Tiredness as Determinant of Subsequent Use of Health and Social Services among Nondisabled Elderly People

Abstract

Objective: To examine whether self-reported tiredness in daily activities at age 75 is an independent determinant of incident hospitalization and use of home services 5 years later. Methods:In all, 275 people participated in a prospective study in Glostrup, Denmark, when they were 75 and 80 years old. Four subgroups were created according to whether participants had been hospitalized or used home care in the year before the baseline study and whether or not they were disabled at the time. The key predictor variables were measured by two scales about tiredness in daily activities. Results:Nondisabled individuals who felt tired in their daily activities had about twice the risk of being hospitalized and of being users of home help 5 years later. Conclusions:Because tiredness in daily activities is related to subsequent hospitalization and use of home help, it should be taken seriously in preventive services among elderly people.

Get full access to this article

View all access options for this article.

References

Avlund, K. (1997). Methodological challenges in measurements of functional ability in gerontological research: A review. Aging Clinical and Experimental Research, 9, 164-174.

Avlund, K. , Davidsen, M. , & Schultz-Larsen, K. (1995). Changes in functional ability from age 70 to 75: A Danish longitudinal study. Journal of Aging and Health, 7, 254-282.

Avlund, K. , Heikkinen, E. , Steen, B. , & Schroll, M. (1999). Tiredness in daily activities as a determinant of dependency of help: A Nordic comparative study among 75-to 80-year-old men and women. Zeitschrift für Gerontologi und Geriatrie(Abstracts from the IVth European Congress of Gerontology), 32, II18-II18.

Avlund, K. , & Holstein, B. E. (1998). Functional ability among elderly people in three service settings: The discriminatory power of a new functional ability scale. European Journal of Epidemiology, 14, 783-790.

Avlund, K. , Kreiner, S. , & Schultz-Larsen, K. (1993). Construct validation and the Rasch Model: Functional ability of healthy elderly people. Scandinavian Journal of Social Medicine, 21, 233-245.

Avlund, K. , Kreiner, S. ,& Schultz-Larsen, K. (1996). Functional ability scales for the elderly: A validation study. European Journal of Public Health, 6, 35-42.

Avlund, K. , Schroll, M. , Davidsen, M. , Løvborg, B. ,& Rantanen, T. (1994). Maximal isometric muscle strength and functional ability in daily activities among 75-year-old men andwomen. Scandinavian Journal of Medicine and Science in Sports, 4, 32-40.

Avlund, K. , Schultz-Larsen, K. ,& Davidsen, M. (1998). Tiredness in daily activities at age 70 as a predictor of mortality during the next 10 years. Journal of Clinical Epidemiology, 51, 323-333.

Avlund, K. , Thudium, D. , Davidsen, M. , & Fuglsang-Sørensen, B. (1995). Are self-ratings of functional ability reliable? Scandinavian Journal of Occupational Therapy, 2, 10-16.

10.

Axelsen, U., & Soerensen, L. V. (1998). Social participation, functional ability, and urinary incontinence from age 75 to age 80(in Danish). Thesis, Institute of Public Health, Copenhagen, Denmark.

11.

Bazargan, M. , Bazargan, S. , & Baker, R.. (1998). Emergency department utilization, hospital admissions, and physician visits among elderly African American persons. The Gerontologist, 38, 25-36.

12.

Bensing, J. M. , Hulsman, R. L. , & Schreurs, K.M.G. (1999). Gender differences in fatigue: Biopsychosocial factors relating to fatigue inmenandwomen. Medical Care, 37, 1078-1083.

13.

Clark, D. O. , Stump, T. E. , Hui, S. L. ,& Wolinsky, F. D. (1998). Predictors of mobility and basic ADL difficulty among adults aged 70 years and older. Journal of Aging and Health, 10, 422-440.

14.

Era, P. , Avlund, K. , Jokela, J. , Gause-Nilsson, I. , Heikkinen, E. , Steen, B. ,& Schroll, M. (1997). Postural balance and self-reported functional ability in 75-year-old men and women: A cross-national comparative study. Journal of the American Geriatrics Society, 45, 21-29.

15.

Fried, L. P. , Ettinger, W. H. , Lind, B. , Newman A. B. , & the Cardiovascular Health Study Research Group . (1994). Physical disability in older adults: Aphysiological approach. Journal of Clinical Epidemiology, 47, 747-760.

16.

Guralnik, J. M. , Ferrucci, L. , Simonsick, E. M. , Salive, M. E. , & Wallace, R. B. (1995). Lower extremity function in persons over the age of 70 years as a predictor of subsequent disability. New England Journal of Medicine, 332, 556-561.

17.

Guralnik, J. M. , LaCroix, A. Z. , Abott, R. D. , Berkman, L. F. , Satterfield, S. , Evans, D. A. , & Wallace, R. B. (1993). Maintaining mobility in late life: I. Demographic characteristics and chronic conditions. American Journal of Epidemiology, 137, 845-857.

18.

Guralnik, J. M. , Land, K. C. , Blazer, D. , Fillenbaum, G. G. ,& Branch, L. G. (1993). Educational status and active life expectancy among older blacks and whites. New England Journal of Medicine, 329, 110-116.

19.

Heikkinen, E. , Waters, W. E. , & Brzezinsky, Z. J. (1983). The elderly in eleven countries: A sociomedical survey. Copenhagen, Denmark: World Health Organization.

20.

Hendriksen, C. , Lund, E. , & Strømgård, E. (1984). Consequences of assessment and intervention among elderly people: A three-year randomised controlled trial. British Medical Journal, 289, 1522-1524.

21.

Holstein, B. E. , Avlund, K. , & Heikkinen, R.-L. (1997). Home help and informal social support for elderly people in three Nordic localities. Facts, Research and Intervention in Geriatrics, Supplement, 41-54.

