Health Differences in Advanced Old Age

AbstractThe first part of this paper provides a general outline of objectives and methods of the Internal Medicine and Geriatrics Unit of the Berlin Aging Study (BASE). Based on a multi-dimensional conceptualization of health, objective and laboratory data collected about different organ systems, e.g. cardiovascular and musculoskeletal, and functional capacity are complemented by qualitative clinical diagnoses and judgements as well as self-reported health problems and functional limitations. Some of the central questions that can be addressed using these data relate to understanding the nature and processes of differential ageing. The second part of the paper includes initial analyses of inter-individual health differences in advanced old age (70 to 105 years). Initial findings indicated that heterogeneity in somatic morbidity and functional capacity was at least as large in old adults (70 to 84 years) as in very old adults (85 to 105 years), even though higher rates of somatic morbidity and lower levels of functional capacity were observed in the very old. Chronological age and morbidity as well as psychosocial and demographic factors were found to be independent predictors of functional capacity in advanced old age. Additionally, the relative importance of psychosocial factors was found to be a function of age with lower predictive ability among the very old. In conclusion, these initial findings support the hypothesis of significant health differences in advanced old age due to differential ageing.

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Cardiac Rehabilitation in Very Old Adults: Effect of Baseline Functional Capacity on Treatment Effectiveness

Journal of the American Geriatrics Society ◽

10.1111/jgs.14239 ◽

2016 ◽

Vol 64 (8) ◽

pp. 1640-1645 ◽

Cited By ~ 23

Author(s):

Samuele Baldasseroni ◽

Alessandra Pratesi ◽

Sara Francini ◽

Rachele Pallante ◽

Riccardo Barucci ◽

...

Keyword(s):

Cardiac Rehabilitation ◽

Functional Capacity ◽

Treatment Effectiveness ◽

Very Old ◽

Old Adults

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Morbidity, Medication, and Functional Limitations in Very Old Age

The Berlin Aging Study ◽

10.1017/cbo9780511586545.006 ◽

1998 ◽

pp. 131-166 ◽

Cited By ~ 5

Author(s):

E. Steinhagen-Thiessen ◽

M. Borchelt

Keyword(s):

Old Age ◽

Functional Limitations ◽

Very Old ◽

Very Old Age

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Linking Emotion Regulation Capacity and the Frequency of Daily Stressors in Old and Very Old Age

Innovation in Aging ◽

10.1093/geroni/igab046.1279 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 331-331

Author(s):

Denis Gerstorf ◽

Anna Lücke ◽

Hans-Werner Wahl ◽

Oliver Schilling ◽

Ute Kunzmann ◽

...

Keyword(s):

Emotion Regulation ◽

Old Age ◽

Negative Emotion ◽

Daily Stressors ◽

Very Old ◽

Old Adults ◽

Film Clips ◽

Very Old Age ◽

Young Old ◽

Initial Results

Abstract Lifespan theories and lab-based research both suggest that the ability to downregulate negative emotions is often well preserved into old age, but becomes increasingly fragile in very old age. However, little is known about factors that may alleviate such age differences. Here, we ask whether exposure to daily stressors helps very old adults to maintain effective emotion regulation skills. We used data from 130 young-old (65-69 years, 48% women) and 59 very-old adults (83-89 years, 58% women) who watched negative emotion evoking film clips in the lab under emotion regulation instructions and also reported stress situations they experienced in everyday life (42 occasions across seven days). Initial results indicate that very-old adults were indeed less successful in regulating sadness than young-old adults, but those very-old adults who reported many daily stressful situations were as capable of emotion regulation as young-old adults. We discuss possible factors contributing to our age-differential findings.

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Associations of Wellbeing Levels, Changes, and Within-Person Variability With Late-Life All-Cause Mortality Across 12 Years: Contrasting Hedonic vs. Eudaimonic Wellbeing Among Very Old Adults

Frontiers in Psychology ◽

10.3389/fpsyg.2021.750891 ◽

2022 ◽

Vol 12 ◽

Author(s):

Oliver Karl Schilling ◽

Markus Wettstein ◽

Hans-Werner Wahl

Keyword(s):

