Physical disability and cognitive impairment among recipients of long-term care

Døhl, Øystein; Garåsen, Helge; Kalseth, Jorid; Magnussen, Jon

doi:10.5430/jnep.v6n7p1

Cited by 4 publications

(2 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We did not find any significant effect of the Barthel index. The Barthel index constitutes of only ADL and mobility variables, ADL variables might have a ceiling effect, making it difficult to detect differences among elderly with low disability [45]. So a possible reason for this could be that gait speed is sensitive in detecting differences among stroke survivors with higher ability.…”

Section: Discussionmentioning

confidence: 99%

Factors contributing to post-stroke health care utilization and costs, secondary results from the life after stroke (LAST) study

Døhl

Halsteinli

Askim

et al. 2020

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

Background The result from the Life After Stroke (LAST) study showed that an 18-month follow up program as part of the primary health care, did not improve maintenance of motor function for stroke survivors. In this study we evaluated whether the follow-up program could lead to a reduction in the use of health care compared to standard care. Furthermore, we analyse to what extent differences in health care costs for stroke patients could be explained by individual need factors (such as physical disability, cognitive impairment, age, gender and marital status), and we tested whether a generic health related quality of life (HRQoL) is able to predict the utilisation of health care services for patients post-stroke as well as more disease specific indexes. Methods The Last study was a multicentre, pragmatic, single-blinded, randomized controlled trial. Adults (age ≥ 18 years) with first-ever or recurrent stroke, community dwelling, with modified Rankin Scale < 5. The study included 380 persons recruited 10 to 16 weeks post-stroke, randomly assigned to individualized coaching for 18 months (n = 186) or standard care (n = 194). Individual need was measured by the Motor assessment scale (MAS), Barthel Index, Hospital Anxiety and Depression Scale (HADS), modified Rankin Scale (mRS) and Gait speed. HRQoL was measured by EQ-5D-5 L. Health care costs were estimated for each person based on individual information of health care use. Multivariate regression analysis was used to analyse cost differences between the groups and the relationship between individual costs and determinants of health care utilisation. Results There were higher total costs in the intervention group. MAS, Gait speed, HADS and mRS were significant identifiers of costs post-stroke, as was EQ-5D-5 L. Conclusion Long term, regular individualized coaching did not reduce health care costs compared to standard care. We found that MAS, Gait speed, HADS and mRS were significant predictors for future health care use. The generic EQ-5D-5 L performed equally well as the more detailed battery of outcome measures, suggesting that HRQoL measures may be a simple and efficient way of identifying patients in need of health care after stroke and targeting groups for interventions. Trial registration https://www.clinicaltrials.govNCT01467206. The trial was retrospectively registered after the first 6 participants were included.

show abstract

Section: Discussionmentioning

confidence: 99%

Factors contributing to post-stroke health care utilization and costs, secondary results from the life after stroke (LAST) study

Døhl

Halsteinli

Askim

et al. 2020

BMC Health Serv Res

Self Cite

View full text Add to dashboard Cite

show abstract

“…We did not find any significant effect of the Barthel index. The Barthel index constitutes of only ADL and mobility variables, ADL variables might have a ceiling effect, making it difficult to detect differences among elderly with low disability [36]. So a possible reason for this could be that gait speed is sensitive in detecting differences among stroke survivors with higher ability.…”

Section: Discussionmentioning

confidence: 99%

Factors contributing to health care utilization and health care costs in the long term after stroke. Secondary results from the Life After Stroke (LAST) study, a pragmatic randomized controlled trial

Døhl

Halsteinli

Askim

et al. 2019

Preprint

Self Cite

View full text Add to dashboard Cite

Background The result from the Life After Stroke (LAST) study showed that an 18-month follow up program as part of the primary health care, did not improve maintenance of motor function for stroke survivors. In this study we evaluated whether the follow-up program could lead to a reduction in the use of health care compared to standard care. Furthermore, we analyse to what extent differences in health care costs for stroke patients could be explained by individual need factors (such as physical disability, cognitive impairment, age, gender and marital status), and we tested whether a generic health related quality of life (HRQoL) is able to predict the utilisation of health care services for patients post-stroke as well as more disease specific indexes. Methods The Last study was a multicentre, pragmatic, single-blinded, randomized controlled trial. Adults (age ≥18 years) with first-ever or recurrent stroke, community dwelling, with modified Rankin Scale <5. The study included 380 persons recruited 10 to 16 weeks post-stroke, randomly assigned to individualized coaching for 18 months (n=186) or standard care (n=194). Individual need was measured by the Motor assessment scale (MAS), Barthel Index, Hospital Anxiety and Depression Scale (HADS), modified Rankin Scale (mRS) and Gait speed. HRQoL was measured by EQ-5D-5L. Health care costs were estimated for each person based on individual information of health care use. Multivariate regression analysis was used to analyse cost differences between the groups and the relationship between individual costs and determinants of health care utilisation. Results There were higher total costs in the intervention group. MAS, Gait speed, HADS and mRS were significant identifiers of costs post-stroke, as was EQ-5D-5L. Conclusion Long term, regular individualized coaching did not reduce health care costs compared to standard care. We found that MAS, Gait speed, HADS and mRS were significant predictors for future health care use. The generic EQ-5D-5L performed equally well as the more detailed battery of outcome measures, suggesting that HRQoL measures may be a simple and efficient way of identifying patients in need of health care after stroke and targeting groups for interventions. Clinical Trial Registration: https://www.clinicaltrials.gov NCT01467206.

show abstract

Shielded by Education? The Buffering Role of Education in the Relationships Between Changes in Mental Health and Physical Functioning Through Time Among Older Europeans

Settels

2024

J Appl Gerontol

View full text Add to dashboard Cite

This study investigated among older Europeans how physical function limitations lead to depressive symptoms and reductions in quality of life and well-being, and vice-versa. Further examined was how years of education moderate these relationships. These objectives were pursued using a sample of Europeans aged 50+ years ( N = 46,492) within waves 5 (2013) and 6 (2015) of the Survey of Health, Ageing and Retirement in Europe. The analyses employed conditional change multilevel mixed-effects linear regressions. Mental health was found to affect physical function limitations, and vice-versa. More education significantly reduced only how earlier mental health problems lead to later physical function limitations, plausibly because of the former’s higher controllability. Thus highlighted are education-linked psychosocial resources’ protective effects.

show abstract

Physical disability and cognitive impairment among recipients of long-term care

Cited by 4 publications

References 42 publications

Factors contributing to post-stroke health care utilization and costs, secondary results from the life after stroke (LAST) study

Factors contributing to post-stroke health care utilization and costs, secondary results from the life after stroke (LAST) study

Factors contributing to health care utilization and health care costs in the long term after stroke. Secondary results from the Life After Stroke (LAST) study, a pragmatic randomized controlled trial

Shielded by Education? The Buffering Role of Education in the Relationships Between Changes in Mental Health and Physical Functioning Through Time Among Older Europeans

Contact Info

Product

Resources

About