Trends of Physical Functioning, Morbidity, and Disability-Free Life Expectancy Among the Oldest Old: Six Repeated Cross-Sectional Surveys Between 2001 and 2018 in the Vitality 90+ Study

Abstract

Background It remains unclear whether increasing longevity is accompanied by a compression or expansion of poor health and disability. We examined trends of physical functioning and morbidity in a population aged 90 and older, and disease- and disability-free life expectancy (LE) at age 90 between 2001 and 2018 in Finland’s third most populated city. Methods We used survey data from the Vitality 90+ Study, which comprises a series of six repeated mailed surveys (7,590 observations). Information on mortality came from Statistics Finland. We examined trends of functioning (activities of daily living [ADL] and mobility) and cardiovascular and dementia morbidity using age-adjusted generalized estimating equation models stratified by sex. In addition, age-, sex-, and period-specific health expectancies were calculated using Sullivan’s method. Results Over time, functioning improved, especially, in women, and morbidity increased in men. From 2001 to 2018, LE at age 90 increased by 5.3 months for men and 6.4 months for women. LE without ADL disability increased by 5.0 months for men and 8.4 months for women, and LE without mobility disability by 6.0 months for men and 4.4 months for women. LE without cardiovascular and dementia morbidity decreased for men (2.6 months) and increased for women (1.9 months). Conclusions In relative terms, we found a compression of disability for both sexes and an expansion of morbidity for men. Although the trends overall are rather positive, the increase in absolute morbidity and, to some extent, in disability will inevitably mean increasing care needs with population aging.

Stigma, Health and Well-Being

“…Although the modern world has enhanced the quality of healthcare and increased the successful rate of treatment due to the health technologies and available medications available, some psychosocial issues related to diseases remain unresolved. Indeed, the literature shows that populations with different disabilities have increased life expectancy [ 1 , 2 ]; however, their psychosocial health seems not to be well taken care of in our communities.…”

Peer-led exercise program for ageing adults to improve physical functions - a randomized trial

“…It is possible that ageing adults who are already more physically active than the average are those who seek out these community programs. Nonetheless, an increase in physical function could lead to greater life expectancy and living independently for a more extended period, as suggested in the literature [27]. The minimally clinically important difference (MCID), within a clinical setting, is the smallest benefit of value to the patient and is not just based on statistical significance but meaningful changes to the individual [28,29].…”

Trends in the Social Class Inequalities in Disability and Self-Rated Health: Repeated Cross-Sectional Surveys from Finland and Sweden 2001–2018

“…The Vitality 90+ Study encompasses population-based data on 90 years and older in the third largest city of Finland. The demographic characteristics in the city of Tampere; a doubling of the 90+ population; an increase in the relative proportion of 90+ population; and the sex distribution resembles the overall demographic changes in Finland between 2001 and 2018 [ 9 ]. The oldest old populations in both Finland and Tampere are homogenous in terms of ethnic background and language [ 10 ], and Tampere encompasses both urban and rural areas.…”

“…The Vitality 90+ Study encompasses everyone aged 90 years and over residing in the third largest city of Finland (Tampere) in 2001, 2003, 2007, 2010, 2014 and 2018. The data were collected using a mailed questionnaire and have response rates between 77-86% over the years [ 9 ]. There were in total 5,440 participants with 7,589 observations between 2001 and 2018 of which 78% were women.…”

“…ADL, mobility and SRH are all associated with quality of life, care needs and mortality, and are considered important health indicators in old age [ 6 , 7 ]. The recent trends for the oldest old populations suggest some improvement in mobility and ADL [ 8 , 9 ] but worsening in SRH [ 8 , 10 ] in Finland and Sweden.…”