scholarly journals 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

2020 ◽  
Author(s):  
Linda Enroth ◽  
Jani Raitanen ◽  
Pauliina Halonen ◽  
Kristina Tiainen ◽  
Marja Jylhä
Keyword(s):  
Life Expectancy ◽  
Physical Functioning ◽  
Population Aging ◽  
Oldest Old ◽  
Estimating Equation ◽  
Care Needs ◽  
Cross Sectional ◽  
Disability Free Life Expectancy ◽  
Adl Disability ◽  
Specific Health

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.

scholarly journals A study on disability in terms of activities of daily living among elderly in Palam village of west Delhi

2019 ◽  
Vol 6 (11) ◽  
pp. 4777
Author(s):  
Devendra Kumar ◽  
S. K. Rasania ◽  
Ranjan Das
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Cross Sectional Study ◽  
Care Needs ◽  
Cross Sectional ◽  
Quality Life ◽  
High Incidence ◽  
Study Population ◽  
Adl Disability ◽  
Elderly Living

Background: Aging, an integral part of living, typically is accompanied by gradual but progressive physiological changes and an increased prevalence of acute and chronic illness. Although neither a disease nor disability per se, aging nonetheless is associated with a high incidence of physical impairment as well.The objective of the present study was to assess the prevalence of activities of daily living (ADL) disability in elderly living in Palam village of Delhi.Methods: A community based cross-sectional study was carried out to assess the prevalence of ADL disability in elderly living in Palam village of Delhi using Barthel ADL index. It uses ten variables describing ADL and mobility. The sample size was estimated to be 350 and systematic random sampling was used to choose the study subjects.Results: The prevalence of ADL disability was found to be 20.3% in the study population. This was found to be 16.3% in males and 23.9% in females.Conclusions: After obtaining adequate data on elderly having difficulty in performing their routine activities of daily living, appropriate steps needs to be taken to mitigate its ill effects which should also address their health care needs and help them to live a healthy and good quality life.

scholarly journals Longitudinal change in physical functioning and dropout due to death among the oldest old: a comparison of three methods of analysis

2019 ◽  
Vol 17 (2) ◽  
pp. 207-216 ◽  
Author(s):  
Jani Raitanen ◽  
Sari Stenholm ◽  
Kristina Tiainen ◽  
Marja Jylhä ◽  
Jaakko Nevalainen
Keyword(s):  
Physical Functioning ◽  
Average Rate ◽  
Elderly Care ◽  
Oldest Old ◽  
Estimating Equation ◽  
Joint Model ◽  
Longitudinal Change ◽  
Intervention Measures ◽  
Age Related ◽  
Working Correlation

Abstract Longitudinal studies examining changes in physical functioning with advancing age among very old people are plagued by high death rates, which can lead to biased estimates. This study was conducted to analyse changes in physical functioning among the oldest old with three distinct methods which differ in how they handle dropout due to death. The sample consisted of 3992 persons aged 90 or over in the Vitality 90+ Study who were followed up on average for 2.5 years (range 0–13 years). A generalized estimating equation (GEE) with independent ‘working’ correlation, a linear mixed-effects (LME) model and a joint model consisting of longitudinal and survival submodels were used to estimate the effect of age on physical functioning over 13 years of follow-up. We observed significant age-related decline in physical functioning, which furthermore accelerated significantly with age. The average rate of decline differed markedly between the models: the GEE-based estimate for linear decline among survivors was about one-third of the average individual decline in the joint model and half the decline indicated by the LME model. In conclusion, the three methods yield substantially different views on decline in physical functioning: the GEE model may be useful for considering the effect of intervention measures on the outcome among living people, whereas the LME model is biased regarding studying outcomes associated with death. The joint model may be valuable for predicting the future characteristics of the oldest old and planning elderly care as life expectancy continues gradually to rise.

