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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Authors: | Jacqueline M Quail Vittorio Addona Christina Wolfson John E Podoba Louise Y Lévesque Josette Dupuis |
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Institution: | 1. Division of Clinical Epidemiology (DICE), McGill University Health Centre (MUHC), 1025 Pine Avenue West, Montréal, QC, Canada, H3A 1A1 4. Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Avenue West, Montréal, QC, Canada, H3A 1A2 2. Department of Mathematics and Computer Science, Macalester College, 1600 Grand Avenue, Saint Paul, MN, USA, 55105 3. Division of Clinical Epidemiology (DICE), McGill University Health Centre (MUHC), 1025 Pine Avenue West, Suite P2.028, Montréal, QC, Canada, H3A 1A1 5. Centre for Clinical Epidemiology and Community Studies, Sir Mortimer B. Davis-Jewish General Hospital, 3755 C?te Ste-Catherine, Suite A114, Montréal, QC, Canada, H3T 1E2 6. Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montréal, Canada
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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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Keywords: | Self-rated health Unmet need Cross-sectional Older adults Community dwelling |
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