Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-25T17:15:34.701Z Has data issue: false hasContentIssue false
  • English
  • Français

One-Year Follow-up of Non-institutionalized Dependent Older Adults: Mortality, Hospitalization, and Mobility

Published online by Cambridge University Press:  18 July 2012

Marcos Aparecido Sarria Cabrera ,
Mara Solange Gomes Dellaroza ,
Celita Salmaso Trelha ,
Celso Henrique Cecilio  and
Sara Ellias de Souza
Marcos Aparecido Sarria Cabrera*
Affiliation:
Universidade Estadual de Londrina – Brazil
Mara Solange Gomes Dellaroza
Affiliation:
Universidade Estadual de Londrina – Brazil
Celita Salmaso Trelha
Affiliation:
Universidade Estadual de Londrina – Brazil
Celso Henrique Cecilio
Affiliation:
Universidade Estadual de Londrina – Brazil
Sara Ellias de Souza
Affiliation:
Universidade Estadual de Londrina – Brazil
*
*Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Marcos Aparecido Sarria Cabrera, M.D., Ph.D. Universidade Estadual de Londrina – Brazil rua Montese 65 – A Londrina, Paraná Brazil, CEP 86015020 ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Non-institutionalized dependent older adults present high morbidity and mortality, demand care from their families, and consume primary health care resources. To expand knowledge about this group, we conducted a population-based one-year prospective cohort study of 130 non-institutionalized dependent older persons (age 60 and older), stratified according to baseline mobility: independent walking (group A), use of walking aids (group B), and bedridden or confined to a wheelchair (group C). The outcomes analysed were death, hospitalization, and mobility disability. Total mortality was 8.5 per cent (p = .05). Overall hospitalization rate was 34.6 per cent; the main causes were stroke and pneumonia. After one year, there was a decline in the proportion of subjects classified as independent walking (57% vs. 43%; p = .03). We conclude that there was a high rate of mortality and hospitalization in this group of dependent older people, and an increase in disability after a one-year follow-up.

Résumé

Les aînés dépendants qui ne sont pas institutionnalisées présentent une forte morbidité et mortalité, exigent des soins de leurs familles et consomment de ressources primaires de soins de santé. Pour élargir les connaissances en ce qui concerne ce groupe, nous avons effectué une étude prospective d’un an, basée sur la population de cohorte de 130 personnes âgées dépendantes et non-institutionnalisées (60 ans et plus). Cette étude a été stratifiée en fonction du degré de la mobilité: la marche indépendante (groupe A), l’utilisation des aides pour la marche (groupe B), et alité ou confiné au fauteuil roulant (groupe C). Les résultats analysés étaient les suivants: la mort, l’hospitalisation, et l’incapacité de se déplacer. La mortalité totale était au pourcentage de 8.5 (p = 0,05). Le taux global d’hospitalisation était au pourcentage de 34,6, les principales causes étant l’AVC et la pneumonie. La mortalité totale était de 8,5 pour cent (p = 0,05). Le taux global d’hospitalisation était de 34,6 pour cent, les principales causes étant l’AVC et la pneumonie. À la fin d’un an, la proportion de sujets classés comme capables de marcher d’une façon indépendante a baissé (57% contre 43%, p = 0,03). Nous pourrions déduire qu’il y avait un taux élevé de mortalité et d’hospitalisation dans ce groupe de personnes âgées dépendantes, et une proportion croissante de gens handicapés après un an.