Trends in disability-free life expectancy at age 50 years in Australia between 2001 and 2011 by social disadvantage

2021 ◽  
pp. jech-2020-214906
Author(s):  
Richard Tawiah ◽  
Carol Jagger ◽  
Kaarin J Anstey ◽  
Kim M Kiely
Keyword(s):  
Life Expectancy ◽  
Dynamic Equilibrium ◽  
Short Form ◽  
Social Disadvantage ◽  
Multistate Models ◽  
Disability Free Life Expectancy ◽  
Economic Indexes ◽  
Nationally Representative ◽  
Adl Disability ◽  
Disability Severity

BackgroundThe aims of this study were (1) to estimate 10-year trends in disability-free life expectancy (DFLE) by area-level social disadvantage and (2) to examine how incidence, recovery and mortality transitions contributed to these trends.MethodsData were drawn from the nationally representative Household Income and Labour Dynamics in Australia survey. Two cohorts (baseline age 50+ years) were followed up for 7 years, from 2001 to 2007 and from 2011 to 2017, respectively. Social disadvantage was indicated by the Socio-Economic Indexes for Areas (SEIFA). Two DFLEs based on a Global Activity Limitation Indicator (GALI) and difficulties with activities of daily living (ADLs) measured by the 36-Item Short Form Survey physical function subscale were estimated by cohort, sex and SEIFA tertile using multistate models.ResultsPersons residing in the low-advantage tertile had more years lived with GALI and ADL disability than those in high-advantage tertiles. Across the two cohorts, dynamic equilibrium for GALI disability was observed among men in mid-advantage and high-advantage tertiles, but expansion of GALI disability occurred in the low-advantage tertile. There was expansion of GALI disability for all women irrespective of their SEIFA tertile. Compression of ADL disability was observed for all men and for women in the high-advantage tertile. Compared to the 2001 cohort, disability incidence was lower for the 2011 cohort of men within mid-advantage and high-advantage tertiles, whereas recovery and disability-related mortality were lower for the 2011 cohort of women within the mid-advantage tertile.ConclusionOverall, compression of morbidity was more common in high-advantage areas, whereas expansion of morbidity was characteristic of low-advantage areas. Trends also varied by sex and disability severity.

scholarly journals Religion, Life Expectancy, and Disability-Free Life Expectancy Among Older Women and Men in the United States

2018 ◽  
Vol 74 (8) ◽  
pp. e107-e118 ◽  
Author(s):  
Mary Beth Ofstedal ◽  
Chi-Tsun Chiu ◽  
Carol Jagger ◽  
Yasuhiko Saito ◽  
Zachary Zimmer
Keyword(s):  
Life Expectancy ◽  
The United States ◽  
Health Expectancy ◽  
Religious Services ◽  
Iadl Disability ◽  
Disability Free Life Expectancy ◽  
Adl Disability ◽  
Health And Mortality ◽  
Multistate Life Table ◽  
Retirement Study

Abstract Objectives Existing literature shows religion is associated with health and survival separately. We extend this literature by considering health and survival together using a multistate life table approach to estimate total, disability-free, and disabled life expectancy (LE), separately for women and men, for 2 disability measures, and by 2 indicators of religion. Method Data come from the Health and Retirement Study (1998–2014 waves). Predictors include importance of religion and attendance at religious services. The disability measures are defined by ADLs and IADLs. Models control for sociodemographic and health covariates. Results Attendance at religious services shows a strong and consistent association with life and health expectancy. Men and women who attend services at least once a week (compared with those who attend less frequently or never) have between 1.1 and 5.1 years longer total LE and between 1.0 and 4.3 years longer ADL disability-free LE. Findings for IADL disability are similar. Importance of religion is related to total and disabled LE (both ADL and IADL), but the differentials are smaller and less consistent. Controlling for sociodemographic and health factors does not explain these associations. Discussion By estimating total, disability-free, and disabled LE, we are able to quantify the advantage of religion for health. Results are consistent with previous studies that have focused on health and mortality separately.

scholarly journals Influencing Factors of Undermet Care Needs of the Chinese Disabled Oldest Old People When Their Children Are Both Caregivers and Older People: A Cross-Sectional Study

Healthcare ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 365
Author(s):  
Qilin Zhang ◽  
Yanli Wu ◽  
Erpeng Liu
Keyword(s):  
Older People ◽  
Influencing Factors ◽  
Oldest Old ◽  
Frailty Index ◽  
Binary Logistic Regression Analysis ◽  
Old People ◽  
Care Needs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Term Care

