Health and disease in the very old : findings from the Newcastle 85+ study

• Main Author: Collerton, Joanna Clare
• Published: University of Newcastle Upon Tyne 2012
• Subjects: 362.6
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.613628

The oldest old, defined variously as those aged '80 and over' or '85 and over', are the most rapidly expanding age group across most of the world. The potential for very old age to be accompanied by high morbidity and dependency is a source of concern for policy makers, health and social care providers, and society as a whole. Research evidence concerning the oldest old is limited. There is a pressing need for robust information on the diversity of their health and needs. This thesis brings together a series of eight publications from my work in the Newcastle 85+ Study, a population-based longitudinal study undertaken in the 1921 birth cohort living in North-East England. A detailed examination of the health status and care needs of very old people was conducted. Study participants were recruited at a mean age of 85.5 years (standard deviation 0.4). Comprehensive multidimensional health assessment was performed in the home setting. General practice medical records were reviewed for disease, medication and service use data. The main findings were: Levels of morbidity and healthcare use were high. A substantial proportion of morbidity remained undiagnosed. Despite the high morbidity burden, participants generally managed well with daily activities, and the majority lived in non-supported housing. Self-rated health was generally good. However, one-fifth of participants required frequent daily or 24 hour support, and one-tenth were resident in care homes. Women out-numbered men, yet were generally in poorer health. Inflammatory biomarkers were associated with frailty; and telomere length, a cellular ageing biomarker, was associated with cardiac function. This work provides a comprehensive evidence-base on the health and needs of very old people. It will inform effective planning of current and future services. Potentially causal associations between inflammatory and cellular ageing biomarkers and health status in the very old have been identified.