Sex-based trajectories of health system use in lonely and not lonely older people: A population-based cohort study.

Autor: Savage RD; Women's Age Lab, Women's College Hospital, Toronto, Ontario, Canada.; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.; ICES, Toronto, Ontario, Canada.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada., Sutradhar R; ICES, Toronto, Ontario, Canada.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada., Luo J; ICES, Toronto, Ontario, Canada., Strauss R; ICES, Toronto, Ontario, Canada., Guan J; ICES, Toronto, Ontario, Canada., Rochon PA; Women's Age Lab, Women's College Hospital, Toronto, Ontario, Canada.; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.; ICES, Toronto, Ontario, Canada.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.; Department of Medicine, Division of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada., Gruneir A; ICES, Toronto, Ontario, Canada.; Department of Family Medicine, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada., Sanmartin C; Analytical Studies and Modelling Branch, Statistics Canada, Ottawa, Ontario, Canada., Goel V; ICES, Toronto, Ontario, Canada.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada., Rosella LC; ICES, Toronto, Ontario, Canada.; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.; Institute for Better Health, Trillium Health Partners, Mississauga, Ontario, Canada.; Department of Laboratory Medicine and Pathobiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada., Stall NM; Women's Age Lab, Women's College Hospital, Toronto, Ontario, Canada.; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.; Department of Medicine, Division of Geriatric Medicine, University of Toronto, Toronto, Ontario, Canada., Chamberlain SA; Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, Alberta, Canada., Yu C; Women's Age Lab, Women's College Hospital, Toronto, Ontario, Canada.; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada., Bronskill SE; Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.; ICES, Toronto, Ontario, Canada.; Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada.; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
Jazyk: angličtina
Zdroj: Journal of the American Geriatrics Society [J Am Geriatr Soc] 2024 Apr; Vol. 72 (4), pp. 1100-1111. Date of Electronic Publication: 2024 Feb 26.
DOI: 10.1111/jgs.18833
Abstrakt: Background: There is growing interest in understanding the care needs of lonely people but studies are limited and examine healthcare settings separately. We estimated and compared healthcare trajectories in lonely and not lonely older female and male respondents to a national health survey.
Methods: We conducted a retrospective cohort study of community-dwelling, Ontario respondents (65+ years) to the 2008/2009 Canadian Community Health Survey-Healthy Aging. Respondents were classified at baseline as not lonely, moderately lonely, or severely lonely using the Three-Item Loneliness Scale and then linked with health administrative data to assess healthcare transitions over a 12 -year observation period. Annual risks of moving from the community to inpatient, long-stay home care, long-term care settings-and death-were estimated across loneliness levels using sex-stratified multistate models.
Results: Of 2684 respondents (58.8% female sex; mean age 77 years [standard deviation: 8]), 635 (23.7%) experienced moderate loneliness and 420 (15.6%) severe loneliness. Fewer lonely respondents remained in the community with no transitions (not lonely, 20.3%; moderately lonely, 17.5%; and severely lonely, 12.6%). Annual transition risks from the community to home care and long-term care were higher in female respondents and increased with loneliness severity for both sexes (e.g., 2-year home care risk: 6.1% [95% CI 5.5-6.6], 8.4% [95% CI 7.4-9.5] and 9.4% [95% CI 8.2-10.9] in female respondents, and 3.5% [95% CI 3.1-3.9], 5.0% [95% CI 4.0-6.0], and 5.4% [95% CI 4.0-6.8] in male respondents; 5-year long-term care risk: 9.2% [95% CI 8.0-10.8], 11.1% [95% CI 9.3-13.6] and 12.2% [95% CI 9.9-15.3] [female], and 5.3% [95% CI 4.2-6.7], 9.1% [95% CI 6.8-12.5], and 10.9% [95% CI 7.9-16.3] [male]).
Conclusions: Lonely older female and male respondents were more likely to need home care and long-term care, with severely lonely female respondents having the highest probability of moving to these settings.
(© 2024 The Authors. Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.)
Databáze: MEDLINE
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