title: [Longitudinal Predictors of the Need for Care].
abstract: Background:Little is known about the longitudinal predictors of the need for care in old age. However, the knowledge of these factors is important for developing strategies for prevention or delay the need for care. Thus, we aimed at investigating the factors affecting the need for care in old age.Methods:In this population-based prospective cohort study (AgeCoDe, with n=3 217 individuals aged 75 years and above at baseline), the need for care was observed over 4.5 years. The need for care was quantified by the care level defined by the German Law (§ 15 SGB XI). Longitudinal predictors (sociodemographic variables, impairment in mobility/hearing/vision, dementia and depression) of the need for care were examined by using Random Effects Logit regressions.Results:Longitudinal regression analysis revealed that the probability of the need for care significantly increased with the occurrence of dementia (OR: 48.2), mobility impairments (aggravated walking, OR: 26.4; disability of walking, OR: 747.9) and age (e. g. 90 years and above vs.<80 years, OR: 32.3). The influence of family status, living conditions, visual impairment and depression on need for care was markedly smaller, and the effect of hearing impairments did not achieve statistical significance.Conclusion:In order to prevent or delay the need for care in old age, treatments should aim at preserving mobility and cognition. Due to demographic ageing, developing such programs is of major importance for health policy.
authors.affiliation: Institut für Gesundheitsökonomie und Versorgungsforschung, Universitätsklinikum Hamburg-Eppendorf, Hamburg.
authors.forename: A
authors.initials: A
authors.lastname: Hajek
authors.affiliation: Institut für Gesundheitsökonomie und Versorgungsforschung, Universitätsklinikum Hamburg-Eppendorf, Hamburg.
authors.forename: C
authors.initials: C
authors.lastname: Brettschneider
authors.affiliation: Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg.
authors.forename: A
authors.initials: A
authors.lastname: Ernst
authors.affiliation: Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg.
authors.forename: T
authors.initials: T
authors.lastname: Posselt
authors.affiliation: Institut für Allgemeinmedizin, Medizinische Hochschule Hannover, Hannover.
authors.forename: S
authors.initials: S
authors.lastname: Mamone
authors.affiliation: Institut für Allgemeinmedizin, Medizinische Hochschule Hannover, Hannover.
authors.forename: B
authors.initials: B
authors.lastname: Wiese
authors.affiliation: Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, Mannheim.
authors.forename: S
authors.initials: S
authors.lastname: Weyerer
authors.affiliation: Zentralinstitut für Seelische Gesundheit, Klinik für Psychiatrie und Psychotherapie, Mannheim.
authors.forename: J
authors.initials: J
authors.lastname: Werle
authors.affiliation: Institut für Allgemeinmedizin, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf.
authors.forename: M
authors.initials: M
authors.lastname: Pentzek
authors.affiliation: Institut für Allgemeinmedizin, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf.
authors.forename: A
authors.initials: A
authors.lastname: Fuchs
authors.affiliation: Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, Leipzig.
authors.forename: J
authors.initials: J
authors.lastname: Stein
authors.affiliation: Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, Leipzig.
authors.forename: T
authors.initials: T
authors.lastname: Luck
authors.affiliation: Klinik und Poliklinik für Psychiatrie und Psychotherapie, TU München - Klinikum rechts der Isar, München.
authors.forename: H
authors.initials: H
authors.lastname: Bickel
authors.affiliation: Klinik und Poliklinik für Psychiatrie und Psychotherapie, TU München - Klinikum rechts der Isar, München.
authors.forename: E
authors.initials: E
authors.lastname: Mösch
authors.affiliation: Klinik und Poliklinik für Psychiatrie/Psychotherapie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn.
authors.forename: L
authors.initials: L
authors.lastname: Kleineidam
authors.affiliation: Klinik und Poliklinik für Psychiatrie/Psychotherapie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn.
authors.forename: K
authors.initials: K
authors.lastname: Heser
authors.affiliation: Klinik und Poliklinik für Psychiatrie/Psychotherapie, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn.
authors.forename: W
authors.initials: W
authors.lastname: Maier
authors.affiliation: Institut für Allgemeinmedizin, Universitätsklinikum Hamburg-Eppendorf, Hamburg.
authors.forename: M
authors.initials: M
authors.lastname: Scherer
authors.affiliation: Institut für Sozialmedizin, Arbeitsmedizin und Public Health, Universität Leipzig, Leipzig.
authors.forename: S G
authors.initials: SG
authors.lastname: Riedel-Heller
authors.affiliation: Institut für Gesundheitsökonomie und Versorgungsforschung, Universitätsklinikum Hamburg-Eppendorf, Hamburg.
authors.forename: H-H
authors.initials: HH
authors.lastname: König
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003704:Dementia / Q000453:epidemiology* / Q000628:therapy; D003863:Depression / Q000453:epidemiology* / Q000628:therapy; D006233:Persons with Disabilities / Q000534:rehabilitation* / Q000706:statistics & numerical data; D005260:Female; D005858:Germany / Q000453:epidemiology; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D051346:Mobility Limitation; D020380:Needs Assessment; D012307:Risk Factors