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Biomedical subjects

E Grundy

Publications and source records attributed to E Grundy.

At least 19 recordsLinked to original sources
PubMed2000

Socio-demographic differences in the onset and progression of disability in early old age: a longitudinal study.

OBJECTIVES: to analyse socio-demographic differences in the onset and progression of disability. DESIGN: analysis of a cohort of people aged 55-69 in 1988-9 and in 1994. SUBJECTS: a representative sample of 3543 adults. METHODS: we measured severity of disability at baseline and follow-up. We analysed variations in incidence and progression of disability by using logistic regression. RESULTS: Baseline severity of disability was similar for men and women but varied by age group, social class, educational qualifications and housing tenure. At follow-up, 36% had worse disability, 12% better and 53% the same as at baseline. Increased severity of disability and new incidence of disability were associated with lower socioeconomic status, baseline self-rated health status, age and gender. High initial levels of disability were associated with improvement at follow-up. CONCLUSION: disability can be dynamic, although deterioration is more usual than improvement. The reasons for the associations found between disability and socio-economic status are unclear.

Aged↗
PubMed1999

Looking beyond the household: intergenerational perspectives on living kin and contacts with kin in Great Britain.

In this article we present the first results from a special module on kin and contact with kin included in the Omnibus Survey earlier in 1999. Our results show that nearly everybody in contemporary Britain has a living parent or a living child, and many have both. Membership of three generational families is now common and quite large minorities of very old people aged 80 and over are members of families including four living generations. Half or more of those with a father, mother or (eldest) child alive see them at least once a week and exchanges of help between mothers and their own mothers are common. Half of those who have the relatives considered, live within half an hour's journey time of them, and half of the sample live within half an hour of the place where they spent most of their childhood. The results show that in contemporary Britain the vast majority has close relatives in different generations with whom they are in regular contact.

Adult↗
PubMed1997

Activities of daily living: changes in functional ability in three samples of elderly and very elderly people.

OBJECTIVES: to investigate changes in functional ability and physical health, psychiatric morbidity, life satisfaction, service use and social support. DESIGN: a structured interview survey of three samples of elderly people living at home at two points in time. The three samples comprised one census of people aged 85 and over [City (of London) and Hackney], and two random samples of people aged 65-84 (City and Hackney and Braintree). The follow-up interviews took place 2.5-3 years after the baseline interviews. SETTING: City and Hackney (East London) and Braintree (Essex). Respondents were interviewed at home by one of 12 trained interviewers. SUBJECTS: 630 people aged 85+ at baseline (70% response rate) and 78% of survivors re-interviewed at follow-up; 464 people aged 65-84 in Hackney at baseline (67% response rate), and 83% of survivors re-interviewed; 276 people aged 65-84 in Braintree at baseline (82% response rate), and 78% of survivors re-interviewed. MAIN OUTCOME MEASURES: scores on scales of functional ability, psychiatric morbidity, life satisfaction and social support, and items measuring number and type of health symptoms and services used. CONCLUSIONS: decreasing levels of physical functioning were associated with poor mental health, trouble with feet and problems with muscles and joints. There were no associations with level of physical functioning and use of rehabilitative or general medical services, use of social worker or carer relief. Few respondents used preventive or rehabilitation services.

Activities of Daily Living↗
PubMed1997

Trends in, and transitions to, institutional residence among older people in England and Wales, 1971-91.

OBJECTIVES: To compare transitions from private households to institutions between 1971-81 and 1981-91 among elderly people and see whether (1) differentials in the risk of institutionalisation changed and (2) whether the risk was higher in the second period. DESIGN: Cross sequential analysis of data from the Office of National Statistics longitudinal study, a record linkage study which included individual level data from three national censuses, (1971, 1981, and 1991) and linked vital registration data. SUBJECTS: Altogether 26,400 people aged 65 and over in 1971-81 and 32,500 persons aged 65 and over in 1981-91. These samples represent 1% of the population of England and Wales. RESULTS: In both periods models including age, housing tenure, and marital status or household/family type terms fitted the data reasonably well. The effect of age was stronger in the second decade, while that of marital status was reduced. The risk of transition to an institution was nearly 33-52% higher in the second decade after controlling for these factors. CONCLUSIONS: During the 1980s the availability of state financed institutional care increased substantially; a growth which the 1990 NHS and Community Care Act was designed to reverse. Increased access to institutional care undoubtedly is one factor underlying the higher transition rate to institutions observed in 1981-91 than for the previous decade. During 1981-91, transitions to live with relatives also declined substantially. It is not clear whether this simply represents the continuation of a previous trend or whether the increased availability of institutional care led to some substitution for family care. Either interpretation has worrying implications for policy makers keen to promote care in the community.

Age Factors↗
PubMed1993

Changes in life satisfaction over a two and a half year period among very elderly people living in London.

