Temporal trends of functional dependence and survival among older adults from 1991 to 2010 in Sweden: toward a healthier aging

Declines in functional dependence among older adults were observed before the 1990s, but there is uncertainty about subsequent trends. Our study aimed to verify the temporal trends in disability during 1991-2010 in an older Swedish population and to estimate the associated changes in survival. Funct...

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Published inThe journals of gerontology. Series A, Biological sciences and medical sciences Vol. 70; no. 6; p. 746
Main Authors Angleman, Sara B, Santoni, Giola, Von Strauss, Eva, Fratiglioni, Laura
Format Journal Article
LanguageEnglish
Published United States 01.06.2015
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Abstract Declines in functional dependence among older adults were observed before the 1990s, but there is uncertainty about subsequent trends. Our study aimed to verify the temporal trends in disability during 1991-2010 in an older Swedish population and to estimate the associated changes in survival. Functional status in octogenarians and nonagenarians was assessed at seven occasions with intervals of 2-3 years. Sample size varied at each assessment with an average of 646 (range 212-1096). Disability was defined as difficulty in one or more of personal activities of daily living. We compared prevalence and incidence, as well as mortality, and survival associated with disability over the 20-year period. Sex-standardized prevalence of disability remained steady over time with a tendency toward a gradual decline, and a statistically significant decrease was present among nonagenarians. Sex-standardized cumulative incidence also remained steady. The proportion of people with prevalent disability who died <3 years remained stable, as did the survival time of people with incident disability. In contrast, among nondisabled persons, 3-year mortality decreased significantly, and for octogenarians median survival time was 1.3 years longer at the more recent assessment than a decade earlier. Both prevalence and incidence of disability remained stable over the last two decades in this urban Swedish population, with a trend toward a slow decline. Mortality remained steady among disabled persons but decreased among persons without disability, suggesting that increased life expectancy during the last two decades may be essentially driven by longer lives of functionally independent people.
AbstractList Declines in functional dependence among older adults were observed before the 1990s, but there is uncertainty about subsequent trends. Our study aimed to verify the temporal trends in disability during 1991-2010 in an older Swedish population and to estimate the associated changes in survival. Functional status in octogenarians and nonagenarians was assessed at seven occasions with intervals of 2-3 years. Sample size varied at each assessment with an average of 646 (range 212-1096). Disability was defined as difficulty in one or more of personal activities of daily living. We compared prevalence and incidence, as well as mortality, and survival associated with disability over the 20-year period. Sex-standardized prevalence of disability remained steady over time with a tendency toward a gradual decline, and a statistically significant decrease was present among nonagenarians. Sex-standardized cumulative incidence also remained steady. The proportion of people with prevalent disability who died <3 years remained stable, as did the survival time of people with incident disability. In contrast, among nondisabled persons, 3-year mortality decreased significantly, and for octogenarians median survival time was 1.3 years longer at the more recent assessment than a decade earlier. Both prevalence and incidence of disability remained stable over the last two decades in this urban Swedish population, with a trend toward a slow decline. Mortality remained steady among disabled persons but decreased among persons without disability, suggesting that increased life expectancy during the last two decades may be essentially driven by longer lives of functionally independent people.
Author Angleman, Sara B
Fratiglioni, Laura
Santoni, Giola
Von Strauss, Eva
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  fullname: Angleman, Sara B
  email: sara.angleman@ki.se
  organization: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden. Stockholm Gerontology Research Center, Sweden. sara.angleman@ki.se
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  givenname: Giola
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  fullname: Santoni, Giola
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  givenname: Eva
  surname: Von Strauss
  fullname: Von Strauss, Eva
  organization: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden. The Swedish Red Cross University College, Stockholm, Sweden
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  givenname: Laura
  surname: Fratiglioni
  fullname: Fratiglioni, Laura
  organization: Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden. The Swedish Red Cross University College, Stockholm, Sweden
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Copyright The Author 2014. Published by Oxford University Press on behalf of the Gerontological Society of America. All rights reserved. For permissions, please email: journals.permissions@oup.com.
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Issue 6
Keywords Disability
Temporal trends
Swedish National Study of Aging and Care-Kungsholmen (SNAC-K)
Kungsholmen Project
Activities of daily living
Language English
License The Author 2014. Published by Oxford University Press on behalf of the Gerontological Society of America. All rights reserved. For permissions, please email: journals.permissions@oup.com.
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Snippet Declines in functional dependence among older adults were observed before the 1990s, but there is uncertainty about subsequent trends. Our study aimed to...
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StartPage 746
SubjectTerms Aged
Aged, 80 and over
Aging
Cohort Studies
Disability Evaluation
Disabled Persons - statistics & numerical data
Female
Humans
Longitudinal Studies
Male
Mortality
Sweden - epidemiology
Urban Population
Title Temporal trends of functional dependence and survival among older adults from 1991 to 2010 in Sweden: toward a healthier aging
URI https://www.ncbi.nlm.nih.gov/pubmed/25394618
Volume 70
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