Longitudinal change in physical functioning and dropout due to death among the oldest old: a comparison of three methods of analysis.

Longitudinal studies examining changes in physical functioning with advancing age among very old people are plagued by high death rates, which can lead to biased estimates. This study was conducted to analyse changes in physical functioning among the oldest old with three distinct methods which diff...

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Publicado en:European Journal of Ageing Vol. 17; no. 2; pp. 207 - 217
Autores principales: Raitanen, Jani, Stenholm, Sari, Tiainen, Kristina, Jylhä, Marja, Nevalainen, Jaakko
Formato: Artículo
Publicado: Springer Nature Jun2020
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Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jun2020
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      pub: Springer Nature
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        10.1007/s10433-019-00533-x
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        atl: Longitudinal change in physical functioning and dropout due to death among the oldest old: a comparison of three methods of analysis.
      aug:
        au:
          Raitanen, Jani
          Stenholm, Sari
          Tiainen, Kristina
          Jylhä, Marja
          Nevalainen, Jaakko
        affil:
          Faculty of Social Sciences (Health Sciences), Tampere University, PO Box 100, 33014, Tampere, Finland
          UKK Institute for Health Promotion Research, PO Box 30, 33501, Tampere, Finland
          Department of Public Health, University of Turku and Turku University Hospital, PO Box 52, 20521, Turku, Finland
          Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
          Gerontology Research Center, Tampere University, PO Box 100, 33014, Tampere, Finland
          Science Center of Tampere University Hospital, PO Box 2000, 33521, Tampere, Finland
      su:
        Elder care
        Aging
        Life expectancy
        Life skills
        Mortality risk factors
        Geriatric assessment
        Comparative studies
        Functional assessment
        Longitudinal method
        Risk assessment
        Statistical models
      sug:
        subj:
          Elder care
          Aging
          Life expectancy
          Life skills
          Continuing Care Retirement Communities
          Mortality risk factors
          Geriatric assessment
          Comparative studies
          Functional assessment
          Longitudinal method
          Risk assessment
          Statistical models
      keyword:
        Attrition due to death
        Functioning
        Joint model
        Longitudinal study
        Model comparison
        Attrition due to death
        Functioning
        Joint model
        Longitudinal study
        Model comparison
      ab: Longitudinal studies examining changes in physical functioning with advancing age among very old people are plagued by high death rates, which can lead to biased estimates. This study was conducted to analyse changes in physical functioning among the oldest old with three distinct methods which differ in how they handle dropout due to death. The sample consisted of 3992 persons aged 90 or over in the Vitality 90+ Study who were followed up on average for 2.5 years (range 0–13 years). A generalized estimating equation (GEE) with independent 'working' correlation, a linear mixed-effects (LME) model and a joint model consisting of longitudinal and survival submodels were used to estimate the effect of age on physical functioning over 13 years of follow-up. We observed significant age-related decline in physical functioning, which furthermore accelerated significantly with age. The average rate of decline differed markedly between the models: the GEE-based estimate for linear decline among survivors was about one-third of the average individual decline in the joint model and half the decline indicated by the LME model. In conclusion, the three methods yield substantially different views on decline in physical functioning: the GEE model may be useful for considering the effect of intervention measures on the outcome among living people, whereas the LME model is biased regarding studying outcomes associated with death. The joint model may be valuable for predicting the future characteristics of the oldest old and planning elderly care as life expectancy continues gradually to rise.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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