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Updated: Jul 2, 2026
06:52
Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Exceptional longevity does not result in excessive levels of disability
Kaare Christensen1, Matt McGue, Inge Petersen
1The Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, DK-5000, Odense C, Denmark. kchristensen@health.sdu.dk
Summary
Long life increases the risk of losing independence for individuals. However, for society, reduced mortality does not predict widespread disability among the very old, as dependent individuals face higher mortality rates.
Area of Science:
- Gerontology
- Epidemiology
- Public Health
Background:
- Late-life loss of independence is a significant concern for aging individuals and society.
- Increased survival to advanced age presents complex implications at both individual and population levels.
Purpose of the Study:
- To assess the loss of physical and cognitive independence in individuals aged 92 to 100 years.
- To analyze the discrepancy between individual and population trajectories of independence.
Main Methods:
- Longitudinal study of the entire Danish 1905 cohort from 1998 to 2005.
- Assessed independence defined by basic activities of daily living and Mini-Mental State Examination (MMSE) scores.
- Analyzed missing data due to nonresponse and mortality.
Main Results:
- The aggregate cohort showed a modest decline in independence (39% to 33%) between ages 92 and 100.
- For survivors, independence decreased significantly (70% to 33%) from age 92 to 100.
- Increased mortality among dependent individuals explained the population vs. individual trajectory difference.
Conclusions:
- Longer lifespan increases an individual's risk of losing independence.
- Mortality reductions are unlikely to cause exceptional disability levels in the very old population.
- The study highlights the differing experiences of independence at individual versus population levels in advanced age.
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