Clinical characteristics and patterns of health deficits of centenarians receiving home care and long-term care services

• Published in: Experimental gerontology 2017-12, Vol.99, p.46-52
• Main Authors: Freeman, Shannon, Armstrong, Joshua J., Tyas, Suzanne L., Neufeld, Eva
• Format: Article
• Language: English
• Subjects: Age Factors; Aged, 80 and over; Aging - psychology; Cluster Analysis; Cognition Disorders - diagnosis; Cognition Disorders - epidemiology; Cognition Disorders - psychology; Cognition Disorders - therapy; Dependent Ambulation; Depression - diagnosis; Depression - epidemiology; Depression - psychology; Depression - therapy; Female; Geriatric Assessment; Geriatrics; Home Care Services; Homes for the Aged; Humans; Longevity; Male; Mental Health; Mobility Limitation; Nursing home; Nursing Homes; Oldest old; Ontario - epidemiology; Urinary Bladder Diseases - diagnosis; Urinary Bladder Diseases - epidemiology; Urinary Bladder Diseases - physiopathology; Urinary Bladder Diseases - therapy
• ISSN: 0531-5565; 1873-6815
• DOI: 10.1016/j.exger.2017.09.010

Centenarians (persons aged 100years and older) are one of the fastest growing cohorts in countries across the world. With the increasing prevalence of centenarians and growing amount of clinical information in large administrative health databases, it is now possible to more fully characterize the health of this unique and heterogeneous population. This study described patterns of health deficits in the centenarian population receiving care from community-based home care services and long-term care facilities (LTCFs) in Ontario, Canada. All centenarians who received home care and were assessed using the interRAI-Home Care Assessment instrument between 2007 and 2011 (n=1163) and all centenarians who resided in LTCFs between 2005 and 2011 who were assessed using the interRAI Minimum Data Set (MDS 2.0) (n=2228) were included in this study. Bivariate analyses described the centenarian population while K-means clustering analyses were utilized to identify relatively homogeneous subgroups within this heterogeneous population. The 3391 centenarians were aged 100 to 114 (mean age 101.5years ±1.9 SD) and the majority were women (84.7%). Commonly reported deficits included cognitive impairment, physical impairment, and bladder problems. Centenarians residing in LTCFs were significantly more likely than centenarians receiving home care services to report cognitive or functional impairment, or to exhibit symptoms of depression. The commonalities and uniqueness of four clusters of centenarians are described. Although there is great variability, there is also commonality within the centenarian population. Recognizing patterns within the heterogeneity of centenarians is key to providing high-quality person-centered care and to targeting health promotion and intervention strategies. •K-means clustering analyses identified 4 centenarian subgroups. Each cluster showed varying levels of clinical complexity.•Centenarians experience a wide variety of health deficits that are inter-related, resulting in common patterns of deficits.•When compared to national estimates, centenarians reported lower prevalence of diabetes, cancer and respiratory diseases.