Abstract
Background and aims: With an increasing population aged 85 years and over, the aim of this study was to describe health status and living conditions in the oldest old and to estimate age and sex differences in a Northern European population. Methods: A population-based cross-sectional study, The Umeå 85+ Study, was carried out in the municipality of Umeå in northern Sweden. Out of 319 eligible participants aged 85, 90 and 95 years and over, 253 participated. Structured interviews and assessments were conducted with the participants in their homes, and data were also collected from relatives, caregivers and medical charts. Cognition was screened with the Mini-Mental State Examination (MMSE), depressive symptoms with the Geriatric Depression Scale-15 (GDS-15) and nutritional status with the Mini Nutritional Assessment (MNA). Activities of daily living (ADL) were assessed applying the Staircase of ADL (including Katz’ Index of ADL) and morale with the Philadelphia Geriatric Center Morale Scale (PGCMS). Participants also rated their own health. Results: Over half of the participants had hypertension, one out of four was depressed, and the same proportion had had a hip fracture; the mean number of drugs taken was 6.4±4.0. Younger participants had lower rates of diagnoses and prescribed drugs, and were less dependent in ADL and other functional variables; men had lower rates of diagnoses and reported symptoms. The majority of participants rated their general health and morale as good. Conclusions: There were large variations in social, medical and functional variables within and between age and sex groups. This northern population of the oldest old seems to have a very high prevalence of hypertension, depression, hip fractures, and many prescribed drugs.
Similar content being viewed by others
References
United Nations. World Population Prospects: The 2000 Revision, vol II: Sex and age: United Nations publication, Sales No. E.01.XIII.9; 2000.
Population statistics 2001. Part 3. Distribution by sex, age, country of birth and citizenship etc. Örebro: Statistics Sweden; 2002.
Fratiglioni L, Viitanen M, Backman L, Sandman PO, Winblad B. Occurrence of dementia in advanced age: the study design of the Kungsholmen Project. Neuroepidemiology 1992; 11: 29–36.
Samuelsson SM, Alfredson BB, Hagberg B, et al. The Swedish Centenarian Study: a multidisciplinary study of five consecutive cohorts at the age of 100. Int J Aging Hum Dev 1997; 45: 223–53.
Svensson T, Dehlin O, Hagberg B, Samuelsson G. The Lund 80+ Study: some general findings. In Schroots JJF, ed. Aging, health and competence. Amsterdam: Elsevier Science Publishers; 1993: 345–54.
Johansson B, Zarit SH. Prevalence and incidence of dementia in the oldest old: a longitudinal study of a population-based sample of 84–90-year-olds in Sweden. Int J Geriatr Psychiatry 1995; 10: 359–66.
Steen B, Djurfeldt H. The gerontological and geriatric population studies in Gothenburg, Sweden. Z Gerontol 1993; 26: 163–9.
Parker MG, Thorslund M, Lundberg O. Physical function and social class among Swedish oldest old. J Gerontol 1994; 49: S196–201.
Heikkinen E, Heikkinen R, Ruoppila I. Functional capacity and health of elderly people — the Evergreen Project. Scand J Soc Med Suppl 1997; 53: 1–106.
Haavisto M, Geiger U, Mattila K, Rajala S. A health survey of the very aged in Tampere, Finland. Age Ageing 1984; 13: 266–72.
Sörensen KH. A socio-medical population study of the elderly in the city of Copenhagen 1978/79. Housing conditions and marital status. Dan Med Bull 1982; 29: 280–5.
Nybo H, Gaist D, Jeune B, et al. The Danish 1905 cohort: a genetic-epidemiological nationwide survey. J Aging Health 2001; 13: 32–46.
Ingerslev J. 85-year-olds in Denmark. Dan Med Bull 1992; 39: 207–11.
Goebeler S, Jylha M, Hervonen A. Medical history, cognitive status and mobility at the age of 90. A population-based study in Tampere, Finland. Aging Clin Exp Res 2003; 15: 154–61.
Dening TR, Chi LY, Brayne C, Huppert FA, Paykel ES, O’Connor DW. Changes in self-rated health, disability and contact with services in a very elderly cohort: a 6-year follow-up study. Age Ageing 1998; 27: 23–33.
Jagger C, Spiers NA, Clarke M. Factors associated with decline in function, institutionalization and mortality of elderly people. Age Ageing 1993; 22: 190–7.
