Factors Affecting Functional Impairment among Elderly Germans - Results of a Longitudinal Study

OBJECTIVE

To investigate causal factors of functional impairment in old age in a longitudinal approach.

DESIGN

A population-based prospective cohort study.

SETTING

Elderly individuals were recruited via GP offices at six study centers in Germany. They were observed every 1.5 years over six waves.

PARTICIPANTS

Three thousand two hundred fifty-six people aged 75 years and older at baseline.

MEASUREMENTS

Functional impairment was quantified by the Lawton and Brody Instrumental Activities of Daily Living scale (IADL) and the Barthel-Index (BI).

RESULTS

Fixed effects regressions revealed that functional impairment (IADL; BI) increased significantly with ageing (β=-.2; β=-1.1), loss of a spouse (β= .5; β=-3.1), not living alone in private household (β=-1.2; β=-5.5), depression (solely significant for IADL: β= .6) and dementia (β=-2.3; β=-18.2). The comorbidity score did not affect functional impairment.

CONCLUSION

Our findings underline the relevance of changes in sociodemographic variables as well as the occurrence of depression or dementia for functional impairment. While several of these causal factors for functional decline in the oldest old are inevitable, some may not be, such as depression. Therefore, developing interventional strategies to prevent depression might be a fruitful approach in order to delay functional impairment in old age.

Predictors of Frailty in Old Age - Results of a Longitudinal Study

OBJECTIVES

To investigate time-dependent predictors of frailty in old age longitudinally.

DESIGN

Population-based prospective cohort study.

SETTING

Elderly individuals were recruited via GP offices at six study centers in Germany. The course of frailty was observed over 1.5 years (follow up wave 4 and follow up wave 5).

PARTICIPANTS

1,602 individuals aged 80 years and older (mean age 85.4 years SD 3.2, with mean CSHA CFS 3.5 SD 1.6) at follow up wave 4.

MEASUREMENTS

Frailty was assessed by using the Canadian Study of Health and Aging Clinical Frailty Scale (CSHA CFS), ranging from 1 (very fit) to 7 (severely frail).

RESULTS

Fixed effects regressions revealed that frailty increased significantly with increasing age (β=.2) as well as the occurrence of depression (β=.5) and dementia (β=.8) in the total sample. Changes in marital status and comorbidity did not affect frailty. While the effects of depression and dementia were significant in women, these effects did not achieve statistical significance in men.

CONCLUSION

Our findings highlight the role of aging as well as the occurrence of dementia and depression for frailty. Specifically, in order to delay frailty in old age, developing interventional strategies to prevent depression might be a fruitful approach.