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.

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.

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 An internet-based self-help intervention for people with psychological distress due to COVID-19: study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Noemi Anja Brog ◽  
Julia Katharina Hegy ◽  
Thomas Berger ◽  
Hansjörg Znoj
Keyword(s):  
Randomized Controlled Trial ◽  
Psychological Distress ◽  
Depressive Symptoms ◽  
Controlled Trial ◽  
The Self ◽  
Randomized Controlled ◽  
Self Help ◽  
Parallel Group ◽  
Related Quality ◽  
Health Related

Abstract Background The coronavirus-19 (COVID-19) has reached pandemic status and is affecting countries all over the world. The COVID-19 pandemic is accompanied by various stressors that require adjustment in everyday life and possibly changes in personal future prospects. While some individuals cope well with these challenges, some develop psychological distress including depressive symptoms, anxiety, or stress. Internet-based self-help interventions have proven to be effective in the treatment of various mental disorders such as depression and anxiety. Based on that, we developed an internet-based self-help program for individuals with psychological distress due to the situation surrounding the COVID-19 pandemic. The 3-week self-help program consists of 6 modules comprising texts, videos, figures, and exercises. Participants can request guidance within the self-help program (guidance on demand). The primary aim of this study is to evaluate the efficacy and feasibility of the self-help program compared to a waiting control condition. Methods The design is a parallel group randomized controlled trial. Participants are allocated to a 3-week self-help intervention plus care as usual or a 3-week waiting period with only care as usual. There are follow-ups after 6 weeks and 18 weeks. At least 80 participants with COVID-19 pandemic related psychological distress will be recruited. Primary outcome are depressive symptoms. Secondary outcomes include anxiety and chronic stress, suicidal experiences and behavior, health-related quality of life, generalized optimism and pessimism, embitterment, optimistic self-beliefs, emotion regulation skills, loneliness, resilience, and the satisfaction with and usability of the self-help program. Discussion To the best of our knowledge, this is one of the first studies investigating the efficacy of an internet-based self-help program for psychological distress due to the situation surrounding the COVID-19 pandemic. Thus, the results of this study may give further insight into the use of internet-based self-help programs in pandemic-related psychological distress. Trial registration ClinicalTrials.gov NCT04380909. Retrospectively registered on 8 May 2020.

scholarly journals Health-Related Quality of Life among Cancer Survivors Depending on the Occupational Status

2021 ◽  
Vol 18 (7) ◽  
pp. 3803
Author(s):  
Kisook Kim ◽  
Hyohyeon Yoon
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Cancer Survivors ◽  
Occupational Status ◽  
Influential Factors ◽  
Health Related Quality ◽  
Factors Affecting ◽  
Related Quality ◽  
Health Related

The study aimed to identify and compare the factors affecting health-related quality of life (HRQoL) depending on the occupational status of cancer survivors. This study was a secondary data analysis from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2014 to 2018. Hierarchical multivariate linear regression was used to investigate the factors affecting the HRQoL of each group. Non-working cancer survivors had significantly lower HRQoL than working cancer survivors (p < 0.001). A hierarchical multiple regression model showed that demographic, health-related, and psychological characteristics explained 62.0% of non-working cancer survivors’ HRQoL (F = 4.29, p < 0.001). Among the input variables, health-related characteristics were the most influential factors (ΔR2 = 0.274, F = 9.84, p < 0.001). For working cancer survivors, health-related characteristics were the only variable that was statistically associated with HRQoL (F = 5.556, p < 0.001). It is important to enhance physical activities and manage the chronic disease to improve the HRQoL of working cancer survivors. Further, managing health-related characteristics, including depressive symptoms and suicidal ideation, is necessary for non-working cancer survivors. Regarding working survivors, psychological factors such as depressive symptoms and suicidal tendencies did not affect HRQoL. Therefore, an early and effective return to work program should be developed for the improvement of their HRQoL.

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

O107 Depressive symptoms mediate the relationship between sleep quality and health-related quality of life in heart failure

Global Heart ◽  
2014 ◽  
Vol 9 (1) ◽  
pp. e29
Author(s):  
An-Yun Yeh ◽  
Susan J. Pressler ◽  
Seongkum Heo ◽  
Debra K. Moser ◽  
Sandra B. Dunbar ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Depressive Symptoms ◽  
Sleep Quality ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Relationship

scholarly journals Health-related quality of life, anxiety, and depressive symptoms in children with primary immunodeficiencies

2014 ◽  
pp. 323 ◽  
Author(s):  
Nina Kuburovic ◽  
Srdjan Pasic ◽  
Gordana Susic ◽  
Dejan Stevanovic ◽  
Vladimir Kuburovic ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Primary Immunodeficiencies ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related

Predictors of Improvement in Health-Related Quality of Life Among Elderly Patients With Depression

2001 ◽  
Vol 13 (1) ◽  
pp. 63-73 ◽  
Author(s):  
Yochi Shmuely ◽  
Mona Baumgarten ◽  
Barry Rovner ◽  
Jesse Berlin
Keyword(s):  
Quality Of Life ◽  
Depressive Symptoms ◽  
Initial Level ◽  
The Elderly ◽  
Living Alone ◽  
Negatively Associated ◽  
Related Quality ◽  
Health Related ◽  
Probability Of Improvement

Background: Depression is the most prevalent disabling psychiatric syndrome of aging and may lead to important decrements in the elderly depressed patient's health-related quality of life (HRQL). The goal of this study was to determine whether severity of chronic illness at admission, severity of depressive symptoms at admission, or living alone before admission was associated with lack of improvement in HRQL at 3 months postdischarge among elderly depressed inpatients. Methods: Subjects were 100 consecutive patients admitted to a 26-bed inpatient geriatric psychiatry unit from 1994 through 1997, who were residing in the community and were not demented. At admission, severity of depressive symptoms was assessed using the Geriatric Depression Scale and severity of chronic physical illness was measured using the Cumulative Illness Rating Scale (Geriatrics). HRQL was assessed at admission and again at 3 months postdischarge using the Medical Outcomes Study (MOS) 6-Item General Health Survey. Results: This study found large improvements in all MOS items between admission and 3 months postdischarge. Severity of chronic physical disease was negatively associated with the probability of improvement in three MOS items (role functioning, psychological functioning, and general health perceptions) whereas the severity of depressive symptoms on admission was negatively associated with the probability of improvement in role functioning, social functioning, and bodily pain. Living alone was negatively associated with social functioning but not with any of the other MOS items. Conclusion: The results of this study suggest that the inpatient treatment of depression in the elderly brings about improvements in quality of life that persist for at least 3 months follwing discharge. The patient's initial level of depression and initial level of physical health may be important factors to be considered when evaluating a patient's prognosis.

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