Search results for ‘Subject term:"older people"’ Sort:
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Cold comfort: the social and environmental determinants of excess winter death in England, 1986-96
- Authors:
- WILKINSON Paul, et al
- Publisher:
- Policy Press
- Publication year:
- 2001
- Pagination:
- 33p.,bibliog.
- Place of publication:
- Bristol
This study makes a direct connection between the risk of winter mortality and housing quality in England. It demonstrates that people living in homes that are difficult or costly to h eat are at increased risk of winter and cold related deaths. It is based on epidemiological analysis, which links mortality data with data on housing quality from a large national survey.
Re-thinking social exclusion in later life: a case for a new framework for measurement
- Authors:
- MacLEOD Catherine A., et al
- Journal article citation:
- Ageing and Society, 39(1), 2019, pp.74-111.
- Publisher:
- Cambridge University Press
Social exclusion is a dynamic multi-dimensional process that is interactive in nature. The complex interplay between domains, whereby each domain can act as a determinant, indicator and/or outcome of social exclusion, hinders understanding of the process and the mechanisms through which social exclusion exists. This article highlights the need to disentangle these pathways and move beyond descriptive accounts of social exclusion, presenting a new working framework that allows direct hypothesis testing of these between-domain relationships. Whilst this working framework can be applied to any population, this article focuses on older adults. Life events that can drive social exclusion such as bereavement and changes in health are more likely to occur in later life, and occur more frequently, increasing the risk of social exclusion for this population. Rooted in the new working framework, this article presents the construction of later life social exclusion measures for use with Understanding Society – the United Kingdom Household Longitudinal Study. The validity of these measures are considered by examining the characteristics of those aged 65 years and over who score the highest, and therefore experience the greatest level of exclusion. This new working framework and developed social exclusion measures provide a platform from which to explore the complex relationships between domains of social exclusion and ultimately provide a clearer understanding of this intricate multi-dimensional process. (Publisher abstract)
A study of suicides of older people in Sydney
- Authors:
- SNOWDON John, BAUME Pierre
- Journal article citation:
- International Journal of Geriatric Psychiatry, 17(3), March 2002, pp.261-269.
- Publisher:
- Wiley
Reports based on studies of coroner's files show that suicides in old age are commonly related to depression, but that in a majority of cases disability or ill-health is also a major factor. The aim of this study was to try to understand more clearly the precipitant causes of suicide in an older population using an Australian metropolitan coroner's office provided data concerning suicides in 1994-1998 of persons aged over 65 years. Of 210 elderly people who killed themselves, 160 (76%) were clearly depressed, including a majority of the 24% deemed to have understandable reasons for suicide. Physical ill-health or disability was the major factor leading to suicide in 34% and appeared to contribute to suicidal ideation in another 24% of those who died; they had usually not been seen by psychiatrists. Because depression is often treatable, even when associated with depressing circumstances, there is potential for further reduction of old age suicide rates by recognising and appropriately responding to symptoms of depression and distress.
Risk factors of falls in community-dwelling older adults: logistic regression tree analysis
- Authors:
- YAMASHITA Takashi, NOE Douglas A., BAILER A. John
- Journal article citation:
- Gerontologist, 52(6), December 2012, pp.822-832.
- Publisher:
- Oxford University Press
The authors applied a novel logistic regression tree-based method to identify fall risk factors and possible interactions among them. A nationally representative sample of American adults aged 65 years and over (n = 9,592) in the Health and Retirement Study 2004 and 2006 modules was used. Logistic Tree with Unbiased Selection, a computer algorithm for tree-based modelling, recursively split the entire group in the data set into mutually exclusive subgroups and fitted a logistic regression model in each subgroup to generate a tree diagram. Older adults with; a fall history, no activities of daily living (ADL) limitation, at least one instrumental activity of daily living limitation, or fall histories and at least one ADL limitation were at highest risk of falls. The best predictor of falls varied within each subgroup. The authors conclude that the use of tree-based methods may provide useful information for intervention program design and resource allocation targeting subpopulations of older adults at risk of falls.
Predicting social care costs: a feasibility study
- Authors:
- BARDSLEY Martin, et al
- Publisher:
- Nuffield Trust
- Publication year:
- 2011
- Pagination:
- 81p.
- Place of publication:
- London
This report describes a study that explored whether statistical models can be used to predict an individual person’s future need for intensive social care in the UK. The aim of the project was to obtain pseudonymous individual-level data from several primary care, secondary care and social care organisations; link collate and analyse these data at the individual level; and attempt to develop a statistical model to predict which individuals are at greatest risk of requiring intensive social care in the 12 months after prediction. Data was provided by 4 Primary Care Trusts (PCTs) and one care trust. The research shows how it is possible to link routine data from health and social care information systems in a way that protects individuals’ identities. The project showed that it is possible to construct predictive models for social care. How these models might fit into everyday working practice now needs investigating. The predictive accuracy of the models was comparable to some of the models used by the NHS to predict hospital admissions. The authors comment that linked person-level information has the potential to improve quality of care services, whether through improved identification of high-risk individuals, comparative performance measures, service evaluations or budget-setting. There is a need to ensure that the quality of information about social care services improves comparably to the recent improvement seen in the quality of data about individual health care use.
