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Morbidity and Comorbidity in Relation to Functional Status: A Community‐Based Study of the Oldest Old (90+ Years)
Author(s) -
Strauss Eva,
Fratiglioni Laura,
Viitanen Matti,
Forsell Yvonne,
Winblad Bengt
Publication year - 2000
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2000.tb02638.x
Subject(s) - medicine , dementia , odds ratio , confidence interval , comorbidity , gerontology , activities of daily living , epidemiology , demography , population , disease , physical therapy , environmental health , sociology
OBJECTIVES : To describe health and functional status in the oldest old; to explore the relationships of morbidity and functional status; and to verify whether this relationship was modified by gender. DESIGN AND SETTING : A community‐based survey including all inhabitants aged ≥90 living in central Stockholm, Sweden. All participants were clinically examined by physicians, cognitively assessed by psychologists, and interviewed by nurses. Diagnoses were made according to the International Classification of Diseases‐Ninth Revision (ICD‐9), the DSM‐III‐R criteria for dementia, and Katz index of activities of daily living. PARTICIPANTS : Of the 698 subjects in the study population, 99 (14%) had died and 29 (4%) moved before examination. Of the remaining subjects, 502 (88.1%) were examined, and the refusal rate was 11.9%. MEASUREMENTS : Age‐ and gender‐specific prevalence figures, and age‐, gender‐ and education‐adjusted odds ratios (OR) were used. RESULTS : Of 502 examined subjects, 19% had no disease and 73% were functionally independent. Dementia was the most prevalent disease among women (42.2%), and cardio‐and cerebrovascular diseases were the most frequent among men (42.4%). Women had higher prevalences of dementia (adjusted OR = 2.1, 95% confidence interval (CI) 1.2–3.7) and fractures and musculoskeletal diseases (adjusted OR = 2.8, 95% CI 1.1–7.3), whereas men had a higher prevalence of malignancy (OR = 0.2, 95% CI 0.1–0.7). Women were more disabled than men independent of age, education, and number of diseases (adjusted OR = 2.2, 95% CI 1.1–4.3). CONCLUSIONS : A great proportion of nonagenarians were functionally independent despite their advanced age. Further studies are needed to clarify the excess of disability among very old women.