Old Age ◽

Structural Equation ◽

Structural Equation Models ◽

Oldest Old ◽

Residual Lifetime ◽

Very Old ◽

Old Adults ◽

All Cause Mortality ◽

Mortality Predictors ◽

Eudaimonic Wellbeing

Advanced old age has been characterized as a biologically highly vulnerable life phase. Biological, morbidity-, and cognitive impairment-related factors play an important role as mortality predictors among very old adults. However, it is largely unknown whether previous findings confirming the role of different wellbeing domains for mortality translate to survival among the oldest-old individuals. Moreover, the distinction established in the wellbeing literature between hedonic and eudaimonic wellbeing as well as the consideration of within-person variability of potentially relevant mortality predictors has not sufficiently been addressed in prior mortality research. In this study, we examined a broad set of hedonic and eudaimonic wellbeing indicators, including their levels, their changes, as well as their within-person variability, as predictors of all-cause mortality in a sample of very old individuals. We used data from the LateLine study, a 7-year longitudinal study based on a sample of n = 124 individuals who were living alone and who were aged 87–97 years (M = 90.6, SD = 2.9) at baseline. Study participants provided up to 16 measurement occasions (mean number of measurement occasions per individual = 5.50, SD = 4.79) between 2009 and 2016. Dates of death were available for 118 individuals (95.2%) who had deceased between 2009 and 2021. We ran longitudinal multilevel structural equation models and specified between-person level differences, within-person long-term linear change trends, as well as the “detrended” within-person variability in three indicators of hedonic (i.e., life satisfaction and positive and negative affect) and four indicators of eudaimonic wellbeing (i.e., purpose in life, autonomy, environmental mastery, and self-acceptance) as all-cause mortality predictors. Controlling for age, gender, education, and physical condition and testing our sets of hedonic and eudaimonic indictors separately in terms of their mortality impact, solely one eudaimonic wellbeing indicator, namely, autonomy, showed significant effects on survival. Surprisingly, autonomy appeared “paradoxically” related with mortality, with high individual levels and intraindividual highly stable perceptions of autonomy being associated with a shorter residual lifetime. Thus, it seems plausible that accepting dependency and changing perceptions of autonomy over time in accordance with objectively remaining capabilities might become adaptive for survival in very old age.

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‘At home it's just so much easier to be yourself’: older adults' perceptions of ageing in place

Ageing and Society ◽

10.1017/s0144686x14001214 ◽

2014 ◽

Vol 36 (3) ◽

pp. 449-481 ◽

Cited By ~ 44

Author(s):

DAMIEN STONES ◽

JUDITH GULLIFER

Keyword(s):

Lived Experience ◽

Old Age ◽

Qualitative Methodology ◽

Psychological Research ◽

Ageing In Place ◽

Very Old ◽

Old Adults ◽

Research Perspective ◽

Care Assessment ◽

At Home

ABSTRACTBy 2050, the number of people in Australia aged over 85 is expected to quadruple. Yet, from a socio-psychological research perspective, little is known about the experiences of people who continue to live at home during late old age (85 years and over), a period when challenging problems associated with ageing escalate and threaten to compromise independence. Utilising a qualitative methodology, the subjective lived experience of 23 very old adults (19 women, four men, with a mean age of 90.7 years, range 85–101 years) who live independently in rural Australia were elicited. The aims of the research were to understand their thoughts and feelings about ageing in place at home, and what psychological, social and practical adaptive strategies they employ to cope with difficulties encountered during very old age. In-depth interviews were analysed in an interpretive phenomenological tradition of thematic analysis, interpretation of paradigm cases and interpretation of exemplars. Participants described how historical, cultural and environmental contexts shaped their everyday thoughts, activities and what was meaningful for them. The findings add to our understanding of the largely unnarrated lives of the very old, suggest a need for person-centred home-care assessment processes and aid significant others (family, friends and neighbours) to understand better what very old adults need to live independently.

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Airflow limitation by the Global Lungs Initiative equations in a cohort of very old adults

European Respiratory Journal ◽

10.1183/09031936.00217214 ◽

2015 ◽

Vol 46 (1) ◽

pp. 123-132 ◽

Cited By ~ 13

Author(s):

Eralda Turkeshi ◽

Bert Vaes ◽

Elena Andreeva ◽

Catharina Matheï ◽

Wim Adriaensen ◽

...

Keyword(s):

Cox Regression ◽

Multivariable Analysis ◽

Predictive Ability ◽

Population Based ◽

Forced Expiratory Volume ◽

Airflow Limitation ◽

Chronic Obstructive ◽

Very Old ◽

Old Adults ◽

All Cause Mortality

The cut-off for forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) defining airflow limitation for chronic obstructive pulmonary disease (COPD) is still contested. We assessed airflow limitation prevalence by the lower limit of normal (LLN) of Global Lungs Initiative (GLI) 2012 reference values and its predictive ability for all-cause mortality and hospitalisation in very old adults (aged ≥80 years) compared with the fixed cut-off.In a Belgian population-based prospective cohort of 411 very old adults, airflow limitation prevalence by the 5th percentile of GLI 2012 z-scores (GLI-LLN) and fixed cut-off (0.70) were compared with COPD reported by general practitioners (GPs). Survival and Cox regression multivariable analysis assessed the association of airflow limitation by both cut-offs with 5-year all-cause mortality and first hospitalisation at 3 years.9.2% had airflow limitation by GLI-LLN and 27% by fixed cut-off, without good agreement (kappa coefficient ≤0.40) with GP-reported COPD (9%). Only airflow limitation by GLI-LLN was independently associated with mortality (adjusted hazard ratio 2.10, 95% CI 1.30–3.38). FEV1/FVC <0.70 but ≥GLI-LLN (17.8%) had no significantly higher risk for mortality or hospitalisation.In a cohort of very old adults, airflow limitation by GLI-LLN has lower prevalence than by fixed cut-off, independently predicts all-cause mortality and does not miss individuals with significantly higher all-cause mortality and hospitalisation.

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