Health and physical performance of elderly Europeans. SENECA Investigators.

OBJECTIVE

To assess four-year changes in different measures of health, functional limitations and activities of daily living occurring in elderly Europeans who participated in the SENECA surveys of 1988/89 and 1993.

METHODS

Similar questions on self-perceived health, chronic diseases, drug intake and activities of daily living (ADL) were asked in a standardized way in 1988/89 and in 1993. In 1993 an objective test of physical performance (PPT) was added.

SETTING

Nineteen towns in 12 European countries were surveyed in 1988/89; 1282 men and 1304 women born between 1913 and 1918 participated in SENECA's baseline study. Nine of the towns participated in the follow-up study in 1993 and four new localities joined.

SUBJECTS

Data on health and physical performance are presented for 571 men and 603 women from nine towns in Europe who took part in both SENECA studies and, additionally for 105 men and 156 women from the four localities examined in 1993 only.

RESULTS

Of the 571 men and 603 women examined at both baseline and follow-up, 54% of the men and 37% of the women could do all mobility and selfcare items of daily living in 1988/89 without difficulty or help. In 1993, only 40% of the men and 22% of the women could do so, i.e. on balance 63 fewer men and 72 fewer women than in 1988. There was much less variation between towns in simple function tests than in the basic ADL actions. The PPT (sum score) was on average 20.8 in men and 20.3 in women, ranging from 14.8 to 22.8 across towns. Over the four-year period, the proportion perceiving their health to be excellent or good decreased, but the changes differed considerably from one town to another. At follow-up, 68% of the men and 78% of the women had at least one chronic disease; the average number of diseases for each participant in the total SENECA population being 1.1. The range in prevalence of chronic diseases varied from 40% in Spanish men to 100% in Portuguese women. Although there was no significant increase in the number of participants reporting chronic disease, the number of chronic diseases per participant increased from 0.9 to 1.0 in men and from 1.1 to 1.3 in women.

CONCLUSIONS

During the period from 1988/89 to 1993 the proportion of ADL-independent men and women decreased by 25% and the number of people perceiving their health to be poor increased by 21%, but there was no change in the prevalence of chronic diseases.