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Liegert P, Pabst A, Conrad I, van den Bussche H, Eisele M, Hajek A, Heser K, Kleineidam L, Weyerer S, Werle J, Pentzek M, Weeg D, Mösch E, Wiese B, Oey A, Wagner M, Maier W, König HH, Riedel-Heller SG, Scherer M, Luppa M. The effect of depressive symptoms on quality of life and its different facets in the oldest age population: evidence from the AgeQualiDe prospective cohort study. Qual Life Res 2024; 33:387-398. [PMID: 37897642 PMCID: PMC10850022 DOI: 10.1007/s11136-023-03526-7] [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] [Accepted: 09/22/2023] [Indexed: 10/30/2023]
Abstract
PURPOSE The present study aims to investigate the prospective effect of depressive symptoms on overall QoL in the oldest age group, taking into account its different facets. METHODS Data were derived from the multicenter prospective AgeCoDe/AgeQualiDe cohort study, including data from follow-up 7-9 and n = 580 individuals 85 years of age and older. Overall QoL and its facets were assessed using the WHOQOL-OLD instrument. The short form of the geriatric depression scale (GDS-15) was applied to assess depressive symptoms. Cognitively impaired individuals were excluded. Linear mixed-effects models were used to assess the effect of depressive symptoms on QoL. RESULTS Depressive symptoms were significantly associated with overall QoL and each of the different facets of WHOQOL-OLD, also after adjustment for time and sociodemographic characteristics such as age, gender, education, marital status, living situation, and cognitive status. Higher age and single as well as divorced marital status were also associated with a lower QoL. CONCLUSION This work provides comprehensive longitudinal results on the relationship between depressive symptoms and QoL in the oldest age population. The results underscore the relevance of tailored and targeted care planning and the development of customized interventions.
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Affiliation(s)
- Paula Liegert
- Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Ines Conrad
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hendrik van den Bussche
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marion Eisele
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kathrin Heser
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim, Mannheim, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Anke Oey
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.
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Esteban-Burgos AA, Hueso-Montoro C, Mota-Romero E, Montoya-Juarez R, Gomez-Batiste X, Garcia-Caro MP. The prognostic value of the NECPAL instrument, Palliative Prognostic Index, and PROFUND index in elderly residents of nursing homes with advanced chronic condition. BMC Geriatr 2023; 23:715. [PMID: 37924015 PMCID: PMC10623722 DOI: 10.1186/s12877-023-04409-9] [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: 01/19/2023] [Accepted: 10/15/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND It is essential to assess the need for palliative care and the life prognosis of elderly nursing home residents with an advanced chronic condition, and the NECPAL ICO-CCOMS©4.0 prognostic instrument may be adequate for both purposes. The objective of this study was to examine the predictive capacity of NECPAL, the Palliative Prognosis Index, and the PROFUND index in elderly residents with advanced chronic condition with and without dementia, comparing their results at different time points. METHODS This prospective observational study was undertaken in eight nursing homes, following the survival of 146 residents with advanced chronic condition (46.6% with dementia) at 3, 6, 12, and 24 months. The capacity of the three instruments to predict mortality was evaluated by calculating the area under the receiver operating characteristic curve (AUC), with 95% confidence interval, for the global population and separately for residents with and without dementia. RESULTS The mean age of residents was 84.63 years (± 8.989 yrs); 67.8% were female. The highest predictive capacity was found for PROFUND at 3 months (95%CI: 0.526-0.756; p = 0.016), for PROFUND and NECPAL at 12 months (non-significant; AUC > 0.5), and NECPAL at 24 months (close-to-significant (AUC = 0.624; 95% CI: 0.499-0.750; p = 0.053). The highest capacity at 12 months was obtained using PROFUND in residents with dementia (AUC = 0.698; 95%CI: 0.566-0.829; p = 0.003) and NECPAL in residents without dementia (non-significant; AUC = 0.649; 95%CI: 0.432-0.867; p = 0.178). Significant differences in AUC values were observed between PROFUND at 12 (p = 0.017) and 24 (p = 0.028) months. CONCLUSIONS PROFUND offers the most accurate prediction of survival in elderly care home residents with advanced chronic condition overall and in those with dementia, especially over the short term, whereas NECPAL ICO-CCOMS©4.0 appears to be the most useful to predict the long-term survival of residents without dementia. These results support early evaluation of the need for palliative care in elderly care home residents with advanced chronic condition.
