Impact of unmet need on health status in community-dwelling older adults: An eight-year longitudinal study

Background: Research has shown that unmet need is related to a variety of negative consequences of the disabled older adults. However, the influence of unmet need on health status still needs to be investigated. Method: Using an eight-year longitudinal and population representative sample of community-dwelling older adults in Taiwan, we explored the impact of unmet needs for personal assistance with ADL, personal assistance with IADL, and access of healthcare on health status. Measures of health status include self-rated health (SRH), psychological distress, cognitive function, and levels of functional disability. Generalized estimating equations (GEE) models were employed, adjusted for sociodemographic factors (i.e. age, gender, marital status, household income, education level, urbanization of living areas), psychosocial factors (i.e. living arrangement and perceived social support), health conditions and number of chronic illness Result: Among 1389 disabled community-dwelling older adults, the presence of unmet ADL need and difficulties in accessing healthcare showed a significant association with poorer SRH, and higher levels of psychological distress, ADL disability and IADL disability, with covariates controlled. Moreover, unmet IADL need was only associated with poorer SRH and higher level of psychological distress. Yet, poorer cognition function is only related to difficulties of access to healthcare. Conclusion: This study underscored the importance of meeting unmet needs and improving access to care for promoting multidimensional well-being of older adult with disabilities.