To describe disability severity transitions in the ageing population in Switzerland using an overall functioning score to define four disability severity states (no, mild, moderate and severe) and death, and to investigate the association of multimorbidity and further predictors with these transitions.

Secondary analysis of the Swiss version of the Survey of Health, Ageing and Retirement in Europe (SHARE).

Switzerland.

Community-dwelling population aged 50+ with at least two interviews in SHARE (N=3505).

Not applicable.

Primary outcome measures are the disability severity as assessed by a previously developed overall functioning score, and death status as assessed by the SHARE end-of-life interview. Transition analysis between disability severity states and death was conducted using multistate Markov models. The association between predictor variables and transition intensities was quantified using the proportional hazards assumption. Two distinct operationalisations of multimorbidity (count, burden) were used and analysed according to two separate models (A, B).

The findings for both models were similar: Estimated HRs for transition intensities suggest that being multimorbid or having a higher disease burden score increases the risk of transitioning to higher disability severity states and death for most transitions (HRs between 0.90 and 2.34 for model A compared with not being multimorbid; HRs between 0.95 and 1.46 for model B for a one-point increase in the disease burden score). In addition, most transitions to higher disability severity states and death are more likely for higher age (HRs between 1.00 and 1.14 for model A, and between 1.00 and 1.15 for model B for a 1 year increase in age), and transitions to death are less likely for women, compared with men (HRs between 0.34 and 0.88 for model A, and between 0.38 and 0.71 for model B).

This study is a first attempt to understand disability severity transitions in the older population in Switzerland. Although we believe that such an approach is suitable to inform resource allocation to LTC, rehabilitation and prevention, more detailed information on contextual factors will be important to consider for future research. Moreover, our study contributes to the discussion on how to operationalise multimorbidity in healthy ageing research.

Research for pandemic response needs to be timely to inform evidence-based decision making. The lack of epidemiological data at the start of the COVID-19 pandemic led experts to call for cohorts that could rapidly supply data about newly emerging infectious diseases. The ‘Bern, get ready’ (BEready) study aims to establish a prospective ‘pandemic preparedness cohort’ in the canton of Bern, Switzerland. This cohort can be pivoted to the needs of a new pandemic pathogen. The aim of this pilot study was to investigate the potential response and to test the feasibility of procedures for BEready.

Closed population-based cohort study.

Random sample of private households in the canton of Bern, Switzerland, that had previously responded to an online survey.

Adults, children and pets.

Enrolment as a percentage, associations between the agreement to participate and the demographic and socioeconomic variables of the invited household member, number of social contacts, proportion of samples collected, proportion of complete questionnaires and proportion of participants responding after 12 months.

After the initial in-person visit with venous blood sampling, participants were followed up for 1 year. We tested remote data collection methods, with online questionnaires and self-collected capillary blood and nasopharyngeal samples, and established a biobank.

The pilot study enrolled 106/1138 (9%) of invited households plus two additional households that had proactively contacted us. In total, we enrolled 193 people in 108 households (1.8 per household) and 44 pets between April and September 2023. We obtained and stored at least one venous and/or capillary baseline blood sample from 184/193 (95%) people and 40/44 (91%) pets. After 1 year, 172/193 (89%) people in 101/108 (94%) of households completed a follow-up survey, as did 22 owners of 34/44 (77%) pets. 151/172 (88%) respondents returned a follow-up capillary blood sample.

The response rate to the pilot study shows that obtaining high levels of participant enrolment in a pandemic preparedness cohort study is challenging. Data collection without face-to-face contact with a study team is feasible for household members and will be needed in BEready if control measures during a pandemic prevent in-person studies.