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Affiliation(s)
- Ana Alejandra Esteban-Burgos
- Departamento de Enfermería, Universidad de Jaén, Jaén, Spain
- Instituto Investigación Biosanitaria Granada (IBS), Granada, Spain
- Programa de Doctorado en Medicina Clínica y Salud Pública, Universidad de Granada, Granada, Spain
| | - César Hueso-Montoro
- Departamento de Enfermería, Universidad de Jaén, Jaén, Spain
- Instituto Investigación Biosanitaria Granada (IBS), Granada, Spain
| | - Emilio Mota-Romero
- Instituto Investigación Biosanitaria Granada (IBS), Granada, Spain
- Centro de Salud Salvador Caballero. Distrito Sanitario Granada-Metropolitano. Servicio Andaluz de Salud, Granada, Spain
- Departamento de Enfermería, Universidad de Granada, Granada, Spain
| | - Rafael Montoya-Juarez
- Instituto Investigación Biosanitaria Granada (IBS), Granada, Spain.
- Departamento de Enfermería, Universidad de Granada, Granada, Spain.
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada, Granada, Spain.
| | - Xavier Gomez-Batiste
- Cátedra de Cuidados Paliativos, Universitat de Vic-Universitat Central de Catalunya (UVIC-UCC), Barcelona, Spain
| | - María Paz Garcia-Caro
- Instituto Investigación Biosanitaria Granada (IBS), Granada, Spain
- Departamento de Enfermería, Universidad de Granada, Granada, Spain
- Centro de Investigación Mente, Cerebro y Comportamiento (CIMCYC), Universidad de Granada, Granada, Spain
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Hajek A, König HH. Frequency and Correlates of Multimorbidity Among the Oldest Old: Study Findings from the Representative "Survey on Quality of Life and Subjective Well-Being of the Very Old in North Rhine-Westphalia (NRW80+)". Clin Interv Aging 2023; 18:41-48. [PMID: 36660544 PMCID: PMC9843470 DOI: 10.2147/cia.s388469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 12/14/2022] [Indexed: 01/12/2023] Open
Abstract
Purpose Our aim was to clarify the frequency and correlates of multimorbidity among the oldest old. Patients and Methods We used data from the representative "Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)" covering participants ≥80 years living in private households and in institutionalized settings in North Rhine-Westphalia (n = 1484, mean age was 86.3 years). Multimorbidity is defined as the co-occurrence of at least two chronic conditions. Sociodemographic, lifestyle-related, and health-related (including health literacy) correlates were included in regression analysis. Results About 79% of the participants were multimorbid. Logistic regressions showed that the likelihood of multimorbidity significantly increased with living in a private household, having a larger network size, worse self-rated health, higher functional impairment, and more depressive symptoms, whereas the remaining sociodemographic and lifestyle-related factors as well as health literacy were not significantly associated with multimorbidity. Conclusion A large proportion of participants in very late life is multimorbid. Apart from health-related factors, also two sociodemographic factors (ie, living situation and network size) were associated with multimorbidity among the oldest old. This knowledge may help to identify individuals at risk for multimorbidity in very late life.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany,Correspondence: André Hajek, Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistr. 52, Hamburg, 20246, Germany, Tel +49 40 7410 52877, Fax +49 40 7410-40261, Email
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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Hajek A, Kretzler B, Riedel-Heller SG, König HH. Frequency and correlates of mild cognitive impairment and dementia among the oldest old - Evidence from the representative "Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)". Arch Gerontol Geriatr 2023; 104:104804. [PMID: 36084607 DOI: 10.1016/j.archger.2022.104804] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/24/2022] [Accepted: 08/31/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Since there is limited knowledge with regard to the frequency and correlates of mild cognitive impairment and dementia among the oldest old based on large representative data (including institutionalized individuals), our objective was to fill this research gap. METHODS For our study, data came from the representative "Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)". This study included community-dwelling and institutionalized individuals aged 80 years and over (n = 1,173, mean age: 86 years) residing in the most populous state of Germany (North Rhine-Westphalia). The DemTect was used to quantify cognitive impairment (i.e., probable mild cognitive impairment and probable dementia). RESULTS Overall, 73.1% of the individuals were not cognitively impaired, 17.0% of the individuals had probable mild cognitive impairment and 9.9% of the individuals had probable dementia. Compared to individuals without cognitive impairment, individuals with probable mild cognitive impairment were more likely to be male, live in an institutionalized setting, have a lower educational level, have a smaller network size, and have lower functional abilities. Moreover, compared to individuals without cognitive impairment, individuals with probable dementia were more likely to be older, live in an institutionalized setting, have a lower educational level, have a smaller network size, not be multimorbid, and have lower functional abilities. CONCLUSIONS Our study identified several sociodemographic and health-related factors which are associated with probable mild cognitive impairment and probable dementia among the oldest old. This knowledge may help to address individuals at risk for mild cognitive impairment and dementia.