Health and participation problems in older adults with long-term disability

Hilberink, Sander R.; Slot, Wilma M A van der; Klem, Martijn

doi:10.1016/j.dhjo.2016.12.004

Cited by 25 publications

(17 citation statements)

References 23 publications

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“…In our research group, over a 4-year period, Verhoef et al 10 reported increasing employment in emerging adults with CP entering the labour market. The observed decline in work hours might be linked to worsening health problems and mobility decline, 19 likely reflecting a reduced work capacity in adults living with CP. Verhoef et al 10 expected a further increase in employment after the age of 20 to 24 years, since at that age range a proportion was still studying.…”

Section: Discussionmentioning

confidence: 99%

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Course of employment in adults with cerebral palsy over a 14‐year period

Benner

Hilberink

Veenis

et al. 2017

Develop Med Child Neuro

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in nonambulatory than ambulatory children with CP. Relying on BMI alone may lead to a misclassification of children with CP into underweight, normal/healthy weight and overweight/ obesity categories. Mathematical models were developed to estimate FMI and FFMI in children with CP from BMI and other easily obtainable measures. Background and Objective(s): Adults with cerebral palsy (CP) experience restrictions in participation, among them employment. Little is known about the course of employment in the long term. This prospective cohort study in adults with CP aimed to describe the course of employment over 14 years, and to identify subgroups at risk for unemployment. Study Design: Prospective cohort study. Study Participants & Setting: Sixty-five adults with CP (51% male; baseline age 21-31y; 25% intellectual impairment; 72% GMFCS level I-III) from a representative Dutch cohort (n=88) of adults formerly known in pediatric rehabilitation care participated. Respondents completed assessments in 1996, 2000 and in 2010. Materials/Methods: Data were collected using self-report questionnaires , by post (1996 and 2010) or interview-format (2000). Primary outcomes were employment status (including sheltered work) and-for those employed-work hours/week. Generalized Estimating Equations (GEE) analyses were performed to study course over time and associated factors. Finally, comparisons with the age-matched Dutch general population were made using one-sample binomial or t-tests. Proportions employed (%), mean (SD) hours/week, and odds ratio (OR) or regression coefficient (B) [95%CI] are reported. Results: Overall, the employment rate in adults with CP was stable over time (38 to 45%, OR 1.10 [0.88, 1.36], p=0.41), but significantly lower than in the general population (75 to 86%, p<0.001). Employment rates were specifically low in adults with intellectual impairment, bilateral CP, and in adults with GMFCS levels IV-V. Work hours/week declined (35.0 (7.9) to 31.2 (10.3), B À1.78 [À3.42, À0.15], p=0.03), specifically among females (32.3 (6.4) to 23.4 (7.4), B À4.78 [À7.21, À2.35], p<0.001). Similar to the Dutch general population, females often worked part-time. Conclusions/Significance: Employment in adults with CP was consistently low compared with the general population, but remained stable up to age 45. However, work hours/week decreased, specifically in females with CP. Adults with more severe intellectual and physical limitations are at risk for unemployment. Employers may better meet the needs of

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Section: Discussionmentioning

confidence: 99%

“…However, we already demonstrated a decline in work hours before the age of 45. The observed decline in work hours might be linked to worsening health problems and mobility decline, 19 likely reflecting a reduced work capacity in adults living with CP. Moreover, we observed a strong decline in work hours among females with CP.…”

Section: Discussionmentioning

confidence: 99%

Course of employment in adults with cerebral palsy over a 14‐year period

Benner

Hilberink

Veenis

et al. 2017

Develop Med Child Neuro

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“…The WHODAS 2.0 scale is widely used to measure last-month limitations in activity and daily-life participation. It covers six domains explored through a total of 12 items (two per domain): [1] cognition and communication, [2] self-care, [3] mobility, [4] interpersonal relations, [5] life activities, and [6] participation. The results of the 12 items are added up to obtain a global score expressed on a continuous scale from 0 (no disability) to 100 (full disability) (31).…”

