title: The oldest old in England and Wales: a descriptive analysis based on the MRC Cognitive Function and Ageing Study.
abstract: OBJECTIVE
  to describe the characteristics and survival of the oldest old in England and Wales.
  
  
  METHODS
  retrospective analysis of the oldest old from a population-based cohort study.
  
  
  METHODS
  population-based study in England and Wales: two rural and three urban sites.
  
  
  METHODS
  two types of analyses were conducted: (i) a descriptive analysis of those individuals who were aged 90 years or more, and 100 years or more, and (ii) a survival analysis of those who reached their 90th, 95th, or 100th birthday during the study. Median survival time was calculated by the Kaplan-Meier method. Effects of socio-demographic characteristics on survival were evaluated using the Cox proportional-hazards regression model.
  
  
  RESULTS
  in total, 958 individuals aged 90 years or more, and 24 individuals aged 100 years or more, had been interviewed at least once during the study. Twenty-seven per cent were living in residential or nursing homes. Women aged 90 years or more were more likely to be living in residential and nursing homes, be widowed, have any disability or have lower MMSE scores. The centenarians were mostly cognitively and functionally impaired. The median survival times for those reaching their 90th (n = 2,336), 95th (n = 638), or 100th birthday (n = 92) during the study were 3.7 years (95% CI: 3.5-4.0), 2.3 (2.1-2.6) and 2.1 (1.7-2.6) years for women, and 2.9 (95% CI: 2.6- 3.1), 2.0 (1.2-3.1) and 2.2 (0.5-2.3) for men, respectively. Those living in residential and nursing homes had a shorter survival when aged 90 years, with similar non-significant effects for those aged 95 and 100 years. After the age of 100 years, the high mortality rate and small sample size limited the ability to detect any differences between the different groups.
  
  
  CONCLUSIONS
  even at the very oldest ages, the majority live in non-institutionalised settings. Among the oldest old, women were frailer than men. Being male and living in residential nursing homes shortened survival in those aged 90 years or more.
authors.affiliation: Department of Public Health and Primary Care, Institute of Public Health, Cambridge, CB2 0SR, UK.
authors.forename: Jing
authors.initials: J
authors.lastname: Xie
authors.forename: Fiona E
authors.initials: FE
authors.lastname: Matthews
authors.forename: Carol
authors.initials: C
authors.lastname: Jagger
authors.forename: John
authors.initials: J
authors.lastname: Bond
authors.forename: Carol
authors.initials: C
authors.lastname: Brayne
mesh_terms: D000369:Aged, 80 and over; D000375:Aging; D003071:Cognition; D003072:Cognition Disorders / Q000401:mortality*; D004739:England / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D016852:Housing for the Elderly / Q000706:statistics & numerical data; D006801:Humans; D008136:Longevity; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012424:Rural Population / Q000706:statistics & numerical data; D016019:Survival Analysis; D014505:Urban Population / Q000706:statistics & numerical data; D014852:Wales / Q000453:epidemiology