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Health of Aging Adults
Geleitet von Anna Oksuzyan; Maciej Danko, Jennifer Caputo; in Zusammenarbeit mit Angela Carollo, Jutta Gampe (beide: MPIDR), Jo Mhairi Hale (University of St Andrews, Großbritannien), Karen Andersen-Ranberg (University of Southern Denmark, Odense, Dänemark), Karin Modig (Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Schweden), Jonas Wastesson (Karolinska Institutet, Stockholm, Schweden)
Remarkable improvements over the last two centuries in life expectancy in high-income countries have led to the proliferation of research on how healthy people live to old age. In the last decade, however, more research has been initiated to study late-life health transitions and the place and quality of death. Measuring the share of the population dying in different contexts is central to planning policies for end-of-life care. Using high-quality register data on the total Danish population, we have demonstrated that hospital deaths declined from 1980 to 2014, except for oldest-old individuals, diseases of the respiratory system, and terminal hospitalizations lasting one to three days among the oldest-old. These trends may be driven by intensiﬁed needs for professional clinical care. They also raise the question of whether more education on end-of-life symptom management should be incorporated in the training for healthcare professionals, and they reemphasize the need for better healthcare delivery models that allow patients to have “good death.” Currently, we are studying the age of onset and duration of health dependency – home care and long-term care use – among immigrant women and men and how these pattern differ by country of birth and marital composition of immigrant families.
Another research strand of this project focused on methodological challenges related to studying the health of old-age populations, which is usually based on survey data. Typically, survey data are collected via interviews with selected respondents, or, when this is not possible, with their proxies. The inclusion of proxy interviews overcomes some methodological problems, such as increases in sample size, and helps to improve the representativeness of the study population. However, the inclusion of proxy-respondents may create another challenge, as the lower accuracy of proxy responses may lead to biased estimates. To provide methodological insights into this research, we examined the accuracy of the reporting of medication use by proxy- and self-respondents, and we compared the prognostic value of the number of medications from survey and registry data for predicting mortality among self- and proxy-respondents. Our study has revealed that the agreement between survey and registry data for most therapeutic groups and the predictive value of the number of medications for mortality was lower among the proxies than among the self-respondents. These findings suggest that the levels of medication use and their ability to predict mortality may be underestimated when assessed through surveys, when proxy-respondents are involved.
Studies on panel conditioning show that being surveyed can affect the self-reported knowledge of participants, their labor-force participation, and their health. Two questions evoked and unanswered by these findings we explored in this project are whether participation in longitudinal health surveys had actual effects on participants’ health behaviors and whether these effects were gender-specific. Our analyses of the REGLINK-SHAREDK data suggest that the age-related increase in register-recorded doctor’s visits did not differ between Danish adult men and women who participated in the SHARE survey for the first time, and it also did not differ between their peers who had yet (but would go on) to participate.
Ageing, Mortality and Longevity, Health Care, Public Health, Medicine, and Epidemiology, Data and Surveys, Intergenerational Relationships
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Pharmacoepidemiology and Drug Safety 26:2, 152–161. (2017)
The Lancet 382:9903, 1507–1513. (2013)
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