We examined the influencing factors of the undermet care needs of the Chinese disabled oldest old people when their children are both caregivers and are themselves older people. Data were obtained from a cross-sectional survey: the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2018. The study participants included 1617 disabled oldest old people whose primary caregiver were their children or children-in-law and were aged 60 years and over. The results showed that the prevalence of undermet needs remained high, with 49.6% disabled oldest old people reporting undermet care needs. Binary logistic regression analysis revealed that living in a rural area (OR = 1.309, 95% CI = 1.133–1.513) and a higher frailty index (OR = 1.103, 95% CI = 1.075–1.131) were significantly positively associated with higher odds for undermet care needs, while a higher annual household income (OR = 0.856, 95% CI = 0.795–0.923), more financial support from children (OR = 0.969, 95% CI = 0.941–0.997), higher care expenditures (OR = 1.044, 95% CI = 1.002–1.088), better caregiver’s performance (OR = 0.282, 95% CI = 0.196–0.407) and sufficient income to pay for daily expenses (OR = 0.710, 95% CI = 0.519–0.973) were significantly inversely associated with higher odds for undermet care needs. This evidence suggests the importance of policies to establish a community-based socialized long-term care system and supporting family caregivers of the disabled oldest old people.

scholarly journals Associations of poor oral health with frailty and physical functioning in the oldest old: results from two studies in England and Japan

2021 ◽  
Author(s):  
Viviana Albani ◽  
Kennsuke Nishio ◽  
Tomoka Ito ◽  
Eftychia Kotronia ◽  
Paula Moynihan ◽  
...  
Keyword(s):  
Oral Health ◽  
Grip Strength ◽  
Physical Functioning ◽  
Gait Speed ◽  
Tooth Loss ◽  
Oldest Old ◽  
Mobility Limitations ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Increased Risk

Abstract Background: Very few studies have examined the relationship of oral health with physical functioning and frailty in the oldest old (>85 years). We examined the association of poor oral health with markers of disability, physical function and frailty in studies of oldest old in England and Japan.Methods: The Newcastle 85+ Study in England (n=853) and the Tokyo Oldest Old Survey on Total Health (TOOTH; n=542) comprise random samples of people aged >85 years. Oral health markers included tooth loss, dryness of mouth, difficulty swallowing and self-reported difficulty eating due to dental problems. Physical functioning was based on grip strength and gait speed; disability was assessed as mobility limitations. Frailty was ascertained using the Fried frailty phenotype. Cross-sectional analyses were undertaken using logistic regression.Results: In the Newcastle 85+ Study, dry mouth symptoms, difficulty swallowing, difficulty eating, and tooth loss were associated with increased risks of mobility limitations after adjustment for gender, socioeconomic position, behavioural factors and co-morbidities [odds ratios (95%CIs) were 1.76 (1.26-2.46); 2.52 (1.56-4.08); 2.89 (1.52-5.50); 2.59 (1.44-4.65) respectively]. Similar results were observed for slow gait speed. Difficulty eating was associated with weak grip strength and frailty on full adjustment. In the TOOTH Study, difficulty eating was associated with increased risks of frailty, mobility limitations and slow gait speed; and complete tooth loss was associated with increased risk of frailty.Conclusion: Different markers of poor oral health are independently associated with worse physical functioning and frailty in the oldest old age groups. Research to understand the underlying pathways is needed.

scholarly journals Associations of poor oral health with frailty and physical functioning in the oldest old: results from two studies in England and Japan

2020 ◽  
Author(s):  
Viviana Albani ◽  
Kennsuke Nishio ◽  
Tomoka Ito ◽  
Eftychia Kotronia ◽  
Paula Moynihan ◽  
...  
Keyword(s):  
Oral Health ◽  
Grip Strength ◽  
Physical Functioning ◽  
Gait Speed ◽  
Tooth Loss ◽  
Oldest Old ◽  
Mobility Limitations ◽  
Frailty Phenotype ◽  
Cross Sectional ◽  
Increased Risk