Heeren TJ, Lagaay AM, Hijmans W, Rooymans HG. Prevalence of dementia in the ‘oldest old’ of a Dutch community. J Am Geriatr Soc 1991; 39: 755–9.
Baltes P, Mayer K, Helmchen H, Steinhagen-Thissen E. The Berlin Aging Study (BASE): Overview and design. Aging and Society 1993; 13: 483–515.
Cacciatore F, Gallo C, Ferrara N, et al. Morbidity patterns in aged population in southern Italy. A survey sampling. Arch Gerontol Geriatr 1998; 26: 201–13.
Meller I, Fichter M, Schroppel H, Beck-Eichinger M. Mental and somatic health and need for care in octo- and nonagenarians. An epidemiological community study. Eur Arch Psychiatry Clin Neurosci 1993; 242: 286–92.
Hofman A, Grobbee DE, de Jong PT, van den Ouweland FA. Determinants of disease and disability in the elderly: the Rotterdam Elderly Study. Eur J Epidemiol 1991; 7: 403–22.
Launer LJ, Andersen K, Dewey ME, et al. Rates and risk factors for dementia and Alzheimer’s disease: results from EURODEM pooled analyses. EURODEM Incidence Research Group and Work Groups. European Studies of Dementia. Neurology 1999; 52: 78–84.
Deiana L, Ferrucci L, Pes GM, et al. AKEntAnnos. The Sardinia Study of Extreme Longevity. Aging Clin Exp Res 1999; 11: 142–9.
Fichter MM, Bruce ML, Schroppel H, Meller I, Merikangas K. Cognitive impairment and depression in the oldest old in a German and in U.S. communities. Eur Arch Psychiatry Clin Neurosci 1995; 245: 319–25.
Breitner JC, Wyse BW, Anthony JC, et al. APOE-epsilon4 count predicts age when prevalence of AD increases, then declines: the Cache County Study. Neurology 1999; 53: 321–31.
Edland SD, Rocca WA, Petersen RC, Cha RH, Kokmen E. Dementia and Alzheimer disease incidence rates do not vary by sex in Rochester, Minn. Arch Neurol 2002; 59: 1589–93.
Kovar MG, Fitti JE, Chyba MM. The longitudinal study of aging: 1984–90. National Center for Health Statistics. Vital Health Stat 1992; 1: 1–248.
Canadian Study of Health and Aging: study methods and prevalence of dementia. Can Med Assoc J 1994; 150: 899–913.
Haavisto MV, Heikinheimo RJ, Mattila KJ, Rajala SA. Living conditions and health of a population aged 85 years or over: a five-year follow-up study. Age Ageing 1985; 14: 202–8.
von Strauss E, Fratiglioni L, Viitanen M, Forsell Y, Winblad B. Morbidity and comorbidity in relation to functional status: a community-based study of the oldest old (90+ years). J Am Geriatr Soc 2000; 48: 1462–9.
Jagger C, Clarke M, Cook AJ. Mental and physical health of elderly people: five-year follow-up of a total population. Age Ageing 1989; 18: 77–82.
Miech RA, Breitner JC, Zandi PP, Khachaturian AS, Anthony JC, Mayer L. Incidence of AD may decline in the early 90s for men, later for women: The Cache County study. Neurology 2002; 58: 209–18.
Nybo H, Gaist D, Jeune B, McGue M, Vaupel JW, Christensen K. Functional status and self-rated health in 2,262 nonagenarians: the Danish 1905 Cohort Survey. J Am Geriatr Soc 2001; 49: 601–9.
Leinonen R, Heikkinen E, Jylha M. Predictors of decline in self-assessments of health among older people — a 5-year longitudinal study. Soc Sci Med 2001; 52: 1329–41.
Nyström L, Rosen M, Wall S. Why are diabetes, stomach cancer and circulatory diseases more common in Northern Sweden? Scand J Prim Health Care 1986; 4: 5–12.
Jensen E, Ruilian L, Dehlin O, Hagberg B, Samuelsson G, Svensson T. Laboratory values, symptoms and survival in an 80-year-old population. Arch Gerontol Geriatr 1996; 22: 71–80.
Dehlin O, Hagberg B, Samuelsson G, Svensson T. 80 år och äldre — hur mår man, hur har man det? (80 years and above — how are you then?). Lund: Department of Community Medicine Sciences, University of Lund and Gerontological Center; 1998.
