Piotr Błędowski

Medical, psychological and socioeconomic aspects of aging in Poland Assumptions and objectives of the PolSenior project

Both descriptive and longitudinal studies of aging are nowadays a subject of growing interest in different countries worldwide. However, in Poland and other Central-Eastern European countries, such comprehensive, nationally representative, multidimensional studies were never performed in the past in elderly population. The present paper describes the PolSenior project including its objectives, sample selection and structure, methods, fieldwork procedures and study flow. The aim of the project was to examine medical, psychological and socioeconomic aspects of aging in Poland. The research sample included 5695 respondents (2899 males and 2796 females) split into six equally sized age groups of elderly individuals (65-69 years, 70-74 years, 75-79 years, 80-84 years, 85-89 years, 90+years) and one group of subjects just about to enter old age (55-59 years). Subjects were recruited using three stage stratified, proportional draw. The response rate was 42% and ranged from 32% to 61% between provinces. The study consisted of three visits performed by trained nurses including questionnaire survey, comprehensive geriatric assessment and blood and urine sampling. The questionnaire consisted of medical and specific socioeconomic questions. The comprehensive geriatric assessment included blood pressure and anthropometric measurements, as well as selected scales and tests routinely used in the examination of elderly subjects. Blood and urine samples were collected from 4737 and 4526 individuals, respectively. More than 50 biochemical parameters were measured, and DNA was isolated and banked. In a selected group of 1018 subjects, a medical examination by a physician was performed. The self-rated health was lower in females than in males in age groups 70-84, but similar in individuals of both sexes aged 65-69 and 85 years. Besides providing data on health and functioning of elderly population, the PolSenior project aims to analyze interrelationships between different elements of health and social status, and between genetics and health status in advanced age. The results of the PolSenior project will facilitate prioritizing the states public health and social policies in elderly population. Such a program provides also an excellent starting point for longitudinal studies and a basis for comparative analysis between Poland and other European countries or regions.

Reduced functionality in everyday activities of patients with self-reported heart failure hospitalization — Population-based study results

AIM To assess daily functioning and geriatric conditions of older subjects suffering from heart failure (HF) as compared to the general population. METHODS AND RESULTS The data were collected as part of the nationwide PolSenior project (2007-2011). Of 4979 individuals (age range 65-104 years), data on self-reported HF hospitalization were available for 4795 subjects (96%). Geriatric assessment (GA) included functional status (ADL, Activities of Daily Living and IADL, Instrumental ADL scales), cognitive function, mood disorders, sensory organ impairment, falls and comorbidity. Mean age ± SD of the study population was 73.8 ± 6.5 years; 62% were female. The proportion of subjects with HF hospitalizations increased from 8% in subjects aged 65-69 years up to 13% in the age group of 85-89 years, and decreased in nonagenarians (11%). Subjects with the HF hospitalization were older, used more drugs, and were characterized by a higher prevalence of comorbid conditions, mood disorders, hearing impairment and functional limitations. In logistic regression, HF hospitalization increased the age-sex adjusted risk of disability by 40%, both in ADL and IADL. After adjustment to other clinical and geriatric conditions, HF hospitalization remained an independent predictor of disability in both ADL (OR=1.36, 95%CI: 1.00-1.84) and IADL (OR=1.40, 95%CI: 1.01-1.93). CONCLUSIONS Older people who reported HF admissions had a higher number of comorbidities and geriatric conditions: mood disorders, hearing impairment and functional limitations. Besides, in our study, HF hospitalization independently and significantly increased the risk of limitations in IADL and ADL. Therefore, further studies are needed to evaluate the benefits of GA in patients with HF.

Education systems as transition spaces

The changes that have occurred in the field of education over the course of the last couple of decades have been associated with increased demands that are not only placed on individuals from both within and beyond the education system, but also on the support they require to make successful educational choices. One central way this need is being addressed is through educational and vocational guidance provided at different stages and transition points of educational trajectories. The aim of this article is to provide a context for the research findings presented in the subsequent articles of this special issue by illustrating the ways educational trajectories are regulated through the organization of schooling and the structures of educational and vocational guidance in the eight countries that participated in the Governance of Educational Trajectories in Europe (GOETE) research project. This article presents three country clusters of education and welfare based on the comparative analysis conducted by the project.

Program badawczy PolSenior – cele i metoda

Do najistotniejszych przyczyn demograficznego starzenia sie spoleczenstw nalezy stopniowe wydluzanie sie zycia ludzkiego, spowodowane m.in. poprawą warunkow egzystencji i podniesieniem jakości świadczen zdrowotnych, oraz spadek dzietności. Jeszcze w 2007 roku, kiedy rozpoczeto projekt PolSenior, liczba osob w grupie 65 lat i wiecej wynosila 5,1 mln, co stanowilo 13,5% ogolu ludności. Prognoza GUS zaklada, ze do 2035 roku liczba ludności w tej grupie wieku zwiekszy sie w stosunku do 2007 roku o 3,2 mln, a jej udzial w ogolnej liczbie ludności wyniesie 23,2%