Association of late childbearing with healthy longevity among the oldest-old in China

Statistical analysis of a large and unique longitudinal data set demonstrates that late childbearing after age 35 or 40 is significantly associated with survival and healthy survival among very old Chinese women and men. The association is stronger in oldest-old women than men. The estimates are adjusted for a variety of confounding factors of demographic characteristics, family support, social connections, health practices, and health conditions. Further analysis based on an extension of the Fixed Attribute Dynamics method shows that late childbearing is positively associated with long-term survival and healthy survival from ages 80-85 to 90-95 and 100-105. This association exists among oldest-old women and men, but, again, the effects are substantially stronger in women than men. We discuss four possible factors which may explain why late childbearing affects healthy longevity at advanced ages: (1) social factors; (2) biological changes caused by late pregnancy and delivery; (3) genetic and other biological characteristics; and (4) selection.

Attributes of age-identity

Chronological age can be an unsatisfactory method of discriminating between older people. The lay concept of how old people actually feel may be more useful. The aim of the analyses reported in this paper was to investigate indicators of age-identity (or subjective age) among a national random sample of people aged 65 or more years living at home in Britain. Information was initially collected by home interview and a follow-up postal questionnaire 12-18 months later. The age that respondents felt was a more sensitive indicator than chronological age of many indicators of the respondents' health, psychological and social characteristics. Multiple regression analysis showed that baseline health and functional status, and reported changes in these at follow-up, explained 20.4 per cent of the variance in self-perceived age. Adding baseline mental health (anxiety/depression), feelings and fears about ageing at follow-up explained a further 0.8 per cent of the variance, making the total variance explained 21.2 per cent. It is concluded that measures of physical health and functional status and their interactions influenced age-identity. Mental health status and psychological perceptions made a small but significant additional contribution

Describing Disability among High and Low Income Status Older Adults in Canada

The purpose of this study was to determine the prevalence, types, and severity of disabilities, as well as the medical conditions that may have caused disabilities among non-institutionalized older adults by high and low income. Disabled individuals aged 55 years and older were identified from the 1986 and 1991 Health and Activity Limitation Surveys. The overall unweighted sample sizes for each survey were 132,337 in 1986 and 91,355 in 1991. Approximately 40% of senior men and women reported having at least one disability, with women just slightly more likely than men to report being disabled. Almost twice as many senior women had low income compared with senior men. Mobility and agility disabilities were the most common types of disabilities reported by older adults. Arthritis/rheumatism was the medical condition most often reported as the primary cause of a disability among women. Men most often reported diseases of the ear and mastoid processes, with differences reported by low and high income respondents. Among 55-64 year olds, low income respondents were generally less likely to be categorized as mildly disabled and more likely to be categorized as severely disabled compared with high income respondents. In an effort to postpone or prevent disabilities in an ever-growing older population, public health initiatives are required to educate older adults about medical conditions and impairments that often lead to disability, particularly among low income seniors.disability; income; seniors

Describing Disability among High and Low Income Status Older Adults in Canada

The purpose of this study was to determine the prevalence, types, and severity of disabilities, as well as the medical conditions that may have caused disabilities among non-institutionalized older adults by high and low income. Disabled individuals aged 55 years and older were identified from the 1986 and 1991 Health and Activity Limitation Surveys. The overall unweighted sample sizes for each survey were 132,337 in 1986 and 91,355 in 1991. Approximately 40% of senior men and women reported having at least one disability, with women just slightly more likely than men to report being disabled. Almost twice as many senior women had low income compared with senior men. Mobility and agility disabilities were the most common types of disabilities reported by older adults. Arthritis/rheumatism was the medical condition most often reported as the primary cause of a disability among women. Men most often reported diseases of the ear and mastoid processes, with differences reported by low and high income respondents. Among 55-64 year olds, low income respondents were generally less likely to be categorized as mildly disabled and more likely to be categorized as severely disabled compared with high income respondents. In an effort to postpone or prevent disabilities in an ever-growing older population, public health initiatives are required to educate older adults about medical conditions and impairments that often lead to disability, particularly among low income seniors.disability; income; seniors

Aging at home: factors associated with independence in activities of daily living among older adults in Norway—a HUNT study

