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Gepubliceerd in: Quality of Life Research 10/2014

01-12-2014

Health status profiles in community-dwelling elderly using self-reported health indicators: a latent class analysis

Auteurs: Charis W. L. Ng, Nan Luo, Bee Hoon Heng

Gepubliceerd in: Quality of Life Research | Uitgave 10/2014

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Abstract

Purpose

Latent class analysis (LCA), a statistical method for identifying latent classes within a population using multiple indicators, has been used to study the heterogeneity of health among the elderly. We aim to identify health status profiles of older adults using LCA and examine the socio-demographic characteristics associated with each profile.

Methods

A community health survey of residents ≥60 years was conducted in Marine Parade, Singapore. We performed LCA on seven health indicators (number of chronic conditions, activities of daily living (ADL) dependency, pain, depression, cognition, social isolation, and frequency of socialising) to identify distinct classes of health status profiles. Multivariable logistic regression was conducted to examine the socio-demographic characteristics associated with each profile.

Results

Of the 2,444 elderly interviewed, we identified two health status profiles: “Health at risk” (n = 465, 19.0 %), and “Relatively healthy” (n = 1,979, 81.0 %). The “Health at risk” profile was characterised by high probabilities of 3+ chronic conditions (λ = 0.63), at least one basic/instrumental ADL dependency (λ = 0.56), moderate/extreme pain (λ = 0.55), cognitive impairment (λ = 0.29), depressive symptoms (λ = 0.29), social isolation (λ = 0.27), and infrequent socialisation (λ = 0.61). Individuals who were older (65–74, 75–84, and 85+ years), females, of non-Chinese ethnicity (Indian, Malay, and Others), had primary and lower education, and were unemployed/not employed were more likely to be “Health at risk”.

