Journal Article

Accelerated Dysfunction Among the Very Oldest-Old in Nursing Homes

Brant E. Fries, John N. Morris, Kimberly A. Skarupski, Caroline S. Blaum, Andrzej Galecki, Fred Bookstein and Miel Ribbe

in The Journals of Gerontology: Series A

Volume 55, issue 6, pages M336-M341
Published in print June 2000 | ISSN: 1079-5006
Published online June 2000 | e-ISSN: 1758-535X | DOI: http://dx.doi.org/10.1093/gerona/55.6.M336
Accelerated Dysfunction Among the Very Oldest-Old in Nursing Homes

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  • Geriatric Medicine
  • Public Health
  • Biological Sciences
  • Molecular and Cell Biology
  • Neuroscience

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Background. The population aged 65 and older is often analyzed in three categories: young-old (65–74), middle-old (75–84), and oldest-old (≥85). This may blind heterogeneity within the oldest category. New, large data sets allow examination of the very oldest-old (e.g., aged ≥95) and contrasts with those who are younger.

Methods. We determined the annual change of prevalence of physical and cognitive function, and of disease problems in the old to very oldest-old, using data from existing Resident Assessment Instrument records from nursing homes in seven states during 1992–1994. We used data from 193,467 unique residents aged 80 or older, including 6,556 residents aged 100 or older. We computed the prevalence, by age, of selected conditions: physical and cognitive function, diseases, problem behavior, mood disturbance, restraint use, falls, weight loss, eating less, body mass index, chewing and swallowing problems, incontinence (bowel and bladder), catheter use, and selected diagnoses.

Results. Prevalence of all measures of physical and cognitive dysfunction increased most rapidly with each year of age among the very oldest-old. Most of the slope changes occurred from 95 to 100 years of age. Such changes are less pronounced or not seen in measures of disease prevalence.

Conclusions. Accelerated change in prevalence of dysfunction seen in the nursing home population may suggest a change in the mechanisms of aging that occur after the mid-nineties. Examination of the very oldest-old may provide new insight into the nature of the aging process.

Journal Article.  4085 words.  Illustrated.

Subjects: Geriatric Medicine ; Public Health ; Biological Sciences ; Molecular and Cell Biology ; Neuroscience

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