The Study for Improvement of Frailty and Depression in the Health Vulnerable Elderly of Home Visiting Health Care Service

ABSTRACT

BACKGROUND: Home health-care services have been implemented to promote health among older adults (medicare beneficiaries and low-income or vulnerable older adults) with health conditions, though there is limited evidence to support their effectiveness. This study aimed to identify improvements in frailty and depression in vulnerable older adults who received home health-care services. METHODS: We used a database comprised of approximately 15,053 older adults residing in the Seoul metropolitan area having received home health-care services from 2008 to 2011. Frailty was measured using the Otasha-Kenshin scale, and geriatric depression was measured using the short-form Geriatric Depression Scale. RESULTS: We observed a significant decline in the prevalence of frailty and depression symptoms in vulnerable older adults between 2009 and 2011 (p<0.001). Logistic regression analysis found that the decreased prevalence observed in vulnerable older adults was statistically significant for both frailty (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.43-0.63; p<0.001) and depression (OR, 0.61; 95% CI, 0.51-0.72; p<0.001). A greater decrease was observed among the younger elderly subjects. CONCLUSION: This study showed that frailty and depression were significantly improved in the vulnerable older adults who received home health-care services. These services need to focus on high-risk groups with frailty and depression. In particular, early intervention is needed for younger elderly people, and more professional and focused management is needed for those aged 85 and above.