Health status of the advanced elderly in six european countries: results from a representative survey using EQ-5D and SF-12

Abstract

Background Due to demographic change, the advanced elderly represent the fastest growing population group in Europe. Health problems tend to be frequent and increasing with age within this cohort. Aims of the study To describe and compare health status of the elderly population in six European countries and to analyze the impact of socio-demographic variables on health. Methods In the European Study of the Epidemiology of Mental Disorders (ESEMeD), representative non-institutionalized population samples completed the EQ-5D and Short Form-12 (SF-12) questionnaires as part of personal computer-based home interviews in 2001-2003. This study is based on a subsample of 1659 respondents aged ≥ 75 years from Belgium (n = 194), France (n = 168), Germany (n = 244), Italy (n = 317), the Netherlands (n = 164) and Spain (n = 572). Descriptive statistics, bivariate- (chi-square tests) and multivariate methods (linear regressions) were used to examine differences in population health. Results 68.8% of respondents reported problems in one or more EQ-5D dimensions, most frequently pain/discomfort (55.2%), followed by mobility (50.0%), usual activities (36.6%), self-care (18.1%) and anxiety/depression (11.6%). The proportion of respondents reporting any problems increased significantly with age in bivariate analyses (age 75-79: 65.4%; age 80-84: 69.2%; age ≥ 85: 81.1%) and differed between countries, ranging from 58.7% in the Netherlands to 72.3% in Italy. The mean EQ VAS score was 61.9, decreasing with age (age 75-79: 64.1; age 80-84: 59.8; age ≥ 85: 56.7) and ranging from 60.0 in Italy to 72.9 in the Netherlands. SF-12 derived Physical Component Summary (PCS) and Mental Component Summary (MCS) scores varied little by age and country. Age and low educational level were associated with lower EQ VAS and PCS scores. After controlling for socio-demographic variables and reported EQ-5D health states, mean EQ VAS scores were significantly higher in the Netherlands and Belgium, and lower in Germany than the grand mean. Conclusions More than two thirds of the advanced elderly report impairment of health status. Impairment increases rapidly with age but differs considerably between countries. In all countries, health status is significantly associated with socio-demographic variables.

Health status of independently living older adults in Romania

“…The growing number of dependent older adults in Europe will place new demands on the health services in European countries. [1][2][3] However, large differences exist within Europe. Aging is developing faster in former communist Central-East European (CEE) countries as compared with Western European countries, whereas their total population decreases and long-term care arrangements are lacking.…”

“…Such data are required to maintain the present health care services, to evaluate these and to plan new ones. 3,9 Data available on the health status of the population in CEE countries are based on single measures, such as mortality, life expectancy or specific causes of morbidity, 10,11 but such measures might not contain all dimensions of health, nor do they necessarily show the (health care) needs of older citizens. Some researchers view self-rated health as an interesting and promising indicator to assess health in older adults.…”

“…[14][15][16][17][18] However, considerable differences exist in health status even within Western European countries. 3 Therefore, it is necessary to analyze which factors are associated with various components of the health of older adults. The literature shows a range of relationships between sociodemographic variables, psychological and social characteristics of older adults, and various indicators of health.…”

“…The literature shows a range of relationships between sociodemographic variables, psychological and social characteristics of older adults, and various indicators of health. 3,[17][18][19][20][21][22][23][24][25][26] Older age and being female are associated with more health problems and negative subjective health, 22,23 but this was not found among the advanced old. 3 Low level of education, low income and living alone have been found to be associated with poor health status.…”

“…3,[17][18][19][20][21][22][23][24][25][26] Older age and being female are associated with more health problems and negative subjective health, 22,23 but this was not found among the advanced old. 3 Low level of education, low income and living alone have been found to be associated with poor health status. 3,22,23 Older adults seeking social engagement (high extraversion), are found to have a positive subjective health, better physical functioning and reduced risk of mortality, whereas those with poor coping with stress and experiencing situations as threatening (high neuroticism) have a negative subjective health and more medical problems.…”