People aged 80 years and over are the world’s fastest growing age group.1 In the United States from July 2007 to July 2008 the over 85 age group grew by 3.5%, whereas the overall population grew by 0.73%.2 In the linked population based study (doi:10.1136/bmj.b4904), Collerton and colleagues point out that despite this unprecedented growth, relatively little is known about what is perceived by many to be a predominantly frail and disabled group.3 4 The authors recruited 53 of 64 general practices in Newcastle upon Tyne and North Tynside to send letters of invitation to all but their terminally ill patients who were born in 1921. Sociodemographic, medical, cognitive function, and physical function data were collected from personal visits and reviews of the medical records. In all, 1042 people (72%) agreed to participate (62% women, 38% men), 10% of whom were living in non-family care settings.

The authors found that despite high prevalence and complexity of age related diseases, these people had difficulty with a median of only three of 17 …