Assessing risk factors for mortality in elderly white and African American people: implications of alternative analyses
- Authors:
- KUCHIBHATLA Maragatha, FILLENBAUM Gerda G.
- Journal article citation:
- Gerontologist, 42(6), December 2002, pp.826-834.
- Publisher:
- Oxford University Press
The aim of this study was to ascertain whether the determinants of death differ as a function of type of analysis in a representative sample of older African American and White people with comparable mortality rates. It was found that risk factors for mortality were comparable, but the constellation of characteristics indicating higher risk for death differed between African American and White people. The analysis used may influence the type and manner of intervention.
The use of acute hospital services by elderly residents or nursing and residential care homes
- Authors:
- GODDEN Sylvia, POLLOCK Allyson M.
- Journal article citation:
- Health and Social Care in the Community, 9(6), November 2001, pp.367-374.
- Publisher:
- Wiley
Reports on a study to compare hospitalisation rates by cause of admission, hospital death rates and length of stay for residents from nursing and residential care homes with those in the community. It is a retrospective study of acute hospital emergency admissions in one health district, Merton, Sutton and Wandsworth between April 1996 and March 1997. The relative risk of emergency admission from a care home compared with the community was 1.39 for all diagnoses, 2.68 for all injuries, and 3.96 for fracture of neck of femur. Concludes that there are major difficulties in monitoring admissions from nursing and residential care homes due to poor recording and inaccuracies in NHS coding. This was compounded by an absence of data on the age and sex profile and health care needs of the resident population in care homes.
Ethnic inequalities in health in later life
- Author:
- EVANDROU Maria
- Journal article citation:
- Health Statistics Quarterly, 8, Winter 2000, pp.20-28.
- Publisher:
- Office for National Statistics
This paper uses data from the General Household Survey (1991-96) to investigate differences in health status amongst ethnic minority elders in Britain, and to assess the extent to which these can be accounted for by differences in material resources between different ethnic groups. Multivariate analysis suggests both that ethnic inequalities in socio-economic position make a significant contribution to ethnic inequalities in health, and that other factors also play a role in contributing to ethnic inequalities in health. Policies which attempt to tackle and reduce deprivation may contribute to the reduction in health inequalities, but targeted interventions and more culturally competent health care services are also necessary.
A prevalence study of suicide ideation among older adults in Hong Kong SAR
- Authors:
- YIP Paul S. F., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 18(11), November 2003, pp.1056-1062.
- Publisher:
- Wiley
The objective of this paper is to ascertain estimates of the prevalence, and associated risk factors for, suicidal ideation among community-dwelling older adults in Hong Kong. The study was conducted as part of the General Household Survey (GHS), using face to face interviews of ethnic Chinese people aged 60 or above living in the community. Elders living in institutions or elderly homes were excluded from the study. Six percent of the sample was found to have ever had suicide ideation. The results showed that poor physical health, including poor vision, hearing problems, and a greater number of diseases; and poor mental health, especially in the form of depression, are predictors of suicidal ideation in the elderly population. Also, statistical analysis by linking individual factors to depression showed that financial and relationship problems are significant risk factors as well. Older adults who engaged in active coping, that is, those who actively seek to manage or control the negative events in their lives, fare better with lower levels of suicidal ideation than those who use passive coping styles. The prevalence of suicidal ideation is similar among elders in Hong Kong and western countries. Factors that contribute to risk for suicidal ideation span physical and mental health, social, and psychological domains. Although the association of suicidal ideation to self-destructive acts remains to be determined, these findings indicate a variety of potential foci for late life suicide prevention efforts.
Alternative statistical approaches to identifying dementia in a community-dwelling sample
- Authors:
- KUCHIBHATLA M., FILLENBAUM G. G.
- Journal article citation:
- Aging and Mental Health, 7(5), September 2003, pp.383-389.
- Publisher:
- Taylor and Francis
Little attention has been paid to examining the extent to which alternative statistical models may facilitate identification of persons with dementia. Using a sub-sample of the Duke Established Populations for Epidemiologic Studies of the Elderly, two analytical approaches were compared: logistic regression (which focuses on identifying specific characteristics predictive here of dementia), and recursive partitioning methods using tree-based models (which permit identification of the characteristics of those groups with high dementing disorder). In the stepwise multiple logistic regression model which included as potential predictors, gender, age, history of chronic health conditions, scales of basic and instrumental activities of daily living (IADL), and cognitive status, only IADL and cognitive status were significant predictors, with cognitive status the single most important factor. The classification tree approach, which permits identification of the characteristics of those groups with particularly high dementia rates, identified cognitive status as the most important criterion for dementia (as did logistic regression analysis). Among those without cognitive impairment, older age was a risk factor, confirming findings consistently reported in the literature. Among the cognitively impaired, IADL was an important risk factor. Those with five or more IADL problems were further classified into two risk groups, based on number of ADL problems. While classification tree analysis encourages identification of groups at risk, logistic regression encourages targeting of specific characteristics.