Changes in Functional Ability with Ageing and Over Time

Abstract

With increasing life expectancy, a major concern is whether the years gained are spent in good or in poor health. Disability has become the main indicator of health at older ages. Important questions are how it increases with age, what factors increase the chance of disability and what consequences disability has. In this chapter, evidence is provided based on results from the Longitudinal Aging Study Amsterdam (LASA), a study on determinants and consequences of changes in daily functioning in a representative sample of ages 55 and over in the Netherlands. In this chapter, the focus is on changes in physical functioning. From longitudinal data, it is observed that many elders experience function loss, especially at higher ages. A host of factors are associated with function loss, such as chronic diseases, cognitive decline, depressive complaints, socio-economic status and lifestyle. A few of these factors are causal, others are characteristics of groups with raised chances of function loss. From trend analyses, it is apparent that the prevalence of functional limitations is not fixed, but varies over time. The LASA study shows that this prevalence is increasing. In light of the absolute and relative rise of the number of older people in the population, it is of great importance to realise a lower prevalence of function loss and a delay of function loss to older ages. Based on the findings presented, some suggestions for this are given. Also, some directions for future research are described.