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Unmet Need for Assistance to Perform Activities of Daily Living and Psychological Distress in Community-Dwelling Elderly Women*

Published online by Cambridge University Press:  31 October 2011

Jacqueline M. Quail ,
Christina Wolfson  and
Abby Lippman
Jacqueline M. Quail*
Affiliation:
Department of Epidemiology and Biostatistics and Occupational Health, McGill University Saskatchewan Health Quality Council
Christina Wolfson
Affiliation:
Department of Epidemiology and Biostatistics and Occupational Health, McGill University Research Institute, McGill University Health Centre
Abby Lippman
Affiliation:
Department of Epidemiology and Biostatistics and Occupational Health, McGill University
*
†Correspondence and requests for offprints should be sent to / La correspondance et les demandes de tirés-à-part doivent être adressées à: Jacqueline Quail, Ph.D. Saskatchewan Health Quality Council 241-111 Research Drive Saskatoon, Saskatchewan Canada S7N 3R2 ([email protected])
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Abstract

Community-dwelling seniors increasingly require physical assistance to perform the activities of daily living (ADL). To examine the possible association of this need with psychological distress, we conducted a prospective cohort study of community-dwelling people age 75 and older in Montreal, Canada. We report the results for women only (n = 530). Multivariable linear regression was used to examine the association between met and unmet need in instrumental ADL (IADL) and personal ADL (PADL) with concomitant psychological distress. Unmet IADL need was associated with elevated psychological distress [β = 0.42 (95% CI: 0.26, 0.60)], as was met IADL need [β = 0.19 (95% CI: 0.06, 0.33)], but not met and unmet PADL need. The full model explained 32.8 per cent of the total variance in psychological distress. Receiving assistance to meet IADL needs is associated with elevated psychological distress. Not receiving assistance, however, is associated with even greater distress.

Résumé

De plus en plus, les aînés vivant dans les communautés ont besoin d’une assistance physique pour les activités de la vie quotidienne (AVQ). L’association de ce besoin, que ce soit atteint ou non satisfaits, avec la détresse psychologique est inconnue. Nous avons mené une étude prospective des cohortes sur des résidents vivant dans les communautés âgées de 75 ans et plus à Montreal, au Canada. Nous rapportons les résultats pour les femmes seulement (n = 530). On a utilisé une régression lineaire multivariable pour examiner l’association entre les besoins satisfaits et ceux qui restent insatisfaits dans les activités déterminantes de la vie quotidienne (ADVQ) et les activités personnelles de la vie quotidienne (APVQ) et la détresse psychologique concomitante. Alors que les besoins ADVQ non satisfaits ont été associés à une détresse psychologique élevée, [β = 0.19 (95% CI: 0.06, 0.33)], comme cela a été avec les besoins ADVQ satisfaits [β = 0.42 (95% CI: 0.26, 0.60)], les besoins APVQ satisfaits et non satisfaits ne l’étaient pas. Le modèle complet explique 32,8 pour cent de la variance totale de la détresse psychologique. Recevoir de l’aide pour répondre aux besoins ADVQ est associé à une détresse psychologique élevée. Ne pas recevoir d’aide, cependant, est associé à une détresse encore plus élevée.

Keywords

vieillissementbesoin non satisfaithandicapaînésanté mentaleaging/vieillissmentunmet needdisabilityelderlymental health
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 30 , Issue 4 , December 2011 , pp. 591 - 602
Copyright
Copyright © Canadian Association on Gerontology 2011

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Footnotes

*

We thank the study participants who generously gave their time and who were a constant motivation to everyone involved with the study. We also acknowledge Louise Levesque, a co-primary investigator for the Montreal Unmet Needs Study, as well as the MUNS study coordinator and all of the interviewers for working on various aspects of the study. Sources of funding for this research include Le Fonds de la Recherche en Santé du Quebec; l’Institut universitaire de gériatrie de Montreal; Ministère de la Santé et des Services Sociaux; Neuroinflammation CIHR Strategic Training Program; Canadian Health Services Research Foundation; and the Canadian Institutes of Health Research.

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