The Gloucestershire Longitudinal Study of Disability: outcomes in nonresponders, responders, and subsequent defaulters

Abstract

Routine health checks of older adults (age > 75 years) are a potential source of disability data to inform general practitioners, trusts, and health authorities. The value of the data heavily depends on the representativeness of those agreeing to the checks. The aim of this study was to determine the outcomes of responders, subjects who refused the offer of a health check, and those who defaulted from regular health checks after the first year. A sample of 1815 subjects more than 75 years old, drawn from seven general practices, who started an annual routine health check in 1990. All were interviewed by their practice nurse using the Elderly At Risk Rating Scale. Survival and hospital admission rates were ascertained for responders and refusers. The average age of the responders was 81.1 (standard deviation [SD] 4.7); for refusers, 80.5 (SD = 7.7); and for dropouts, 80.2 (SD = 4.2). In women, the age-adjusted survival was 37.6 months (95% confidence interval [CI] 36.3-38.9) in refusers (70% survival) and 39.5 months (95% CI 38.4-40.6) in responders (73% survival); the respective figures in men were 37.4 months (95% CI 35.6-39.1, 67% survival) and 36.8 months (95% CI 34.9-38.7, 66% survival). Crude mortality rates of responders and the inhabitants of areas that matched the locations of the practices were similar. Hospital admission rates and mean length of stay were similar in responders and refusers. Similarly, those who defaulted did not differ from continued responders in their mortality or hospital admission rates. Nonresponders to elderly health checks and defaulters have similar health outcomes to responders.