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Marinela and Wim van den Heuvel

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Assessment of health status and frailty in old age.



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The number of people aged 65 years and over is increasing rapidly in former communist Central–Eastern European countries (CEE countries). The growing number of dependent older people ('frail old') puts new demands on the health services in these countries. At the same time, a shortage of personnel to care for the dependent elderly is predicted. However, large differences exist within Europe. The proportion of the population who are elderly will increase more rapidly in CEE countries in the coming decades, whereas the availability of long-term care arrangements is scarce, as compared with Western European countries. For families in CEE countries, it is considered to be a duty to take care of sick and elderly family members at home.

In the coming two decades, the number of people who are aged 65 years and over in Romania will increase by 5.4%, whereas at the same time the total population will decrease by 3.1%.
Romania, like other CEE countries, were characterized by dramatic socioeconomic changes in thelast decades, which led to a deterioration in the health status of the population. For example, Bulgaria and Romania have the highest age-standardized death rates for treatable mortality in the European Union since 1990. In addition, preventable mortality for both men and women has increased in recent decades in Romania. Moreover, the ability of the older people to adapt to the changing conditions is limited, and they usually wait passively for services. On the other hand, family ties continue to be an important form of emotional and instrumental support between children and old parents.

The reforms in social security and health care in Romania during the last two decades have worsened the socio-economic situation for most old people. Their health status is expected to suffer from these developments, as indicated by the data on life expectancy and preventable mortality. However, there is a lack of reliable data on the health status of elderly people in CEE countries, including Romania, or even instruments to assess health status of old people. Therefore, to get a clear picture of the health status and health care problems of old Romanians, the development of validated instruments is needed as well as surveys to know the health care problems of old people.

The aims of the study are to validate instruments to assess health status en frailty of old Romanians, to describe their health status and to analyze the relationship of health status with sociodemographic, psychological, and social characteristics.