Keywords

vieillissementmortalitéhospitalisationmobilitépersonne âgée fragileagingmortalityhospitalizationmobilityfrail elderly
Type
Research Notes
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 31 , Issue 3 , September 2012 , pp. 357 - 361
Copyright
Copyright © Canadian Association on Gerontology 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Belmini, J., Auffray, J.C., Berbezier, C., Boirin, P., Mercier, S., Revier, B., et al. . (2007). Level of dependency: A simple marker associated with mortality during the 2003 heat wave among French dependent elderly people living in the community or in institutions. Age and Ageing, 36, 298–303.CrossRefGoogle Scholar
Berges, I.M., Graham, J.E., Ostir, G.V., Markides, K.S., & Ottenbacher, K.J. (2009). Sex differences in mortality among older frail Mexican Americans. Journal on Womens Health (Larchmt), 18(10), 1647–1651.CrossRefGoogle ScholarPubMed
Carey, E.C., Covinsky, K.E., Lui, L.Y., Eng, C., Sands, L.P., & Walter, L.C. (2008). Prediction of mortality in community-living frail elderly people with long-term care needs. Journal of the American Geriatrics Society, 56, 68–75.Google Scholar
Carey, E.C., Walter, L.C., Lindquist, K., & Covinsky, K.E. (2004). Development and validation of a functional morbidity index to predict mortality in community-dwelling elders. Journal of General Internal Medicine, 19, 1027–1033.Google Scholar
Carvalho, J.A.M., & Garcia, R.A. (2003). The ageing process in the Brazilian population: A demographic approach. Cadernos de Saúde Pública, 19(3), 725–733.CrossRefGoogle ScholarPubMed
Espaulella, J., Arnau, A., Cub, D., Ambla, S.J., & Nez, A.Y. (2007). Time-dependent prognostic factors of 6-month mortality in frail elderly patients admitted to post-acute care. Age and Ageing, 36, 407–413.Google Scholar
Fried, L.P. (2000). Epidemiology of aging. Epidemiologic Reviews, 22(11), 95–106.CrossRefGoogle ScholarPubMed
Fried, L.P., Tangen, C.M., Walston, J., Newman, A.B., Hirsch, C., Gottdiener, J., et al. . (2001). Frailty in older adults: Evidence for a phenotype. Journal of Gerontology, Series A: Biological Sciences and Medical Sciences, 56, M146–M156.Google Scholar
Gill, T.M., Gahbauer, E.A., Han, L., & Allore, H.G. (2010). Trajectories of disability in the last year of life. The New England Journal of Medicine, 362(13), 1173–1180.Google Scholar
Graham, J.E., Snih, S.A., Berges, I.M., Ray, L.A., Markides, K.S., & Ottenbacher, K.J. (2009). Frailty and 10-year mortality in community-living Mexican American older adults. Gerontology, 55(6), 644–651.CrossRefGoogle ScholarPubMed
Keeler, E., Guralnik, J.M., Tian, H., Wallace, R.B., & Reuben, D.B. (2010). The impact of functional status on life expectancy in older persons. Journal of Gerontology, Series A: Biological Sciences and Medical Sciences, 65(7), 727–733.CrossRefGoogle ScholarPubMed
Landi, F., Abbatecola, A.M., Provinciali, M., Corsonello, A., Bustacchini, S., Manigrasso, L., et al. . (2010). Moving against frailty: Does physical activity matter? Biogerontology, 11, 537–545.Google Scholar
Landi, F., Liperoti, R., Russo, A., Capoluongo, E., Barillaro, C., Pahor, M., et al. . (2010). Disability, more than multimorbidity, was predictive of mortality among older persons aged 80 years and older. Journal of Clinical Epidemiology, 63, 752–759.Google Scholar
Ramos, L.R., Simoes, E.J., & Albert, M.S. (2001). Dependence in activities of daily living and cognitive impairment strongly predicted mortality in older urban residents in Brazil: A 2-year follow-up. Journal of the American Geriatrics Society, 49(9), 1168–1175.CrossRefGoogle ScholarPubMed
Topinková, E. (2008). Ageing, disability and frailty. Annals of Nutrition and Metabolism, 52(Suppl 1), 6–11.CrossRefGoogle ScholarPubMed
Vass, M., Avlund, K., Siersma, V., & Hendriksen, C. (2009). A feasible model for the prevention of functional decline in older home-dwelling people–the GP role. A municipality-randomized intervention trial. Family Practice, 26(1), 56–64. Epub 2008 Dec 12.CrossRefGoogle Scholar
Ward, D., Drahota, A., Gal, D., Severs, M., & Dean, T.P. (2008). Care home versus hospital and own- home environments for rehabilitation of older people. Cochrane Database Systematic Review, 8(4), CD003164.Google Scholar
World Health Organization. (2004). Towards age-friendly primary health care. (Active ageing series). Geneva, Switzerland: World Health Organization.Google Scholar
Zhao, L., Tatara, K., Kuroda, K., & Takayama, Y. (1993). Mortality of frail elderly people living at home in relation to housing conditions. Journal of Epidemiology and Community Health, 47, 298–302.CrossRefGoogle ScholarPubMed