engleski

Functional Ability and the Duration of Dependence in Oldest-old Residents of Zagreb Retirement Homes

Persons of very old age are the hallmarks of successful ageing, yet at the same time, the objects of considerable health and social care burden. Understanding the factors of healthy ageing is the key to unburdening the health care sector in the century that population ageing is one of the most significant trends. Therefore, the present study aims to add some evidence for the complete dependence duration of oldest-old retirement home users on the care of the personnel. The sample consists of 250 unrelated participants of both sexes who were residents of homes for the elderly and infirm. Their functional ability was initially estimated through a study conducted between 2007 and 2009 with the inclusion age of 85 years and older, i.e., octogenarians and nonagenarians. Ten years after the initial study, a first-class opportunity to detect two key outcomes: the examinees' survival time and the duration of their preserved functional ability emerged (thanks to the mortality statistics register and the City of Zagreb retirement homes archives' data, respectively). The main variables of the present study are mobility and independence (at the initial interview and the year of death), and age at death. Additionally, several derived variables can be obtained: the age at which loss of mobility and/or independence occurred; survival time after immobility/dependence initiation; the degree of mobility/independence at the year of death; approximate duration of functional ability (mobility and/or independence) of oldest-old institutionalized persons, etc. Kaplan-Meier survival analysis showed that gender differences in terms of life duration are present in the oldest-old age group as well: median number of years from the interview until death is 4 years in women and 3 in men (p = 0.012). The participants' longevity is also differentiated according to the initially estimated functional abilities: the median length of life after the initial interview is 3 years (for permanently immobile or permanently limitedly mobile individuals), 4 years for limitedly mobile and 6 years for fully mobile persons (p < 0.001). Also the respective lengths of life are: 1 year (for permanently dependent individuals), 3 years for permanently limitedly independent, and 4 years for fully independent persons (p < 0.001). Cox regression analysis confirmed the above findings and showed that all three variables – gender, initial mobility, and independence – remain significant predictors of the age at death in the multivariate model (p < 0.001); irrespectively of the age at initial interview. We expect the presented results on the duration of functional disability (complete dependence on other people's care) of oldest-old persons to bring valuable information for social and health care planning and impact everyday gerontologic and geriatric practice.

octogenarians; nonagenarians; longevity; healthy ageing; functional status; old age homes

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