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Accelerated dysfunction among the very oldest-old in nursing homes.

B E Fries1, J N Morris, K A Skarupski

  • 1Institute of Gerontology, School of Public Health, University of Michigan, Ann Arbor VA Medical Center, USA. bfries@umich.edu

The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
|June 8, 2000
PubMed
Summary

The study reveals that physical and cognitive decline accelerates significantly after age 95 in the oldest-old nursing home residents. This accelerated decline in function, unlike disease prevalence, suggests unique aging mechanisms in extreme longevity.

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Area of Science:

  • Gerontology
  • Biomedical Geriatrics
  • Aging Research

Background:

  • Traditional age categories (young-old, middle-old, oldest-old) may obscure critical changes within the oldest age groups.
  • The very oldest-old (e.g., 95+) represent a distinct demographic requiring specialized analysis.
  • Large datasets enable detailed examination of aging trajectories in extreme longevity.

Purpose of the Study:

  • To analyze the annual changes in physical and cognitive function and disease prevalence in individuals aged 80 and older.
  • To specifically investigate the aging process in the very oldest-old (95+) and compare it to younger elderly populations.
  • To identify age-related shifts in various health and functional measures.

Main Methods:

  • Utilized Resident Assessment Instrument (RAI) data from nursing homes across seven states (1992-1994).

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  • Included 193,467 unique residents aged 80+, with 6,556 residents aged 100+.
  • Calculated prevalence of physical/cognitive function, diseases, behaviors, mood, restraint use, falls, weight loss, BMI, and incontinence by age.
  • Main Results:

    • Physical and cognitive dysfunction prevalence increased most rapidly with age among the very oldest-old (95-100 years).
    • Significant slope changes in dysfunction were observed between ages 95 and 100.
    • Disease prevalence changes were less pronounced and did not show the same accelerated trend.

    Conclusions:

    • Accelerated dysfunction in the very oldest-old suggests a potential shift in aging mechanisms post-mid-nineties.
    • Studying the very oldest-old offers unique insights into the fundamental processes of aging.
    • The findings highlight the heterogeneity of aging and the need for age-specific research.