Background: Maintaining independence in activities of daily living (ADL) is essential for the well-being of older adults. This study examined the relationship between demographic and living situation factors and ADL independence among community-dwelling older adults in Norway. Methods: Data was collected in Norway between 2017 and 2019 as part of the fourth wave of the ongoing Trøndelag Health Study (HUNT) survey, sent to all citizens in Trøndelag county over 20  years of age, which is considered representative of the Norwegian population. Included in the current crosssectional study were 22,504 community-living individuals aged 70  years or older who completed the survey and responded to all items constituting the ADL outcome measure. Group differences in ADL independence were examined with Chi Square tests, while crude and adjusted associations with ADL independence were examined with logistic regression analyses. Statistical significance was set at p  <  0.05. Results: The participants reported a high degree of independence in primary ADL and slightly lower in instrumental ADL. In the fully adjusted analyses, ADL independence was associated with lower age, female gender, higher levels of education and income, higher subjective well-being, having no chronic or disabling disease, and having someone to talk to in confidence. Surprisingly, women who were married had higher likelihood of ADL independence than unmarried women, whereas married men had lower likelihood of ADL independence than unmarried men. Conclusion: In addition to known demographic and disease-related factors, the social context affects independence in ADL even in a society that offers advanced health and homecare services to all older adults equally. Furthermore, the same social setting can have differential effects on men and women. Despite the healthcare system in Norway being well-developed, it does not completely address this issue. Further improvements are necessary to address potential challenges that older adults encounter regarding their social connections and feelings of inclusion. Individuals with limited education and income are especially susceptible to ADL dependency as they age, necessitating healthcare services to specifically cater to this disadvantaged demographic.publishedVersio

A closer look on dementia, elder abuse and multimorbidity in representative samples of the oldest old

Background: Due to the growing number of old aged persons in Germany and other countries the question arises how old aged persons can be described representatively in surveys. In this work old aged people are defined as persons above and including the age of 80 years. Old age describes a population that, due to limited health, a higher prevalence rates of dementia and a substantial part of the population living in nursing homes, is not only hard to survey. Additionally, constructs that are difficult to measure such as elder abuse become of greater importance when other resources diminish which is more common in old age. A theoretical framework that was formed to improve survey quality and enables discussions about possible survey errors is the Total Survey Error framework. Objective: Using the Total Survey Error framework it is examined how the constructs of elder abuse, dementia and multimorbidity can be assessed in representative samples of the old age. Results: Regarding representativity the presented papers show, that the inclusion of the nursing home population, people with dementia and proxy informants enhances the representativity of the survey and reduce non-response bias. On the other hand the inclusion of these hard to survey groups can lead to higher measurements errors. Measurement invariance is not established between proxy and self-reports in reports of elder abuse leading to an exclusion of proxy interviews in measurements of elder abuse. By reweighting the resulting non-response bias is reduced. Discussion: Inclusion of hard to survey groups can increase measurement errors while their exclusion increases sampling, frame and non-response errors. Presented methods that moderate these kinds of errors are reweighting the survey and separate analyses and presentation of subpopulations of the survey. The latter can allow to optimize measurements in subpopulations but may not yield a common estimator for the whole population

Low co-morbidity, low levels of malnutrition, and low risk of falls in a community-dwelling sample of 85-year-old are associated with succesful aging: the Octabaix study

The population is aging throughout the world. Preserving physical and cognitive functions is crucial to successful aging. The aim of this study was to determine the proportion of 85-year-old community-dwelling subjects aging successfully, applying a quantitative approach, and assessing the association of successful aging with sociodemographic data, global geriatric assessment, and co-morbidity. This was a community-based survey of inhabitants aged 85 years, with 328 out of 487 subjects born in 1924 assigned to seven primary health-care teams, representing a participation rate of 67.5%. Sociodemographic variables, Barthel index (BI), the Spanish version of the Mini-Mental State Examination (MEC), Mini Nutritional Assessment (MNA), Charlson Index, Gait Rating Scale, social risk, quality of life (QoL), and prevalent chronic diseases were assessed. Subjects scoring higher than 90 on the BI and higher than 24 on the MEC were compared with the rest. Multiple regression analysis was performed. Using these criteria, successful aging status was defined in 162 (49.3%) subjects. Using multiple logistic regression analysis, successful agers had significantly lower co-morbidity scores (p 0.0001). Almost half of the individuals presented successful aging. Successful agers had less co-morbidity and a lower risk of falls or malnutrition, and they had higher scores on the QoL scale

Cluster analysis of physical and cognitive ageing patterns in older people from Shanghai

This study investigated the relationship between education, cognitive and physical function in older age, and their respective impacts on activities of daily living (ADL). Data on 148 older participants from a community-based sample recruited in Shanghai, China, included the following measures: age, education, ADL, grip strength, balance, gait speed, global cognition and verbal memory. The majority of participants in the present cohort were cognitively and physically healthy and reported no problems with ADL. Twenty-eight percent of participants needed help with ADL, with the majority of this group being over 80 years of age. Significant predictors of reductions in functional independence included age, balance, global cognitive function (MMSE) and the gait measures. Cluster analysis revealed a protective effect of education on cognitive function that did not appear to extend to physical function. Consistency of such phenotypes of ageing clusters in other cohort studies may provide helpful models for dementia and frailty prevention measures