Objective: To assess four-year changes in different measures of health
, functional limitations and activities of daily living occurring in e
lderly Europeans who participated in the SENECA surveys of 1988/89 and
1993. Methods: Similar questions on self-perceived health, chronic di
seases, drug intake and activities of daily living (ADL) were asked in
a standardized way in 1988/84 and in 1993. In 1993 an objective test
of physical performance (PPT) was added. Setting: Nineteen towns in 12
European countries were surveyed in 1988/89; 1282 men and 1304 women
born between 1913 and 1918 participated in SENECA's baseline study. Ni
ne of the towns participated in the follow-up study in 1993 and four n
ew localities joined. Subjects: Data on health and physical performanc
e are presented for 571 men and 603 women from nine towns in Europe wh
o took part in both SENECA studies and, additionally for 105 men and 1
56 women from the four localities examined in 1993 only. Results: Of t
he 571 men and 603 women examined at both baseline and follow-up, 54%
of the men and 37% of the women could do all mobility and selfcare ite
ms of daily living in 1988/89 without difficulty or help. In 1993, onl
y 40% of the men and 22% of the women could do so, i.e. on balance 63
fewer men and 72 fewer women than in 1988. There was much less variati
on between towns in simple function tests than in the basic ADL action
s. The PPT (sum score) was on average 20.8 in men and 20.3 in women, r
anging from 14.8 to 22.8 across towns. Over the four-year period, the
proportion perceiving their health to be excellent or good decreased,
but the changes differed considerably from one town to another. At fol
low-up, 68% of the men and 78% of the women had at least one chronic d
isease; the average number of diseases for each participant in the tot
al SENECA population being 1.1. The range in prevalence of chronic dis
eases varied from 40% in Spanish men to 100% in Portuguese women. Alth
ough there was no significant increase in the number of participants r
eporting chronic disease, the number of chronic diseases per participa
nt increased from 0.9 to 1.0 in men and from 1.1 to 1.3 in women. Conc
lusions: During the period from 1988/89 to 1993 the proportion of ADL-
independent men and women decreased by 25% and the number of people pe
rceiving their health to be poor increased by 21%, but there was no ch
ange in the prevalence of chronic diseases.