Spiers Gemma F, Davies Laurie E, Sinclair David, Tan Michelle M C, Kingston Andrew, Hanratty Barbara
Newcastle University, Newcastle upon Tyne, UK
Newcastle University, Newcastle upon Tyne, UK.
BMJ Open. 2025 Jan 22;15(1):e084812. doi: 10.1136/bmjopen-2024-084812.
Unmet need for social care is linked to numerous adverse health outcomes. Understanding which unmet needs have the biggest impact on healthy ageing could help resource-stretched services prioritise care. To address this evidence gap, our analysis aimed to explore the association between selected individual unmet care needs and an indicator of healthy ageing.
Cross-sectional analysis of data from the English Longitudinal Study of Ageing (Wave 9). A total of 6109 people aged 50 years or over, with complete data items, formed the basis for this analysis.
Absolute unmet need for help with each: walking 100 yards and climbing one flight of steps (mobility); managing money, managing medication, doing housework and shopping for groceries (instrumental activities of daily living (IADLs)); and dressing, walking across a room, bathing or showering, eating, using the toilet and getting in and out of bed (activities of daily living (ADLs)). Our outcome measure was poor self-rated health .
Associations between poor self-rated health and most unmet ADL, IADL and mobility needs were not statistically significant. People with an unmet need for support with managing money were nine times more likely to report poor self-rated health than those whose support needs were met in this domain (OR=9.23, 95% CI: 2.12 to 40.23). In a comparison of people with met and unmet needs, individuals with met needs had higher levels of dependency than those with unmet needs.
Some unmet needs may be especially consequential for older people's health. However, shortcomings in current data limit a clear and confident assessment of this. Our analysis highlights the importance of data on the level of need to better understand the link between unmet care needs and healthy ageing.
社会护理需求未得到满足与众多不良健康结局相关。了解哪些未满足的需求对健康老龄化影响最大，有助于资源紧张的服务机构确定护理重点。为填补这一证据空白，我们的分析旨在探讨选定的个体未满足护理需求与健康老龄化指标之间的关联。
对英国老龄化纵向研究（第9波）的数据进行横断面分析。共有6109名50岁及以上且数据项完整的人构成了本分析的基础。
分别在以下方面存在的绝对未满足帮助需求：行走100码和爬一段楼梯（行动能力）；管理钱财、管理药物、做家务和购买食品杂货（日常生活工具性活动（IADLs））；以及穿衣、穿过房间、洗澡或淋浴、吃饭、使用厕所和上下床（日常生活活动（ADLs））。我们的结局指标是自我健康评价差。
自我健康评价差与大多数未满足的ADL、IADL和行动能力需求之间的关联无统计学意义。在管理钱财方面存在未满足支持需求的人报告自我健康评价差的可能性是该领域支持需求得到满足的人的9倍（比值比=9.23，95%置信区间：2.12至40.23）。在有满足需求和未满足需求的人群比较中，需求得到满足的个体比需求未得到满足的个体有更高的依赖水平。
一些未满足的需求可能对老年人的健康尤为重要。然而，当前数据的缺陷限制了对此进行清晰且有把握的评估。我们的分析强调了需求水平数据对于更好理解未满足护理需求与健康老龄化之间联系的重要性。