Guigoz Y, Vellas BJ, Garry PJ. Mini Nutritional Assessment: A practical assessment tool for grading the nutritional state of elderly patients. Facts Res Gerontol 1994; 4: 15–59.
Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 1992; 30: 473–83.
Vellas B, Guigoz Y, Garry PJ, et al. The Mini Nutritional Assessment (MNA) and its use in grading the nutritional state of elderly patients. Nutrition 1999; 15: 116–22.
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–98.
Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc 1992; 40: 922–35.
Sheikh J, Yesavage J. Geriatric Depression Scale (GDS): recent evidence and development of a shorter version. Clin Gerontol 1986; 5: 165–72.
Lawton MP. The Philadelphia Geriatric Center Morale Scale: a revision. J Gerontol 1975; 30: 85–9.
Lawton M. The dimensions of morale. In Kent D, Kastenbaum R, Sherwood S, eds. Research planning and action for the elderly: the power and potential of social science. New York: Behavioral Publications; 1972: 144–65.
Downton JH, Andrews K. Prevalence, characteristics and factors associated with falls among the elderly living at home. Aging Clin Exp Res 1991; 3: 219–28.
Sonn U. Longitudinal studies of dependence in daily life activities among elderly persons. Scand J Rehabil Med Suppl 1996; 34: 1–35.
Katz S, Ford A, Moskowitz R. Studies of illness in the aged. The Index of ADL: a standardized measure of biological and psychosocial function. JAMA 1963; 185: 914–9.
Jensen E, Dehlin O, Gustafson L. A comparison between three psychogeriatric rating scales. Int J Geriatr Psychiatry 1993; 8: 215–29.
Montgomery SA, Åsberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979; 134: 382–9.
Meller I, Fichter MM, Schroppel H. Risk factors and psychosocial consequences in depression of octo- and nonagenerians: results of an epidemiological study. Eur Arch Psychiatry Clin Neurosci 1997; 247: 278–87.
van Exel E, Gussekloo J, de Craen A, et al. Cognitive function in the oldest old: women perform better than men. J Neurol Neurosurg Psychiatry 2001; 71: 29–32.
Bergdahl E, Gustavsson JM, Kallin K, et al. Depression among the oldest old: the Umeå 85+ study. Int Psychogeriatr 2005; 17: 557–75.
de Craen AJ, Heeren TJ, Gussekloo J. Accuracy of the 15-item geriatric depression scale (GDS-15) in a community sample of the oldest old. Int J Geriatr Psychiatry 2003; 18: 63–6.
Izaks GJ, Gussekloo J, Dermout KM, Heeren TJ, Ligthart GJ. Three-year follow-up of Mini-Mental State Examination score in community residents aged 85 and over. Psychol Med 1995; 25: 841–8.
Agüero-Torres H, von Strauss E, Viitanen M, Winblad B, Fratiglioni L. Institutionalization in the elderly: the role of chronic diseases and dementia. Cross-sectional and longitudinal data from a population-based study. J Clin Epidemiol 2001; 54: 795–801.
Maggi S, Kelsey JL, Litvak J, Heyse SP. Incidence of hip fractures in the elderly: a cross-national analysis. Osteoporos Int 1991; 1: 232–41.
Thorngren KG, Hommel A, Norrman PO, Thorngren J, Wingstrand H. Epidemiology of femoral neck fractures. Injury 2002; 33 Suppl 3: C1–7.
Österlind PO, Bucht G. Drug consumption during the last decade among persons born in 1902 in Umeå, Sweden. A longitudinal population study. Drugs Aging 1991; 1: 477–86.
Saletti A, Lindgren EY, Johansson L, Cederholm T. Nutritional status according to mini nutritional assessment in an institutionalized elderly population in Sweden. Gerontology 2000; 46: 139–45.
Hoe J, Katona C, Roch B, Livingston G. Use of the QOL-AD for measuring quality of life in people with severe dementia—the LASER-AD study. Age Ageing 2005; 34: 130–5.
Ryden MB, Knopman D. Assess not assume—measuring the morale of cognitively impaired elderly. J Gerontol Nurs 1989; 15: 27–32.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Wågert, P.v.H., Gustavsson, J.M.C., Lundin-Olsson, L. et al. Health status in the oldest old. Age and sex differences in the Umeå 85+ Study. Aging Clin Exp Res 18, 116–126 (2006). https://doi.org/10.1007/BF03327426
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/BF03327426