Need of help and care in old age in the former East German states: resultsfrom the Leipzig longitudinal study of the aged population (LEILA75+)

In a representative sample of the Leipzig population age 75 and older 61.8% of the participants showed relevant deficits in their capacity of independ ent living as assessed by a combined ADL/IADL scale. According to a staging model of care as promoted by Schneekloth and coworkers, 17% of the sample was in need of care. Especially, mobility-related instrumental activities o f daily living (IADL) such as shopping, cleaning and visiting are affected, but also basic activities (ADL) such as climbing stairs, walking or taking a shower/bath. Each of these activities created problems for more than 45% of the participants. Between 18 and 33% of the sample even regarded it as impossible to carry out these activities. Expectedly, the percentages of as sistance needed with ADLs/IADLs appeared to be strongly age-related with ex ponential increases beyond the age of 85. Beyond effects of sampling and li fe expectancy, significantly more women suffered from decreases in their ca pacity of independent living. Community-dwelling elderly on average had a 1 0% higher rate of problems with ADLs/IADLs as compared to German reference data from the studies on "Chances and Limits of Independent Living in Old A ge"; the rate of institutionalized participants, who regarded it impossible to carry out these activities, was even higher by about 30%. As discussed by Schneekloth et al., data from the LEILA study support the hypothesized p attern that ecological disadvantages under both community-dwelling as well as insitutionalized living conditions lead to higher percentages of elderly in the former East German states who are in need of care. As a consequence and although more disabled, elderly seem to stay longer under community-dw elling living conditions and move even more disabled into an institutionali zed form of living.