Functional Impairment and Co-Disability in the Oldest Old

Abstract
Using a multidimensional approach, we explore rates of co-disability in a representative sample of the oldest old living in Sweden. Drawing from census data, 324 subjects ranging in age from 84 to 90 were identified and evaluated for five domains of functioning: sensory, mobility, physical activities of daily living (PADL), instrumental activities of daily living (IADL), and cognitive. Three patterns of functioning were found: (1) a minority of high-functioning subjects (23%) with no or only mild disability in any domain; (2) a group (17%) with IADL deficits only; and (3) a majority of subjects (55%) with multiple disabilities. These results suggest that an accurate portrayal of the oldest old requires a multidimensional approach in which the interrelations among domains of functioning are taken into account Of particular relevance for planning services and care is the heterogeneity of this population, which necessitates a flexible mix of supportive programs that match the resources and abilities of the individual.

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