Dataset Information

Socioeconomic status and improvement in functional ability among older adults in Japan: a longitudinal study.

ABSTRACT:

Background

Recovery from functionally disabled status is an important target of public health measures for older adults. This study aimed to examine socioeconomic inequalities in the improvement of functional ability among older adults stratified by the level of disability at baseline.

Methods

In the Japan Gerontological Evaluation Study, we conducted a mail survey of community-dwelling older adults (1937 men and 2212 women) who developed functional impairment during 2010-2014. The survey data were individually linked to the longitudinal records of changes in the levels of functional disability based on the Public Long-Term Care Insurance System.

Results

The mean (standard deviation) follow-up period was 316 (269) days. During follow-up, 811 participants (19.5%) showed improved functional ability. Among those with severe disabilities at baseline, men with 13 or more years of education were more likely to improve functional ability than men with 9 or fewer years of education (hazard ratio: 1.97, 95% confidence interval: 1.12-3.45). A similar association was observed among women (hazard ratio: 2.16, 95% confidence interval: 1.03-4.53). Neither income nor occupation was statistically associated with improved functional ability.

Conclusions

There are education-related inequalities in the improvement of functional ability, especially among older adults with severe disabilities. Health policy makers and practitioners should consider the educational background of individuals with reduced functionality in formulating strategies to improve their functional ability.

SUBMITTER: Amemiya A

PROVIDER: S-EPMC6381753 | biostudies-literature | 2019 Feb

REPOSITORIES: biostudies-literature

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Publications

Socioeconomic status and improvement in functional ability among older adults in Japan: a longitudinal study.

Amemiya Airi A Kondo Naoki N Saito Junko J Saito Masashige M Takagi Daisuke D Haseda Maho M Tani Yukako Y Kondo Katsunori K

BMC public health 20190219 1

<h4>Background</h4>Recovery from functionally disabled status is an important target of public health measures for older adults. This study aimed to examine socioeconomic inequalities in the improvement of functional ability among older adults stratified by the level of disability at baseline.<h4>Methods</h4>In the Japan Gerontological Evaluation Study, we conducted a mail survey of community-dwelling older adults (1937 men and 2212 women) who developed functional impairment during 2010-2014. Th ...[more]

PMID: 30782149

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Project description:IntroductionAs health reforms move Ireland from a mixed public-private system toward universal healthcare, it is important to understand variations in prescribing practice for patients with differing health cover and socioeconomic status. This study aims to determine how prescribing patterns for patients aged ≥ 65 years in primary care in Ireland differ between patients with public and private health cover.MethodsThis was an observational study using anonymised data collected as part of a larger study from 44 general practices in Ireland (2011-2018). Data were extracted from electronic records relating to demographics and prescribing for patients aged ≥ 65 years. The cohort was divided between those with public health cover (via the General Medical Services (GMS) scheme) and those without. Standardised rates of prescribing were calculated for pre-specified drug classes. We also analysed the number of medications, polypharmacy, and trends over time between groups, using multilevel linear regression adjusting for age and sex, and hospitalisations.ResultsOverall, 42,456 individuals were included (56% female). Most were covered by the GMS scheme (62%, n = 26,490). The rate of prescribing in all drug classes was higher for GMS patients compared to non-GMS patients, with the greatest difference in benzodiazepine anxiolytics. The mean number of unique medications prescribed to GMS patients was 10.9 (SD 5.9), and 8.1 (SD 5.8) for non-GMS patients. The number of unique medications prescribed to both GMS and non-GMS cohorts increased over time. The increase was steeper in the GMS group where the mean number of medications prescribed increased by 0.67 medications/year. The rate of increase was 0.13 (95%CI 0.13, 0.14) medications/year lower for non-GMS patients, a statistically significant difference.ConclusionOur study found a significantly larger number of medications were prescribed to patients with public health cover, compared to those without. Increasing medication burden and polypharmacy among older adults may be accelerated for those of lower socioeconomic status. These findings may inform planning for moves towards universal health care, and this would provide an opportunity to evaluate the effect of expanding entitlement on prescribing and medications use.

Dataset Information

Socioeconomic status and improvement in functional ability among older adults in Japan: a longitudinal study.

Background

Methods

Results

Conclusions

Publications

Socioeconomic status and improvement in functional ability among older adults in Japan: a longitudinal study.

Similar Datasets

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