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Association of subjective and objective measures of health and functional capacity with institutionalization and mortality – a follow-up study of community-dwelling older people

Year: 2023
Type: dissertation
Study design: Observational Study
Abstract: The ageing population poses increasing challenges on health and social services. There is a need for tools to identify older people at higher risk of institutional care and death to better target interventions. The aim of this thesis was to identify tools feasible to use in primary care to identify persons at a higher risk of institutionalization or death. In addition, the aim was to describe the successful agers still living at home after a 20-year follow-up. The study participants were aged 64 years or over and living in the municipality of Lieto at time of the baseline examination in 1998‒1999 (n=1260). The baseline examination included measures of functional capacity, a physical examination and a review of the participants’ medical records. Data on institutionalization were gathered from the electronic patient record system and data on mortality from the official national records during the follow-up periods of 10 and 18 years. The re-examination mirrored the baseline examination after a 20-year follow-up (n=138). The studied variables were frailty (by three frailty tools), self-rated health, self-reported walking ability, comprehensive subjective health, objective health based on chronic conditions, and multimorbidity. Frailty, self-rated health, self-reported walking ability, dementia, neurological disorders, mood disorders and multimorbidity were associated with institutionalization. Frailty, subjective and objective health were associated with mortality. Subjective health had an additive effect on objective health in predicting mortality. Successful agers still living at home without daily care at the age of 84 years or over had a lower biological than chronological age, and were satisfied with their lives both at baseline and at re-examination. Self-rated health, self-reported walking ability, certain chronic conditions and multimorbidity could be used to screen for older people at higher risk of institutionalization. Frailty tools could be used in identifying older adults at higher risk of institutionalization and mortality. Successful agers were satisfied with life despite hardships and had a lower biological than chronological age. Further research is needed to evaluate possible causality.
Language: English
Field: Medicine
Open Access status: green
OpenAlex ID: W7054729660
Cites: 162
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Related to: 10