Determinants of functional status in healthy Italian nonagenarians and centenarians: A comprehensive functional assessment by the instruments of geriatric practice

Giovanni Ravaglia, Paola Forti, Fabiola Maioli, Federica Boschi, Annalena Cicognani, Mauro Bernardi, Loredana Pratelli, Arturo Pizzoferrato, Sebastiano Porcu, Giovanni Gasbarrini

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Abstract

OBJECTIVE: To evaluate the physical ability and psychocognitive status of a population more than 90 years of age with regard to sociodemographic, behavioral, and biomedical variables known to affect functional status in old age. DESIGN: A survey design was used. SETTING: Emilia Romagna, Northern Italy. PARTICIPANTS: Eighty-four healthy community-dwelling subjects aged 90 to 106 years. MEASUREMENTS: Sociodemographic variables, health behavior, anthropometric indices, and serum DHEAS levels were recorded. Functional assessment was performed by instruments currently used in geriatric practice: the MiniMental State Examination (MMSE), Geriatric Depression Scale (GDS), and Activities of Daily Living (ADL) scale. A stepwise multiple regression analysis was performed. RESULTS: GDS scores correlated directly with MMSE scores and inversely with ADL severity scores. Poor education, institutionalization, sensory impairment, muscular mass loss, and lower DHEAS levels were the variables with the highest correlation to functional impairment. Smoking, alcohol consumption, and marital status were relatively unimportant. An inverse association was found between DHEAS levels and dependency scores of single ADLs (continence, mobility). CONCLUSION: Impaired cognitive and physical ability with no increase in depression prevalence was found in a sample of subjects more than 90 years of age free of major age- related disease. Muscular mass and DHEAS levels seem to play a role in maintaining physical independence. In turn, physical independence, as well as social and cultural factors, strongly affect the compliance of long-lived subjects with psychocognitive tests currently used in the clinical evaluation of younger old people, suggesting that these instruments are not reliable for screening for cognitive impairment and depression in the oldest old subjects.

Original languageEnglish
Pages (from-to)1196-1202
Number of pages7
JournalJournal of the American Geriatrics Society
Volume45
Issue number10
Publication statusPublished - Oct 1997

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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    Ravaglia, G., Forti, P., Maioli, F., Boschi, F., Cicognani, A., Bernardi, M., Pratelli, L., Pizzoferrato, A., Porcu, S., & Gasbarrini, G. (1997). Determinants of functional status in healthy Italian nonagenarians and centenarians: A comprehensive functional assessment by the instruments of geriatric practice. Journal of the American Geriatrics Society, 45(10), 1196-1202.