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 age-specific 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.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Cai L, Lubitz J (2007) Was there compression of disability for older Americans from 1992 to 2003? Demography 44:479–495
Case A, Paxson C (2005) Sex differences in morbidity and mortality. Demography 42:189–214
Christensen K, McGue M, Petersen I, Jeune B, Vaupel JW (2008) Exceptional longevity does not result in excessive levels of disability. PNAS 105:13274–13279
Christensen K, Doblhammer G, Rau R, Vaupel JW (2009) Ageing populations: the challenges ahead. Lancet 374:1196–1208
Crimmins EM (2004) Trends in the health of the elderly. Annu Rev Public Health 25:79–98
Crimmins EM, Hayward MD, Hagedorn A, Saito Y, Brouard N (2009) Change in disability-free life expectancy for Americans 70 years old and older. Demography 46(3):627–646
Engberg H, Christensen K, Andersen-Ranberg K, Vaupel JW, Jeune B (2008) Improving activities of daily living in Danish centenarians—but only in women: a comparative study of two birth cohorts born in 1895 and 1905. J Gerontol A 63A:1186–1192
Ferrucci L, Turchi A, Fumagalli S et al (2003) Sex-related differences in the length of disability prior to death in older persons. Aging Clin Exp Res 15:310–314
Fitzmaurice GM, Laird NM, Ware JH (2004) Applied longitudinal analysis. Wiley, Hoboken
Freedman VA, Crimmins EM, Schoeni RF, Spillman BC, Aykan H, Kramarow E, land K, Lubitz K, Manton KG, Martin LG, Shinberg D, Waidmann T et al (2004) Resolving inconsistencies in trends in old-age disability: Report from a technical working group. Demography 41:417–441
Fries JF (1980) Aging, natural death, and the compression of morbidity. N Engl J Med 303:130–135
Fuller-Thomson E, Yu B, Nuru-Jeter A, Guralnik JM, Minkler M (2009) Basic ADL disability and functional limitation rates among older Americans from 2000–2005: The end of the decline? J Gerontol A Biol Sci Med Sci 64:1333–1336
Goebeler S, Jylhä M, Hervonen A (2003) Medical history, cognitive status and mobility at the age of 90 A population-based study in Tampere, Finland. Aging Clin Exp Res 15(2):154–161
Guralnik JM, Ferrucci L (2003) Assessing the building blocks of function. Utilizing measures of functional limitation. Am J Prev Med 25:112–121
Jeune B (2008) Trends in health expectancy at age 65 for various health indicators, 1987–2005, Denmark. Eur J Aging 5:279–285
Jylhä M, Hervonen A (1999) Functional status and need of help among people aged 90 or over: a mailed survey with a total home-dwelling population. Scand J Publ Health 2:106–111
Jylhä M, Paavilainen P, Lehtimäki T, Goebeler S, Karhunen PJ, Hervonen A, Hurme M (2007) Interleukin-1 receptor antagonist, interleukin-6, and c-reactive protein as predictors of mortality in nonagenarians: the Vitality 90+ Study. J Gerontol Sci Med Sci 62A(9):1016–1021
Koskinen S, Martelin T, Sainio P (2006) Iäkkäiden toimintakyvyn kohentaminen välttämätöntä. Duodecim 122:255–257
Kramer M (1980) The rising pandemic of mental disorders and associated chronic diseases and disabilities. Acta Psychiatr Scand 62:282–297
Magaziner J, Simonsick EM, Kashner TM, Hebel JR (1988) Patient-proxy response comparability on measures of patient health and functional status. J Clin Epidemiol 41(11):1065–1074
Manton KG (1982) Changing concepts of morbidity and mortality in the elderly population. Milbank Mem Fund Q 60(2):183–244
Manton KG, Gu X (2006) Changes in chronic disability from 1982 to 2004/2005 as measured by long-term changes in function and health in the U.S. elderly population. PNAS 103:18374–18379
Martelin T, Sainio P, Koskinen S (2004) Ikääntyvän väestön toimintakyvyn kehitys. In: Ikääntyminen voimavarana. Tulevaisuusselonteon liiteraportti 5. Valtioneuvoston kanslian julkaisusarja 33:117–131. http://www.vnk.fi/julkaisukansio/2004/j33-ikaantyminen-voimavarana/pdf/fi.pdf
Olshansky SJ, Rudberg MA, Carnes BA, Cassel CK, Brody JA (1991) Trading off longer life for worsening health: the expansion of morbidity hypothesis. J Aging Health 3:194–216
Oman D, Reed D, Ferrara A (1999) Do elderly women have more physical disability than men do? Am J Epidemiol 150:834–842
Parker MG, Ahacic K, Thorslund M (2005) Health changes among Swedish oldest old: prevalence rates from 1992 and 2002 show increasing health problems. J Gerontol A Biol Sci Med Sci 60:1351–1355
Parker MG, Schön P, Lagergren M, Thorslund M (2008) Functional ability in the elderly Swedish population from 1980 to 2005. Eur J Ageing 5:299–309
Robine J-M, Saito Y, Jagger C (2009) The relationships between longevity and healthy life expectancy. Qual Ageing 10:5–14
Seeman TE, Merkin SS, Crimmins EM, Karlamanga AS (2010) Disability trends among older Americans: National Health and Nutritional Examination Surveys, 1988–1994 and 1999–2004. Am J Publ Health 100:100–107
Statistics Finland (2010a) Life tables 1986–2008. Statistics Finland Website http://pxweb2.stat.fi/database/StatFin/vrm/kuol/kuol_en.asp
Statistics Finland (2010b) Population according to age and gender by area 1980–2008. Statistics Finland Website http://pxweb2.stat.fi/database/StatFin/vrm/vaerak/vaerak_en.asp
Statistics Finland (2010c) Population projections according to age and gender, whole country 2009–2060. Statistics Finland Website http://pxweb2.stat.fi/database/StatFin/vrm/vaenn/vaenn_en.asp
Statistics Finland (2010d) Population Statistics
Sulander T, Puska P, Nissinen A, Reunanen A, Uutela A (2007) 75–84-vuotiaiden suomalaisten toiminnanvajeiden muutokset 1993–2005. Suom Lääk 1–2:29–33
Todorov A, Kirchner C (2000) Bias in proxies′ reports of disability: data from the National Health Interview Survey on disability. Am J Public Health 90(8):1248–1253
U.S. Census Bureau (2010a) U.S. Population Projections. http://www.census.gov/population/www/projections/files/nation/download/NP2008_D1.xls
U.S. Census Bureau (2010b) U.S. Population Projections. http://www.census.gov/population/www/socdemo/age/age_sex_older.html
Vaupel JW, Carey JR, Christensen K et al (1998) Biodemographic trajectories of longevity. Science 280:855–860
Verbrugge LM (1989) The twain meet: empirical explanations of sex differences in health and mortality. J Health Soc Behav 30:282–304
Acknowledgments
This study was funded by the Competitive Research Funding from the Pirkanmaa Hospital District, and the Ministry of Social Affairs and Health. We thank our collaborators in health and social care in the city of Tampere for their help and support during the data collection.
Author information
Authors and Affiliations
Corresponding author
Additional information
Responsible editor: D. J. H. Deeg.
Rights and permissions
About this article
Cite this article
Sarkeala, T., Nummi, T., Vuorisalmi, M. et al. Disability trends among nonagenarians in 2001–2007: Vitality 90+ Study. Eur J Ageing 8, 87–94 (2011). https://doi.org/10.1007/s10433-011-0188-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10433-011-0188-2