[Incidence of the onset of disability and recovery of functional autonomy among the very old after one year].
BACKGROUND
This article measures the survival rate and explores the changes in functional autonomy among both men and women over a one-year period in a sample of 272 subjects aged 80-85.


METHODS
Data were taken from the Quebec Longitudinal Study on Aging, a multi-cohort prospective study focusing on health and quality of life. The sample comprises two sub-groups, namely disabled and autonomous subjects. Eligible participants were selected from the Quebec Health Insurance Plan (QHIP) file. However, to obtain the required number of participants, the sample was completed from eligible subjects who volunteered in response to TV, billboard and newspaper advertising about the project. The Functional Autonomy Measurement System (SMAF) was used to assess disability. The SMAF assesses functional disability in 5 domains: activities of daily living (ADL), mobility, instrumental activities (IADL), communication, and mental functioning.


RESULTS
After one year, nearly 5% of the subjects had died and 72.5% were still autonomous, i.e., they had a score under 4.5 on the SMAF. The annual incidence of the onset of disability (including death, lengthy hospitalization, functional incapacities and cognitive deficits) was 20%. However, no difference was found between the sexes in regard to the risk of losing autonomy. The main areas where disability occurred among the previously autonomous subjects were, in order of importance, domestic tasks, mobility and communication. The study confirmed that it is possible to recover autonomy, even at this advanced age, particularly for women (11.2%), but less so for men (3.6%).


CONCLUSIONS
This phenomenon of recovering functional autonomy suggests that octogenarians have a residual potential and confirms the effectiveness of preventive and curative measures and the benefits of interventions by community and family networks.
Lefrançois
R
R
Institut universitaire de gériatrie de Sherbrooke, Québec, Canada.
Hébert
R
R
Dubé
M
M
Leclerc
G
G
Hamel
S
S
Gaulin
P
P
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002423:Cause of Death; D003072:Cognition Disorders / Q000145:classification / Q000628:therapy; D015331:Cohort Studies; D003142:Communication; D003289:Convalescence; D006233:Persons with Disabilities / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008606:Mental Processes; D009043:Motor Activity; D011446:Prospective Studies; D011788:Quality of Life; D011792:Quebec; D012737:Sex Factors; D015996:Survival Rate