Residential Area Socioeconomic Deprivation is Associated with Physical Dependency and Polypharmacy in Community-Dwelling Older Adults: An Analysis of Health Administrative Data in Ireland

Figures & data

Table 1 Health and Demographic Characteristics of Community-Dwelling Older Adults According to Residential Area Deprivation (N = 1591)

Residential Deprivation	Overall (n= 1591)	Affluent (n= 505)	Marginally Above Average (n= 568)	Marginally Below Average (n= 340)	Disadvantaged (n= 178)	p-value
Demographics
Age, mean ± SD^a	83.9 ± 7.1	85.6 ± 6.7	84.6 ± 7.0	82.8 ± 6.6	79.1 ± 7.3	<0.001*
Gender, n (%)
Female	1013 (63.7)	341 (67.5)	373 (65.7)	203 (59.7)	96 (53.9)	<0.001*
Male	578 (36.3)	164 (32.5)	195 (34.3)	137 (40.3)	82 (46.1)	<0.001*
Marital Status, n (%)
Married	471 (29.6)	152 (30.1)	138 (24.3)	125 (36.8)	56 (31.5)	0.112
Divorced/ Separated	67 (4.2)	11 (2.2)	18 (3.2)	17 (0.1)	21 (11.8)	<0.001*
Single	313 (19.7)	137 (27.1)	139 (24.5)	57 (16.8)	40 (22.5)	0.007*
Widowed	680 (42.7)	205 (40.6)	273 (48.1)	141 (41.5)	61 (34.3)	0.223
Lives Alone, n (%)	864 (54.3)	283 (56.0)	328 (57.7)	162 (47.7)	91 (51.1)	0.029*
Health and Dependency
Barthel Index Score^b, mean ± SD^a	13.1 ± 3.9	13.2 ± 3.9	13.0 ± 3.9	13.2 ± 4.1	12.9 ± 3.9	0.688
Barthel Category, n (%)
Maximum dependency	45 (3.0)	17 (3.5)	13 (2.4)	11 (3.4)	4 (2.4)	0.610
High dependency	138 (9.2)	33 (6.9)	54 (10.2)	24 (7.5)	27 (16.2)	0.009*
Moderate dependency	298 (19.9)	83 (17.3)	110 (20.7)	70 (21.7)	35 (21.0)	0.151
Mild dependency	959 (64.0)	329 (68.7)	332 (62.5)	202 (62.7)	96 (57.5)	0.008*
Independent	59 (3.9)	17 (3.5)	22 (4.1)	15 (4.7)	5 (3.0)	0.889
Polypharmacy, n (%)
Prescribed ≥5 medications	1076 (67.6)	325 (64.5)	390 (68.7)	228 (67.1)	133 (74.7)	0.030*
Prescribed ≥10 medications	519 (32.6)	139 (27.5)	198 (34.9)	111 (32.6)	71 (39.9)	0.005*
Median number of medications^c	7 (9)	7 (10)	7 (8)	7 (9)	8 (8)	0.034*
Documented Cognitive Impairment	686 (43.1)	205 (40.6)	248 (43.7)	152 (44.7)	81 (45.5)	0.170
Documented Mental Health Condition (≥1)	313 (19.7)	97 (19.2)	106 (18.7)	65 (19.1)	45 (25.3)	0.190
Acute hospitalization, n (%)	531 (33.4)	147 (29.1)	182 (32.0)	128 (37.6)	74 (41.6)	<0.001*
Died, n (%)	148 (9.3)	35 (6.9)	54 (9.5)	41 (12.1)	18 (10.1)	0.033*

Notes: ^aMean ± standard deviation; one-way ANOVA test. ^bMissing values n= 92 (5.8%); Barthel Index Score ranges from 1 to 20 with lower scores indicating dependence. ^cMedian (IQR); Kruskal–Wallis H-Test. *Denotes p<0.05.

Figure 1 Prevalence (%) of health variables in community-dwelling dependent older adults based on residential area deprivation (n= 1591). *Denotes Mantel-Haenszel test for trend p <0.05.

Table 2 Multivariable Logistic Regression Analyses for Residential Area Deprivation with Prespecified Health Variables, Adjusted for Age and Gender

	Polypharmacy (n= 1591)		Physical Dependency (n= 1499)		Acute Hospitalization (n= 1591)		Mental Health Condition (n= 1591)		Cognitive Impairment (n= 1591)
	OR	95% CI	OR	95% CI	OR	95% CI	OR	95%	OR	95% CI
Residential Area Deprivation
Affluent	Reference
Marginally Above Average	1.23	0.95–1.58	1.53	0.97–2.41	1.14	0.87–1.47	0.92	0.68–1.26	1.15	0.90–1.47
Marginally Below Average	1.16	0.86–1.50	1.09	0.63–1.88	1.41*	1.05–1.90	0.89	0.63–1.28	1.24	0.94–1.65
Disadvantaged	1.75*	1.18–2.61	2.60*	1.47–4.58	1.59*	1.10–2.30	1.10	0.72–1.68	1.35	0.94–1.93

Notes: Binary logistic regression analysis was used to determine the odds ratio (OR) and 95% confidence intervals (CI) for associations between residential area deprivation status and health outcomes of interest, when adjusted for age and gender. *Denotes p<0.05.