Trajectories of Health Status in Older People

One of the main successes of healthcare is the continuing increase in life expectancy. This challenges both older people themselves and the society due to the increase in people aged 80 years and over in the coming decades. Older people want to live as independently and healthy for as long as possible. It is therefore important to recognize early signs of health status deterioration in older people, so that effective actions can be undertaken at an early stage, by the elderly themselves and by informal caregivers.
This dissertation showed that:
1. Measuring change in health status is not straightforward. Some common and frequently used instruments to measure functional status and frailty status in geriatrics appeared suitable for research purposes, but only at group level. These instruments are not suitable for measuring change in the health status of individual older patients.
2. A small decline in activities of daily living during hospitalization does not reflect the functional decline as experienced by the patient.
3. Chronic illnesses and frailty are predictive of unfavorable health status trajectories in both community-dwelling older people and older hospitalized patients.
4. Improving lifestyle behavior and reducing fatigability potentially reverse or positively affect the negative trend of an unfavorable health status.
5. Further research is needed to identify older people who will benefit the most from interventions to positively affect negative health outcomes. Only then can concrete recommendations be formulated for developing targeted interventions.