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Canadian Journal of Public Health

, Volume 90, Issue 5, pp 338–342 | Cite as

Health, Function and Survival of a Cohort of Very Old Canadians: Results from the Second Wave of the Canadian Study of Health and Aging

  • David B. HoganEmail author
  • Tak S. Fung
  • Erika M. Ebly
Article

Abstract

Seniors 85 years of age and older (85+) make up the fastest-growing segment of the Canadian population. There is a need for longitudinal data on the health status of this group. We used data collected as part of the Canadian Study of Health and Aging to examine how health status changed over five years in a large (n=1799) cohort of Canadians 85+. By the time of the follow-up assessment, 60.1% had died and 33.9% of those who had been residing in the community when the cohort was initially formed had been institutionalized. Most (79.2%) of the community survivors felt that their health had stayed the same or improved, even though over two thirds (67.9%) reported a decline in their functional abilities. Potential predictors of both good and adverse outcomes were explored. While disease prevention, health promotion and environmental modifications may decrease the personal and societal impacts of these age-associated findings, health care planning for the very old should take these data into account.

Résumé

Les personnes âgées de 85 ans et plus (85 +) constituent le segment de la population canadienne dont la croissance est la plus rapide. Il existe un besoin de données longitudinales sur l’état de santé de ce groupe. Nous nous sommes servis de données recueillies dans le cadre de l’Étude canadienne sur la santé et le vieillissement pour étudier comment l’état de santé d’une important cohorte (N = 1 799) de Canadiens âgés de 85 ans et plus avait changé sur cinq ans. Au moment de l’évaluation de suivi, 60,1 % d’entre eux étaient décédés et 33,9 % de ceux qui résidaient dans la collectivité au moment de la constitution de la cohorte avaient été placés en institutions. La plupart (79,2 %) des survivants estimaient que leur santé n’avait pas changé ou s’était améliorée, même si plus de deux tiers d’entre eux (67,9 %) déclaraient constater une diminution de leurs capacités fonctionnelles. On a étudié les prédicteurs potentiels de résultats positifs et négatifs. Bien que la prévention de la maladie, la promotion de la santé et les modifications de l’environnement puissent faire diminuer l’impact personnel et social de ces résultats associés à l’âge, la planification des soins de santé pour les personnes très âgées devrait prendre en considération ces données.

