Disability trends among nonagenarians in 2001–2007: Vitality 90+ Study

Abstract

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.

Physical and cognitive functioning of people older than 90 years: a comparison of two Danish cohorts born 10 years apart

“…To include the most recent demographic data available, we accessed the Human Mortality Database. 3 In line with previous research, recent cohort comparisons 7,9,10,18–20 reached differing conclusions about the health outcomes between cohorts, but the studies that used physical and cognitive testing generally focused on younger elderly people (age <85 years) and excluded those in residential care.…”

“…However, the sample size in both studies was small. 24–26 A larger Finnish study 18 of nonagenarians in Tampere was based on a questionnaire survey and so did not include cognitive or physical tests, but the investigators reported stable frequencies of disability in 2001–07. In the USA, a series of analyses of data from the Health and Retirement Survey of people aged 70 years and older showed mixed results; Freedman and colleagues 27 reported improvement in cognitive functioning for individuals aged 80 years and older from 1993 to 1998, whereas Rodgers and colleagues 28 noted little improvement from 1993 to 2000 when age distribution and practice effect from previous study participation were taken into account.…”

Trends of Functioning and Health in Nonagenarians: The Vitality 90+ Study

“…Data in the Vitality 901 Study are collected by mailed surveys to the whole target population, face-to-face interviews, performance tests, blood samples with subgroups, and qualitative life story interviews (Jylhävä, Jylhä, Lehtimäki, Hervonen, & Hurme, 2012;Lisko et al, 2012;Sarkeala, Nummi, Vuorisalmi, Hervonen, & Jylhä, 2011). In 1996 and 1998, questionnaires were sent to community-dwelling inhabitants of Tampere and in the years 2001, 2003, 2007, and 2010 to every 90 years old and older persons in the area, irrespective of health or place of living.…”

The normative implications of the longevity transition

“…It is a question of fact, for example, whether or not increasing life expectancy at older ages does indeed increase the risk of experiencing a prolonged period of serious cognitive impairment before death [17], and there is now a growing body evidence to suggest that life years with serious disability are not increasing [18,19]. It is also a question of fact whether or not the more effective implementation of current strategies for maximising the number of healthy life years in the average lifespan will have the desired outcome for end-of-life trajectories.…”