The prevalence of diagnoses, impairments, disabilities and handicaps in a population of elderly people living in a defined geographical area: the Gospel Oak project

Objective: to measure the prevalence of impairments, disabilities and handicaps in a geographically-defined elderly population. Design: cross-sectional analysis of an interview survey. Setting: a single North London electoral ward (district). Participants: 654 residents (74%) over the age of 65 years were interviewed from a register of 889. A random sample of 225 had additional data collected which are reported in this analysis. Main outcome measures: point prevalence and distribution of the total number of reported diagnoses, impairments and disabilities, and distributions of the Office of Population Censuses and Surveys (OPCS) disability scale and the London Handicap Scale scores. Results: participants had a median of three reported diagnoses and two impairments. Forty-three percent were in the least disabled OPCS disability category (i.e. below the disability threshold) and 41% were able to undertake all of 12 basic activities of daily living without difficulty. Overall handicap scores were heavily skewed towards no health-related disadvantage, with a median score of 83 out of 100, and 37% having a score of 90 or more. All indicators showed deteriorating health with increasing age, but age-adjusted gender differences were small. Conclusions: an elderly population's health problems mere classified using a comprehensive framework, revealing high prevalences of diagnoses, impairments, disabilities and handicaps. The schema is appropriate for health care needs assessment and is a suitable basis for describing the population's health.