Search

It is predicted that the future increase in the oldest-old (85 years and older) population will have a marked influence on society. However, little is known about the features of various functions in the oldest-old. The purpose of this study was to clarify the functional status of the oldest-old. We surveyed all oldest-old residents in a small area of Itabashi ward in metropolitan Tokyo to clarify their living conditions. The oldest-old themselves and their family members were invited to participate, and 235 out of 311 residents (75.6%) agreed to do so. Forty-two percent of the participants were dependent and needed care from others. The ADL status measured by the Barthel Index showed that 30% of independent participants also had some deterioration of physical function. These results are indicative of increased frailty in the oldest-old. Comparison between independent and dependent (need care from others in daily living) showed that the functional status was lower in dependent group. However, the psychological well-being was the same in this two groups. These results indicate progressive functional deterioation and psychological adaptation to it, in the oldest-old. Further research to elucidate the process of psychological adaptation to frailty is necessary in order to promote the well-being among the oldest-old, in whom functional limitation is evident.

This study was conducted to clarify the characteristics of cognitive function among physically independent very old people dwelling in an urban community in Japan. Five hundred and thirteen Old-Old (aged 75-84 years) and 168 Oldest-Old (aged 85-100 years) adults participated. We carried out the Mini-Mental State Examination (MMSE) for measuring cognitive functions in the elderly. Age-related differences in the total score and sub-scale scores of the MMSE were analyzed by sex using ANCOVA, controlling for education, vision and hearing problems. Mean MMSE scores for Old-Old and Oldest-Old males were 27.53 and 25.88, respectively, and those for Old-Old and Oldest-Old females were 27.77 and 24.98, respectively. Age-related differences in the MMSE total score between the Old-Old and Oldest-Old were observed in both sexes, suggesting that overall cognitive functions continue to decline over time in very old age. Age-related differences between the Old-Old and Oldest-Old in items measuring, registration, calculation and delayed recall were observed in both sexes, and in addition, time orientation, place orientation, delayed recognition, writing sentences, and copying figures were observed in females. These findings suggest that the faculties are those most sensitive to normal aging among very old individuals. There were no age group differences in five items: reverse spelling, naming objects, repeating a sentence, listening and obeying, and reading and obeying.

The Japanese version of the GBS Scale (GBSS-J) was administered to 246 elderly patients with dementia in a geriatric hospital to test the inter-rater reliability and validity of the items and the subscales of the GBSS-J. The inter-rater reliability of the 26 items was tested by rating 20 patients. After the raters conferred with each other how to rate the items of the scale, the items were rated independently. Pearson's correlation coefficients indicating the agreement between the rates were as good as more than. 660 except for the items of impaired wakefulness and confusion. The validity of the 28 items was examined by comparing them with the stages of Functional Assessment Staging (FAST). Hasegawa's dementia scale (HDS) was employed as an external standard to test the items of the subscale of intellectual functions. Physical disability was checked by using the Rapid Disability Rating Scale (RDRS). Mean scores of the 20 items except for the 6 items included in the subscale of different symptoms common in dementia significantly increased as the FAST stage advanced. These results indicated that the 20 items of the GBSS-J measured the severity of dementia with sufficient validity. In addition, according to the results of analysis of variance and covariance, the items of motor insufficiency in taking food, impaired physical activity, impaired wakefulness and irritability were related to the severity of physical disability rather than that of dementia. Also, the 10 items of the subscale of intellectual functions showed significant correlations with the scores of HDS, while the item of impaired wakefulness showed a significant, although fairly low correlation.(ABSTRACT TRUNCATED AT 250 WORDS)