Sirven Nicolas, Dumontet Magali, Rapp Thomas
EHESP, Rennes, France.
IRDES (Institute for research and Information on Health Economics), Paris, France.
Eur J Public Health. 2020 Aug 1;30(4):715-719. doi: 10.1093/eurpub/ckaa068.
The frailty phenotype for older people is defined as an increased vulnerability to stressors, leading to adverse health outcomes. It is acknowledged as a specific precursor of disability besides chronic diseases that allows for some reversibility in the loss of autonomy. Although the literature on the socio-economic determinants of frailty is emerging in cross-sectional settings, little is known about the dynamics of this relationship over time. This article examines the joint evolution of frailty and change in economic conditions for the 65+ in Europe.
Individual and longitudinal data from SHARE (Survey on Health, Ageing and Retirement in Europe) over the period 2004-12 has been used. The sample contains 31 044 observations from 12 002 respondents aged 65 or more. A fixed effect Poisson model is estimated in order to control for unobserved individual heterogeneity. Three types of explanative economic variables have been considered in turn: income, wealth and a subjective variable of deprivation.
Our results indicate that individuals with worsening economic conditions (wealth and subjective deprivation) over time simultaneously experience a rapid increase in the frailty symptoms. Results also show that the nature of economic variable does not affect the frailty process in the same way. Subjective measure of deprivation seems to better evaluate the household's financial difficulties than objective measure.
From a public policy perspective, these results show that policies fostering economic conditions of the elderly could have a significant impact on frailty and henceforth, could reduce the risks of disability.
老年人的衰弱表型被定义为对应激源的易感性增加，从而导致不良健康后果。除了慢性疾病外，它被认为是残疾的一种特定先兆，这使得自主性丧失在一定程度上具有可逆性。尽管关于衰弱的社会经济决定因素的文献在横断面研究中不断涌现，但对于这种关系随时间的动态变化却知之甚少。本文研究了欧洲65岁及以上人群衰弱与经济状况变化的共同演变情况。
使用了2004年至2012年期间欧洲健康、老龄化与退休调查（SHARE）的个体纵向数据。样本包含来自12002名65岁及以上受访者的31044条观测数据。为了控制未观察到的个体异质性，估计了固定效应泊松模型。依次考虑了三种解释性经济变量：收入、财富和贫困主观变量。
我们的结果表明，随着时间推移经济状况恶化（财富和主观贫困）的个体同时经历衰弱症状的快速增加。结果还表明，经济变量的性质对衰弱过程的影响方式不同。贫困主观衡量指标似乎比客观衡量指标能更好地评估家庭经济困难。
从公共政策角度来看，这些结果表明，改善老年人经济状况的政策可能对衰弱产生重大影响，进而降低残疾风险。