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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Hajek A, König HH. Frequency and correlates of driving status among the oldest old: results from a large, representative sample. Aging Clin Exp Res 2022; 34:3083-3088. [PMID: 36123581 DOI: 10.1007/s40520-022-02252-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 09/07/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND/AIMS In the light of the restricted knowledge, our aim was to explore the frequency and correlates of driving status among the oldest old. METHODS Data came from the representative "Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80 +)" consisting of community-dwelling and institutionalized individuals ≥ 80 years residing in the most populous German state (North Rhine-Westphalia; n = 1,832 in the analytical sample, mean age: 86.5 years). The present driving status (no; yes, I drive myself; yes, as a passenger; yes, as driver and passenger) served as outcome measure. RESULTS Overall, 43.62% (95% CI 40.98-46.29%) of the individuals did not drive, whereas 30.12% (95% CI 27.75-32.59%) of the individuals drove by themselves, 20.97% (95% CI 18.91-23.20%) of the individuals drove as a passenger, and 5.29% of the individuals drove both (by themselves and as a passenger) (95% CI 4.16-6.71%). Multinomial logistic regressions showed, e.g., that being male (RRR: 0.13, 95% CI 0.09-0.18), younger age (RRR: 0.88, 95% CI 0.84-0.91), being married and living together with spouse (RRR: 1.48, 95% CI 1.08-2.02), living in a private household (RRR: 0.04, 95% CI 0.01-0.35), better self-rated health (RRR: 1.26, 95% CI 1.02-1.56), and lower functional impairment (RRR: 19.82, 95% CI 12.83-30.62) were positively associated with 'Yes, I drive myself' (compared to not driving a car). DISCUSSION/CONCLUSIONS A sizable proportion of the individuals aged 80 years and above still drove by themselves. Less than half of the oldest old individuals did not drive. Moreover, our current study identified some correlates of driving status among individuals in latest life.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Buczak-Stec EW, Hajek A, Pabst A, Brettschneider C, van den Bussche H, Wiese B, Weyerer S, Werle J, Hoell A, Pentzek M, Fuchs A, Luppa M, Löbner M, Stein J, Förster F, Weeg D, Mösch E, Heser K, Scherer M, Maier W, Angermeyer MC, Wagner M, Riedel-Heller SG, König HH. Frequency and gender differences in the use of professional home care in late life. Findings from three German old-age cohorts. Front Med (Lausanne) 2022; 9:924818. [PMID: 36117967 PMCID: PMC9478461 DOI: 10.3389/fmed.2022.924818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
AimThe aim of this study was to investigate the frequency of and the gender differences in the use of professional home care in Germany.MethodsWe used harmonized data from three large cohort studies from Germany (“Healthy Aging: Gender-specific trajectories into the latest life”; AgeDifferent.de Platform). Data were available for 5,393 older individuals (75 years and older). Mean age was 80.2 years (SD: 4.1 years), 66.6% were female. Professional homecare outcome variables were use of outpatient nursing care, paid household assistance, and meals on wheels' services. Logistic regression models were used, adjusting for important sociodemographic variables.ResultsAltogether 5.2% of older individuals used outpatient nursing care (6.2% women and 3.2% men; p < 0.001), 24.2% used paid household assistance (26.1% women and 20.5% men; p < 0.001) and 4.4% used meals on wheels' services (4.5% women and 4.0% men; p = 0.49). Regression analysis revealed that women had higher odds of using paid household assistance than men (OR = 1.48, 95% CI: [1.24–1.76]; p < 0.001), whereas they had lower odds of using meals on wheels' services (OR = 0.64, 95% CI: [0.42–0.97]; p < 0.05). No statistically significant differences in using outpatient nursing care between women and men were found (OR = 1.26, 95% CI: [0.87–1.81]; p = 0.225). Further, the use of home care was mainly associated with health-related variables (e.g., stroke, Parkinson's disease) and walking impairments.ConclusionsOur study showed that gender differences exist in using paid household assistance and in culinary dependency. For example, meals on wheels' services are of great importance (e.g., for individuals living alone or for individuals with low social support). Gender differences were not identified regarding outpatient nursing care. Use of professional home care services may contribute to maintaining autonomy and independence in old age.
