Examining Health Conditions as Predictors of Unmet Need in Older Adults

Abstract

According to current research, unmet need for activities of daily living (ADLs) are associated with greater negative health outcomes in older adults. ADLs include eating, bathing, dressing, transferring from a bed or a chair, and toileting. As the U.S. population ages, it is vital to identify predictors of unmet need in order to interrupt this progression and improve quality of life throughout the aging process. In our analysis, we evaluated chronic and acute health conditions, such as high blood pressure, osteoporosis, and cancer, as predictors of unmet need. We distinguished self-care and mobility-specific types of unmet need, and computed the frequencies of each condition and unmet need of each type. We then used the Chi Square (Χ²) and Fisher’s Exact tests to evaluate relationships for statistical significance. Through these analyses, we have identified dementia (p=0.04), heart attack (p=0.04), and stroke (p=0.02) as having significant associations with unresolved unmet need. Working from a disablement model theoretical framework that distinguishes between actual and intrinsic disability, we recommend a large-scale shift from the diagnostic healthcare model to more preventative model of healthcare. Specifically, we suggest providing free or affordable mobility assistance upon diagnosis of heart attack or stroke and free or affordable self-care assistance upon diagnosis of dementia, thus reducing future hospitalization costs and bridging the gap between human physical/mental capacity and environmental demand. We recommend further research be done to evaluate the causal relationship between chronic and acute health conditions and unmet need.

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