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Health and disease in 85 year olds: baseline findings from the Newcastle 85+ cohort study

in
Publisher: 
BMJ
Author: 
Joanna Collerton, principal clinical research fellow1, Karen Davies, research nurse manager1, Carol Jagger, professor of epidemiology1,2, Andrew Kingston, research assistant (medical statistics)1, John Bond, professor of social gerontology and health services research1,3, Martin P Eccles, William Leech professor of primary care research1,3, Louise A Robinson, professor of primary care and ageing1,3, Carmen Martin-Ruiz, senior research associate1, Thomas von Zglinicki, professor of cellular gerontology1, Oliver F W James, senior research fellow1, Thomas B L Kirkwood, director1
Date published: 
4 January, 2010
Region: 
United Kingdom
England

Publication type: 
research
Publication link: 
Health and disease in 85 year olds: baseline findings from the Newcastle 85+ cohort study
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1 Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne NE4 5PL, 2 Department of Health Sciences, University of Leicester, Leicester, 3 Institute of Health and Society, Newcastle University, Newcastle upon Tyne

Correspondence to: J Collerton j.c.collerton@ncl.ac.uk

Abstract

Objectives The Newcastle 85+ Study aims to systematically study the clinical, biological, and psychosocial attributes of an unselected cohort of 85 year olds and to examine subsequent health trajectories as the cohort ages; health at baseline is reported.

Design Cross sectional analysis of baseline data from a cohort study.

Setting Newcastle upon Tyne and North Tyneside primary care trusts, United Kingdom.

Participants 1042 people born in 1921 and registered with the participating general practices.

Main outcome measures Detailed health assessment and review of general practice records (disease, medication, and use of general practice services); participants could decline elements of the protocol.

Results Of the 1453 eligible people, 851 (58.6%) were recruited to health assessment plus record review, 188 (12.9%) to record review only, and 3 (0.2%) to health assessment only. Data from record review are reported on a maximum of 1030 and from health assessment on a maximum of 853; individual denominators differ owing to withdrawal and missing values. Of the health assessment sample (n=853), 62.1% (n=530) were women and 10.4% (n=89) were in institutional care. The most prevalent diseases were hypertension (57.5%, 592/1030) and osteoarthritis (51.8%, 534/1030). Moderate or severe cognitive impairment was present in 11.7% (96/824) of participants, severe or profound urinary incontinence in 21.3% (173/813), hearing impairment in 59.6% (505/848), and visual impairment in 37.2% (309/831). Health assessment identified participants with possible disease but without a previous diagnosis in their medical record for hypertension (25.1%, 206/821), ischaemic heart disease (12.6%, 99/788), depression (6.9%, 53/772), dementia (6.7%, 56/840), and atrial fibrillation (3.8%, 30/788). Undiagnosed diabetes mellitus and thyroid disease were rare (1%, 7/717 and 6/762, respectively). A median of 3 (interquartile range 1-8) activities of daily living were undertaken with difficulty. Overall, 77.6% (646/832) of participants rated their health compared with others of the same age as good, very good, or excellent. High contact rates in the previous year with general practitioners (93.8%, 960/1024) were recorded. Women had significantly higher disease counts (medians: women 5, men 4; P=0.033) and disability scores (medians: women 4, men 2; P=0.0006) than men, but were less likely to have attended outpatient clinics in the previous three months (women 29% (150/524), men 37% (118/320), odds ratio 0.7, 95% confidence interval 0.5 to 0.9).

Conclusions This large cohort of 85 year olds showed good levels of both self rated health and functional ability despite significant levels of disease and impairment. Hypertension, ischaemic heart disease, atrial fibrillation, depression, and dementia may be underdiagnosed. Notable differences were found between the sexes: women outnumbered men and had more disease and disability.

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