Abstract
A preventive home visitation scheme has been part of Danish legislation since 1996. The aim of this study was to describe functional trajectories of older home-dwelling people, and to identify whether education of the preventive home visitation staff and individual risk factors were related to specific functional decline patterns. The study is a secondary analysis of a population-based prospective controlled cohort study. Participation totalled 3,129 non-disabled 75- and 80-year-old men and women without mobility disability at baseline living in 34 municipalities. Self-reported functional ability was measured at baseline and after 1½, 3 and 4½ years follow-up. No functional decline was seen in 58% of the participants. A total of 17% developed catastrophic decline, 6% progressive and 7% showed a reversible decline pattern. The remaining 12% showed mixed patterns. Education of the preventive home visitation staff was associated with a reduced risk of progressive decline, RR = 0.66 (CI 95% 0.50–0.86, p = 0.002). Not receiving home visits and living alone were associated with increased risk of catastrophic decline. Younger age (75 at baseline) was less associated with all decline patterns compared with older age (80 at baseline). Men had less risk of developing progressive, reversible and mixed decline patterns than women, but an increased risk of developing catastrophic decline. A feasible educational preventive staff intervention was associated with a reduced risk of progressive functional decline but not with other functional decline patterns. Early signs of functional decline may serve as an important trigger for when to intensify the search for and actively seek to ameliorate preventable conditions.
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Acknowledgments
We thank all participating municipalities and Eva Jepsen, Lisbeth Villemoes Sørensen and Annette Johannesen for following up the questionnaires. We are indebted to Christian Cato Holm for data management.
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None. The corresponding author has full access to all the data in the study, and has taken final responsibility for the decision to submit for publication.
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This study was supported by grants from the Danish Ministry of Social Affairs, the Danish Medical Research Council, the Research Foundation for General Practice and Primary Care, the Eastern Danish Research Forum, and the County Value-Added Tax Foundation and the Aase and Ejnar Danielsen Foundation. None of these funding sources have any involvement in study design, data collection, data analysis, interpretation of data, writing of the paper or the decision to submit for publication.
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Vass, M., Avlund, K., Parner, E.T. et al. Preventive home visits to older home-dwelling people and different functional decline patterns. Eur J Ageing 4, 107–113 (2007). https://doi.org/10.1007/s10433-007-0059-z
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DOI: https://doi.org/10.1007/s10433-007-0059-z