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References

  1. 1.
    Statistics Canada. Population Projections of Canada, Provinces and Territories. Catalogue 91-520. Ottawa: Statistics Canada, 1994.Google Scholar
  2. 2.
    Statistics Canada. Annual Demographics Statistics. Catalogue 91-213. Ottawa: Statistics Canada, 1998.Google Scholar
  3. 3.
    Aevarsson O, Skoog I. A population-based study on the incidence of dementia disorders between 85 and 88 years of age. J Am Geriatr Soc 1996;44:1455–60.CrossRefGoogle Scholar
  4. 4.
    Canadian Study of Health and Aging Working Group. Canadian Study of Health and Aging: Study methods and prevalence of dementia. Can Med Assoc J 1994;150(6):899–914.Google Scholar
  5. 5.
    Teng EL, Chui HC. The modified mini-mental state (3MS) examination. J Clin Psychiatry 1987;48(8):314–18.PubMedGoogle Scholar
  6. 6.
    McDowell I, Newell C. Measuring Health: A Guide to Rating Scales and Questionnaires. New York: Oxford University Press, 1987.Google Scholar
  7. 7.
    Fillenbaum GG. Multidimensional Functional Assessment of Older Adults: The Duke Older Americans Resources and Services Procedures. Hillsdale, NJ: Lawrence Erlbaum Associates, 1988.Google Scholar
  8. 8.
    Ebly EM, Hogan DB, Parhad IM. Cognitive impairment in the nondemented elderly: Results from the Canadian Study of Health and Aging. Arch Neurol 1995;52:612–19.CrossRefGoogle Scholar
  9. 9.
    American Psychiatric Association. Diagnostic and Statistical Manual, 3rd ed, revised. Washington, DC: American Psychiatric Association, 1987.Google Scholar
  10. 10.
    Stone L, Frenken H. Declines in the proportion of institutional residents among those under 85. In: Focus on Canada: Canada’s Seniors. Ottawa: Statistics Canada, 1986.Google Scholar
  11. 11.
    Schnieder EL, Guralnik JM. The aging of America: Impact on health care costs. JAMA 1990;263:2335–40.CrossRefGoogle Scholar
  12. 12.
    Branch LG, Jette AM. A prospective study of long-term care institutionalization among the aged. Am J Public Health 1982;72:1373–79.CrossRefGoogle Scholar
  13. 13.
    Branch LG, Katz S, Kniepman K, et al. A prospective study of functional status among community elders. Am J Public Health 1984;74:266–68.CrossRefGoogle Scholar
  14. 14.
    Fried LP, Ettinger WH, Lind B, et al. Physical disability in older adults: A physiological approach. J Clin Epidemiol 1994;47(7):747–60.CrossRefGoogle Scholar
  15. 15.
    Wolinsky FD, Callahan CM, Fitzgerald JF, et al. Changes in functional status and the risks of subsequent nursing home placement and death. J Gerontology 1993;48(3):S93–S101.CrossRefGoogle Scholar
  16. 16.
    Hart FD Ed.). French’s Index of Differential Diagnosis. 12th ed. Bristol: Wright, 1985; 273.Google Scholar
  17. 17.
    Guyatt GH, Eagle DJ, Sackett B, et al. Measuring quality of life in the frail elderly. J Clin Epidemiol 1993;46(12):1433–44.CrossRefGoogle Scholar
  18. 18.
    Freedman VA. Family structure and the risk of nursing home admission. J Gerontology 1996;51B(2):S61–69.CrossRefGoogle Scholar
  19. 19.
    Ebly EM, Hogan DB, Fung TS. Correlates of self-rated health in persons aged 85 and over: Results from the Canadian Study of Health and Aging. Can J Public Health 1996;87(1):28–31.PubMedGoogle Scholar
  20. 20.
    Johnson RJ, Wolinsky FD. The structure of health status among older adults: Disease, disability, functional limitation, and perceived health. J Health Soc Behav 1993;34(2):105–21.CrossRefGoogle Scholar
  21. 21.
    Suzman RM, Harris T, Hadley EC, et al. The robust oldest old: Optimistic perspectives for increasing healthy life expectancy. In: Suzman RM, Willis DP, Manton KG (Eds.), The Oldest Old. New York: Oxford University Press, 1992; 341–58.Google Scholar
  22. 22.
    Manton KG. A longitudinal study of functional change and mortality in the United States. J Gerontology 1988;43(5):S153–61.CrossRefGoogle Scholar
  23. 23.
    Guralnik JM, Lacroix AZ, Branch LG, et al. Morbidity and disability in older persons in the years prior to death. Am J Public Health 1991;81:443–47.CrossRefGoogle Scholar
  24. 24.
    Fried LP, Guralnik JM. Disability in older adults: Evidence regarding significance, etiology and risk. J Am Geriatr Soc 1997;45:92–100.CrossRefGoogle Scholar
  25. 25.
    Guccione AA, Felson DT, Anderson JJ, et al. The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health 1994;84:351–58.CrossRefGoogle Scholar
  26. 26.
    Hogan DB, Ebly EM, Fung TS. Disease, disability and age in cognitively intact seniors: Results from the Canadian Study of Health and Aging. J Gerontology 1999; 54A(2):M77–M82.Google Scholar
  27. 27.
    Bernard SL, Kincade JE, Konrad TR, et al. Predicting mortality from community surveys of older adults: The importance of self-rated functional ability. J Gerontology 1997;52(3):S155–63.CrossRefGoogle Scholar
  28. 28.
    Johansson B, Zarit SH. Early cognitive markers of the incidence of dementia and mortality: A longitudinal population-based study of the oldest old. Int J Geriatr Psychiatry 1997;12:53–59.CrossRefGoogle Scholar
  29. 29.
    Hadley EC. Causes of death among the oldest old. In: Suzman RM, Willis DP, Manton KG (Eds.), The Oldest Old. New York: Oxford University Press, 1992;183–96.Google Scholar
  30. 30.
    Thomas SP, Hrudey SE. Risk of Death in Canada: What We Know and How We Know it. Edmonton: University of Alberta Press, 1997.Google Scholar
  31. 31.
    Statistics Canada. Causes of Death, 1994. Catalogue 84-208. Ottawa, 1996.Google Scholar
  32. 32.
    Roos NP, Havens B, Black C. Living longer but doing worse: Assessing health status in elderly persons at two points in time in Manitoba, Canada, 1971 and 1983. Soc Sci Med 1993;36(3):272–82.CrossRefGoogle Scholar
  33. 33.
    Manton KG, Corder L, Stallard E. Chronic disability trends in elderly United States popula-tions:1982-1994. Proc Natl Acad Sci USA 1997;94:2593–98.CrossRefGoogle Scholar
  34. 34.
    Singer BH, Manton KG. The effects of health changes on projections of health service needs for the elderly population of the United States. Proc Natl Acad Sci USA 1998;95:15618–22.CrossRefGoogle Scholar
  35. 35.
    Crimmins EM, Saito Y, Reynolds SL. Further evidence on recent trends in the prevalence and incidence of disability among older Americans from two sources: The LSOA and the NHIS. J Gerontology 1997;52B(2):S59–71.CrossRefGoogle Scholar

Copyright information

© The Canadian Public Health Association 1999

Authors and Affiliations

  • David B. Hogan
    • 1
    • 2
    Email author
  • Tak S. Fung
    • 3
  • Erika M. Ebly
    • 1
  1. 1.Department of MedicineUniversity of CalgaryCalgaryCanada
  2. 2.Department of Clinical NeurosciencesUniversity of CalgaryCalgaryCanada
  3. 3.Department of University Computing ServicesUniversity of CalgaryCalgaryCanada

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