title: Predictors of mortality in men and women aged 90 and older: a nine-year follow-up study in the Vitality 90+ study.
abstract: BACKGROUND
  information about the predictors of mortality among the oldest-old is limited. Also possible gender differences are poorly known.
  
  
  OBJECTIVE
  to examine the predictors of mortality among individuals aged 90 and older, focusing on differences between men and women. We also analysed gender differences in survival at different levels of mobility and activities in daily living (ADL).
  
  
  METHODS
  this 9-year follow-up study is part of the Vitality 90+ study, a population-based study of people aged 90 and older.
  
  
  METHODS
  all inhabitants aged 90 and older in the area of Tampere, Finland were contacted, irrespective of health or dwelling place. The study population consisted of 171 men and 717 women.
  
  
  METHODS
  data were collected with a mailed questionnaire asking questions concerning ADL and mobility, self-rated health, chronic conditions and socio-economic factors. The participation rate was 79%. Cox regression enter models were used for the analysis.
  
  
  RESULTS
  older age, male gender, disability in ADL and mobility, poor self-rated health and institutionalisation increased the risk of mortality in the total study group. In age-adjusted Cox regression models, ADL and mobility were stronger predictors in men than in women (gender interactions, P < 0.001). Among those who were partly but not totally dependent in ADL or mobility women survived longer than men.
  
  
  CONCLUSIONS
  the same health indicators that are important at younger old age also predict mortality in the oldest-old. Disability increases the likelihood of death more in men than women. At a very old age, women survive longer with moderate disability than do men.
authors.affiliation: Gerontology Research Center and School of Health Sciences, University of Tampere, Finland. kristina.tiainen@uta.fi
authors.forename: Kristina
authors.initials: K
authors.lastname: Tiainen
authors.forename: Tiina
authors.initials: T
authors.lastname: Luukkaala
authors.forename: Antti
authors.initials: A
authors.lastname: Hervonen
authors.forename: Marja
authors.initials: M
authors.lastname: Jylhä
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000369:Aged, 80 and over; D000375:Aging; D002423:Cause of Death; D015897:Comorbidity; D004185:Disability Evaluation; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D051346:Mobility Limitation; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D013997:Time Factors
keywords: functional status; longitudinal; mortality; nonagenarians; older people; the oldest-old