HIGH, USUAL AND IMPAIRED FUNCTIONING IN COMMUNITY-DWELLING OLDER MEN AND WOMEN - FINDINGS FROM THE MACARTHUR FOUNDATION RESEARCH NETWORK ONSUCCESSFUL AGING

The objective of this study is to determine the range of complex physi cal and cognitive abilities of older men and women functioning at high , medium and impaired ranges and to determine the psychosocial and phy siological conditions that discriminate those in the high functioning group from those functioning at middle or impaired ranges. The subject s for this study were drawn from men and women aged 70-79 from 3 Estab lished Populations for the Epidemiologic Study of the Elderly (EPESE) programs in East Boston MA, New Haven CT, and Durham County NC screene d on the basis of criteria of physical and cognitive function. In 1988 , 4030 men and women were screened as part of their annual EPESE inter view. 1192 men and women met criteria for ''high functioning''. Age an d sex-matched subjects were selected to represent the medium (n = 80) and low (n = 82) functioning groups. Physical and cognitive functionin g was assessed from performance-based examinations and self-reported a bilities. Physical function measures focused on balance, gait, and upp er body strength. Cognitive exams assessed memory, language, abstracti on, and praxis. Significant differences for every performance-based ex amination of physical and cognitive function were observed across func tioning groups. Low functioning subjects were almost 3 times as likely to have an income of less-than-or-equal-to $5000 compared to the high functioning group. They were less likely to have completed high schoo l. High functioning subjects smoked cigarettes less and exercised more than others. They had higher levels of DHEA-S and peak expiratory flo w rate. High functioning elders were more likely to engage in voluntee r activities and score higher on scales of self-efficacy, mastery and report fewer psychiatric symptoms.