Older people are not only living longer: positive results in the temporal trends of physical functioning
Giola Santoni is a researcher on health status and health trends in older people. She has worked at the Aging Research Center, Karolinska Institutet in Sweden and she is currently a biostatistician at the same institute. Anna-Karin Welmer is associate professor and senior university lecturer at Karolinska Institutet. She is vice-principal investigator of the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) population-study. Anna-Karin’s primary area of research interest is the epidemiology of physical function, disability and falls in older persons.
Despite the rapid gain in life expectancy in the last century, it is not clear if the added years consist of healthy years or years lived in poor health and disability.
Previous studies have reported stable or even declining levels of disability. However, disability is defined as the inability to perform basic activities of daily living independently in the environment a person lives. Disability trends can therefore be influenced by changes in the environment such as development of technical equipment. To what extent does the encouraging trend towards declines in disability in the older population reflect actual improvements in physical function? As measures of physical function are strong markers of current health status and independent predictors of disability, dementia, health care utilisation, and mortality in older adults, studying their temporal trends has relevant clinical and public health implications.
In a recent paper in Age and Ageing, we looked at the temporal trends in physical function during 2001-2016 in a population of Swedes aged 66-90 years. We found that prevalence of impairment in walking speed and in the ability to stand up from a chair was lower in 2013-2016 than in 2001-2004 among most age cohorts. However, prevalence of impairment in balance remained substantially unchanged over the 12-year period. Interestingly, the improvements in walking speed and the ability to stand up from a chair appear to be driven by improved prognosis amongst those without impairments, rather than any substantial changes in prognosis for those with impairments.
These findings are consistent with and build upon previous research by suggesting that older adults not only seem to gain in life expectancy, but that they also may be more likely to maintain good functional ability. If confirmed in further studies, this trend towards a healthier ageing may offer a more optimistic view of ageing.