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Affiliation(s)
- Elżbieta W. Buczak-Stec
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- *Correspondence: Elżbieta W. Buczak-Stec
| | - André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hendrik van den Bussche
- Department of General Practice and Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Andreas Hoell
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Michael Pentzek
- Institute of General Practice (ifam), Centre for Health and Society (chs), Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Angela Fuchs
- Institute of General Practice (ifam), Centre for Health and Society (chs), Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Margit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Franziska Förster
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Kathrin Heser
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Martin Scherer
- Department of General Practice and Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | | | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Zaccaria D, Cavalli S, Masotti B, Gomes Da Rocha C, von Gunten A, Jopp DS. Social Isolation and Loneliness among Near-Centenarians and Centenarians: Results from the Fordham Centenarian Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105940. [PMID: 35627476 PMCID: PMC9141482 DOI: 10.3390/ijerph19105940] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 02/05/2023]
Abstract
Social isolation and loneliness have been recognized as problems older people face due to their adverse effects on health and mortality, but very few researchers have analyzed their co-occurrence, which might be particularly prevalent and critical among the very old. In this study, we investigated the prevalence of combinations of social isolation and loneliness among near-centenarians and centenarians. We used data collected from 94 individuals aged 95–107 from the Fordham Centenarian Study. We built a four-group typology and explored associations with individual characteristics in various domains (demographic, socioeconomics, social, health, care, and psychological) with multinomial logistic regression models. Considering their combinations, the most prevalent groups were “isolated and lonely” and “neither isolated nor lonely” (29.8% and 28.7%, respectively). The “lonely but not isolated” (20.2%) and “isolated but not lonely” (21.3%) groups were also notably large. The likelihood of belonging to each group varied according to various individual characteristics, such as education, health, and personality. Social isolation and loneliness are distinct phenomena among centenarians. The consideration of their varied combination can help better assess life conditions at very old ages. Taking into account the differences between groups can facilitate the design of tailored interventions to improve the lives of near-centenarians and centenarians.
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Affiliation(s)
- Daniele Zaccaria
- Centre of Competence on Ageing, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), 6928 Manno, Switzerland; (S.C.); (B.M.)
- Correspondence:
| | - Stefano Cavalli
- Centre of Competence on Ageing, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), 6928 Manno, Switzerland; (S.C.); (B.M.)
| | - Barbara Masotti
- Centre of Competence on Ageing, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland (SUPSI), 6928 Manno, Switzerland; (S.C.); (B.M.)
| | - Carla Gomes Da Rocha
- Service of Old Age Psychiatry, Lausanne University Hospital, 1011 Lausanne, Switzerland; (C.G.D.R.); (A.v.G.)
