TY - JOUR
T1 - Kwetsbaarheid, dagelijkse beperkingen en ziektelast
T2 - samenhang met kwaliteit van leven en zorggebruik bij ouderen
AU - Lutomski, Jennifer E.
AU - Baars, Maria A.E.
AU - Boter, Han
AU - Buurman, Bianca M.
AU - den Elzen, Wendy P.J.
AU - Jansen, Aaltje P.D.
AU - Kempen, Gertrudis I.J.M.
AU - Steunenberg, Bas
AU - Steyerberg, Ewout W.
AU - Olde Rikkert, Marcel G.M.
AU - Melis, René J.F.
PY - 2014
Y1 - 2014
N2 - OBJECTIVE: To assess the independent and combined impact of frailty, multi-morbidity, and activities of daily living (ADL) limitations on self-reported quality of life and healthcare costs in elderly people.DESIGN: Cross-sectional, descriptive study.METHOD: Data came from The Older Persons and Informal Caregivers Minimum DataSet (TOPICS-MDS), a pooled dataset with information from 41 projects across the Netherlands from the Dutch national care for the Elderly programme. Frailty, multi-morbidity and ADL limitations, and the interactions between these domains, were used as predictors in regression analyses with quality of life and healthcare costs as outcome measures. Analyses were stratified by living situation (independent or care home). Directionality and magnitude of associations were assessed using linear mixed models.RESULTS: A total of 11,093 elderly people were interviewed. A substantial proportion of elderly people living independently reported frailty, multi-morbidity, and/or ADL limitations (56.4%, 88.3% and 41.4%, respectively), as did elderly people living in a care home (88.7%, 89.2% and 77,3%, respectively). One-third of elderly people living at home (31.9%) reported all three conditions compared with two-thirds of elderly people living in a care home (68.3%). In the multivariable analysis, frailty had a strong impact on outcomes independently of multi-morbidity and ADL limitations. Elderly people experiencing problems across all three domains reported the poorest quality-of-life scores and the highest healthcare costs, irrespective of their living situation.CONCLUSION: Frailty, multi-morbidity and ADL limitations are complementary measurements, which together provide a more holistic understanding of health status in elderly people. A multi-dimensional approach is important in mapping the complex relationships between these measurements on the one hand and the quality of life and healthcare costs on the other.
AB - OBJECTIVE: To assess the independent and combined impact of frailty, multi-morbidity, and activities of daily living (ADL) limitations on self-reported quality of life and healthcare costs in elderly people.DESIGN: Cross-sectional, descriptive study.METHOD: Data came from The Older Persons and Informal Caregivers Minimum DataSet (TOPICS-MDS), a pooled dataset with information from 41 projects across the Netherlands from the Dutch national care for the Elderly programme. Frailty, multi-morbidity and ADL limitations, and the interactions between these domains, were used as predictors in regression analyses with quality of life and healthcare costs as outcome measures. Analyses were stratified by living situation (independent or care home). Directionality and magnitude of associations were assessed using linear mixed models.RESULTS: A total of 11,093 elderly people were interviewed. A substantial proportion of elderly people living independently reported frailty, multi-morbidity, and/or ADL limitations (56.4%, 88.3% and 41.4%, respectively), as did elderly people living in a care home (88.7%, 89.2% and 77,3%, respectively). One-third of elderly people living at home (31.9%) reported all three conditions compared with two-thirds of elderly people living in a care home (68.3%). In the multivariable analysis, frailty had a strong impact on outcomes independently of multi-morbidity and ADL limitations. Elderly people experiencing problems across all three domains reported the poorest quality-of-life scores and the highest healthcare costs, irrespective of their living situation.CONCLUSION: Frailty, multi-morbidity and ADL limitations are complementary measurements, which together provide a more holistic understanding of health status in elderly people. A multi-dimensional approach is important in mapping the complex relationships between these measurements on the one hand and the quality of life and healthcare costs on the other.
KW - Activities of Daily Living
KW - Aged
KW - Aged, 80 and over
KW - Caregivers
KW - Cross-Sectional Studies
KW - Disabled Persons
KW - Female
KW - Frail Elderly
KW - Health Care Costs
KW - Health Status
KW - Humans
KW - Male
KW - Middle Aged
KW - Morbidity
KW - Netherlands
KW - Outcome Assessment (Health Care)
KW - Quality of Life
KW - English Abstract
KW - Journal Article
M3 - Article
C2 - 25204442
JO - Nederlands tijdschrift voor geneeskunde
JF - Nederlands tijdschrift voor geneeskunde
SN - 0028-2162
ER -