Substantial growth of the population aged 90 years or over has focused interest on trends in the functioning and disability of the oldest old, but research findings are scarce and they vary. In the Vitality 90? Study, we evaluated overall, gender-specific, and agespecific trends in disability among total cohorts of people aged 90 years or older in the city of Tampere, Finland, in the years 2001, 2003, and 2007. The size of the target population ranged from 1113 to 1146 and the participation rate from 79 to 86%. The participants were asked whether they were able to get in and out of bed, dress and undress, move about indoors, walk 400 m, and use stairs. Independence was defined as being able to perform an activity without help. The aggregate outcome measures included independence in all five activities, dependence in one to four activities, dependence in all five activities (severe dependence), and a disability score. In analyses taking into account the within subject associations which resulted due to those who participated in several years, and proxy respondents, no overall or gender-specific trend was found in any of the independence or dependence estimates. In each year, independence decreased clearly by increasing age. Our results imply stable disability levels in nonagenarians in a population with increasing life expectancy and improving survival until the age of 90. Longer-time series are needed to confirm the trends.
The aim of this study was to examine if there are differences in self-rated health (SRH) between older people in St. Petersburg, Russia, and Tampere, Finland. Two SRH measures were examined: a global measure without any frame of reference, and an age-comparative SRH with an explicitly elicited reference of age peers. The Tampere data, consisting of 737 60-89-year-old respondents, came from the Tampere Longitudinal Study on Ageing (TamELSA) in 1989. The St. Petersburg data, consisting of 1,168 people aged 60-89 years, came from the Planning of Medical and Social Services within Elder Care in St. Petersburg project (IPSE) in 2000. In both cities the data were collected by same structured questionnaire. Self-rated health, both global and comparative, was better in Tampere than in St. Petersburg when symptoms, chronic diseases and functional ability were adjusted for. Also, the association of chronic diseases with global SRH was different in St. Petersburg and Tampere. In addition to the real differences in the prevalence and seriousness of health problems, the differences in SRH may be caused by different ways of evaluating health. Our conclusion is that self-rated health is sensitive to cultural and social factors. Direct comparisons between different countries should be made with caution, and the differences in language use must be taken into account when interpreting the results.
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