- School of Health Sciences, HES-SO Valais-Wallis, 3960 Sion, Switzerland
- Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal
| | - Armin von Gunten
- Service of Old Age Psychiatry, Lausanne University Hospital, 1011 Lausanne, Switzerland; (C.G.D.R.); (A.v.G.)
| | - Daniela S. Jopp
- Institute of Psychology, University of Lausanne, 1015 Lausanne, Switzerland;
- Swiss Centre of Expertise in Life Course Research (LIVES), 1015 Lausanne, Switzerland
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8
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Buczak-Stec EW, Hajek A, van den Bussche H, Eisele M, Oey A, Wiese B, Weyerer S, Werle J, Fuchs A, Pentzek M, Luppa M, Löbner M, Weeg D, Mösch E, Heser K, Wagner M, Riedel-Heller SG, Maier W, Scherer M, König HH. Factors Contributing to Persistent Frequent Attendance in Primary Care Among the Oldest Old: Longitudinal Evidence From the AgeCoDe-AgeQualiDe Study. Front Med (Lausanne) 2022; 9:815419. [PMID: 35386909 PMCID: PMC8977578 DOI: 10.3389/fmed.2022.815419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 02/09/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Since there is a lack of longitudinal studies in this area, our aim was to identify the determinants of persistent frequent attendance in primary care among the oldest old in Germany. Methods Longitudinal data (follow-up wave 7-9) were taken from the multicenter prospective cohort "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), covering primary care patients ≥ 85 years (FU7 n = 741, mean age 88.9 years (SD 2.9; 85-100)). Persistent frequent attenders of general practitioner (GP) services (the patients in the top decile of the number of GP consultations in two or more consecutive waves) were our main outcome of interest. Logistic random-effects models were used. Results Our analysis included 1,891 observations (766 individuals). Across three waves, we identified 56 persistent frequent attenders. Results of random-effects logistic regressions showed that the odds of being persistent frequent attender were higher for widowed individuals (OR = 4.57; 95% CI [1.07-19.45]). Moreover, a one-point increase in the frailty score and having one more chronic condition increased the odds of being a persistent frequent attender by 68% (OR =1.68; 95% CI [1.05-2.69]) and 23% (OR=1.23, 95% CI [1.05-1.44]), respectively. Conclusion Our study stressed the longitudinal association between frailty and widowhood as well as chronic diseases and persistent frequent attendance among the oldest old in Germany.
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Affiliation(s)
- Elżbieta W Buczak-Stec
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hendrik van den Bussche
- Department of General Practice and Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marion Eisele
- Department of General Practice and Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anke Oey
- Hannover Medical School, Institute of General Practice, Hanover, Germany
| | - Birgitt Wiese
- Hannover Medical School, Institute of General Practice, Hanover, Germany
| | - Siegfried Weyerer
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Central Institute of Mental Health, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - Angela Fuchs
- Medical Faculty, Institute of General Practice, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Michael Pentzek
- Medical Faculty, Institute of General Practice, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Margit Löbner
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Kathrin Heser
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Martin Scherer
- Department of General Practice and Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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9
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Hajek A, Brettschneider C, Mallon T, Kaduszkiewicz H, Oey A, Wiese B, Weyerer S, Werle J, Pentzek M, Fuchs A, Conrad I, Luppa M, Weeg D, Mösch E, Kleineidam L, Wagner M, Scherer M, Maier W, Riedel-Heller SG, König HH. Social support and health-related quality of life among the oldest old - longitudinal evidence from the multicenter prospective AgeCoDe-AgeQualiDe study. Qual Life Res 2021; 31:1667-1676. [PMID: 34939147 PMCID: PMC9098616 DOI: 10.1007/s11136-021-03070-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2021] [Indexed: 11/26/2022]
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.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Tina Mallon
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hanna Kaduszkiewicz
- Institute of General Practice, Faculty of Medicine, Kiel University, Kiel, Germany
| | - Anke Oey
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Birgitt Wiese
- Institute of General Practice, Hannover Medical School, Hannover, Germany
| | - Siegfried Weyerer
- Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Jochen Werle
- Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Michael Pentzek
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Angela Fuchs
- Institute of General Practice, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Ines Conrad
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Dagmar Weeg
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Edelgard Mösch
- Department of Psychiatry, Technical University of Munich, Munich, Germany
| | - Luca Kleineidam
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Martin Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Maier
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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10
