Health and social care provision needs to be put in place for a large increase (33%) in the 85 year old population in the UK by 2020, according to a study published today in the British Medical Journal.
The researchers say that while "the oldest old" (individuals aged 80 or 85 years and over) are the fastest growing sector of the world's population, detailed data about the health problems experienced in this age group is lacking.
The Newcastle 85+ Study, funded by the Medical Research Council, assessed the health of more than one thousand individuals born in 1921 and living in Newcastle and North Tyneside. The majority of participants underwent a detailed health assessment and a medical record review.
Lead researcher, Professor Tom Kirkwood said the research group provided an invaluable resource of material as they had "evaded the risks of mortality associated with specific adverse factors and are therefore particularly likely to be informative about the effects of intrinsic ageing".
Despite significant levels of disease and impairment, the researchers found that "these 85 year olds seemed optimistic" and almost eight out of ten (78%) of them rated their health, compared to others of the same age, as 'good' or better. Low levels of disability were found and only one out of ten participants (10%) was in institutional care.
The results also show that almost six out of ten participants (58%) suffered from high blood pressure and just over a half (52%) had osteoarthritis. Moderate to severe cognitive impairment was present in 12% of the group and 21% of them had severe to profound urinary incontinence. Six out of ten (60%) had some form of hearing impairment and almost four out of ten (37%) had visual impairment.
More than nine out of ten (94%) participants had seen their GP and almost eight out of ten (77%) had seen a practice nurse in the previous year. Although women had a higher number of diseases and disabilities than men, they were less likely to have gone to hospital as an outpatient in the previous three months.
The authors conclude that the study is important as it will help local and national policy makers plan services for the expanding population of oldest old. They argue that 61% of the non-institutionalised individuals in their study were living alone and this has implications for social and health care providers.
An accompanying editorial suggests that functional status, rather than age alone, must be an important consideration in establishing goals of medical treatment in the very old.
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