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Use of primary care and other healthcare services between age 85 and 90 years: longitudinal analysis of a single-year birth cohort, the Newcastle 85+ study.

ABSTRACT: OBJECTIVE:To describe, using data from the Newcastle 85+ cohort?study, the use of primary care and other healthcare services by 85-year-olds as they age. DESIGN:Longitudinal population-based cohort study. SETTING:Newcastle on Tyne and North Tyneside, UK. PARTICIPANTS:Community dwelling and institutionalised men and women recruited through general practices (n=845, 319 men and 526 women). RESULTS:Contact was established with 97% (n=1409/1459) of eligible 85-year-olds, consent obtained from 74% (n=1042/1409) and 851 agreed to undergo the multidimensional health assessment and a general practice medical records review. A total of 845 participants had complete data at baseline for this study (319 male, 526 female), with 344 (118 male, 226 female) reinterviewed at 60 months. After adjusting for confounders, all consultations significantly increased over the 5?years (incidence rate ratio, IRR=1.03, 95%?CI 1.01 to 1.05, P=0.001) as did general practitioner (GP) consultations (IRR=1.03, 95%?CI 1.01 to 1.05, P=0.006). Significant increases were also observed in inpatient and day hospital use over time, though these disappeared after adjustment for confounders. CONCLUSIONS:Our study of primary, secondary and community care use by the very old reveals that, between the ages of 85 and 90 years, older people are much more likely to consult their GP than any other primary healthcare team members. With a rapidly ageing society, it is essential that both current and future GPs are appropriately skilled, and adequately supported by specialist colleagues, as the main healthcare provider for a population with complex and challenging needs.

SUBMITTER: Yadegarfar ME

PROVIDER: S-EPMC5786130 | biostudies-literature | 2018 Jan

REPOSITORIES: biostudies-literature

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Use of primary care and other healthcare services between age 85 and 90 years: longitudinal analysis of a single-year birth cohort, the Newcastle 85+ study.

Yadegarfar Mohammad Esmaeil ME Jagger Carol C Duncan Rachel R Fouweather Tony T Hanratty Barbara B Parker Stuart S Robinson Louise L

BMJ open 20180124 1

<h4>Objective</h4>To describe, using data from the Newcastle 85+ cohort study, the use of primary care and other healthcare services by 85-year-olds as they age.<h4>Design</h4>Longitudinal population-based cohort study.<h4>Setting</h4>Newcastle on Tyne and North Tyneside, UK.<h4>Participants</h4>Community dwelling and institutionalised men and women recruited through general practices (n=845, 319 men and 526 women).<h4>Results</h4>Contact was established with 97% (n=1409/1459) of eligible 85-yea ...[more]

PMID: 29371280

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Project description:BackgroundA number of studies have indicated a beneficial effect of tea consumption on the reduction of risk of cognitive impairment and dementia in older aged populations. However, there is a paucity of data on these associations in the very old, defined as individuals aged 85 years and over. We investigated the relationship between tea consumption in the very old and measures of global cognitive function, memory, attention and psychomotor speed.MethodLongitudinal (5-years), population-based cohort study of individuals aged 85+ years in the North East of England, United Kingdom. Participants were community-dwelling and institutionalized men and women recruited through general medical practices (n = 676). Baseline tea consumption and longitudinal measures of global and domain specific (memory, speed and attention) cognitive function were assessed. Linear mixed models, controlling for demographic (e.g. age, sex and education) and health variables were used to determine whether tea consumption was protective against cognitive decline.ResultsTea consumption was not associated with cognitive function at baseline on any measure (unadjusted and adjusted analyses). In the linear mixed effects models adjusted for age, sex, education and disease co-morbidity, higher tea consumption was associated with significantly better attention (focused and sustained attention), and psychomotor speed (complex tasks only) over five-years follow-up. However, there was no association between tea consumption and global cognitive function, memory or performance on simple speed tasks over time.ConclusionsIn this cohort study of non-demented very old adults we found that higher (vs. lower) tea consumption was associated with better performance over time on measures of focused and sustained attention and some psychomotor speed tasks. No associations with global cognition, memory or easy speed tasks (simple Reaction Time or Word Recognition) were detected. The results have implications for the development of possible diet-based interventions focused on improving cognitive function in the very old age group. These findings need to be confirmed in a sufficiently powered and well-designed RCT with non-demented very old adults.

Dataset Information

Use of primary care and other healthcare services between age 85 and 90 years: longitudinal analysis of a single-year birth cohort, the Newcastle 85+ study.

Publications

Use of primary care and other healthcare services between age 85 and 90 years: longitudinal analysis of a single-year birth cohort, the Newcastle 85+ study.

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