Conclusion

Using LCA, we identified two distinct health status profiles which accounted for the heterogeneity of the elderly population. Selected socio-demographic characteristics were associated with different profiles and provide implications for the structuring of future public health interventions targeting the older population.
Literatuur
1.
go back to reference Chan, A., Malhotra, C., Malhotra, R., & Ostbye, T. (2011). Living arrangements, social networks and depressive symptoms among older men and women in Singapore. International Journal of Geriatric Psychiatry, 26, 630–639.PubMedCrossRef Chan, A., Malhotra, C., Malhotra, R., & Ostbye, T. (2011). Living arrangements, social networks and depressive symptoms among older men and women in Singapore. International Journal of Geriatric Psychiatry, 26, 630–639.PubMedCrossRef
3.
go back to reference Orrell, M., & Hancock, G. A. (Eds.). (2004). CANE: The Camberwell assessment of need for the elderly. London: Gaskell. Orrell, M., & Hancock, G. A. (Eds.). (2004). CANE: The Camberwell assessment of need for the elderly. London: Gaskell.
5.
go back to reference Fried, L. P., Ferrucci, L., Darer, J., Williamson, J. D., & Anderson, G. (2004). Untangling the concepts of disability, frailty, and comorbidity: Implications for improved targeting and care. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 59(3), 255–263.CrossRef Fried, L. P., Ferrucci, L., Darer, J., Williamson, J. D., & Anderson, G. (2004). Untangling the concepts of disability, frailty, and comorbidity: Implications for improved targeting and care. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 59(3), 255–263.CrossRef
6.
go back to reference Inouye, S. K., Studenski, S., Tinetti, M. E., & Kuchel, G. A. (2007). Geriatric syndromes: Clinical, research and policy implications of a core geriatric concept. Journal of the American Geriatrics Society, 55(5), 780–791.PubMedCentralPubMedCrossRef Inouye, S. K., Studenski, S., Tinetti, M. E., & Kuchel, G. A. (2007). Geriatric syndromes: Clinical, research and policy implications of a core geriatric concept. Journal of the American Geriatrics Society, 55(5), 780–791.PubMedCentralPubMedCrossRef
7.
go back to reference Tomaka, J., Thompson, S., & Palacios, R. (2006). The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. Journal of Aging and Health, 18(3), 359–384.PubMedCrossRef Tomaka, J., Thompson, S., & Palacios, R. (2006). The relation of social isolation, loneliness, and social support to disease outcomes among the elderly. Journal of Aging and Health, 18(3), 359–384.PubMedCrossRef
8.
go back to reference Topinkova, E. (2008). Aging, disability and frailty. Annals of Nutrition and Metabolism, 52(Suppl 1), 6–11.PubMed Topinkova, E. (2008). Aging, disability and frailty. Annals of Nutrition and Metabolism, 52(Suppl 1), 6–11.PubMed
9.
go back to reference Lafortune, L., Beland, F., Bergman, H., & Ankri, J. (2009). Health status transitions in community-living elderly with complex care needs: A latent class approach. BMC Geriatrics, 9(6), 1–14. Lafortune, L., Beland, F., Bergman, H., & Ankri, J. (2009). Health status transitions in community-living elderly with complex care needs: A latent class approach. BMC Geriatrics, 9(6), 1–14.
11.
go back to reference Wickrama, K. A. S., Mancini, J. A., Kwag, K., & Kwon, J. (2013). Heterogeneity in multidimensional health trajectories of late old years and socioeconomic stratification: A latent trajectory class analysis. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 68(2), 290–297.CrossRef Wickrama, K. A. S., Mancini, J. A., Kwag, K., & Kwon, J. (2013). Heterogeneity in multidimensional health trajectories of late old years and socioeconomic stratification: A latent trajectory class analysis. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 68(2), 290–297.CrossRef
13.
go back to reference Crimmins, E. M., Kim, J. K., & Seeman, T. E. (2009). Poverty and biological risk: The earlier “aging” of the poor. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 64A(2), 286–292.PubMedCentralCrossRef Crimmins, E. M., Kim, J. K., & Seeman, T. E. (2009). Poverty and biological risk: The earlier “aging” of the poor. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 64A(2), 286–292.PubMedCentralCrossRef
14.
15.
go back to reference George, P. P., Heng, B. H., Molina, J. A. D., Wong, L. Y., Ng, C. W. L., & Cheah, J. T. S. (2012). Self-reported chronic diseases and health status and health service utilisation—Results from a community health survey in Singapore. International Journal for Equity in Health, 11, 44.PubMedCentralPubMedCrossRef George, P. P., Heng, B. H., Molina, J. A. D., Wong, L. Y., Ng, C. W. L., & Cheah, J. T. S. (2012). Self-reported chronic diseases and health status and health service utilisation—Results from a community health survey in Singapore. International Journal for Equity in Health, 11, 44.PubMedCentralPubMedCrossRef
