21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Aspects of Home and Health over Nine years among Very Old People in Latvia and Sweden
CHARLOTTE LÖFQVIST2 PHD, REG OT, MARIA HAAK2 PHD, REG. OT
CO-AUTHORS: SIGNE TOMSONE1, VIBEKE HORSTMANN2, SUSANNE IWARSSON2
1 Riga Stradins University, Department of Rehabilitation2 Lund University, Department of Health Sciences,
Centre for Aging and Supportive Environments
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Aim
To present preliminary results from a longitudinal study on
home and health among single-living very old people in
Latvia and Sweden, 2002-2011
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Changes Latvia Sweden
2002 2011 2002 2011
Population, mil. 2.3 2.2 8.9 9.5
Over working age, % 21.6 20.2 17.2 18.5
Life expectancy for males / females
65/77 69/78 78/82 80/84
Unemployment, % 8.5 14.3 6.5 8.5
Health care expenses, % of GDP
6.3 6.2 9.2 9.4
Average pension per month,USD
100 333 1 200 2 100
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Material and methods
Data from the Latvian and Swedish parts of the ENABLE-AGE Survey Study:• Baseline (2002/2003) • Follow-up (2011)• Single living • Urban regions in Latvia
(Riga and Jūrmala) and
Sweden (Lund, Helsingborg,
Halmstad)
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Study participants Latvia
N=303, 75-84 yrs
N=59, 86-90 yrs
Baseline2002/03
Follow-up2011
Sweden
N=397, 80-89 yrs
N=67, 91-99 yrs
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Reasons for drop-out
• Deceased• Health reasons • Not possible to reach (more common in Lv than Sw) • No interest in participating
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
InstrumentsHousing Health
Objective
- Part of The Housing Enabler (Iwarsson, S.& Slaug,B., 2001) - nb of environmental barriers,184 items
- (188 – communication)
- Part of The Housing Enabler (Iwarsson, S.& Slaug,B., 2001) - functional limitations, 15 items
- ADL Staircase (Hulter Åsberg & Sonn, 1989; Sonn & Hulter Åsberg, 1991), difficulty in performing 9 activities
Perceived
- Housing satisfaction (Sixsmith & Sixsmith, 2000), single question
- Housing related control beliefs -external (Oswald, Wahl, Martin, & Mollenkopf, 2003), 16 items
- Meaning of home (Oswald, Mollenkopf, & Wahl, 1999), 23 items
- Geriatric depression scale (Yesavage & Brink, 1983), 15 items
- Perceived functional independence (Oswald et al., 2001), single question
- Perceived health (Sullvan & Karlsson, 1994), single question
- Perceived physical mobility (Sullvan & Karlsson, 1994), single question
- Life satisfaction, single question
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Results: Participants description At baseline Participants Lv
N=59Participants Sw
N=67Age, years, Md (q1,q3) 78 (77-81) 83 (81-86)
Sex, males, n (%) 6 (10) 14 (21)
Lv/Sw identity, n (%) 42 (71) 67 (100)
Marital status, widowed, n (%) 35 (59) 48 (72)
Type of housing, multifamily, n (%)
51 (86) 59 (88)
Number of rooms, Md 1 3
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Results: Objective housingLatvia, N=54 Sweden, N=58
Changes 2002-2011 in each country
Direction of changes P-value Direction of changes P-value
Environmental barriers
Indoor (0-100) Higher nb ** Higher nb ***
Outdoor (0-33) n.s. n.s.
Entry (0-49) Higher nb *** Higher nb ***
p<.05*, p<.01**, p<.001***
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Results: Perceived housingLatvia, N=54 Sweden, N=58
Changes 2002-2011 in each countryDirection of changes
P-value Direction of changes P-value
Housing satisfaction (1- 5) Unchanged (n=14)
Increased (n=13)
Decreased (n=24)
n.s.
Unchanged (n=43)
Increased (n=9)
Decreased (n=5)
n.s.
Housing related control beliefs, external control (1-5)
Slightly higher external control believe
n.s.
Higher external control believe
***
Meaning of home (0-10)
- physical bonding More important * Less important *
- behavioral bonding Slightly less important
n.s. Less important **
- cognitive emotional bonding More important *** Slightly less important n.s.
p<.05*, p<.01**, p<.001***
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Results: Objective healthLatvia, N=59 Sweden, N=67
Changes at individual and group level 2002-2011 in each country
Direction of changes P- value Direction of changes P- value
Nb. of functional limitations, 15 items
Increased * Increased ***
P-ADL, nb. of items performed without difficulty, 5 activities
Unchanged (n=9)
Increased (Better) (n=6)
Decreased (Worse) (n=44)
*** Unchanged (n=30)
Increased (Better) (n=19)
Decreased (Worse) (n=18)
n.s.
I-ADL, nb. of items performed without difficulty, 4 activities
Unchanged (n=7)
Increased (Better) (n=5)
Decreased (Worse) (n=47)
*** Unchanged (n=20)
Increased (Better) (n=5)
Decreased (Worse) (n=42)
***
Statistical tests for differences: Wilcoxon signed rank test with p<.05*, p<.01**, p<.001***
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Results:Perceived health Latvia, N=59 Sweden, N=67
Changes at individual and group level 2002-2011 in each country
Direction of changes P- value Direction of changes P- value
Depression score 0.04 (-3,1.57) n.s. 1(0;2.03) ***
Perceived health, 1- 5 Unchanged (41)
Better health (13)
Worse health (4)
* Unchanged (17)
Better health (15)
Worse health (35)
*
Perceived functional independence, 1- 10
Unchanged (16)
Less dependent (7)
More dependent (33)
*** Unchanged (24)
Less dependent (4)
More dependent (35)
***
Perceived physical mobility, 1- 5
Unchanged (6)
Better mobility (5)
Worse mobility (45)
** Unchanged (8)
Better mobility (28)
Worse mobility (31)
n.s.
p<.05*, p<.01**, p<.001***
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Latvia, N=59 Sweden, N=67
Changes at group level 2002-2011 in each country
Baseline Follow-up P-value
Baseline Follow-up P-value
Depression score 5 4 n.s. 2 3 ***
Health, 1- 5 * 4 4 * 2 3 *
Functional independence, 1- 10**** Higher score indicate higher independence
8 6 *** 10 8 ***
Physical mobility, 1- 5** Higher score indicate worse health/mobility
4 4 (4; 4.25) ** 2 (2; 3) 3 (2; 3) n.s.
p<.05*, p<.01**, p<.001***
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Results: Life satisfactionLatvia, N=59 Sweden, N= 67
Changes at individual and group level 2002-2011 in each country (n)
P-value
P- value
Life satisfaction (0-10)
Unchanged (12)Better satisfaction (30)Worse satisfaction (12)
** Unchanged (18)Better satisfaction (24)Worse satisfaction (22)
n.s.
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Concluding remarks
• One of the first studies of detailed information among very old people taking housing as well as health aspects into account.
• Objective and perceived aspects of home changes over time even in advanced age.
• Need to be further investigated in order to develop suitable and appropriate services and living conditions for very old people in different European contexts.
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Thank you for your attention!
For more information please contact: [email protected] or [email protected]
Please visit us on the web: http://www.med.lu.se/case
21 May 2013 Home and Health Workshop / Charlotte Löfqvist, Maria Haak
Discussion
• How does these results on housing and health correspond with our experiences of very old peoples everyday life in Latvia?
• Perceived aspects of housing – why does it differ between countries – according to satisfaction, control believe, meaning of home etc?