Activities of daily living: Changes in functional ability in three samples of elderly and very elderly people

Objectives: to investigate changes in functional ability and physical health, psychiatric morbidity, life satisfaction, service use and social support. Design: a structured interview survey of three samples of elderly people living at home at two points in time. The three samples comprised one census of people aged 85 and over [City (of London) and Hackney], and two random samples of people aged 65 - 84 (City and Hackney and Braintree). The follow-up interviews took place 2.5 - 3 years after the baseline interviews. Setting: City and Hackney (East London) and Braintree (Essex). Respondents were interviewed at home by one of 12 trained interviewers. Subjects: 630 people aged 85+ at baseline (70% response rate), and 78% of survivors re-interviewed at follow-up; 464 people aged 65-84 in Hackney at baseline (67% response rate), and 83% of survivors re-interviewed; 276 people aged 65-84 in Braintree at baseline (82% response rate), and 78% of survivors re-interviewed. Main outcome measures: scores on scales of functional ability, psychiatric morbidity, life satisfaction and social support, and items measuring number and type of health symptoms and services used. Conclusions: decreasing levels of physical functioning were associated with poor mental health, trouble with feet and problems with muscles and joints. There were no associations with level of physical functioning and use of rehabilitative or general medical services, use of social worker or carer relief. Few respondents used preventive or rehabilitation services.