Changes in indicators of well-being on moving from home to long-term care for Māori in Aotearoa New Zealand: A retrospective cohort study.

Objective: To investigate changes in well-being measures for older Māori after moving from community to long-term care (LTC).

Methods: We undertook a retrospective cohort study of older Māori in New Zealand (NZ) who had received assessments for their health needs whilst living at home (interRAI-HC assessment) as well as a subsequent assessment after moving into a care facility (interRAI-LTCF). All interRAI-HC assessments from 01 July 2013 to 21 December 2018 were identified and matched to LTCF assessments that were undertaken at least 6 months later.

A multistate transition model of changes in loneliness and carer stress among community-dwelling older adults in Aotearoa New Zealand.

Objectives: To identify changes in loneliness and carer stress between two time points for older people of different ethnicities who had repeated interRAI home care assessments.

Methods: Participants consisted of community-dwelling older adults across New Zealand who received two interRAI-HC assessments between 5 July 2012 and 31 December 2019. Two multistate models were developed: the first model was not lonely versus lonely, and the second model was no carer stress versus carer stress.

Exploring older care recipients' sleep status as a predictor for informal carer distress: evidence from New Zealand's interRAI home care assessment data.

Objectives: Understanding factors affecting informal carers' well-being is important to support healthy ageing at home. Sleep disturbances of care recipients are increasingly recognised as affecting the well-being of both parties. This research assesses the relationship between indicators of care recipients' sleep status and carer distress, as well as carer distress with subsequent admission to residential aged care, using prospectively collected Home Care International Residential Assessment Instrument (interRAI-HC) assessment data.

Utility of Big Data to Explore Medication Adherence in Māori and Non-Māori Community-Dwelling Older Adults with Heart Failure in Aotearoa New Zealand: A Cross-sectional Study.

Background: Medication adherence improves morbidity and mortality-related outcomes in heart failure, and knowledge of patterns of medication adherence supports patient and clinician decision-making. Routinely collected national data facilitate the exploration of medication adherence and associated factors in older adults with heart failure, including the association between ethnicity and adherence. There are known inequities in access to medicines between Māori (Indigenous People of Aotearoa New Zealand) and non-Māori, yet ethnic variation in medicines adherence in community-dwelling older adults with heart failure has not been explored.

Chronic health conditions and mortality among older adults with complex care needs in Aotearoa New Zealand.

Background: Older people have more comorbidities than younger groups and multimorbidity will increase. Often chronic conditions affect quality of life, functional ability and social participation. Our study aim was to quantify the prevalence of chronic conditions over a three-year period and their association with mortality after accounting for demographics.

Deprescribing Anticholinergic and Sedative Drugs to Reduce Polypharmacy in Frail Older Adults Living in the Community: A Randomized Controlled Trial.

Background: Polypharmacy is associated with poor outcomes in older adults. Targeted deprescribing of anticholinergic and sedative medications may improve health outcomes for frail older adults. Our pharmacist-led deprescribing intervention was a pragmatic 2-arm randomized controlled trial stratified by frailty.

Carer distress among community living older adults with complex needs in the pre- and post-COVID-19 era: a national population study.

Carer distress is one important negative impact of caregiving and likely exacerbated by the novel coronavirus disease 2019 (COVID-19) pandemic, yet little population-based epidemiological information exists. Using national data from repeated standardized comprehensive geriatric needs assessments, this study aims to: describe the pattern of caregiver distress among those providing informal care to community-living adults aged ≥ 65 years with complex needs in New Zealand over time; estimate the COVID-19 effect on this temporal pattern; and, investigate relationships between participants' sociodemographic and selected health measures on caregiver distress. Fractional polynomial regression and multivariable multilevel mixed-effects models were employed.

Development and validation of a frailty index compatible with three interRAI assessment instruments.

Background: a Frailty Index (FI) calculated by the accumulation of deficits is often used to quantify the extent of frailty in individuals in specific settings. This study aimed to derive a FI that can be applied across three standardised international Residential Assessment Instrument assessments (interRAI), used at different stages of ageing and the corresponding increase in support needs.

Methods: deficit items common to the interRAI Contact Assessment (CA), Home Care (HC) or Long-Term Care Facilities assessment (LTCF) were identified and recoded to form a cumulative deficit FI.

Optimising function and well-being in older adults: protocol for an integrated research programme in Aotearoa/New Zealand.

Background: Maintaining independence is of key importance to older people. Ways to enable health strategies, strengthen and support whanāu (family) at the community level are needed. The Ageing Well through Eating, Sleeping, Socialising and Mobility (AWESSOM) programme in Aotearoa/New Zealand (NZ) delivers five integrated studies across different ethnicities and ages to optimise well-being and to reverse the trajectory of functional decline and dependence associated with ageing.

Factors associated with caregiver distress among home care clients in New Zealand: Evidence based on data from interRAI Home Care assessment.

Objective: To identify factors associated with caregiver distress among home care clients in New Zealand.

