Exploring the relationship between frailty, multi-morbidity and the use of healthcare resource by the very old.

Currently the fastest growing group of our ageing population is the very old, those aged 85 years and over. By 2031, the population of England and Wales will increase by 8% whereas those over 80 years of age will rise by 138%.

Between 25-50% of those aged over 85 years are estimated to be frail; a state of vulnerability which makes them more likely to die, suffer a fall, get an infection and be admitted to hospital and/or a care home. A key responsibility of a GP is to identify a frail older person in order to prevent/reduce use of health services especially unnecessary admission to hospital. It is assumed that use of health and social care services is very high in the very old, and most likely to be driven by nearness-to-death.

The Newcastle 85+ study was the first national study to recruit a large sample of very old people; 850 85 year olds from GP practices in Newcastle and North Tyneside (2006). They were followed up over 5 years. Information was collected on all aspects of their health during home visits by research nurses. The study also looked at their GP medical records to examine use of health services over the last year.

The Newcastle 85+ study showed that for this age group living with multiple chronic illnesses, such as heart disease and arthritis, was normal. It would therefore be assumed that they are very high users of health and social care services; however because the very old are often excluded from research, there is little evidence to prove whether or not this is true. We will explore the use of GP and, hospital services in the very old in the last year of life using existing data from the Newcastle 85+study.

Amount awarded: £31,233