ABSTRACT
Background and Objectives: Sexual satisfaction is an important part of sexual health and overall well-being. A large number of older people continue to be sexually active, and many are satisfied with their sex life. However, little is known about whether sexual satisfaction differs according to sexual orientation. Therefore, the aim of the study was to investigate whether sexual satisfaction differs according to sexual orientation in later life. Research Design and Methods: The German Ageing Survey is a nationally representative study of the German population aged 40+. In the third wave (2008), data on both sexual orientation (heterosexual, homosexual, bisexual, other) and sexual satisfaction (1-very dissatisfied to 5-very satisfied) were collected. Multiple regression analyses with sampling weights were performed (stratified by age: 40-64; 65+). Results: We included 4,856 individuals in our analysis (mean age 57.6 ± 11.6; 40-85 years, 50.4% were women, 92.3% (n = 4,483) were heterosexual, and 7.7% (n = 373) were sexual minority adults). In sum, 55.9% of heterosexual individuals and 52.3% of sexual minority adults were satisfied or very satisfied with their sex life. Multiple regression analysis showed that sexual orientation was not significantly associated with sexual satisfaction among both middle-aged (ß = 0.07; p = .45) and older adults (ß = 0.01; p = .87). Higher sexual satisfaction was associated with lower loneliness scores, partnership satisfaction, importance of sexuality and intimacy, and better health status. Discussion and Implications: Our analysis showed that sexual orientation was not significantly associated with sexual satisfaction among both middle-aged and older adults. Lower loneliness, better health status, and partnership satisfaction significantly contributed to higher sexual satisfaction. Approximately 45% of older individuals (aged 65 years and older), regardless of their sexual orientation, were still satisfied with their sex life.
ABSTRACT
Aim: The aim of this study was to investigate the frequency of and the gender differences in the use of professional home care in Germany. Methods: We used harmonized data from three large cohort studies from Germany ("Healthy Aging: Gender-specific trajectories into the latest life"; AgeDifferent.de Platform). Data were available for 5,393 older individuals (75 years and older). Mean age was 80.2 years (SD: 4.1 years), 66.6% were female. Professional homecare outcome variables were use of outpatient nursing care, paid household assistance, and meals on wheels' services. Logistic regression models were used, adjusting for important sociodemographic variables. Results: Altogether 5.2% of older individuals used outpatient nursing care (6.2% women and 3.2% men; p < 0.001), 24.2% used paid household assistance (26.1% women and 20.5% men; p < 0.001) and 4.4% used meals on wheels' services (4.5% women and 4.0% men; p = 0.49). Regression analysis revealed that women had higher odds of using paid household assistance than men (OR = 1.48, 95% CI: [1.24-1.76]; p < 0.001), whereas they had lower odds of using meals on wheels' services (OR = 0.64, 95% CI: [0.42-0.97]; p < 0.05). No statistically significant differences in using outpatient nursing care between women and men were found (OR = 1.26, 95% CI: [0.87-1.81]; p = 0.225). Further, the use of home care was mainly associated with health-related variables (e.g., stroke, Parkinson's disease) and walking impairments. Conclusions: Our study showed that gender differences exist in using paid household assistance and in culinary dependency. For example, meals on wheels' services are of great importance (e.g., for individuals living alone or for individuals with low social support). Gender differences were not identified regarding outpatient nursing care. Use of professional home care services may contribute to maintaining autonomy and independence in old age.
