Active-life expectancy and terminal dependency: trends in long-term geriatric care over 33 years.

To determine whether medical advances will result in an increasing number of dependent elderly people, or whether postponement of disability in a finite lifespan will lead to a decrease in terminal dependency, an analysis was made of 24,117 admissions to a geriatric unit from 1954 to 1986. During this period, the average age on admission for long-term care rose by 0.24 years per year for women and by 0.09 years per year for men. The median length of stay also increased, more for women than for men, as did the proportion of the total lifespan spent in long-term care. Active-life expectancy became longer and terminal dependency was postponed, but the duration of terminal dependency increased. Active-life expectancy increased more rapidly in women than in men, as did the length of terminal dependency. As life expectancy continues to increase, high priority will have to be given to reduction of disability and dependency in advanced old age.