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Association of unmet need with self-rated health in a community dwelling cohort of disabled seniors 75 years of age and over

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Abstract

Self-rated health (SRH) is a measure of perceived health that has been shown to predict use of community services, functional decline, pain, and mortality. Many factors associated with SRH have been identified, but unmet need for physical assistance with activities of daily living (ADL) has not yet been examined. The objective of this paper is to examine the association between unmet need and SRH while accounting for the effects of other, previously identified, correlates of SRH. We conducted a secondary analysis of a population-based study of 839 residents of Montréal, Québec who were 75 years of age or older, not cognitively impaired, and living in the community. Multivariable logistic regression was used to evaluate the association between met and unmet personal ADL (PADL) and instrumental ADL (IADL) need for physical assistance with SRH. Among 508 disabled community-dwelling elderly, for each additional unmet IADL need, subjects were 1.70 (95% CI: 1.11–2.61) times more likely to report poorer SRH. For each additional unmet PADL need, subjects were 2.26 (95% CI: 1.31–3.91) times more likely to report poorer SRH. Subjects at increased risk of malnutrition, with greater comorbidity and whose income was insufficient to meet their needs were also more likely to report poorer SRH. After adjustment for important correlates, unmet PADL and IADL needs retain a statistically significant association with poorer SRH, with nutritional status, comorbid conditions, and income satisfaction being important confounders of the relationship.

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Acknowledgments

We would like to thank Deborah Weiss, Jean-Pierre Le Cruguel, Marie-Rose Shoucri, and all of the interviewers for working on various aspects of the study. The authors would also like to thank the study participants, who generously gave their time and who were a constant motivation to everyone involved with the study. This research project was funded by a grant from the Canadian Health Services Research Foundation (CHSRF) in partnership with Le Fonds de la Recherche en Santé du Québec (FRSQ), the Ministère de la Santé et des Services Sociaux, and in-kind support from l’Institut universitaire de gériatrie de Montréal. Vittorio Addona was supported by a trainee award from the SOLIDAGE research group and Le Fonds Québécois de la Recherche sur la Nature et les Technologies (FQRNT). Jacqueline Quail was supported by a trainee award from the Neuroinflammation CIHR Strategic Training Program.

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Authors and Affiliations

  1. Division of Clinical Epidemiology (DICE), McGill University Health Centre (MUHC), 1025 Pine Avenue West, Montréal, QC, Canada, H3A 1A1

    Jacqueline M. Quail

  2. Department of Mathematics and Computer Science, Macalester College, 1600 Grand Avenue, Saint Paul, MN, USA, 55105

    Vittorio Addona

  3. Division of Clinical Epidemiology (DICE), McGill University Health Centre (MUHC), 1025 Pine Avenue West, Suite P2.028, Montréal, QC, Canada, H3A 1A1

    Christina Wolfson

  4. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Avenue West, Montréal, QC, Canada, H3A 1A2

    Jacqueline M. Quail, Christina Wolfson & John E. Podoba

  5. Centre for Clinical Epidemiology and Community Studies, Sir Mortimer B. Davis-Jewish General Hospital, 3755 Côte Ste-Catherine, Suite A114, Montréal, QC, Canada, H3T 1E2

    John E. Podoba & Josette Dupuis

  6. Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montréal, Canada

    Louise Y. Lévesque

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  1. Jacqueline M. Quail
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  2. Vittorio Addona
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  3. Christina Wolfson
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  4. John E. Podoba
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Correspondence to Christina Wolfson.

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Quail, J.M., Addona, V., Wolfson, C. et al. Association of unmet need with self-rated health in a community dwelling cohort of disabled seniors 75 years of age and over. Eur J Ageing 4, 45–55 (2007). https://doi.org/10.1007/s10433-007-0042-8

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  • DOI: https://doi.org/10.1007/s10433-007-0042-8

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