Methods: The cohort consisted of 105,978 community-dwelling people aged 65 years or older requiring home care services in New Zealand who had at least one informal caregiver. Bivariate and multivariable logistic regression analyses were used to identify factors associated with caregiver distress.

Risk factors for injuries in New Zealand older adults with complex needs: a national population retrospective study.

Background: Falls and falls-related injuries are common among older adults. Injuries in older adults lead to poor outcomes and lower quality of life. The objective of our study was to identify factors associated with fall-related injuries among home care clients in New Zealand.

Development and validation of multivariable mortality risk-prediction models in older people undergoing an interRAI home-care assessment (RiskOP).

Background: Currently, one-year survival of older people with complex co-morbidities is unpredictable. Identifying older adults with a reduced life expectancy will lead to more targeted care and better healthcare resource allocation.

Methods: Development and validation of one-year and three-month mortality risks in people aged ≥65 years who had completed an International Resident Assessment Instrument-Home Care (interRAI-HC) assessment between July 2012 and March 2018.

Frailty of Māori, Pasifika, and Non-Māori/Non-Pasifika Older People in New Zealand: A National Population Study of Older People Referred for Home Care Services.

Background: Little is known about the prevalence of frailty in indigenous populations. We developed a frailty index (FI) for older New Zealand Māori and Pasifika who require publicly funded support services.

Methods: An FI was developed for New Zealand adults aged 65 and older who had an interRAI Home Care assessment between June 1, 2012 and October 30, 2015.

Effect of Capacity to Undertake Instrumental Activities of Daily Living on Entry to Aged Residential Care in Older People With Heart Failure.

Heart failure is a common condition in older people with complex medical needs. A key factor in resilience after heart failure is the capacity to perform the instrumental activities of daily living (IADLs). Knowing the association between capacity to perform IADLs and entry into aged residential care will help health professionals plan interventions that will allow older people to remain independent longer.

Predictors of Residential Care Admission in Community-Dwelling Older People With Dementia.

Objectives: The objectives of this study were to identify variables associated with dementia and entry into aged residential care (ARC) and derive and validate a risk prediction model for dementia and entry into ARC.

Design: This was an observational study of prospectively collected Home Care International Residential Assessment Instrument (interRAI-HC) assessment data.

Setting And Participants: Participants included all people age ≥65 years who had completed an interRAI-HC assessment between July 1, 2012 and June 30, 2018.

Evaluating the Influence of Social Factors on Aged Residential Care Admission in a National Home Care Assessment Database of Older Adults.

Objectives: Evaluate the influence of social factors on admission to aged residential care (ARC) facilities using a national comprehensive geriatric assessment database in New Zealand.

Design: Time-to-event analysis of a continuously recruited national cohort.

Participants And Setting: An anonymized data extract from a large national database for home care assessments (June 2012-December 2015) was matched with data on mortality and admissions into ARC.

Risk factors for hip fracture in New Zealand older adults seeking home care services: a national population cross-sectional study.

Background: Hip fractures are a common injury in older people. Many studies worldwide have identified various risk factors for hip fracture. However, risk factors for hip fracture have not been studied extensively in New Zealand.

A frailty index derived from a standardized comprehensive geriatric assessment predicts mortality and aged residential care admission.

Background: Frailty in older adults is a condition characterised by a loss or reduction in physiological reserve resulting in increased clinical vulnerability. However, evidence suggests that frailty may be modifiable, and identifying frail older people could help better target specific health care interventions and services.

Methods: This was a regional longitudinal study to develop a frailty index for older adults living in Canterbury New Zealand.

Drug Burden Index and Its Association With Hip Fracture Among Older Adults: A National Population-Based Study.

Background: The Drug Burden Index (DBI) calculates the total sedative and anticholinergic load of prescribed medications and is associated with functional decline and hip fractures in older adults. However, it is unknown if confounding factors influence the relationship between the DBI and hip fractures. The objective of this study was to evaluate the association between the DBI and hip fractures, after correcting for mortality and multiple potential confounding factors.

Profile of ethnicity, living arrangements and loneliness amongst older adults in Aotearoa New Zealand: A national cross-sectional study.

Objective: To explore the patterns of living arrangements, ethnicity and loneliness amongst older adults (aged 65+ years) living at home.

Methods: National interRAI-HC (International Residential Assessment Instrument-Home Care) assessments conducted between 1 September 2012 and 31 January 2016 were analysed. Analysis focused on the associations between loneliness and both ethnic groups and living arrangements.

Drug Burden and its Association with Falls Among Older Adults in New Zealand: A National Population Cross-Sectional Study.

Background: Adverse outcomes associated with advanced diseases are often exacerbated by polypharmacy.

Objectives: The current study investigated an association between exposure to anticholinergic and sedative medicines and falls in community-dwelling older people, after controlling for potential confounders.

Methods: We conducted a retrospective cross-sectional study of a continuously recruited national cohort of community-dwelling New Zealanders aged 65 years and over.