Research evidence concerning the contributions of social networks and support to the subjective wellbeing (i.e. life satisfaction) of older persons is not consistent. This paper reports the results of an investigation of the effects life satisfaction at baseline, social network type and health status, on life satisfaction at follow-up at two and a half years later among people ages 85+ living in the East end of London. The percentage of the total variation in overall life satisfaction which was explained by the model was 47%. Baseline life satisfaction score explained most of this (43%), and the remaining variation was explained largely by functional status and age. Previous analyses of baseline life satisfaction reported that health and functional status had accounted for most of the variation between groups, far more than social network and support variables.

Activities of Daily Living↗
PubMed1987

Community care for the elderly 1976-84.

The aging of the elderly population is of crucial importance as people who are over 80 make far greater use of health and social services than any other age group. Government guidelines on the provision of services, which are generally related to the whole population aged 65 and over, fail to take account of this change in the age structure of the elderly population and are no longer appropriate. Recent trends in the provision of domiciliary services, day care, specialist housing for the elderly, and residential care have been related to changes in the number of potential consumers. Ironically, despite the government's stated commitment to "community care," the chief growth area has been private institutional care. The number of day care places and sheltered housing units has also increased in real terms, but the provision of domiciliary services, such as home help and health visitor visits to the elderly, has either fallen behind or barely matched the increase in the number of very old people. If community care is to be made a reality and if the present inadequate levels of service are to be maintained, let alone improved, then additional resources, greater cooperation among agencies, and a more imaginative approach to the development and delivery of services are urgently needed.

Aged↗
PubMed1986

60 years of suicide in England and Wales. A cohort study.

In a cohort analysis of suicides recorded in England and Wales from 1921 to 1980, there was no discernible trend across the younger cohorts, but there was a fall in the suicide rates of successive older cohorts over this period. The impact of period events (eg, World War II and the detoxification of domestic gas) is demonstrated in these cohorts. In addition to the period effects, there was evidence of a more prolonged cohort effect on suicide rates of the middle-aged and elderly associated with these events. Little relationship was found between early and later suicide rates within cohorts, casting doubt on the usefulness of predicting the future rates of cohorts from their early behavior.

Adolescent↗
PubMed1986

A controlled trial of antidepressant medication in elderly in-patients.

A multi-centre controlled trial of amitriptyline, dothiepin and mianserin in the treatment of depressive illness was undertaken in psychiatric inpatients over the age of 65. Despite the co-operation of many of the leading practitioners in this field in Great Britain, it proved impossible to recruit sufficient patients for firm conclusions to be drawn. Forty-five patients were entered into the trial, 13 withdrew because of lack of improvement, 4 because of intercurrent physical illness, 3 because of adverse effects of trial medication and 2 because of lack of compliance. Only 11 of the 23 patients completing had a final score on the Hamilton Depression Rating Scale of 10 or less. No treatment showed a significant superiority over the others, nor was there any difference in tolerance.

Aged↗
PubMed1984

A comparative study of bed usage by younger and older patients with depression.

Recent follow-up studies of depression in old age have highlighted the high relapse rate in older patients compared with younger patients. The consequences for the provision of acute psychiatric beds for elderly patients has been investigated by comparing the usage of beds by younger and older patients with depression over a 4-year period. Overall, elderly depressed patients consumed one and a half times as many bed days as younger depressed patients and a quarter of all acute bed days available in the hospital were used by elderly depressed patients.

Adolescent↗
PubMed1984

Institutionalization and the elderly: international comparisons.

This paper is an exploratory attempt to examine international differences in the proportion of old people living in non-private households. The aim of the study was to provoke further discussion of the role which institutions play in the care of the elderly in various settings and to examine the effect of certain demographic and economic parameters on the proportion of elderly people in non-private households. Data were drawn from national censuses and indirect standardization was used to allow comparison of the probability of institutionalization in the countries considered. Considerable variation in standardized institutionalization ratios was found but this variation was not significantly associated with any of the demographic or economic variables considered.

Aged↗
PubMed1983

Demography and old age.

Demography is of great importance for those involved in caring for the elderly or in planning services. In this paper, current and future variations in the proportions of elderly people around the world are reviewed. The determinants of age structure are considered, and aging and aged populations are defined and discussed. The consequences of population aging extend into every sphere of life; particular attention is paid to the health service and economic implications. Attitudes to population aging and some of the special characteristics of the elderly in the West today are also considered. The paper concludes with a discussion of probable future trends in both the developed and the less developed parts of the world.

Adolescent↗
PubMed1982

Falling rate of provision of residential care for the elderly.

The rapid increase in the number of very aged people has not been accompanied by appropriate expansion of local authority residential facilities. The rate of provision in 1976 was already acknowledged to be inadequate, but data are now presented to show that since then there has been an effective fall in the rate of provision of some 9000 places equivalent to, say, 180 old people's homes of 50 places each. The prospects for the future are even gloomier: public spending cuts and local authority priorities suggest a continuing fall in the rate of provision that can be expected to have a profound effect on the National Health Service, on the burden on families, and on the condition in which old people are obliged to remain "in the community" (where support services have likewise failed to keep pace with demographic change).

Age Factors↗