Physical functioning in elderly Europeans:: 10 year changes in the north and south:: the HALE project

Objectives: To examine age related changes in physical functioning in elderly men and women. Design: Prospective, population based study. Setting: Population of 15 rural and urban centres in 10 European countries. Participants: Altogether 3496 men and women born between 1900 and 1920 who participated in the baseline survey of the HALE project in 1988-1991. The study population was examined again about five (in 1993-1995) and 10 (in 1999-2001) years after the baseline examination. Main outcome measures: Physical functioning was measured by means of a self administered questionnaire of activities of daily living (ADL). Dichotomised prevalence of disability and need for help in self care and mobility ADL were used as dependent variables in the analyses. Results: Prevalence of disability and need for help tended to be higher in women than in men and in mobility abilities than in self care activities. Disability and need for help increased with advancing age but ameliorated over time from one birth cohort to another. In longitudinal analyses this beneficial time trend was independent of the effect of age, study, and region in self care disability in men and women (OR 0.85, 95% CI 0.75 to 0.97 and OR 0.64, 95% CI 0.43 to 0.97, respectively) and self care need for help in men (OR 0.83, 95% CI 0.70 to 0.96). Mobility disability among men and self care disability among women decreased more in the south than in the north. Conclusion: While European populations are aging, the proportions of elderly people with disability are decreasing. These results suggest that dynamics of functioning may differ across cultures. Future studies are needed to clarify which potentially modifiable and culturally determined factors protect against functional decline.