Section: Outcome Variablementioning

confidence: 99%

Severity Levels of Disability Among Older Adults in Low- and Middle-Income Countries: Results From the Study on Global Ageing and Adult Health (SAGE)

et al. 2020

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Background: Recent studies suggest the importance of distinguishing the severity levels of disability in the older adult population. However, there is still no consensus regarding an optimal classification. Few studies have estimated the prevalence of severe disability, and the results have been confined to high-income countries. There is no evidence for low-and middle-income countries (LMICs). Therefore, the aim of this study was to provide estimates of the levels of severity associated with disability in older adult populations in LMICs and to examine their relationship with health and socioeconomic factors. Methods: We used data from the Study on global AGEing and adult health (SAGE), wave 1 (2007-2010). Nationally representative samples of adults over 50 years from China, Ghana, India, Mexico, Russian Federation, and South Africa were analyzed (n = 33,641). We measured disability using the World Health Organization Disability Assessment Instrument version 2.0 (WHODAS 2.0). Disability levels according to severity were identified through the use of latent class analysis. Socioeconomic and health factors associated with severe disability were estimated using ordinal logistic regression models. Results: We identified four groups of older adult: (1) without disability, 43.4%; (2) mild disability, 33.3%; (3) moderate disability, 15.3%; and (4) severe disability, 8.0%. These results were heterogeneous for the six countries analyzed. Education and socioeconomic status were significantly associated with severe disability along with the following chronic conditions: angina, arthritis, asthma, cataracts, chronic obstructive pulmonary disease, depression, diabetes, and stroke. Severe disability was also associated with the frailty status, sarcopenia, and mild cognitive impairment. Conclusions: In this study, we estimated severity levels of disability for the older adult population in LMICs. Our results show that severe disability affects 8% of older adult, and that there are important socioeconomic and health factors associated with this condition. Measuring the severity of disability is a critical element to study the Salinas-Rodríguez et al. Severe Disability in Older Adults causes and consequences of aging. Moreover, the identification of older adult with severe disability is vital to design prevention programs, modify interventions, or develop enabling environments.

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“…As social networks constrict, this can lead to loneliness with attendant implications for both mental and physical health (Larson, 1990;Burger, 1995;Victor et al, 2009). There is mounting evidence that the risk of social isolation is compounded by the onset of illness or disability (Tomaka et al, 2006;Hilberink et al, 2017) and following the onset of dementia (Fratiglioni et al, 2000). It is helpful to distinguish between isolation, which is the objectively defined situation of being alone with an absence of social interactions and often linked to being confined at home (Larson, 1990;Burger, 1995) and loneliness, which is subjectively defined and based upon a perceived lack of social relations (Perlman and Peplau, 1981).…”

Section: Introductionmentioning

confidence: 99%

‘It's our pleasure, we count cars here’: an exploration of the ‘neighbourhood-based connections’ for people living alone with dementia

et al. 2019

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The extent of social isolation experienced by people living with dementia who reside in the community has been well acknowledged, yet little is known about how people living alone with dementia maintain neighbourhood-based connections. The purpose of this study is to examine the experiences of people with dementia who live alone, focusing upon how they establish social networks and relationships in a neighbourhood context, and how they are supported to maintain this social context within everyday life. Multiple data collection methods were used including, semi-structured interviews, walking interviews, guided home tours and social network mapping, which were conducted with 14 community-dwelling people living alone with dementia (11 women and three men) situated across the three international study sites in England, Scotland and Sweden. Data were analysed using thematic analysis. The analysis revealed four main themes: (a) making the effort to stay connected; (b) befriending by organisations and facilitated friendships; (c) the quiet neighbourhood atmosphere; and (d) changing social connections. The analysis suggests that people with dementia who live alone were active agents who took control to find and maintain relationships and social networks in the neighbourhood. Our findings indicate the need to raise awareness about this specific group in both policy and practice, and to find creative ways to help people connect through everyday activities and by spontaneous encounters in the neighbourhood.

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Health and participation problems in older adults with long-term disability

Cited by 25 publications

References 23 publications

Course of employment in adults with cerebral palsy over a 14‐year period

Course of employment in adults with cerebral palsy over a 14‐year period

Severity Levels of Disability Among Older Adults in Low- and Middle-Income Countries: Results From the Study on Global Ageing and Adult Health (SAGE)

‘It's our pleasure, we count cars here’: an exploration of the ‘neighbourhood-based connections’ for people living alone with dementia

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