Health and disease in 85 year olds: baseline findings from the Newcastle 85+ cohort study

Abstract

Objectives The Newcastle 85+ Study aims to systematically study the clinical, biological, and psychosocial attributes of an unselected cohort of 85 year olds and to examine subsequent health trajectories as the cohort ages; health at baseline is reported. Design Cross sectional analysis of baseline data from a cohort study. Setting Newcastle upon Tyne and North Tyneside primary care trusts, United Kingdom. Participants 1042 people born in 1921 and registered with the participating general practices. Main outcome measures Detailed health assessment and review of general practice records (disease, medication, and use of general practice services); participants could decline elements of the protocol. Results Of the 1453 eligible people, 851 (58.6%) were recruited to health assessment plus record review, 188 (12.9%) to record review only, and 3 (0.2%) to health assessment only. Data from record review are reported on a maximum of 1030 and from health assessment on a maximum of 853; individual denominators differ owing to withdrawal and missing values. Of the health assessment sample (n=853), 62.1% (n=530) were women and 10.4% (n=89) were in institutional care. The most prevalent diseases were hypertension (57.5%, 592/1030) and osteoarthritis (51.8%, 534/1030). Moderate or severe cognitive impairment was present in 11.7% (96/824) of participants, severe or profound urinary incontinence in 21.3% (173/813), hearing impairment in 59.6% (505/ 848), and visual impairment in 37.2% (309/831). Health assessment identified participants with possible disease but without a previous diagnosis in their medical record for hypertension (25.1%, 206/821), ischaemic heart disease (12.6%, 99/788), depression (6.9%, 53/772), dementia (6.7%, 56/840), and atrial fibrillation (3.8%, 30/788). Undiagnosed diabetes mellitus and thyroid disease were rare (1%, 7/717 and 6/762, respectively). A median of 3 (interquartile range 1-8) activities of daily living were undertaken with difficulty. Overall, 77.6% (646/832) of participants rated their health compared with others of the same age as good, very good, or excellent. High contact rates in the previous year with general practitioners (93.8%, 960/1024) were recorded. Women had significantly higher disease counts (medians: women 5, men 4; P=0.033) and disability scores (medians: women 4, men 2; P=0.0006) than men, but were less likely to have attended outpatient clinics in the previous three months (women 29% (150/524), men 37% (118/320), odds ratio 0.7, 95% confidence interval 0.5 to 0.9). Conclusions This large cohort of 85 year olds showed good levels of both self rated health and functional ability despite significant levels of disease and impairment. Hypertension, ischaemic heart disease, atrial fibrillation, depression, and dementia may be underdiagnosed. Notable differences were found between the sexes: women outnumbered men and had more disease and disability.

Comorbidity and dementia: a mixed-method study on improving health care for people with dementia (CoDem)

“…70 Moreover, management of these conditions, in particular self-management, is likely to be complicated by the presence of dementia. 21 VI is also prevalent in older people 71 and may exacerbate confusion. 72 In addition, the ability to cope with VI is reduced if a person also has dementia.…”

Rendimiento en las pruebas “Timed Up and Go” y “Estación Unipodal” en adultos mayores chilenos entre 60 y 89 años

“…En tal sentido, al enfocarse en la prueba TUG se observa una tendencia de mejor rendimiento de los hombres respecto a las mujeres entre los 60 y 80 años. Sin embargo, en los octogenarios esto disminuye, lo cual podría obedecer a dos factores: las características funcionales de quienes han logrado un envejecimiento exitoso [28][29][30] y haber preservado condiciones similares al efecto deletéreo acumulado por la edad 18 .…”

What do we know about the nutritional status of the very old? Insights from three cohorts of advanced age from the UK and New Zealand

“…The recruited cohort was sociodemographically representative of England and Wales and included institutionalised and cognitively impaired very old adults (16) . The study received ethical approval from the Newcastle and North Tyneside 1 Research Ethics Committee (06/Q0905/2).…”

“…Specifically, diet quality has been linked to socioeconomic status defined either by education, social class (occupation) and income in general and older adults populations (aged 60 and over) (56)(57)(58) , but to which extent and which dimension socioeconomic status plays a role in diet characteristics in very late life is not known. Utilising dietary data collected by 24-h multiple-pass dietary recalls from participants in the Newcastle 85+ study (16,17,34) and two-step clustering, we identified three distinct DP, which differed with respect to the key sociodemographic, lifestyle, health and functioning measures (59) . 'High Red Meat' DP had the highest proportion of participants (and the highest mean intake (g/d)) consuming red and processed meats/meat dishes, potato/potato dishes, gravy, legumes (including baked beans) and unsaturated fats spreads, but the lowest consumption of butter.…”