16.
go back to reference Wee, L. E., Yeo, W. X., Yang, G. R., Hannan, N., Lim, K., Chua, C., et al. (2012). Individual and area level socioeconomic status and its association with cognitive function and cognitive impairment (low MMSE) among community-dwelling elderly in Singapore. Dementia and Geriatric Cognitive Disorders Extra, 2, 529–542.PubMedCentralPubMedCrossRef Wee, L. E., Yeo, W. X., Yang, G. R., Hannan, N., Lim, K., Chua, C., et al. (2012). Individual and area level socioeconomic status and its association with cognitive function and cognitive impairment (low MMSE) among community-dwelling elderly in Singapore. Dementia and Geriatric Cognitive Disorders Extra, 2, 529–542.PubMedCentralPubMedCrossRef
17.
go back to reference Yong, V., Saito, Y., & Chan, A. (2011). Gender differences in health and health expectancies of older adults in Singapore: An examination of diseases, impairments, and functional disabilities. Journal of Cross-Cultural Gerontology, 26, 189–203.PubMedCrossRef Yong, V., Saito, Y., & Chan, A. (2011). Gender differences in health and health expectancies of older adults in Singapore: An examination of diseases, impairments, and functional disabilities. Journal of Cross-Cultural Gerontology, 26, 189–203.PubMedCrossRef
19.
go back to reference Schuz, B., Wurm, S., Warner, L. M., & Tesch-Romer, C. (2009). Health and subjective well-being in later adulthood: Different health states—Different needs? Applied Psychology: Health and Well-Being, 1(1), 23–45. Schuz, B., Wurm, S., Warner, L. M., & Tesch-Romer, C. (2009). Health and subjective well-being in later adulthood: Different health states—Different needs? Applied Psychology: Health and Well-Being, 1(1), 23–45.
21.
go back to reference Muthen, B., & Muthen, L. K. (2000). Integrating person-centered and variable-centered analyses: Growth mixture modeling with latent trajectory classes. Alcoholism, Clinical and Experimental Research, 24(6), 882–891.PubMedCrossRef Muthen, B., & Muthen, L. K. (2000). Integrating person-centered and variable-centered analyses: Growth mixture modeling with latent trajectory classes. Alcoholism, Clinical and Experimental Research, 24(6), 882–891.PubMedCrossRef
22.
go back to reference Ministry of Community Development Youth and Sports. (2005). National Survey of Senior Citizens 2005. Singapore: Ministry of Community Development Youth and Sports. Ministry of Community Development Youth and Sports. (2005). National Survey of Senior Citizens 2005. Singapore: Ministry of Community Development Youth and Sports.
23.
go back to reference Ministry of Health. (2007). National Health Surveillance Survey 2007. Singapore: Ministry of Health. Ministry of Health. (2007). National Health Surveillance Survey 2007. Singapore: Ministry of Health.
24.
go back to reference Ng, T. P., Niti, M., Chiam, P. C., & Kua, E. H. (2006). Prevalence and correlates of functional disability in multiethnic elderly Singaporeans. Journal of the American Geriatrics Society, 54, 21–29.PubMedCrossRef Ng, T. P., Niti, M., Chiam, P. C., & Kua, E. H. (2006). Prevalence and correlates of functional disability in multiethnic elderly Singaporeans. Journal of the American Geriatrics Society, 54, 21–29.PubMedCrossRef
26.
go back to reference Hodkinson, H. M. (1972). Evaluation of a mental test score for assessment of mental impairment in the elderly. Age and Ageing, 1(4), 233–238.PubMedCrossRef Hodkinson, H. M. (1972). Evaluation of a mental test score for assessment of mental impairment in the elderly. Age and Ageing, 1(4), 233–238.PubMedCrossRef
27.
go back to reference Chin, J. J. (2002). Screening for cognitive impairment in primary care: The role of objective cognitive tests. The Singapore Family Physician, 28(4), 62–68. Chin, J. J. (2002). Screening for cognitive impairment in primary care: The role of objective cognitive tests. The Singapore Family Physician, 28(4), 62–68.
28.
go back to reference Jitapunkul, S., Pillay, I., & Ebrahim, S. (1991). The abbreviated mental test: Its use and validity. Age and Ageing, 20, 332–336.PubMedCrossRef Jitapunkul, S., Pillay, I., & Ebrahim, S. (1991). The abbreviated mental test: Its use and validity. Age and Ageing, 20, 332–336.PubMedCrossRef
29.
go back to reference Lim, P. P. J., Ng, L. L., Chiam, P. C., Ong, P. S., Ngui, F. T. S., & Sahadevan, S. (2000). Validation and comparison of three brief depression scales in an elderly Chinese population. International Journal of Geriatric Psychiatry, 15, 824–830.PubMedCrossRef Lim, P. P. J., Ng, L. L., Chiam, P. C., Ong, P. S., Ngui, F. T. S., & Sahadevan, S. (2000). Validation and comparison of three brief depression scales in an elderly Chinese population. International Journal of Geriatric Psychiatry, 15, 824–830.PubMedCrossRef
30.
