Background: Frailty is a common condition in older people, and its prevalence increases with age. With an ageing population, the adverse consequences of frailty cause an increasing appeal to the health care system. The impact of frailty on population level is often assessed using adverse health outcomes, such as mortality and medication use. Use of community nursing services and services offered through the Social Support Act are hardly used in assessing the impact of frailty. However, these services are important types of care use, especially in relation to ageing in place. In this cross-sectional study, we aimed to assess the impact of frailty on use of Social Support Act services, use of community nursing services, medication use, and mortality. Methods: We used a frailty index, the FI-HM37, that was based on data from the Dutch Public Health Monitor 2016, for which respondents ≥ 65 years of age were included (n = 233,498). The association between frailty, the use of Social Support Act services, community nursing services and medication use was assessed using the Zero Inflated Poisson (ZIP) regression method. Survival analysis using Cox proportional hazards regression was conducted to estimate the hazard ratios for the association between frailty and mortality. Results: The ZIP regression with a final sample size of 181,350 showed that frailty affected care use even after correcting for several covariates mentioned in the literature. For each unit increase in frailty index (FI) score, the relative probability of using zero Social Support services decreased with 7.7 (p < 0.001). The relative chance of zero community nursing services decreased with 4.0 (p < 0.001) for each unit increase in FI score. Furthermore, for each unit increase in FI score, the likelihood of zero medication use decreased with 2.9 (p < 0.001). Finally, for each unit increase in FI score, the mortality risk was 3.8 times higher (CI = 3.4–4.3; p < 0.001). Conclusions: We demonstrated that frailty negatively affects the use of Social Support Act services, the use of community nursing services, medication use, and mortality risk. This study is the first to demonstrate the impact of frailty on Social Support Act services and community nursing services in the Netherlands. Findings emphasize the importance of frailty prevention for older people and public health policy.
The aim of this study was to explore the association between oral health and frailty in community-dwelling Dutch adults aged 55 years and older. Included were 170 participants (n = 95 female [56%]; median age 64 years [IQR: 59–69 years]). Frailty was assessed by the Groningen Frailty Indicator. Oral health was assessed by the Oral Health Impact Profile-14-NL (OHIP-NL14). OHIP-NL14 item scores were analyzed for differences between frail and non-frail participants. Univariate and multivariate logistic regression analyses were performed to assess the association between oral health and presence of frailty. The multivariate analysis included age, gender, and depressive symptoms as co-variables. After adjustment, 1 point increase on the OHIP-NL14 scale was associated with 21% higher odds of being frail (p = 0.000). In addition, significantly more frail participants reported presence of problems on each OHIP-NL14 item, compared to non-frail participants (p < 0.003). Contrast in prevalence of different oral health problems between frail and non-frail was most prominent in ‘younger’ older adults aged 55–64 years. In conclusion: decreased oral health was associated with frailty in older adults aged 55 years. Since oral health problems are not included in most frailty assessments, tackling oral health problems may not be sufficiently emphasized in frailty policies.
Steeds meer professionals in de zorg (verpleegkundigen, sociaal werkers en ggz agogen) doen een coming-out en kiezen voor professionele zelfonthulling om hun ervaringskennis als een aanvullende deskundigheid in te kunnen zetten (Boevink, 2017). Vooral opleidingen op het gebied van sociaal werk en de zorg bieden hiervoor een ingang. De zorgprofessional met ervaringsdeskundigheid is een relatief nieuw fenomeen waar momenteel onderzoek naar plaatsvindt. In het lopende praktijkgerichte onderzoek getiteld 'De bijdrage van Ervaringsdeskundigheid van professionals in de praktijk van zorg en welzijn' wordt onder leiding van Hogeschool Windesheim, Hogeschool Utrecht, VUMC in samenwerking met vijf zorginstellingen gedurende twee jaar samen opgelopen met 20 zorgprofessionals die hun ervaringsdeskundigheid verder ontwikkelen tot een professionele inzet. In dit artikel lichten wij een klein tipje van de sluier hoe SPV-en hiermee aan het werk zijn.
