Changes in disability, self-rated health, comorbidities and psychological wellbeing in community-dwelling 75–95-year-old cohorts over two decades in Helsinki

Abstract

Objective: To explore changes in self-reported disabilities, health, comorbidities and psychological wellbeing (PWB) in aged cohorts over two decades.

Design, setting and subjects: Cross-sectional cohort studies with postal surveys were conducted among community-dwelling people aged 75, 80, 85, 90 and 95 years in 1989 (n = 660), 1999 (n = 2598) and 2009 (n = 1637) in Helsinki, Finland.

Main outcome measures: Self-reported items on disability, self-rated health (SRH), diagnoses and PWB were compared between cohorts of the same age. Standardized mortality ratios (SMRs) were calculated for each study year to explore the representativeness of the samples compared to general population of same age.

Results: A significantly lower proportion of the 75–85-year-olds of the later study years reported going outdoors daily, although this group had improvements in both SRH and PWB scores. The number of comorbidities increased over time among 75–85-year-olds. The only significant change that could be verified among 90- and 95-year-olds between 1999 and 2009, was the lower proportion of participants going outdoors daily. The trend of leveling-off in disabilities was not explained by the SMRs (0.90, 0.71 and 0.60 for 1989, 1999 and 2009).

Conclusions: The latest older people’s cohorts showed an end to previously reported improvements in disabilities, despite having favorable trends in SRH and PWB. Primary care may be faced with increasing need of appropriate services for their senior members.

Keywords:

• Cohort comparison
• physical functioning
• self-rated health
• psychological wellbeing
• oldest-old
• community-dwelling

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes on contributors

Helena Karppinen, MD, is a Clinical Teacher of General Practice and Primary Health Care at the University of Helsinki, Finland. She is responsible for the design, interpretation of the result and writing the manuscript.

Kaisu H. Pitkälä, PhD, is a Professor of General Practice and Primary Health Care at the University of Helsinki. She is a geriatrician responsible for conception of the design, gathering data and conducting the study.

Hannu Kautiainen, PhD, is a Biostatistician at the University of Helsinki, Helsinki University Hospital, and Medcare Foundation. He is responsible for statistical analyses.

Reijo S. Tilvis, PhD, is an Emeritus Professor of Geriatrics at the University of Helsinki. He started the Helsinki Ageing Study and is responsible for conception of the design, gathering data and conducting the study.

Jaakko Valvanne, PhD, is a Professor of Geriatrics at the University of Tampere. He is responsible for 1989 cohort data.

Käthe Yoder, MD in Helsinki. She participated in the design of the study.

Timo E. Strandberg, PhD, is a Professor of Geriatrics at the University of Helsinki, and responsible for conception of the design, gathering data and conducting the study.

Additional information

Funding

The study was supported by the Academy of Finland (Grant 48613), the Lions Organization (Punainen Sulka-Red Feather), the Ragnar Ekberg Foundation, Frimurarstiftelse, the Finnish Foundation for Cardiovascular Research and Helsinki University Central Hospital.