BMJ 1999;318:1108-1111 ( 24 April )

Papers

Profile of disability in elderly people: estimates from a longitudinal population study

Medical Research Council Cognitive Function and Ageing Study (MRC CFAS) and Resource Implications Study (RIS MRC CFAS). 

Correspondence to: Dr Melzer dm214{at}medschl.cam.ac.uk

Objectives: To provide estimates of the numbers of cognitively impaired and physically disabled elderly people in England and Wales, subdivided by a range of sociodemographic, dependency, care receipt, and survival variables, to support debates on the form and funding of health and welfare programmes.
Design: Interviews at baseline and 2 year follow up plus data on resource use extracted from records for those with disability.
Subjects: 10 377 people aged 65 years and over in Cambridgeshire, Newcastle, Nottingham, and Oxford. All estimates weighted to population of England and Wales in 1996.
Results: 11% of men and 19% of women aged 65 and over were disabled, totalling 1.3 million people; 38% of these were aged 85 or over and a similar percentage were cognitively impaired. Overall, more than 80% of elderly disabled people needed help on at least a daily basis. Over a third of people with limitations to daily activity living in private households were wholly or partly dependent on formal services for help. 63% of disabled elderly people used acute hospitals during the 2 year follow up, 43% as inpatients. 53% of those with cognitive impairment and limitations to daily activity were living in institutions.
Conclusions: Very elderly people and those with cognitive impairment make up a large proportion of those in need of long term care. A large proportion of even the most disabled elderly people currently live outside institutions and depend on formal services as well as informal care givers. Disabled elderly people use acute hospitals extensively, underlining the interrelations between acute and long term care.


Key messages

  • Disability is not present or absent, but rather a matter of degree. On the restrictive study definitions for disability 1.3 million elderly people in England and Wales are classified as disabled or cognitively impaired

  • 38% of disabled elderly people have cognitive impairment

  • People aged 85 years and over and those with cognitive impairment combined with limitations in activities of daily living make up a large proportion of those needing institutional care or intensive home support

  • Formal community services were the only source of support for 29% of physically disabled elderly people and 23% of those with combined disability in the community

  • 43% of disabled elderly people were admitted to acute hospitals during the 2 year follow up period




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