[Risk and risk factors of disability in the aged]

Since 1978 the INSERM's Research (Unit-164) has been conducting a research programme on risk factors of mortality and disability. This study is based on a 5-year follow up of 4,200 elderly persons 60 and over in three regions of France. The aim is to provide the first results on 1082 people 65 and over living in upper Normandy. Initial level of disability appears the best predictive factor of 3-year mortality. Other predictive variables are age, sex, dyspnea during exertion and recent hospitalization. Pathologies reported by general practitioners are less informative on 3-year survival probability than variables related to frailty of subjects. The 5-year mortality is predicted by such pathologies as mental deterioration or cardio-respiratory diseases and age, sex, institutionalization and early smoking habits. The incidence of disability within 3 years is essentially predicted by pathologies: osteo-articular diseases (osteo-arthritis), mental deterioration and respiratory track diseases. These results favour a model of slow sequential decrease of health status, with mortality occurring after a long period of disability.