Health and function assessments in two adjacent Danish birth cohorts of centenarians: Impact of design and methodology

Abstract

Using the results from measures of functional ability, cognitive and physical performance from two adjacent birth cohorts of 100-year-old adults, we aimed to elucidate the possible impact of difference in participation rates, design, and interviewer mode. Participants were birth cohort members born in 1910 (DK-1910) and 1911-12 (DK-1911). Both surveys used the same assessment instruments, but the design was different, and data collection was carried out by trained survey agency interviewers in DK-1910 and trained nurses in DK-1911. Participation rate in DK-1911 (49.8% (251/504)) was lower than in DK-1910 (66.9% (273/408)) (p<0.001). The proportion of interviews with the participant answering alone or mainly alone was significantly higher in DK-1911 (77%) than in DK-1910 (56%), and the proportion living in nursing home was significantly lower (44 vs. 54%, respectively). Higher proportions of DK-1911 independently performed all activities of daily living (ADL) compared to DK-1910, but only significantly for toileting, bathing, and feeding (all p<0.01). Mini-mental state examination (MMSE) score was higher in DK-1911 than in DK-1910 (23.5 vs. 21.0; p<0.001). Handgrip strength, gait speed, and chair stand were almost similar. DK-1911 participants had significantly better one-year survival than DK-1911 non-participants and DK-1910 participants and non-participants (p=0.001). These results suggest that lower participation rate entails selection towards healthier participants in terms of ADL and cognitive functioning. Caution is warranted when comparing studies of centenarians with different participation rates, design, and interviewer mode, and further studies of these methodological issues are required.