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Latent variable modeling of disability in people aged 65 or more

机译：65岁或65岁以上人群的残障潜能变量模型

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摘要

This paper aims at classifying, on the basis of their disability profile, the population of elderly and quantifying the number of those with a very low level of functioning in a central region of Italy. This is accomplished using a set of variables on the difficulty of accomplishing everyday tasks (Activities of Daily Living, ADL) and functions. This issue is very important for National and Local Health organizations in order to evaluate the need for care, planning services, elaborating policies and allocating resources. Latent class models are applied on data coming from the Italian National Survey on Health Conditions and Appeal to Medicare to extract the latent trait of disability and classify the elder population according to their disability profile. Model selection brings to a classification into four latent classes. Looking at posterior probabilities, classes may be interpreted as follows: elderly without disability, with difficulties in movements, with difficulties in movements and daily tasks, with very low functioning level. Estimates of the amount of population aged 65 or more falling in each class is also provided. Cross-validation shows evidence of the robustness of such classification. Item response theory models are also applied to the items considered to study how functions are lost with increasing levels of disability. In particular, the abilities of climbing stairs and stooping down are those lost first, while those of eating and getting washed are those lost last.
机译：本文旨在根据老年人的残疾状况对老年人群进行分类，并对意大利中部功能水平很低的老年人数量进行量化。这是通过使用一组变量来完成日常任务（日常生活活动，ADL）和功能的难度来实现的。这个问题对于国家和地方卫生组织非常重要，以便评估对护理的需求，规划服务，制定政策和分配资源。潜在类别模型应用于来自意大利国家健康状况调查和医疗保险申诉的数据，以提取残疾的潜在特征，并根据老年人的残疾状况对其进行分类。模型选择将分类分为四个潜在类。从后验概率来看，等级可以解释为：老年人，无残疾，行动困难，行动和日常工作困难，功能水平很低。还提供了每个类别中65岁或65岁以上人口的估计数。交叉验证显示了这种分类的鲁棒性。项目反应理论模型也应用于考虑的项目，以研究功能如何随着残疾水平的提高而丧失。特别是，爬楼梯和下弯的能力是首先丢失的，而饮食和洗衣服的能力则是最后丢失的。

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