Functional status and self-rated health in 2,262 nonagenarians: The Danish1905 cohort survey

OBJECTIVES: To describe the functional capacity and self-rated health of a large cohort of nonagenarians. DESIGN: A cross-sectional survey of all Danes born in 1905 (92-93 years of age), carried out August to October 1998. SETTING: Participants' homes. PARTICIPANTS: Two thousand two hundred and sixty-two nonagenarians, corresp onding to a participation rate of 63% (of these, 20% participated by proxy) . MEASUREMENTS: Activities of daily living (ADLs) and self-rated health were assessed by interview. Five items from Katz's ADLs (bathing, dressing, tran sfer, toileting, and eating) were used to construct a three-level five-item ADL scale (not disabled (no disabilities), moderately disabled (1-2 disabi lities), severely disabled (3-5 disabilities)). From responses to a more ex tensive list of questions on ADLs (26 items), we identified scales of stren gth and agility by means of factor analysis. Furthermore, a 26-item ADL sca le was made. Physical performance tests (chair stand, timed walk, lifting a 2.7 kg box, maximum grip-strength, and flexibility tests) were performed a mong non-proxy responders. RESULTS: According to the five-item ADL scale, 50% of the men and 41% of th e women were categorized as not disabled, while 19% and 22%, respectively, were categorized as severely disabled. The five-item ADL scale correlated h ighly with the 26-item ADL scale (r = 0.83). The ADL scales showed moderate -to-good correlation with each other (r = 0.74-0.83), and with tile physica l performance tests (r = 0.32-0.58). Only 3.7% of the women and 6.3% of the men walked (normal pace) with a speed of at least 1 meter per second, whic h is the minimum walking speed required to cross signaled intersections in Denmark. A total of 56% considered their health to be excellent or good. Of the participants, 74% were always or almost always satisfied with their li ves, even though only 45% reported that they "felt well enough to do what t hey wanted." The analyses showed that no single ADL item seemed to be of pa rticular importance for how the participants rated their health. CONCLUSION: The Danish 1905 cohort survey is the largest and the only natio nwide survey of a whole birth-cohort of nonagenarians. A total of 2,262 fai rly nonselected nonagenarians participated. The level of both self-reported disability and functional limitations measured by physical performance tes ts among nonagenarians was high. Despite their lower mortality, women were more disabled than men and did not perform as well as men in the physical p erformance tests. Nevertheless, the majority of the participants considered their health to be good and were satisfied with their lives.