A National Profile of Older Physical Therapy Users in France: Results of the 2015 CARE Representative Survey.

Abstract

Objective: Older adults, a highly heterogeneous group with complex health challenges, are often overlooked in the field of physical therapy despite their already important and growing numbers. This study aimed to estimate the use of physical therapy in the older population and compare the characteristics and health profiles of older adults who consult physical therapists with those who don't.

Methods: Data from the French 2015 Capacities, Aids, and Resources (CARE) survey, a large-scale survey with representative sampling weights was used. It includes community-dwelling and institutionalized older adults aged 60 to 109 years. Main outcome measures were diseases (16 components), clinical symptoms (10 components), functional limitations (16 components), and geriatric syndromes (5 components).

Results: Among the 12,043 older adults included, 26.5% received treatment from a physical therapist, with 23.9% being 80 years or older. They had worse outcomes across all indicators. Rheumatology disorders (55.9%; OR = 2.26; 95% CI, 1.96-2.60), fatigue (48.3%; OR 1.84; 95% CI, 1.61-2.11), lower limb limitations (58.3%; OR = 2.64; 95% CI, 2.28-3.06]), difficulty washing (34.1%; OR = 3.03; 95% CI, 2.54-3.61), difficulty with transportation (52.5%; OR = 2.46; 95% CI, 2.09-2.88), and multimorbidity (68.1%; OR = 2.07; 95% CI, 1.78-2.40), were the most common conditions in disease, symptoms, mobility, basic and instrumental activity limitations, and geriatric syndromes in this population. Several clinical situations were also uncommon but highly related to requiring physical therapeutic care such as having bedsores (OR = 2.67; 95% CI, 1.81-3.97) or Parkinson disease (OR = 3.08; 95% CI, 2.08-4.55). They also cumulate more deficiencies in a 70-items frailty index than their counterpart in every age group and in every disease subgroup suggesting more complex health profile than older adults not requiring physical therapists.

Conclusion: More than a quarter of older adults consulted a physical therapist. These patients showed complex profiles that simultaneously combine diseases, symptoms, geriatric syndromes, and limitations.

Impact: These complex profiles and large-scale demographic changes underway are key challenges in the evolution of a profession that has a significant focus on disability.