Oldest-old People Research Articles

Functional status of the oldest-old in a home setting.

The purpose of this cross-sectional study was to examine six domains of functioning: physical, mental, social, spiritual, economic and activities of daily living. The primary inclusion criteria at the time of recruitment were that participants be over the age of 85, be cognitively intact, and be living in a home setting. Instruments used for the study included the Older Americans Resource Survey (OARS), Mini-Mental Status Examination (MMSE), Geriatric Depression Scale (GDS), Spiritual Well Being Scale (SWBS). Fifty subjects, mean age 89 years, lived alone (65%) or with their spouse (22%) in their homes. Person's correlation analysis found significant relationships among physical, mental, social, economic and activities of daily living. Good to excellent functioning was found in the mental (82%) and social (82%) domains. Highest functional impairments were identified with ability to carry out activities of daily living (72%) and in the domains of physical functioning (55%). Common chronic illnesses reported were arthritis (56%), hypertension (46%) and cardiac problems (30%). The average daily use of prescribed drugs was three times and over-the-counter use was once per day. Eleven per cent of subjects were mildly (7%) or moderately (4%) depressed. Subjects reported that they needed visiting nurses (29%), home health aids (20%) and help with shopping (24%) and transportation (24%). The data suggest that multidimensional assessment is necessary to identify nursing interventions that will regain, maintain or enhance functioning among oldest-old people.

The relationship of dehydroepiandrosterone sulfate (DHEAS) to endocrine-metabolic parameters and functional status in the oldest-old. Results from an Italian study on healthy free-living over-ninety-year-olds.

Dehydroepiandrosterone sulfate (DHEAS), the major circulating adrenal hormone, has been suggested to have a role in many aging related diseases and perhaps in aging itself. Its precise biologic effects are still unknown, and data on healthy people over 90 yr of age are not available. We measured serum DHEAS levels in 75 healthy subjects aged 90-106 yr of both sexes and searched for correlations between DHEAS and several endocrine-metabolic parameters (serum thyroid hormones, GH-insulin-like-growth factor I (GH-IGF-I) axis, serum lipid profile, anthropometric indices of body composition) of the same subjects. The resulting data, normalized by logarithmic transformation (geometric mean at age 90-99, 551 ng/mL in men, 364 ng/mL in women; at age > 100 yr, 404 ng/mL in men, 521 ng/mL in women) resulted five-fold lower than DHEAS levels measured in a young control group (geometric mean at < 40 yr of age, 3110 ng/mL in men, 2824 ng/mL in women). In women over ninety yr, DHEAS was positively correlated with serum free triodothyronine (FT3) levels (r = 0.34, P = 0.05) and inversely with triglycerides (r = -0.45, P = 0.05). In men over 90 yr, DHEAS had positive correlations with body mass index (r = 0.41, P < 0.03) and waist-to-hip ratio (r = 0.47, P < 0.01) taken as indices of body's energy reserves (fat). To determine whether low serum DHEAS levels predict poor functional status in the very old, the Activity Daily Living (ADL) test was administered in all over-ninety subjects. Men with the highest functioning levels had the highest DHEAS levels (P < 0.03). Our data suggest that DHEAS levels may influence and/or be influenced by several endocrine and metabolic features of oldest-old people, depending on the sexual steroid milieu. DHEAS seems also to have a strong interrelation with functional activities. A favorable role for DHEAS in successful aging is proposed.