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 Eighteen percent of firms ask working-age employees to complete
health risk assessments, but the use of these tools in older persons
is relatively new, said lead author Andreas E. Stuck of University
Hospital Bern in Switzerland.
The personal health risk assessments covered multiple potential risk
factors relevant in old age, and participants received
individualized feedback and health counseling, lasting two years,
Stuck said.
“Thus, prevention in old age is likely effective, but only if risk
assessment is combined with individualized counseling over an
extended period of time,” Stuck told Reuters Health by email.
In his team’s study, conducted in Switzerland between 2000 and 2002,
874 healthy adults over age 65 filled out questionnaires and
received individualized computer-generated feedback reports, which
were also sent to their doctors.
Additionally, for two years, nurse counselors visited patients at
home and called them every three to six months to reinforce what
health behaviors they should be pursuing or preventive care they
should be obtaining based on their individualized reports.
About 85 percent of those assigned to the health risk assessment
group returned their questionnaires, the researchers reported in
PLoS Medicine.
Counselors identified the most important risk factors for each
person, and the interaction between risk factors was taken into
account. For example, for a person with low physical activity who
was having pain, the first step was to intervene on management of
pain, then on physical activity, Stuck said.
At the end of two years, the researchers compared the risk
assessment group to another 1,000 similar adults who did not get the
questionnaires or counseling.
Seventy percent of those who completed the health-risk assessments
were physically active and 66 percent had received a seasonal flu
vaccine, compared to 62 percent and 59 percent of the comparison
group, respectively.
Long-term outcomes like nursing home admission or functional status
were not available, but the researchers estimated that almost 78
percent of the adults in the health risk assessment group were still
alive after eight years, compared to almost 73 percent in the
comparison group.
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The health assessment, data entry and individualized feedback report
takes patients about one hour to do and costs about $30, Stuck said,
not including the cost of individualized counseling by the nurse
counselor or a primary care physician.
Health risk assessment should be offered to all older people
starting between age 60 and 65, he said.
“The authors report promising evidence that a complex intervention
might improve longevity and functioning in older adults,” said Evan
Mayo-Wilson of the Johns Hopkins Bloomberg School of Public Health
in Baltimore, Maryland, who was not part of the new study.
“The team provided many services in addition to standard care, and
we cannot tell if all of those services were important or if only
certain activities would be necessary to achieve good outcomes,”
Mayo-Wilson told Reuters Health by email.
But only half of the people assessed for the trial were enrolled,
while many weren’t eligible or refused, and some who were assigned
to the health risk assessments didn’t return their questionnaires or
otherwise didn’t engage with the program, he noted.
“We should be cautious in interpreting the results of this study
because previous studies found inconsistent effects of mortality and
other health outcomes,” Mayo-Wilson said.
SOURCE: http://bit.ly/1NR2dZG PLoS Medicine, online October 19,
2015.
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