Association of long-term care utilization and functional ability in older adults

Abstract

Abstract Background Healthy Ageing is the process of developing and maintaining the functional ability that enables wellbeing in older age as per the World Health Organization (WHO). Establishing foundations necessary for improvements in long-term care (LTC) systems for increasing the world's older adults is one of the public health priorities. LTC provides assisted daily living (ADLs), instrumental assisted daily living (IDALs), healthcare, and social services. This study aims to assess the association of LTC utilization and functional ability in the two industrialized countries with a globalized aging perspective. This study would guide to identify the approaches for establishing fundamentals, developing and sustaining a trained workforce to achieve high-quality, healthy aging. Methods This retrospective longitudinal population-based study, individuals age 65 and above from the national data of the United Kingdom, UK, (English Longitudinal Study of Aging) and the United States, U.S, (Health and Retirement Study). The outcome is LTC: nursing home and home care. Predictors: functional status: scores of ADLs and IADLs, and declining ADLs and IADLs. Covariates are age, gender, marital status, income, chronic diseases. Multiple logistic regression analysis was carried out in SAS software version 9.4, p-vale (p) <0.05. Results LTC utilization (UK) is associated with declining IADLs (OR: 15.01, 95%CI: 1.62,139.23), p- 0.02 with adjustments for covariates. LTC utilization (U.S) is associated with declining ADLs (OR: 2.66, 95%CI:1.82,3.87) and IADLs (OR: 2.42, 95%CI:1.73,3.40), both at p-<0.001. With adjustment for covariates, LTC utilization (U.S) is associated with declining ADLs (OR: 2.20,95%CI:1.51,3.22), p-0.001 and declining IADLs (OR: 2.12, 95%CI:1.49,3.02), p-<0.001. Conclusions Declining functional ability is associated with LTC utilization. This study guide to improve LTC systems to develop personalized social and healthcare foundations, increase the trained workforce. Key messages To demonstrate the long-term care (LTC) utilization by declining functional capacity in the UK and the US older adults to a better understanding of the distribution of LTC utilization between them. To guide developing approaches in the improving long-term care system to achieve high-quality, healthy aging through evidence findings of this national study.