Ways to evaluate how well people are aging taking the complexity of their health status into account
Hi Giola Santoni, PhD student at the Aging Research Center. On 6 June you will defend your thesis "How well are we aging? Capturing the complexity of health trajectories of older adults”, what´s the main focus of the thesis?
“The aim of this thesis was to evaluate how well people are aging, taking the complexity of their health status into account. Despite its positive nature, population aging represents a public health challenge that could be alleviated by maintaining good health during older age. To this aim, we verified temporal trends of disability in the older Swedish adults between 1991-2010 taking into account occurrence, number of years of life lived with disability. We also developed a health assessment tool (HAT) for older people by using four clinical indicators (physical function, cognitive function, morbidity, and disability) and detected age-related variation and individual health trajectories over time. Finally, we proposed a novel approach to monitor older individuals’ health changes through reference health curves that can help delineate ad-hoc public health and care actions”
Which are the most important results?
“Time trends in disability remained stable over 20 years (1991-2010), and at the same time, the increase in life expectancy during recent years appeared to be driven by longer lives of functionally independent people. The health status of this urban Swedish population is fairly good; however, age 80-85 is a transitional period when major health changes take place, often following the co-occurrence of more than one negative health event. HAT, composed of relatively few items, may help assess and identify deviations from expected health trajectories at the individual level and determine medical, rehabilitation, or social care needs at the population level. Determination of individual-level deviations can be facilitated by creating reference health curves similar to the growth charts used by pediatricians”.
How can this new knowledge contribute to the improvement of human health?
“A simplistic conceptualization of health, as the absence or presence of chronic conditions, does not provide a holistic representation of health that enables first researchers to find the best strategies to prolong, reverse, or cope with health changes and losses; and second, public health providers to promote actions to foster health and well-being during older adulthood.
Our findings are encouraging, as they clearly show prevalence of disability is not increasing, but instead is remaining stable, or even tending towards a decline. This positive picture was persistent even when we analyzed the other health indicators separately and together through the HAT. However, the shorter longevity of the disabled people in our sample warns us that there is room for further improvements. With geriatric health charts we envision the possibility for health care providers and policy makers to asses with more reliability the needs of people in terms of health and service care. A prompt and well target response to the health needs of people is key for a society were aging is viewed as a resource and experienced as a positive moment of life”.
What´s in the future for you? Will you keep on conducting research?
“I would like to continue with my research. To plan for future health service and long-term care needs of the population the HAT could indicate what part of the population consume more resources in terms of health services utilization and the need for formal and informal long-term care. The ultimate aim would be to identify subgroups of older adults suitable for interventions aimed at cost containment and prevention of negative health care outcomes”.
Read more here.