Abstract Background: Very few studies have examined the relationship of oral health with physical functioning and frailty in the oldest old (>85 years). We examined the association of poor oral health with markers of disability, physical function and frailty in studies of oldest old in England and Japan.Methods: The Newcastle 85+ Study in England (n=853) and the Tokyo Oldest Old Survey on Total Health (TOOTH; n=542) comprise random samples of people aged >85 years. Oral health markers included tooth loss, dryness of mouth, and self-reported difficulty eating due to dental problems. Physical functioning was based on grip strength and gait speed; disability was assessed as mobility limitations. Frailty was ascertained using the Fried frailty phenotype. Cross-sectional analyses were undertaken using logistic regression.Results: In the Newcastle 85+ Study, dry mouth symptoms, difficulty swallowing, difficulty eating, and tooth loss were associated with increased risks of mobility limitations after adjustment for gender, socioeconomic position, behavioural factors and co-morbidities [odds ratios (95%CIs) were 1.76 (1.26-2.46); 2.52 (1.56-4.08); 2.89 (1.52-5.50); 2.59 (1.44-4.65) respectively]. Similar results were observed for slow gait speed. Difficulty eating was associated with weak grip strength and frailty on full adjustment. In the TOOTH Study, difficulty eating was associated with increased risks of frailty, mobility limitations and slow gait speed; and complete tooth loss was associated with increased risk of frailty.Conclusion: Different markers of poor oral health are independently associated with worse physical functioning and frailty in the oldest old age groups. Research to understand the underlying pathways is needed.

Demographic Dimensions of Global Aging

2000 ◽  
Vol 21 (5) ◽  
pp. 541-558 ◽  
Author(s):  
KEVIN KINSELLA
Keyword(s):  
Life Expectancy ◽  
Population Aging ◽  
Oldest Old ◽  
Later Life ◽  
Private Institutions ◽  
Public And Private ◽  
Health Trends ◽  
Institutional Responses ◽  
First Time ◽  
Global Aging

Population aging in the 20th century represents a human success story; for the first time in history, populations have the luxury of aging. Aging, however, also poses a myriad of challenges to public and private institutions that must adapt to a changing age structure. This article highlights national and regional similarities and differences in the global aging process, focusing on demographic and health trends that are likely to shape future institutional responses in the eldercare arena. Among the topics considered are the importance of past fertility patterns, changes in life expectancy and healthy life expectancy, the feminization of later life, the growth of the “oldest old,” and changing national disease profiles associated with the epidemiological transition.

scholarly journals Effect of the elimination of chronic diseases on disability-free life expectancy among elderly individuals in Sao Paulo, Brazil, 2010

2014 ◽  
Vol 19 (8) ◽  
pp. 3327-3334 ◽  
Author(s):  
Alessandro Gonçalves Campolina ◽  
Fernando Adami ◽  
Jair Licio Ferreira Santos ◽  
Maria Lucia Lebrão
Keyword(s):  
Life Expectancy ◽  
Chronic Diseases ◽  
The Elderly ◽  
Population Based ◽  
Sao Paulo ◽  
São Paulo ◽  
Compression Of Morbidity ◽  
Cross Sectional ◽  
Elderly Individuals ◽  
Disability Free Life Expectancy

The scope of this study was to establish whether the elimination of certain chronic diseases is capable of leading to the compression of morbidity among elderly individuals in Sao Paulo (Brazil), 2010. A population-based, cross-sectional study was carried out with official data for the city of Sao Paulo (Brazil) in 2010 and data from the SABE (Health, Wellbeing and Ageing) study. A total of 907 elderly individuals were evaluated, 640 of whom were women (64.6%). Sullivan's method was used for the calculation of disability-free life expectancy (DFLE). Life tables for cause elimination were used to calculate the probabilities of death with the elimination of health conditions. In absolute terms, the gains in LE and DFLE were greater in the younger age group (60 to 74 years) in both genders. In relative terms (%DFLE in LE), the gains were higher among women aged 75 years or older and among men aged 60 years. If eliminated, heart disease was the condition that would most lead to the compression of morbidity in both genders. The elimination of chronic diseases from the elderly population could lead to a compression of morbidity in men and women at both 60 years of age and 75 years of age or older.

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