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  • 1
    Keywords: MORTALITY ; POPULATION ; HEALTH ; AGE ; VALIDITY ; OLDER-ADULTS ; prescription ; antidepressant ; SOCIAL SUPPORT ; EMERGENCY
    Abstract: Objective: The aim of this study was to evaluate the association between loneliness in elderly people with the use of psychotropic drugs. Methods: A subsample of 3111 participants (ages 55-85) of the large population-based German ESTHER study was included in the study. Loneliness was measured by using a three-item questionnaire. Two subgroups were defined according to their degrees of loneliness. Psychotropic drugs were categorized by study doctors. Logistic regression analyses were conducted to determine the association between loneliness subgroups and the use of psychotropic drugs adjusted for psychosocial variables, multimorbidity, depression, anxiety, and somatic symptom severity. Results: Of the participants 14.1% (95%-CI=[12.9; 15.4]) were estimated to have a high degree of loneliness (women 〉 men); 19% (95%-CI=[17.6; 20.4]) of the participants used psychotropic drugs, 8.4% (95%-CI=[7.5; 9.5]) antidepressants. Logistic regression analysis showed that more lonely participants had significantly higher odds for using psychotropic drugs (OR: 1.495; 95%-CI=[1.121; 1.993]). Depression severity, somatic symptom severity, and female gender were also positively associated with the use of psychotropic drugs. Conclusion: A high degree of subjective loneliness in the elderly is associated with the use of psychotropic drugs, even after adjustment for somatic and psychological comorbidities and psychosocial variables.
    Type of Publication: Journal article published
    PubMed ID: 25504324
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  • 2
    Keywords: POPULATION ; COMORBIDITY ; ACCESS ; MENTAL-HEALTH ; MULTIPLE CHRONIC CONDITIONS ; FULLY CONDITIONAL SPECIFICATION ; ILLNESS RATING-SCALE ; SOCIAL-FACTORS ; MEDICAL-CARE ; MULTIMORBIDITY
    Abstract: Background: To analyze the association of health care costs with predisposing, enabling, and need factors, as defined by Andersen's behavioral model of health care utilization, in the German elderly population. Methods: Using a cross-sectional design, cost data of 3,124 participants aged 57-84 years in the 8 year follow up of the ESTHER cohort study were analyzed. Health care utilization in a 3-month period was assessed retrospectively through an interview conducted by trained study physicians at respondents' homes. Unit costs were applied to calculate health care costs from the societal perspective. Socio-demographic and health-related variables were categorized as predisposing, enabling, or need factors as defined by the Andersen model. Multimorbidity was measured by the Cumulative Illness Rating Scale for Geriatrics (CIRS-G). Mental health status was measured by the SF-12 mental component summary (MCS) score. Sector-specific costs were analyzed by means of multiple Tobit regression models. Results: Mean total costs per respondent were 889 [sic] for the 3-month period. The CIRS-G score and the SF-12 MCS score representing the need factor in the Andersen model were consistently associated with total, inpatient, outpatient and nursing costs. Among the predisposing factors, age was positively associated with outpatient costs, nursing costs, and total costs, and the BMI was associated with outpatient costs. Conclusions: Multimorbidity and mental health status, both reflecting the need factor in the Andersen model, were the dominant predictors of health care costs. Predisposing and enabling factors had comparatively little impact on health care costs, possibly due to the characteristics of the German social health insurance system. Overall, the variables used in the Andersen model explained only little of the total variance in health care costs.
    Type of Publication: Journal article published
    PubMed ID: 24524754
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