Physical function in community-dwelling older adults - a focus on health inequality and ageing in place

Abstract

This thesis sought to explore socioeconomic determinants of physical function in community-dwelling older adults, with implications for ageing in place. While several markers of physical function are explored in this thesis, initial studies largely focussed on probable sarcopenia, a precursor of the muscle condition sarcopenia and a predictor of impaired physical function 37. Firstly, we aimed to identify socioeconomic determinants of probable sarcopenia, in two cross-sectional studies of large nationally representative population datasets in Ireland (Chapter 3) and England (Chapter 4). This thesis further explored whether associations between SEP and adverse health outcomes persist in populations of older age with increased physical dependency; this was achieved through analysis of an Irish health administrative dataset, comprised of a large population of community-dwelling older adults (mean age 84 years) receiving ADL support through formal home care (Chapter 5A). Further aims within a small sample of this population group explored a prospective descriptive study examining the practicality of conducting in-home assessments of physical function, including sarcopenia and frailty, in addition to markers of SEP (Chapter 5B). Finally, the thesis sought to address potential strategies to maintain physical function and support ageing in place; to this end a qualitative study of barriers and enablers to embedding an in-home physical activity intervention for community dwelling older people supported by home care services was conducted (Chapter 6). Overall, across the body of work, in populations of contrasting older age, a greater burden of probable sarcopenia or other markers of impaired physical function was observed in older adults with greater socioeconomic disadvantage.