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65th Annual Meeting of the German Association for Medical Informatics, Biometry and Epidemiology (GMDS), Meeting of the Central European Network (CEN: German Region, Austro-Swiss Region and Polish Region) of the International Biometric Society (IBS)

06.09. - 09.09.2020, Berlin (online conference)

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Is there an association between social determinants and care dependency risk? A multi-state model analysis of a longitudinal study

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  • Alice Schneider - Institut für Biometrie und Klinische Epidemiologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
  • Stefan Blüher - 3Institute of Medical Sociology and Rehabilitation Science; Charité-Universitätsmedizin Berlin, bERLIN, Germany
  • Ulrike Grittner - Insitute of Biometry and Clinical Epidemiology, Charité Universtiaetsmedizin Berlin, Germany, Berlin, Germany
  • Anton Verena - 3Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Berlin, Germany
  • Elke Schäffner - Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
  • Natalie Ebert - Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
  • Olga Jakob - Winicker Norimed GmbH, Berlin, Germany
  • Peter Martus - Institute of Clinical Epidemiology and Medical Biostatistics, Eberhard Karls-University, Tübingen, Tübingen, Germany
  • Adelheid Kuhlmey - Institut für Medizinische Soziologie, Berlin, Germany
  • Volker Wenning - AOK Nordost – Die Gesundheitskasse, Berlin, Germany
  • Susanne Schnitzer - Institute of Medical Sociology and Rehabilitation Science, Charité-Universitätsmedizin Berlin, Berlin, Germany

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. 65th Annual Meeting of the German Association for Medical Informatics, Biometry and Epidemiology (GMDS), Meeting of the Central European Network (CEN: German Region, Austro-Swiss Region and Polish Region) of the International Biometric Society (IBS). Berlin, 06.-09.09.2020. Düsseldorf: German Medical Science GMS Publishing House; 2021. DocAbstr. 230

doi: 10.3205/20gmds349, urn:nbn:de:0183-20gmds3495

Published: February 26, 2021

© 2021 Schneider et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Despite a growing body of knowledge about the morbidities and functional impairment that frequently lead to care dependency, the role of social determinants is not yet well understood. The purpose of this study was to examine the effect of social determinants on care dependency onset and progression.

We used data from the Berlin Initiative Study, a prospective, population-based cohort study including 2,069 older participants living in Berlin.

Care dependency was defined as requiring substantial assistance in at least two activities of daily living for 90 minutes daily (level 1) or three+ hours daily (level 2). Multi-state time to event regression modeling was used to estimate the effects of social determinants (partnership status, education, income, and sex), morbidities, and health behaviors, characteristics and conditions.

During the study period, 556 participants (27.5%) changed their status of care dependency. Participants without a partner at baseline were at a higher risk to become care-dependent than participants with a partner (HR, 95% CI: 1.24 (1.02-1.51)). After adjustment for other social determinants, morbidities and health behaviors, characteristics and conditions the risk decreased to a hazard ratio of 1.19 (95%CI: 0.79-1.79).

Results indicate that older people without a partner may tend to be at higher risk of care dependency onset but not at higher risk of care dependency progression. Clinicians should inquire about and consider patients' partnership status as they evaluate care needs.

The authors declare that they have no competing interests.

The authors declare that a positive ethics committee vote has been obtained.