Social position and geriatric syndromes among Swedish older people: a population-based study

BMC Geriatr. 2019 Oct 15;19(1):267. doi: 10.1186/s12877-019-1295-8.

Abstract

Background: Older people with a low social position are at higher risk of poor health outcomes compared to those with a higher social position. Whether lower social position also increases the risk of geriatric syndromes (GSs) remains to be determined. This study investigates the association of social position with GSs among older community-dwellers.

Methods: Three consecutive population-based health surveys in 2006, 2010 and 2014 among older community-dwellers (age 65-84 years) in Stockholm County were combined (n = 17,612) and linked with Swedish administrative registry information. Social position was assessed using registry information (i.e. education, country of origin and civil status) and by self-reports (i.e. type of housing and financial stress). GSs were assessed by self-reports of the following conditions: insomnia, urinary incontinence, functional decline, falls, depressive disorder, hearing or vision problems. Binomial logistic regression analyses were used to estimate the association between social position and GSs after adjusting for age, sex, health status, health behavior and social stress.

Results: The prevalence of GSs was 70.0%, but varied across GSs and ranged from 1.9% for depression to 39.1% for insomnia. Living in rented accommodation, being born outside the Nordic countries, being widowed or divorced were associated with GS presence. Financial stress was most strongly associated with GSs (adjusted odds ratio, 2.59; 95% CI, 2.13-3.15).

Conclusion: GSs are highly prevalent among older Swedish community-dwellers with wide variations across syndromes and strong association with all measures of social position, most strikingly that of experiencing financial stress.

Keywords: Elderly; Geriatric syndromes; Health inequality; Social position; Socio-economic status.

MeSH terms

  • Accidental Falls / economics*
  • Aged
  • Aged, 80 and over
  • Depression / economics
  • Depression / epidemiology
  • Depression / psychology
  • Female
  • Geriatric Assessment / methods*
  • Health Status
  • Humans
  • Independent Living / economics*
  • Independent Living / psychology
  • Male
  • Population Surveillance* / methods
  • Socioeconomic Factors*
  • Surveys and Questionnaires
  • Sweden / epidemiology
  • Syndrome
  • Urinary Incontinence / economics
  • Urinary Incontinence / epidemiology
  • Urinary Incontinence / psychology