Cohort differences in disease and disability in the young-old: findings from the MRC Cognitive Function and Ageing Study (MRC-CFAS)

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Physical functioning in elderly Europeans: 10 year changes in the north and south: the HALE project

Objectives: To examine age related changes in physical functioning in elderly men and women. Design: Prospective, population based study. Setting: Population of 15 rural and urban centres in 10 European countries. Participants: Altogether 3496 men and women born between 1900 and 1920 who participated in the baseline survey of the HALE project in 1988–1991. The study population was examined again about five (in 1993–1995) and 10 (in 1999–2001) years after the baseline examination. Main outcome measures: Physical functioning was measured by means of a self administered questionnaire of activities of daily living (ADL). Dichotomised prevalence of disability and need for help in self care and mobility ADL were used as dependent variables in the analyses. Results: Prevalence of disability and need for help tended to be higher in women than in men and in mobility abilities than in self care activities. Disability and need for help increased with advancing age but ameliorated over time from one birth cohort to another. In longitudinal analyses this beneficial time trend was independent of the effect of age, study, and region in self care disability in men and women (OR 0.85, 95% CI 0.75 to 0.97 and OR 0.64, 95% CI 0.43 to 0.97, respectively) and self care need for help in men (OR 0.83, 95% CI 0.70 to 0.96). Mobility disability among men and self care disability among women decreased more in the south than in the north. Conclusion: While European populations are aging, the proportions of elderly people with disability are decreasing. These results suggest that dynamics of functioning may differ across cultures. Future studies are needed to clarify which potentially modifiable and culturally determined factors protect against functional decline

Conceituando e mensurando a incapacidade funcional da população idosa: uma revisão de literatura The concept and measurement of functional disability in the elderly population: a literature review

O objetivo deste artigo é rever as principais definições e formas de mensuração da incapacidade funcional que vêm sendo utilizadas nos estudos que focalizam o tema. De acordo com esta revisão, a incapacidade funcional pode ser definida pela dificuldade ou pela necessidade de ajuda para o indivíduo executar tarefas cotidianas básicas ou mais complexas, necessárias para a vida independente na comunidade e tarefas relacionadas à mobilidade. Com relação aos parâmetros de mensuração, observa-se que os estudos não seguem um padrão bem definido. As medidas variam bastante quanto às escalas, dimensões e classificações. Também dependem direta ou indiretamente do tipo de informação disponível. Não existe um método correto ou único para operacionalizar a incapacidade funcional. Por isso, torna-se indispensável que os pesquisadores mencionem claramente em seus estudos o conceito de incapacidade funcional empregado e informem detalhadamente qual a medida ou quais instrumentos foram aplicados.<br>This article aims to review the main concepts and measures of functional disability currently used in studies focusing on this subject. According to this review, functional disability can be defined as a difficulty or the need for help for performing basic or more complex daily activities necessary for keeping an independent life in the community. As refers to measurement criteria, the studies do not follow a clear-cut standard, varying substantially in relation to scales, dimensions and classifications besides depending directly or indirectly on the kind of available information. A correct method for rating functional disability does not exist at yet. For this reason it is essential that the researchers clearly indicate the concept of functional disability used in the studies and detail, which measures or tools were applied