go back to reference Nyunt, M. S. Z., Fones, C., Niti, M., & Ng, T. P. (2009). Criterion-based validity and reliability of the Geriatric Depression Screening Scale (GDS-15) in a large validation sample of community-living Asian older adults. Aging and Mental Health, 13(3), 376–382.PubMedCrossRef Nyunt, M. S. Z., Fones, C., Niti, M., & Ng, T. P. (2009). Criterion-based validity and reliability of the Geriatric Depression Screening Scale (GDS-15) in a large validation sample of community-living Asian older adults. Aging and Mental Health, 13(3), 376–382.PubMedCrossRef
31.
go back to reference Thilagaratnam, S., Ding, Y. Y., Au Eong, K. G., Chiam, P. C., Chow, Y. L., Khoo, G., et al. (2010). Health Promotion Board-Ministry of Health clinical practice guidelines: Functional screening for older adults in the community. Singapore Medical Journal, 51(6), 518–522.PubMed Thilagaratnam, S., Ding, Y. Y., Au Eong, K. G., Chiam, P. C., Chow, Y. L., Khoo, G., et al. (2010). Health Promotion Board-Ministry of Health clinical practice guidelines: Functional screening for older adults in the community. Singapore Medical Journal, 51(6), 518–522.PubMed
32.
go back to reference Singapore Department of Statistics. (2011). Key household characteristics and household income trends. Singapore: Singapore Department of Statistics. Singapore Department of Statistics. (2011). Key household characteristics and household income trends. Singapore: Singapore Department of Statistics.
33.
go back to reference Muthen, L. K., & Muthen, B. O. (1998–2010). Mplus user’s guide (6th ed.). Los Angeles, CA: Muthen & Muthen. Muthen, L. K., & Muthen, B. O. (1998–2010). Mplus user’s guide (6th ed.). Los Angeles, CA: Muthen & Muthen.
35.
go back to reference Lanza, S. T., Collins, L. M., Lemmon, D. R., & Schafer, J. L. (2007). PROC LCA: A SAS procedure for latent class analysis. Structural Equation Modeling, 14(4), 671–694.PubMedCentralPubMedCrossRef Lanza, S. T., Collins, L. M., Lemmon, D. R., & Schafer, J. L. (2007). PROC LCA: A SAS procedure for latent class analysis. Structural Equation Modeling, 14(4), 671–694.PubMedCentralPubMedCrossRef
36.
go back to reference Chan, A., & Jatrana, S. (2007). Gender differences in health among older Singaporeans. International Sociology, 22(4), 463–491.CrossRef Chan, A., & Jatrana, S. (2007). Gender differences in health among older Singaporeans. International Sociology, 22(4), 463–491.CrossRef
37.
go back to reference Fong, C. W., Bhalla, V., Heng, D., Chua, A. V., Chan, M. L., & Chew, S. K. (2007). Educational inequalities associated with health-related behaviours in the adult population of Singapore. Singapore Medical Journal, 48(12), 1091–1099.PubMed Fong, C. W., Bhalla, V., Heng, D., Chua, A. V., Chan, M. L., & Chew, S. K. (2007). Educational inequalities associated with health-related behaviours in the adult population of Singapore. Singapore Medical Journal, 48(12), 1091–1099.PubMed
38.
go back to reference Wister, A. V. (1996). The effects of socioeconomic status on exercise and smoking: Age-related differences. Journal of Aging and Health, 8(4), 467–488.PubMedCrossRef Wister, A. V. (1996). The effects of socioeconomic status on exercise and smoking: Age-related differences. Journal of Aging and Health, 8(4), 467–488.PubMedCrossRef
39.
go back to reference Schwingel, A., Niti, M. M., Tang, C., & Ng, T. P. (2009). Continued work employment and volunteerism and mental well-being of older adults: Singapore longitudinal ageing studies. Age and Ageing, 38, 531–537.PubMedCrossRef Schwingel, A., Niti, M. M., Tang, C., & Ng, T. P. (2009). Continued work employment and volunteerism and mental well-being of older adults: Singapore longitudinal ageing studies. Age and Ageing, 38, 531–537.PubMedCrossRef
40.
go back to reference Hagenaars, J. A., & McCutcheon, A. L. (Eds.). (2002). Applied latent class analysis. Cambridge: Cambridge University Press. Hagenaars, J. A., & McCutcheon, A. L. (Eds.). (2002). Applied latent class analysis. Cambridge: Cambridge University Press.
41.
go back to reference Lafortune, L., Beland, F., Bergman, H., & Ankri, J. (2009). Health state profiles and service utilisation in community-living elderly. Medical Care, 47(3), 286–294.PubMedCrossRef Lafortune, L., Beland, F., Bergman, H., & Ankri, J. (2009). Health state profiles and service utilisation in community-living elderly. Medical Care, 47(3), 286–294.PubMedCrossRef
Metagegevens
Titel
Health status profiles in community-dwelling elderly using self-reported health indicators: a latent class analysis
Auteurs
Charis W. L. Ng
Nan Luo
Bee Hoon Heng
Publicatiedatum
01-12-2014
Uitgeverij
Springer International Publishing
Gepubliceerd in
Quality of Life Research / Uitgave 10/2014
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-014-0723-7

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