Health status of the advanced elderly in six European countries: results from a representative survey using EQ-5D and SF-12.
BACKGROUND
Due to demographic change, the advanced elderly represent the fastest growing population group in Europe. Health problems tend to be frequent and increasing with age within this cohort.


OBJECTIVE
To describe and compare health status of the elderly population in six European countries and to analyze the impact of socio-demographic variables on health.


METHODS
In the European Study of the Epidemiology of Mental Disorders (ESEMeD), representative non-institutionalized population samples completed the EQ-5D and Short Form-12 (SF-12) questionnaires as part of personal computer-based home interviews in 2001-2003. This study is based on a subsample of 1659 respondents aged ≥ 75 years from Belgium (n = 194), France (n = 168), Germany (n = 244), Italy (n = 317), the Netherlands (n = 164) and Spain (n = 572). Descriptive statistics, bivariate- (chi-square tests) and multivariate methods (linear regressions) were used to examine differences in population health.


RESULTS
68.8% of respondents reported problems in one or more EQ-5D dimensions, most frequently pain/discomfort (55.2%), followed by mobility (50.0%), usual activities (36.6%), self-care (18.1%) and anxiety/depression (11.6%). The proportion of respondents reporting any problems increased significantly with age in bivariate analyses (age 75-79: 65.4%; age 80-84: 69.2%; age ≥ 85: 81.1%) and differed between countries, ranging from 58.7% in the Netherlands to 72.3% in Italy. The mean EQ VAS score was 61.9, decreasing with age (age 75-79: 64.1; age 80-84: 59.8; age ≥ 85: 56.7) and ranging from 60.0 in Italy to 72.9 in the Netherlands. SF-12 derived Physical Component Summary (PCS) and Mental Component Summary (MCS) scores varied little by age and country. Age and low educational level were associated with lower EQ VAS and PCS scores. After controlling for socio-demographic variables and reported EQ-5D health states, mean EQ VAS scores were significantly higher in the Netherlands and Belgium, and lower in Germany than the grand mean.


CONCLUSIONS
More than two thirds of the advanced elderly report impairment of health status. Impairment increases rapidly with age but differs considerably between countries. In all countries, health status is significantly associated with socio-demographic variables.
Department of Medical Sociology and Health Economics, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, Hamburg, Germany. h.koenig@uke.uni-hamburg.de
Hans-Helmut
HH
König
Dirk
D
Heider
Thomas
T
Lehnert
Steffi G
SG
Riedel-Heller
Matthias C
MC
Angermeyer
Herbert
H
Matschinger
Gemma
G
Vilagut
Ronny
R
Bruffaerts
Josep M
JM
Haro
Giovanni
G
de Girolamo
Ron
R
de Graaf
Viviane
V
Kovess
Jordi
J
Alonso
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology / Q000523:psychology; D000704:Analysis of Variance; D005060:Europe; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011594:Psychometrics; D011788:Quality of Life; D018571:Sentinel Surveillance; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires