Department of Geriatrics and Rehabilitation, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel. jacobsj @ hadassah.org.il
Gerontology. 2012;58(4):313-21. doi: 10.1159/000335238. Epub 2012 Jan 26.
Old age has traditionally been considered to begin at age 65. The improving health and functional status observed among older people may necessitate reevaluation of this cut-off point.
To present the changing prevalence of common geriatric syndromes, functional parameters, common disease status and health care utilization, at ages 70, 78 and 85, in order to help address the question of when does contemporary aging actually begin.
Medical, psychosocial, cognitive, and functional status, and health service utilization at age 70, 78 and 85 were assessed through the Jerusalem Longitudinal Cohort Study (1990-2010), which prospectively followed a representative sample (born 1920-1921), of 1,861 people, all of whom underwent home-based comprehensive assessment.
At age 70, the cohort had good health, low comorbidity, preserved cognition, mobility and independence in basic and instrumental activities of daily activities (ADL). Rising comorbidity, declining cognitive status, increasing depression, and difficulty in ADLs were seen at 78. By age 85, compared to age 70, comorbidity had tripled, depression, hearing and visual impairment, falls, dizziness and mobility problems had doubled; 23% of subjects had cognitive impairment, 42.5% suffered urinary incontinence, and dependence in basic and instrumental ADLs was common (37.8 and 51.7%, respectively). Home care was 4.5, 10.1, and 24.6%, and hospitalization in the previous year occurred among 12.3, 18.8 and 27.8% at ages 70, 78 and 85, respectively.
At age 70, the overall health profile was favorable, prevalence of geriatric syndromes was low, cognitive and functional status was preserved, and health service utilization was low. The progressive deterioration seen at ages 78 and more profoundly so at age 85, suggest that a cut-off point beyond age 70 years may serve to better define entry into old age.
传统上，老年被认为始于 65 岁。老年人健康和功能状况的改善可能需要重新评估这个截止点。
介绍 70 岁、78 岁和 85 岁时常见老年综合征、功能参数、常见疾病状况和卫生保健利用的变化流行率，以帮助解决当代老龄化从何时开始的问题。
通过耶路撒冷纵向队列研究（1990-2010 年）评估 70 岁、78 岁和 85 岁时的医学、心理社会、认知和功能状况以及卫生服务利用情况，该研究前瞻性地随访了一个代表性样本（1920-1921 年出生），共 1861 人，所有人都接受了基于家庭的综合评估。
70 岁时，该队列的健康状况良好，合并症少，认知、活动能力和日常生活活动（ADL）的基本和工具性活动能力保持完好。到 78 岁时，合并症增加，认知状态下降，抑郁增加，ADL 困难。到 85 岁时，与 70 岁相比，合并症增加了两倍，抑郁、听力和视力障碍、跌倒、头晕和活动能力问题增加了一倍；23%的受试者有认知障碍，42.5%有尿失禁，基本和工具性 ADL 依赖很常见（分别为 37.8%和 51.7%）。家庭护理分别为 4.5%、10.1%和 24.6%，70 岁、78 岁和 85 岁时，前一年住院率分别为 12.3%、18.8%和 27.8%。
70 岁时，整体健康状况良好，老年综合征患病率低，认知和功能状况保持完好，卫生保健服务利用率低。78 岁时的逐渐恶化，到 85 岁时更为明显，表明超过 70 岁的截止点可能更能定义进入老年的时间。
