Health, frailty and disability after ninety: Results of an observational study in France

Background: In spite of their increasing demographic weight, health characteristics of the oldest old remain poorly described in epidemiological studies.

Objective: To describe the health of people aged 70 years and over included in the SIPAF study, and to compare the prevalence of health indicators including successful aging, frailty, and disability between three age groups including the oldest old.

Methods: The study population is composed of 2350 retired people recruited between 2008 and 2010, of whom 512 are aged 90 and over (21.8%). A comprehensive geriatric assessment was performed at home by trained nurses. The prevalence of health and functional indicators, as well as the distribution of people among successful ageing, frailty, and disability, were described by age group (70-79, 80-89, 90+) and sex.

Results: Compared to their younger counterparts, people aged 90 years and over were more likely to experience functional limitations, sensory impairment, cognitive impairment, poor mood, and frailty. One third of the nonagenarians needed help in at least one basic activity of daily living and 25% met the frailty criteria. In contrast, the prevalence of most chronic diseases did not increase after ninety. Successful ageing concerned 9% of the oldest old. Women were less likely to experience successful ageing and more likely to be frail or dependent.

Conclusion: This study shows the diversity of health states in very old age and points out that one quarter of the people aged 90 and over said frail are likely to take advantage of preventive actions of disability.