Evaluation of physical functioning in the older Person: tools and economic aspects

Abstract

Deterioration in physical functioning in older people can have longer term debilitating effects with significant ramifications for social and family support networks. Improving physical functioning in this population could reduce health and social care costs of ageing. The broad aim of this thesis is to contribute to the enhancement of physical functioning in older people through the provision of new information on the tools that are used to measure function, on the costs and types of services used, on the cost-effectiveness of exercise intervention strategies and as a population health promotion program. The studies explore the correlation between self-reported and performance-based methods of evaluation in this population and found small to medium correlation between them. Determination of cost-effectiveness requires accurate estimation of costs and the systematic review of unit costs conducted provides a consolidated resource of unit costs of services that may be used by older people. The types and magnitude of resources used by this population is also explored. Two economic evaluations are conducted of exercise intervention for different groups of older people and the studies provide preliminary evidence of cost-effectiveness. Modelling of the potential impact of a public health program of fall prevention suggests cost-effectiveness for management of the rising costs of fall-related health care services for older people now and into the future.