22.

Holstein, B. E. , Due, E. P. , Almind, G. , & Holst, E. (1990). Which retired old people receive home help? A survey of 1,261 70-95-year-old people (in Danish). Ugeskrift for Laeger, 152, 228-232.

23.

Holstein, B. E. , Due, E. P. , Almind, G. , & Holst, E. (1991). The home-help service in Denmark. In A. Jamieson (Ed.), Home care for older people in Europe(pp. 38-62). Oxford, UK: Oxford University Press.

24.

Jahnigen, D. W. , Applegate, W. B. , Cohen, H. J. , Epstein, A. , Granger, C. , Hogan, D. , Kennedy, H. , & Lazaroff, A. (1991). Working group recommendations: Research on content and efficacy of geriatric evaluation and management interventions. Journal of the American Geriatrics Society, 39, 42S-44S.

25.

Jette, A. M. , Assmann, S. F. , Rooks, D. , Harris, B. A. ,& Crawford, S. (1998). Interrelationships among disablement concepts. Journal of Gerontology, 53A, M395-M404.

26.

Kay, L. ,& Avlund, K. (1994). Abdominal syndromes and functional ability in the elderly. Aging Clinical and Experimental Research, 6, 420-426.

27.

Krasnik, A. , Hansen, E. , Keiding, N. ,& Sawitz, A. (1997). Determinants of general practice utilization in Denmark. Danish Medical Bulletin, 44, 556-560.

28.

Krasnik, A. , & Vallgarda, S. (1997). The health system of Denmark. In M. W. Raffel (Ed.), Health care and reform in industrialized countries(pp. 29-48). University Park, PA: The Pennsylvania State University Press.

29.

Lawrence, R. H. ,& Jette, A. M. (1996). Disentangling the disablement process. Journal of Gerontology, 51B, S173-S182.

30.

Linden, M. , Horgas, A. L. , Gilberg, R. ,& Steinhagen-Thiessen, E. (1997). Predicting health care utilization in the very old: The role of physical health, mental health, attitudinal and social factors. Journal of Aging and Health, 9, 3-27.

31.

Miilunpalo, S. , Vuori, I. , Oja, P. , Pasanen, M. ,& Urponen, H. (1997). Self-rated health status as a health measure: The predictive value of self-reported health status on the use of physician services and on mortality in the working-age population. Journal of Clinical Epidemiology, 50, 517-528.

32.

Penning, M. (1995). Health, social support, and the utilization of health services among older adults. Journal of Gerontology, 50B, S330-S339.

33.

Pohjolainen, P. , Heikkinen, E. , Lyyra, A.-L. , Helin, S. ,& Tyrkkö, K. (1997). Socioeconomic status, health, and lifestyle in two elderly cohorts in Jyväskylä. Scandinavian Journal of Social Medicine, 52(Supplement), 1-65.

34.

Rubenstein, L. Z. , Goodwin, M. , Hadley, E. , Patten, S. K. , Rempusheski, V. F. , Reuben, D. , & Winograd, C. H. (1991). Working group recommendations: Targeting criteria for geriatric evaluation and management research. Journal of the American Geriatrics Society, 39, 37S-41S.

35.

Schroll, M. , Avlund, K. , & Davidsen, M. (1997). Predictors of five-year functional ability in a longitudinal survey of men and women aged 75 to 80: The 1914-population in Glostrup, Denmark. Aging Clinical and Experimental Research, 9, 143-152.

36.

Schroll, M. , Steen, B. , Berg, S. , Heikkinen, E. , & Viidik, A. (1993). NORA—Nordic Research on Ageing: Functional capacity of 75-year-old men and women in three Nordic localities. Danish Medical Bulletin, 40, 618-624.

37.

Schultz-Larsen, K. , Avlund, K. ,& Kreiner, S. (1992). Functional ability of community dwelling elderly: Criterion-related validity of a new measure of functional ability. Journal of Clinical Epidemiology, 45, 1315-1327.

38.

Stuck, A. E. , Aronow, H. U. , Steiner, A. , Alessi, C. A. , Büla, C. J. , Gold, M. N. , Yuhas, K. E. , Nisenbaum, R. , Rubenstein, L. Z. , & Beck, J. C. (1995). A trial of annual in-home comprehensive geriatric assessments for elderly people living in the community. NewEngland Journal of Medicine, 333, 1184-1189.

39.

Stuck, A. E. , Siu, A. L. , Wieland, G. D. , Adams, J. ,& Rubenstein, L. Z. (1993). Comprehensive geriatric assessment: A meta-analysis of controlled trials. The Lancet, 342, 1032-1036.

40.

Stuck, A. E. , Walthert, J. , Nikolaus, T. , Büla, C. J. , Hohmann, C. ,& Beck, J. C. (1999). Risk factors for functional status decline in community-living elderly people: Asystematic literature review. Social Science and Medicine, 48, 445-469.

41.

Vallgarda, S. (1995, October). Have the hospitals always had many old patients? (in Danish). Bibliotek for Laeger, pp. 254-262.

42.

Verbrugge, L. M. ,& Jette, A. M. (1994). The disablement process. Social Science and Medicine, 38, 1-14.

43.

Williams, M. E. (1990). Why screen for functional disability in elderly persons? Annals of Internal Medicine, 112, 639-640.

44.

Winograd, C. H. (1991). Targeting strategies: An overview of criteria and outcomes. Journal of the American Geriatrics Society, 39, 25S-35S.

45.

Wolinsky, F. D. , Culler, S. D. , Callahan, C. M. , & Johnson, R. J. (1994). Hospital resource consumption among older adults: Aprospective analysis of episodes, length of stay, and charges over a seven-year period. Journal of Gerontology, 49, S240-S252.