Longitudinal Predictors of Functional Impairment in Older Adults in Europe – Evidence from the Survey of Health, Ageing and Retirement in Europe

<div><p>Objective</p><p>To examine time-dependent predictors of functional impairment in older adults in Europe longitudinally.</p><p>Methods</p><p>Data were derived from the Survey of Health Ageing, and Retirement in Europe (2004–2013). Functional impairment was assessed by using activities of daily living (ADL) and instrumental activities of daily living (IADL) indices. Fixed effects regressions were used to estimate the effects of sociodemographic factors (age, marital status, living situation, and income deciles (median split)), lifestyle factors (smoking status and alcohol consumption per week), depression, cognitive function and chronic diseases on the outcome variables.</p><p>Results</p><p>Longitudinal regressions revealed that functional impairment increased significantly with age, the occurrence of depression, cognitive impairment, the number of chronic conditions, and less than daily alcohol consumption in the total sample and in both sexes. Moreover, the onset of smoking and living without a spouse/partner in household increased functional impairment in the total sample. The effect of depression on functional impairment was significantly more pronounced in men.</p><p>Conclusion</p><p>Our findings highlight the relevance of changes in age, depression, cognitive function, smoking and chronic diseases for functional impairment. Since particularly depression and smoking may be avoidable, developing strategies to prevent depression or stop smoking might be useful approaches to postpone functional impairment in older adults.</p></div

Longitudinal predictors of functional health (Subscale 'Physical Functioning' of the SF-36): Results of fixed effects regressions (Waves 3–4) in (1) total sample, (2) men and (3) women.

<p>Longitudinal predictors of functional health (Subscale 'Physical Functioning' of the SF-36): Results of fixed effects regressions (Waves 3–4) in (1) total sample, (2) men and (3) women.</p

Longitudinal predictors of depressive symptoms (CES-D): Results of fixed effects regressions (Waves 3–4) in (1) total sample, (2) men and (3) women.

<p>Longitudinal predictors of depressive symptoms (CES-D): Results of fixed effects regressions (Waves 3–4) in (1) total sample, (2) men and (3) women.</p

Intergenerational Caregiving—Longitudinal predictors of SWB (CWB: cognitive well-being; NA: negative affect: PA: positive affect): Results of fixed effects regressions (Waves 2–4).

<p>Intergenerational Caregiving—Longitudinal predictors of SWB (CWB: cognitive well-being; NA: negative affect: PA: positive affect): Results of fixed effects regressions (Waves 2–4).</p

Descriptive statistics over time (for individuals included in FE regressions; with functional health as well as depressive symptoms as outcome variable, Waves 3–4).

<p>Descriptive statistics over time (for individuals included in FE regressions; with functional health as well as depressive symptoms as outcome variable, Waves 3–4).</p

A Systematic Review of Economic Evaluations of Treatments for Borderline Personality Disorder

<div><p>Purpose</p><p>The borderline personality disorder is a common mental disorder. It is frequently associated with various mental co-morbidities and a fundamental loss of functioning. The borderline personality disorder causes high costs to society. The aim of this study was to perform a systematic literature review of existing economic evaluations of treatments for borderline personality disorder.</p><p>Materials and Methods</p><p>We performed a systematic literature search in MEDLINE, EMBASE, PsycINFO and NHSEED for partial and full economic evaluations regarding borderline personality disorder. Reported cost data were inflated to the year 2012 and converted into US-$ using purchasing power parities to allow for comparability. Quality assessment of the studies was performed by means of the Consensus on Health Economic Criteria checklist, a checklist developed by a Delphi method in cooperation with 23 international experts.</p><p>Results</p><p>We identified 6 partial and 9 full economic evaluations. The methodical quality was moderate (fulfilled quality criteria: 79.2% [SD: 15.4%] in partial economic evaluations, 77.3% [SD: 8.5%] in full economic evaluations). Most evaluations analysed psychotherapeutic interventions. Although ambiguous, most evidence exists on dialectical-behavioural therapy. Cognitive behavioural therapy and schema-focused therapy are cost-saving. Evidence on other interventions is scarce.</p><p>Conclusion</p><p>The economic evidence is not sufficient to draw robust conclusions for all treatments. It is possible that some treatments are cost-effective. Most evidence exists on dialectical-behavioural therapy. Yet, it is ambiguous. Further research concerning the cost-effectiveness of treatments is necessary as well as the identification of relevant cost categories and the validation of effect measures.</p></div

Additional file 1: of Psychological determinants of influenza vaccination

Psychological factors (items and explanations). (DOCX 16 kb

Sample characteristics for individuals included in fixed effects regressions (with physician visits and hospital stay as outcome variable, with 2005, 2009 and 2013, pooled).

<p>Sample characteristics for individuals included in fixed effects regressions (with physician visits and hospital stay as outcome variable, with 2005, 2009 and 2013, pooled).</p

The role of personality in health care use: Results of a population-based longitudinal study in Germany

<div><p>Objective</p><p>To determine the role of personality in health care use longitudinally.</p><p>Methods</p><p>Data were derived from the German Socio-Economic Panel (GSOEP), a nationally representative, longitudinal cohort study of German households starting in 1984. Concentrating on the role of personality, we used data from the years 2005, 2009 and 2013. Personality was measured by using the GSOEP Big Five Inventory (BFI-S). Number of physician visits in the last 3 months and hospital stays in the last year were used as measures of health care use.</p><p>Results</p><p>Adjusting for predisposing factors, enabling resources, and need factors, fixed effects regressions revealed that physician visits increased with increasing neuroticism, whereas extraversion, openness to experience, agreeableness and conscientiousness did not affect physician visits in a significant way. The effect of self-rated health on physician visits was significantly moderated by neuroticism. Moreover, fixed effects regressions revealed that the probability of hospitalization in the past year increased with increasing extraversion, whereas the other personality factors did not affect this outcome measure significantly.</p><p>Conclusion</p><p>Our findings suggest that changes in neuroticism are associated with changes in physician visits and that changes in extraversion are associated with the probability of hospitalization. Since recent studies have shown that treatments can modify personality traits, developing interventional strategies should take into account personality factors. For example, efforts to intervene in changing neuroticism might have beneficial effects for the healthcare system.</p></div

Characteristics of partial and full economic evaluations.

<p><i>AUS: Australia; CH: Switzerland; NL: The Netherlands; RCT: Randomized Controlled Trial UK: United Kingdom.</i></p><p>Characteristics of partial and full economic evaluations.</p