Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne NE4 5PL, UK.
Age Ageing. 2021 May 5;50(3):921-927. doi: 10.1093/ageing/afaa227.
Care home residents have complex care and support needs. There is a perception that the needs of residents have increased, but the evidence is limited. We investigated changes in health and functioning of care home residents over two decades in England and Wales.
We conducted a repeated cross-sectional analysis over a 24 year period (1992-2016), using data from three longitudinal studies, the Cognitive Function and Ageing Studies (CFAS) I and II and the English Longitudinal Study of Ageing (ELSA). To adjust for ageing of respondents over time results are presented for the 75-84 age group.
Analysis of 2,280 observations from 1,745 care home residents demonstrated increases in severe disability (difficulty in at least two from washing, dressing and toileting). The prevalence of severe disability increased from 63% in 1992 to 87% in 2014 (subsequent fall in 2016 although wide confidence intervals). The prevalence of complex multimorbidity (problems in at least three out of six body systems) increased within studies over time, from 33% to 54% in CFAS I/II between 1992 and 2012, and 26% to 54% in ELSA between 2006 and 2016.
Over two decades, there has been an increase in disability and the complexity of health problems amongst care home residents in England and Wales. A rise in support needs for residents places increasing demands on care home staff and health professionals, and should be an important consideration for policymakers and service commissioners.
养老院居民有复杂的护理和支持需求。人们认为居民的需求增加了，但证据有限。我们调查了英格兰和威尔士 20 多年来养老院居民健康和功能的变化。
我们在 24 年期间（1992-2016 年）进行了重复的横断面分析，使用了来自三项纵向研究（认知功能与衰老研究（CFAS）I 和 II 以及英国老龄化纵向研究（ELSA））的数据。为了调整随着时间的推移受访者的老龄化，结果呈现给 75-84 岁年龄组。
对 1745 名养老院居民的 2280 次观察分析表明，严重残疾（在洗澡、穿衣和上厕所方面至少有两项困难）有所增加。严重残疾的患病率从 1992 年的 63%上升到 2014 年的 87%（尽管随后在 2016 年有所下降，但置信区间较宽）。在研究中，随着时间的推移，复杂的多种合并症（六个身体系统中至少有三个系统出现问题）的患病率也有所增加，在 1992 年至 2012 年的 CFAS I/II 中从 33%增加到 54%，在 2006 年至 2016 年的 ELSA 中从 26%增加到 54%。
在过去的二十年中，英格兰和威尔士养老院居民的残疾和健康问题的复杂性有所增加。居民对支持的需求增加给养老院工作人员和卫生专业人员带来了越来越大的压力，这应该是政策制定者和服务专员的一个重要考虑因素。