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Hajek A, Kretzler B, König HH. Relationship between personality factors and frailty. A systematic review. Arch Gerontol Geriatr 2021; 97:104508. [PMID: 34507180 DOI: 10.1016/j.archger.2021.104508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 08/05/2021] [Accepted: 08/19/2021] [Indexed: 01/25/2023]
Abstract
PURPOSE To date, some empirical studies showed a link between personality factors and frailty. Nevertheless, a systematic review is lacking synthesizing the current evidence. Consequently, the purpose of this review was to fill this gap in knowledge based on observational studies. MATERIALS AND METHODS Three electronic databases (PubMed, PsycINFO, CINAHL) were searched. Moreover, a hand search was conducted. Observational studies focusing on the association between personality and frailty were included, whereas disease-specific studies were excluded. Data referring to methods, characteristics of the sample and key findings were extracted. The NIH tool was used to assess study quality/risk of bias. Two reviewers performed study selection, extracted the data and conducted the quality assessment. RESULT In sum, five (mostly longitudinal) studies were included in the final synthesis. Mainly based on large, nationally representative cohorts, these studies point to an association between personality and frailty. More precisely, they mainly point to a link between low conscientiousness as well as high neuroticism and increased frailty levels. The quality of the studies included was quite high. CONCLUSIONS This knowledge may assist in identifying individuals at risk for increased frailty levels (i.e., particularly individuals with low conscientiousness and high neuroticism). Efforts to increase conscientiousness and reduce neuroticism may assist in postponing frailty. Future studies are required to elucidate the underlying mechanisms. Prospero registration number: CRD42020193100.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistraße 52, 20246 Hamburg, Germany.
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistraße 52, 20246 Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistraße 52, 20246 Hamburg, Germany.
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11
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Coelho-Júnior HJ, Uchida MC. Effects of Low-Speed and High-Speed Resistance Training Programs on Frailty Status, Physical Performance, Cognitive Function, and Blood Pressure in Prefrail and Frail Older Adults. Front Med (Lausanne) 2021; 8:702436. [PMID: 34381802 PMCID: PMC8350041 DOI: 10.3389/fmed.2021.702436] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/22/2021] [Indexed: 12/19/2022] Open
Abstract
Aim: The current study investigated the effects of low-speed resistance training (LSRT) and high-speed resistance training (HSRT) on frailty status, physical performance, cognitive function and blood pressure in pre-frail and frail older people. Material and Methods: Sixty older adults, 32 prefrail and 28 frail, were randomly allocated into LSRT, HSRT, and control group (CG). Before and after intervention periods frailty status, blood pressure, heart rate, and a set of physical performance capabilities and cognitive domains were assessed. Exercise interventions occurred over 16 weeks and included four resistance exercises with 4–8 sets of 4–10 repetitions at moderate intensity. Results: The prevalence of frailty criteria in prefrail and frail older adults were reduced after both LSRT and HSRT. In prefrail, LSRT significantly improved lower-limb muscle strength, while mobility was only improved after HSRT. Muscle power and dual-task performance were significantly increased in both LSRT and HSRT. In frail, LSRT and HSRT similarly improved lower-limb muscle strength and power. However, exclusive improvements in dual-task were observed after LSRT. Memory was significantly increased in prefrail and frail, regardless of the type of resistance training. No significant changes were observed in blood pressure and heart rate. Conclusion: Findings of the present study indicated that both LSRT and HSRT reversed frailty status and improved physical performance in prefrail and frail older adults. Notably, different patterns of improvement were observed among RT protocols. Regarding frailty status, LSRT seemed to be more effective in reverse prefrailty and frailty when compared to HSRT. Greater improvements in muscle strength and power were also observed after LSRT, while HSRT produced superior increases in mobility and dual-task performance. One-leg stand performance was significantly reduced in LSRT, but not HSRT and CG, after 16 weeks. In contrast, RT programs similarly improved verbal memory in prefrail. Finally, no changes in blood pressure and heart rate were observed, regardless of the type of RT. Trial Registration: The protocol was approved by the University of Campinas Human Research Ethics Committee (Protocol No. 20021919.7.0000.5404) and retrospectively registered at ClinicalTrials.gov Protocol Registration and Results System: NCT04868071.
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Affiliation(s)
- Hélio José Coelho-Júnior
- Laboratory of Applied Kinesiology, School of Physical Education, University of Campinas, Campinas, Brazil
| | - Marco Carlos Uchida
- Laboratory of Applied Kinesiology, School of Physical Education, University of Campinas, Campinas, Brazil
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