Aged Adults ◽  
Early Old Age

Abstract This secondary data analysis study aimed to examine the changes in physical activities (PAs) over time (2009-2017) in the same participants and to determine an association between changes in PA and health-related quality of life (HRQoL) in early older adults (n=994) using data from the Korea Health Panel Survey. The HRQoL was measured using the EuroQol quality-of-life system and the amount of PA were grouped to 4 activity levels (remained inactive, became inactive, became active, and remained active). The association of changes in PA over 8 years with HRQoL was examined using logistic regression analysis while controlling for socioeconomic and behavioral factors. The total PA decreased from 1,859.72±1,760.01 MET-minutes in 2009 to 1,264.80 ±1,251.14 MET-minutes in 2017 (P < 0.001). In 2017, 142 (14.3%) remained inactive, whereas 419 (42.2%) remained active. The participants who remained inactive at early old age were more likely to be at the lowest 10% HRQoL of the sample (odds ratio = 1.95, 95% confidence interval = 1.09–3.48). This indicates that educating middle-aged adults who are relatively inactive must be a priority in order to maintain and improve PA, enhance HRQoL, and maximize the benefits of PA in old age.

scholarly journals Determinants of Health-Related Quality of Life Decline in Interstitial Lung Disease

2020 ◽  
Author(s):  
Phillen Nozibuyiso Maqhuzu ◽  
Boglárka Lilla Szentes ◽  
Michael Kreuter ◽  
Thomas Bahmer ◽  
Nicolas Kahn ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Psychological Impact ◽  
Sociodemographic Factors ◽  
Health Related Quality ◽  
Lower Baseline ◽  
Related Quality ◽  
Health Related

Abstract Background: Health-related quality of life (HRQL) in interstitial lung disease (ILD) patients is impaired. We aimed to identify baseline predictors for HRQL decline within a 12-month observation period. Methods: We analyzed 194 ILD patients from two German ILD-centers in the observational HILDA study. We employed the disease-specific King’s Brief Interstitial Lung Disease questionnaire (K-BILD) with the subdomains ‘psychological impact’, ‘chest symptoms’ and ‘breathlessness and activities’, and the generic EQ-5D Visual Analog Scale (VAS). We evaluated how many patients experienced a clinically meaningful decline in HRQL. Subsequently, we investigated medical and sociodemographic factors as potential predictors of HRQL deterioration. Results: Within the study population (34.0% male, Ø age 61.7) mean HRQL scores hardly changed between baseline and follow up (K-BILD: 52.8 vs. 52.5 | VAS: 60.0 vs. 57.3). On the intra-individual level, 30.4% (n = 59) experienced a clinically relevant deterioration in K-BILD total score and 35.4% (n = 68) in VAS. Lower baseline forced vital capacity % predicted determined HRQL decline in K-BILD total score (ß– coefficient -0.02, p = 0.007), VAS (ß–coefficient -0.03, p < 0.0001), and in the subdomain ‘psychological impact’ (ß– coefficient -0.02, p = 0.014). Lower baseline diffusing capacity of carbon monoxide % predicted determined deterioration in ‘breathlessness and activities’ (ß– coefficient -0.04, p = 0.003) and ‘chest symptoms’ (ß– coefficient -0.04, p = 0.002). Additionally, increasing age predicted decline in ‘psychological impact’ (ß–coefficient 0.06, p < 0.007). Conclusion: A third of ILD patients experience a clinically relevant HRQL deterioration within 12 months, which is mainly predicted by lung function baseline value.

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