Longitudinal Analysis of Mortality for Older Adults Receiving or Waiting for Aging Network Services.

Abstract

For older adults screened by an Area Agency on Aging (AAA) in the National Aging Network, we aimed to examine the 12-month mortality rate for wait-listed callers compared with those who received services within 12 months, and to assess whether the mortality rate differed according to how quickly they received services. The design was a longitudinal analysis of 3 years of AAA administrative data, using survival analysis. The data source was administrative data from an AAA spanning a five-county region in west central Florida. All older adults (age 60 y and older) screened for service eligibility from July 15, 2013, to August 15, 2015, who completed initial screening during the study period were included (N = 6288). The outcome was mortality within 12 months of the initial screening. Covariates included demographics, caregiver status, health status, access to healthcare, and AAA service status. In the first survival analysis, the strongest predictor was waiting for services compared with receiving services; waiting increased the odds to die vs not to die by 141%, after controlling for health status and other covariates. In the second survival analysis, those who received services within 0 to 3 months had a higher mortality risk compared with those who received services within 6 to 9 months or 9 to 12 months. Older adults placed on aging service waiting lists may be at a greater risk of mortality within 12 months than those receiving services. Given that rapid receipt of services was less protective than receiving services later, those prioritized to receive services quickly may be at very high risk of adverse outcomes. Findings raise the possibility that aging services may lower mortality, although additional services may benefit those waiting long periods for services, as well as those eligible for services rapidly. Research is needed to replicate and extend these findings. J Am Geriatr Soc 68:519-525, 2020.