From Curing to Caring: A Sequence Analysis Exploring Trajectories of Multimorbidity and Social Care Needs among Older Adults in Twelve European Countries

Mariana Calderón-Jaramillo , Centre d'Estudis Demogràfics
Elisenda Rentería, Centre d'Estudis Demogràfics
Jeroen Spijker, Centre d'Estudis Demogràfics (CED)

The process from multimorbidity to experiencing care needs is usually understood as a linear process known as the ‘evolution of chronic disease’. However, this process might be less straightforward, mainly because the trajectories of (multi)morbidity and social care needs are complex, but also due to the heterogeneous ways through which healthcare and social care systems in each country respond to individuals’ needs. Previous evidence has highlighted the consequences of multimorbidity on health care systems, as well as on increasing demands of social care needs. However, less have been said about its joint courses. This study explores trajectories of multimorbidity and social care needs, respectively measured as having more than one chronic health condition and facing any moving limitation and for performing Activities of Daily Living and Instrumental Activities of Daily Living. Using data from 41,100 individuals that were 50+ in six waves (1st, 2nd, 4th, 5th, 6th and 8th) of the Survey of Health, Ageing and Retirement in Europe (SHARE), we analysed trajectories in 12 European countries. The following four trajectories were identified through sequence analysis: (1) Permanent multimorbidity and social care needs; (2) Chronic condition evolving to multimorbidity with social care needs; (3) Chronic condition evolving to multimorbidity without social care needs; (4) Recovered from one chronic condition. Multinomial regression models were fitted to understand how demographic, socioeconomic, living arrangements and health-related dimensions explained individuals’ trajectories. Understanding these trajectories might help to inform and adapt social and healthcare services to ageing societies’ urgent needs and demands.

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 Presented in Session 1. Health, Wellbeing and Morbidity in Old Age