Subjects of two clusters could walk without difficulty and were functionally independent prior to their hip fracture. One year later, however, mobility and functioning were only fully recovered by the members of one cluster. The majority of predictors were of less favorable prognostic value for the members of the second cluster. The other two clusters regrouped patients with impaired prefracture mobility that were either unaltered or even aggravated 1 year later. CONCLUSIONS. Cluster analysis identified typical profiles of elderly hip fracture patients. Close scrutiny of their respective global structure, in terms of combined prognostic determinants and outcomes, may help to develop specific management strategies that are more efficiently adapted to these different groups of patients.

Using a sample of octogenarians from the Swiss Interdisciplinary Longitudinal Study on the Oldest Old, the authors investigated the predictive validity of an expanded working definition of frailty based on deficiencies in mobility, memory, energy, and physical or sensory capacities and analyzed the resulting health transitions. The five domains were considered as predictors of the onset of dependence in activities of daily living (ADLs) and death using logistic multilevel and Cox survival regression models. Health transitions were studied with Markov chains. Deficiencies in memory, energy, and sensory capacities contributed to the prediction of the onset of ADL dependence and death in participants free of physical pains and mobility impairments. With two domains affected, frailty in very old persons indicated an increased risk of adverse outcomes. The study of transitions showed that ADL-independent frailty was a highly probable and relatively long transitional stage between robustness and ADL dependence

We hypothesize that the existence of siblings or close friends may beneficially affect survival, due to the potential influence on the attitudes of octogenarians regarding health practices and adaptive strategies.

This article deals with the following two questions: In very old age, which are the main sources of bereavement? And what are the consequences of such losses on health and on relationships? The findings are based on the complete set of data compiled in the course of the Swiss Interdisciplinary Longitudinal Study on the Oldest Old (SWILSOO), which provided a 10-year follow-up of a first cohort (1994-2004) and a 5-year follow-up of a second (1999-2004). The data revealed that, in very old age, the great majority of the dear ones who died were either siblings or close friends. Taken as a whole, the bereaved suffered a marked and lasting increase in depressive symptoms, together with a short-term deterioration in their functional status; those bereft of a spouse or a child saw their functional status worsen and exhibited enduring depressive symptoms but they also benefited from support in the form of increased interaction; those bereft of siblings only suffered from a mild, short-term deterioration in functional status; those who had lost a close friend suffered a very significant increase in depressive symptoms. In the medium term, most of these effects disappeared, lending weight to the claim that the survivors manage to cope with the misfortunes of life.

The impact of social relationships on the maintenance of independence over periods of 12-18 months in a group of 306 octogenarians is assessed in this study. The study is based on the results of the Swilsoo (Swiss Interdisciplinary Longitudinal Study on the Oldest Old). Participants (80-84 years old at baseline) were interviewed five times between 1994 and 1999. Independence was defined as the capacity to perform without assistance eight activities of daily living. We distinguished in our analyses kinship and friendship networks and evaluated social relationships with the help of a series of variables serving as indicators of network composition and contact frequency. Logistic regression models were used to identify the short-term effects of social relationships on independence, after controlling for sociodemographic and health-related variables; independence at a given wave of interviews was interpreted in the light of social factors measured at the previous wave. Our analyses indicate that the existence of a close friend has a significant impact on the maintenance of independence (OR=1.58, p<0.05), which is not the case with the other variables concerning network composition. Kinship contacts were also observed to have a positive impact on independence (OR=1.12, p<0.01).