ABSTRACT
Objective: The aim of this study was to investigate the longitudinal impact of depressive symptoms on utilization of healthcare in terms of GP visits as well as specialist visits and hospital admission in late life among community-dwelling individuals. Methods: Longitudinal data (baseline and follow-up) were derived from the German multicentre, prospective cohort study "Late-life depression in primary care: needs, health care utilization and costs" study (AgeMooDe). At baseline, n = 1,230 patients aged 75 years and older were recruited from primary care practices. Main outcomes of interest were use of health care services: the number of GP visits, the number of medical specialist visits, and hospital admission. We used the Geriatric Depression Scale (GDS-15) to measure depression. Outcomes were analyzed with multilevel random intercept negative binominal regression and logistic random-effects models. Results: At baseline (n = 1,191), mean age was 80.7 (SD 4.6) years, 62.9% were female, and 196 individuals (16.5%) had depression (GDS-15 ≥6). Our longitudinal analyses indicated that older individuals with more depressive symptoms visited their GP more often (IRR=1.03; CI [1.01-1.04], p < 0.001), were visiting medical specialists more frequently (IRR=1.03; CI [1.01-1.04], p < 0.01), and had higher odds of being hospitalized (OR=1.08; CI [1.02-1.13], p < 0.01). Conclusions: Based on this large longitudinal study we showed that, after adjustment for important covariates, older individuals with more depressive symptoms had higher health care utilization over time. They visited their GP and specialists more frequently and they had higher odds of being hospitalized. This may suggest that higher utilization of specialist care and increased likelihood of being hospitalized may be also attributable to unspecific symptoms or symptoms that are elevated through depressive symptoms.
ABSTRACT
Objective: Since there is a lack of longitudinal studies in this area, our aim was to identify the determinants of persistent frequent attendance in primary care among the oldest old in Germany. Methods: Longitudinal data (follow-up wave 7-9) were taken from the multicenter prospective cohort "Study on needs, health service use, costs, and health-related quality of life in a large sample of oldest-old primary care patients (85+)" (AgeQualiDe), covering primary care patients ≥ 85 years (FU7 n = 741, mean age 88.9 years (SD 2.9; 85-100)). Persistent frequent attenders of general practitioner (GP) services (the patients in the top decile of the number of GP consultations in two or more consecutive waves) were our main outcome of interest. Logistic random-effects models were used. Results: Our analysis included 1,891 observations (766 individuals). Across three waves, we identified 56 persistent frequent attenders. Results of random-effects logistic regressions showed that the odds of being persistent frequent attender were higher for widowed individuals (OR = 4.57; 95% CI [1.07-19.45]). Moreover, a one-point increase in the frailty score and having one more chronic condition increased the odds of being a persistent frequent attender by 68% (OR =1.68; 95% CI [1.05-2.69]) and 23% (OR=1.23, 95% CI [1.05-1.44]), respectively. Conclusion: Our study stressed the longitudinal association between frailty and widowhood as well as chronic diseases and persistent frequent attendance among the oldest old in Germany.
ABSTRACT
Aim: The aim of the study was to investigate the effect of the onset of Parkinson's disease (PD) on life satisfaction. Method: Data from 2008, 2011, and 2014 were used from a population-based prospective cohort (German Ageing Survey; 8,982 observations in FE regression analysis) of community-residing individuals in the second half of life (≥40 years) in Germany. Satisfaction with life was quantified using the established Satisfaction with Life Scale. Physician-diagnosed PD was reported. Results: In total, 48.9% were female. The mean age was 63.8 years (±11.3 years). Average life satisfaction equaled 3.8 (±0.7). Linear fixed effects regressions revealed that the onset of PD was associated with a considerable decline in life satisfaction (ß = -0.37, 95% CI -0.69 to -0.05, p < 0.05). This effect was significantly more pronounced in men. Moreover, a decrease in life satisfaction was associated with younger age, changes from "employed" to "not employed," worsening self-rated health, the onset of depression, and an increase in the number of physical illnesses. Conclusions: The onset of PD is associated with a marked reduction of life satisfaction among individuals in the second half of life in the total sample and in men, but not in women. For example, this effect was about twice as large as the effect of depression on life satisfaction. Moreover, the effect of PD on life satisfaction was more pronounced than the effect of a strong decrease in self-rated health (from "very good" to "very bad") on life satisfaction. Effective treatment of symptoms might contribute to maintaining life satisfaction.
