Are frail elderly people in Europe high-need subjects? First evidence from the SPRINTT data

Sicsic, Jonathan; Ravesteijn, Bastian; Rapp, Thomas

doi:10.1016/j.healthpol.2020.05.009

Cited by 12 publications

(8 citation statements)

References 51 publications

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“…Frailty is associated with old age and is characterized by increased vulnerability to stressors, placing older adults (OA) at high risk for adverse events such as falls, disability, hospitalization, institutionalization, and death (Cesari et al, 2016; Fried et al, 2001). In addition, frailty is associated with increased health care and long-term care (LTC) use (Roquebert et al, 2021; Sicsic et al, 2020). Frailty can be treated and reverted with exercise (Kojima et al, 2019), and there is increasing interest in diagnosing and treating frailty.…”

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confidence: 99%

Improving the Identification of Frailty in Long-Term Care Residents: A Cross-Sectional Study

Arrieta

Rezola-Pardo

Sanz

et al. 2022

Biological Research For Nursing

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Purpose To compare the capacity of blood myostatin concentration and physical, cognitive, and affective function tests to predict frailty among long-term care (LTC) residents. Methods This cross-sectional analysis used baseline data from three randomized controlled trials involving 260 older adults in 14 LTC centers. Serum myostatin levels were analyzed by enzyme-linked immunosorbent assay. Frailty, physical fitness, cognitive and affective functions were assessed using validated tests and scales. Results The Timed Up and Go, gait speed, 6-minute walk, and Berg Balance Scale had excellent capabilities in identifying frail individuals in accordance with Fried’s Frailty Phenotype (FFP). The best tests for identifying frailty in accordance with the Clinical Frailty Scale (CFS) were Timed Up and Go and Berg Balance Scale. For the Tilburg Frailty Indicator (TFI), the best tests were Quality of Life in Alzheimer’s Disease (QoL-AD) and Goldberg Anxiety. Myostatin, along with physical, cognitive, and affective function tests, improved the capability of the hand grip, arm-curl, Montreal Cognitive Assessment, Goldberg Anxiety, Goldberg Depression, and QoL-AD to identify frailty according to FFP, while myostatin improved CFS-defined frailty identification by the hand grip, arm-curl, 6-minute walk test, Berg Balance Scale, 30-second chair-stand, gait speed, Montreal Cognitive Assessment, Goldberg Anxiety, and De Jong-Gierveld Loneliness Scale. Conclusion Among LTC residents, serum myostatin was associated with being frail according to FFP and CFS. However, this measure was less discriminating of frailty than physical fitness tests (for FFP and CFS) and affective function parameters (for TFI). However, evaluated concurrently with physical, cognitive, and affective parameters, myostatin improved the capabilities of these measures to predict CFS-defined frailty.

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mentioning

confidence: 99%

Improving the Identification of Frailty in Long-Term Care Residents: A Cross-Sectional Study

Arrieta

Rezola-Pardo

Sanz

et al. 2022

Biological Research For Nursing

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“…Similarly, decreased cognitive function rose the risk for NCU (4,8,9,11,14). Using different assessment tools, previous studies (15,(17)(18)(19) consistently showed that physical frailty was associated with increased use of home care services. Based on Tilburg Frailty Indicator, Verver et al (18) observed that besides physical frailty, also the combination of physical, social (e.g., living alone, low social support), and psychological frailty (e.g., problems with memory) contributed to higher use of informal and home care.…”

Section: Introductionmentioning

confidence: 89%

Individual characteristics associated with utilization of nursing care in very old population: cross-sectional study

Zimmermann

2022

Preprint

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Background: Older adults aged 80 or older belong to the most frequent recipient of nursing care. Since this age group remains often underrepresented in previous research, little is known about the characteristics associated with utilization of nursing care services. Therefore, the aim of this study was to examine individual (predisposing, enabling, and need) predictors of nursing care utilization in very old population of North Rhine-Westphalia (NRW). Methods: Using data from a representative cross-sectional study, 1,531 community-dwelling and institutionalized individuals aged ≥80 years were included. The use of outpatient care services, day care, private and inpatient nursing care was considered. Multinomial regression was applied to investigate the factors explaining nursing care use in very old adults. Results: Overall, 69.9% of participants used no nursing care services, 21.9% were using outpatient/day and/or private care, and 8.2% were institutionalized. Compared to very old adults who did not use any nursing care services, users of outpatient/day and/or private care had higher likelihood of being older, having no partner, and experiencing higher functional and cognitive disability. Comparing non-users with those using inpatient nursing care, institutionalized individuals were more likely older, had lower socioeconomic status, were childless and not in partnership, socially isolated, felt more likely lonely, were more functional and cognitive impaired, but they experienced less likely five or more chronic conditions, and were less likely physically pre-frail and frail. Conclusions: Individual need factors (referring to health status) dominated in explaining utilization of outpatient/day and/or private care, suggesting that very old population in NRW may have equitable access to these services. Since social structure, region, and social resources explained who have received inpatient nursing care, this kind of care might be inequitable accessible to very old adults in NRW. Nevertheless, the results indicate that nursing homes could substitute the role of missing closest relatives as potential caregivers, prevent frailty and multimorbidity, but fail to ensure social inclusion of the oldest-old within facilities.

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“…As LTC is significantly associated with higher longevity, we consider the life expectancy at age 65 ( life_exp ). Besides, as longer life can be associated with an increase in the prevalence of chronic diseases [ 46 , 47 ], we also introduce two measures of frailty, the number of healthy life years at 65 (for men, healthylife_exp_M , and women healthylife_exp_F ) and the share of people aged over 65 with two or more chronic diseases ( cronic ).…”

Section: The Empirical Strategymentioning

confidence: 99%

The residential healthcare for the elderly in Italy: some considerations for post-COVID-19 policies

Cepparulo

Giuriato

2021

Eur J Health Econ

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In Italy, the COVID-19 pandemic and the death of many elderly people have put in evidence the uneven territorial distribution of nursing homes, which have amplified the spread and severity of the pandemic. By applying a pooled OLS model to the Italian regions, over the 2010–18 period, we investigate the demand factors, market forces and institutional drivers of the spatial distribution of residential healthcare for the elderly. Using a fine-grained approach that considers specific regional and age-related elements and the market environment, which can reduce or increase the pressure on regional governments to provide formal assistance, we find that the financial resources and the availability of unemployed women as potential caregivers explain the distribution of expenditure better than the health needs of the elderly. As a result, the expenditure is concentrated in richer and more financially autonomous regions and it is not congruent with the distribution of chronicity, health and frailty factors or income among the elderly. These critical issues of the care services for frail elderly people, related to a highly decentralized governance and resulting in fragmented, market-driven provision, could be attacked only by a national reform.

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Are frail elderly people in Europe high-need subjects? First evidence from the SPRINTT data

Cited by 12 publications

References 51 publications

Improving the Identification of Frailty in Long-Term Care Residents: A Cross-Sectional Study

Improving the Identification of Frailty in Long-Term Care Residents: A Cross-Sectional Study

Individual characteristics associated with utilization of nursing care in very old population: cross-sectional study

The residential healthcare for the elderly in Italy: some considerations for post-COVID-19 policies

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