title: Cohort differences in disease and disability in the young-old: findings from the MRC Cognitive Function and Ageing Study (MRC-CFAS).
abstract: BACKGROUND
  Projections of health and social care need are highly sensitive to assumptions about cohort trends in health and disability. We use a repeated population-based cross-sectional study from the Cambridgeshire centre of the UK Medical Research Council Cognitive Function and Ageing Study to investigate trends in the health of the young-old UK population
  
  
  METHODS
  Non-overlapping cohorts of men and women aged 65-69 years in 1991/2 (n = 689) and 1996/7 (n = 687) were compared on: self-reported diseases and conditions; self-rated health; mobility limitation; disability by logistic regression and four-year survival by Cox Proportional Hazards Regression models, with adjustments for differences in socio-economic and lifestyle factors.
  
  
  RESULTS
  Survival was similar between cohorts (HR: 0.91, 95% CI: 0.62 to 1.32). There was a significant increase in the number of conditions reported between cohorts, with more participants reporting 3 or more conditions in the new cohort (14.2% vs. 10.1%). When individual conditions were considered, there was a 10% increase in the reporting of arthritis and a significant increase in the reporting of chronic airways obstruction (OR: 1.36, 95% CI: 1.04 to 1.78).
  
  
  CONCLUSIONS
  This study provides evidence of rising levels of ill-health, as measured by the prevalence of self-reported chronic conditions, in the newer cohorts of the young-old. Though changes in diagnosis or reporting of disease cannot, as yet, be excluded, to better understand whether our findings reflect real increases in ill-health, investment should be made into improved population-based databases, linking self-report and objective measures of health and function, and including those in long-term care.
authors.affiliation: Leicester Nuffield Research Unit, Department of Health Sciences, University of Leicester, UK. cxj@leicester.ac.uk
authors.forename: Carol
authors.initials: C
authors.lastname: Jagger
authors.forename: Ruth J
authors.initials: RJ
authors.lastname: Matthews
authors.forename: Fiona E
authors.initials: FE
authors.lastname: Matthews
authors.forename: Nicola A
authors.initials: NA
authors.lastname: Spiers
authors.forename: Judith
authors.initials: J
authors.lastname: Nickson
authors.forename: Eugene S
authors.initials: ES
authors.lastname: Paykel
authors.forename: Felicia A
authors.initials: FA
authors.lastname: Huppert
authors.forename: Carol
authors.initials: C
authors.lastname: Brayne
mesh_terms: D000368:Aged; D000375:Aging / Q000502:physiology / Q000523:psychology; D002908:Chronic Disease / Q000453:epidemiology*; D003072:Cognition Disorders / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance / Q000379:methods*; D016016:Proportional Hazards Models; D016019:Survival Analysis; D006113:United Kingdom / Q000453:epidemiology