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最年长老人机构化的相关因素——来自多中心 AgeCoDe-AgeQualiDe 研究的证据。

Correlates of institutionalization among the oldest old-Evidence from the multicenter AgeCoDe-AgeQualiDe study.

机构信息

Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany.

出版信息

Int J Geriatr Psychiatry. 2021 Jul;36(7):1095-1102. doi: 10.1002/gps.5548. Epub 2021 Apr 2.

Abstract

OBJECTIVES

There is a lack of studies identifying the correlates of institutionalization specifically among the oldest old. Therefore, our aim was to fill this gap in knowledge.

METHODS

Cross-sectional data (Follow up wave 9; n = 633 observations in the analytical sample) were used from the multicenter prospective cohort study "Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)" Correlates of institutionalization among the oldest old-Evidence from a multicenter cohort study. The sample consists of primary care patients aged 86 years and over (mean 90.5 years, SD: 2.9 years). Sociodemographic and health-related independent variables were included in our regression model. Institutionalization was defined as living in a nursing home or an old-age home (not including assisted living facilities).

RESULTS

Out of the 633 participants, 502 individuals (79.3%) did not live in an institutionalized setting, whereas 73 individuals (20.7%) lived in an institutionalized setting. Multiple logistic regressions showed that the likelihood of institutionalization increased with being divorced/widowed/single (compared to being married; OR: 5.35 [95% CI: 1.75-16.36]), the presence of social isolation (OR: 2.07 [1.20-3.59]), more depressive symptoms (OR: 1.11 [1.01-1.23]), increased cognitive impairment (OR: 1.67 [1.31-2.15]) and higher levels of frailty (OR: 1.48 [1.07-2.06]).

CONCLUSION

The study findings identified various sociodemographic and health-related factors associated with institutionalization among the oldest old. Longitudinal studies are required to gain further insights into these associations.

摘要

目的

专门针对最年长老年人的机构化相关因素的研究较少。因此,我们的目的是填补这一知识空白。

方法

使用多中心前瞻性队列研究“大量 85 岁以上初级保健患者的需求、卫生服务利用、成本和与健康相关的生活质量(Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+))”的横断面数据(随访第 9 波;分析样本中共有 633 个观察值)。最年长老年人机构化的相关因素-多中心队列研究的证据。样本由 86 岁及以上的初级保健患者组成(平均年龄为 90.5 岁,标准差:2.9 岁)。我们的回归模型纳入了社会人口统计学和与健康相关的自变量。机构化被定义为居住在养老院或养老院(不包括辅助生活设施)。

结果

在 633 名参与者中,有 502 人(79.3%)没有居住在机构化环境中,而 73 人(20.7%)居住在机构化环境中。多变量逻辑回归显示,与已婚者相比,离异/丧偶/单身者(OR:5.35[95%CI:1.75-16.36])、社交孤立(OR:2.07[1.20-3.59])、更多抑郁症状(OR:1.11[1.01-1.23])、认知障碍加重(OR:1.67[1.31-2.15])和衰弱程度增加(OR:1.48[1.07-2.06])的人更有可能入住机构。

结论

研究结果确定了与最年长老年人机构化相关的各种社会人口统计学和与健康相关的因素。需要进行纵向研究以进一步了解这些关联。

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