Is it worth supporting the functional capacity, health and wellbeing of the elderly?
Keywords:The health and functional capacity of the elderly are better than before. The reason for positive development is improvements in healthcare and the identification of risk factors. The improved functional capacity of an elderly person is also significant with regard to health policies and economic factors.
The study confirmed that a healthy lifestyle and rehabilitation have a long-term impact on the elderly.
In Western countries, citizens above the age of 65 are the fastest growing age group. They have chronic illnesses and impaired functional capacity more frequently than others. The HEVA cohort study (the health and wellbeing of people dwelling in Helsinki and living at home; the Helsinki Aging Study) monitored the functional capacity and wellbeing of persons between the ages of 75 and 95 for a period of 30 years with surveys conducted every 10 years.
The study showed that the functional capacity, mental wellbeing and self-evaluated health of people aged 75 to 85 have improved somewhat in these age groups compared to previous cohorts on the same age groups. For example, they are able to easily move around outdoors, and fewer and fewer needed help with everyday household chores. During the follow-up, mobility had, for example, become 20.1% easier for 85-year-olds than in the previous reference groups. The need for daily help at home was reduced by 6.9% in this age group.
Improved health care and addressing any risk factors have positively impacted the health and functional capacity in old age
Health and functional capacity were clearly better in the youngest age groups than in the equivalent age groups in previous decades. This may be the result of improved health care: diagnostics, treatment and identification of various risk factors, which have resulted in addressing issues such as hypertension, high cholesterol levels, and smoking. Better access to services, accessible homes and public buildings, as well as technological developments are all contributing to an active and independent life for the elderly, regardless of limitations in functional capacity.
In the HEVA study, the most senior age cohort (ages 90–95) did not show the same positive performance improvement in functional capacity as in the younger age groups. The reason for this may be that in the very elderly, the changes due to physiological aging are inevitable. Thus, their effects cannot be significantly reversed by medical means or by changing the living environment anymore.
The reserve for functional capacity must be acquired before the age of 90
So, the most important factor for those aged 90–95 is to acquire a capacity reserve, that is, more cognitive capacity, muscle strength and balance when they are still younger and it is easier. From these reserves, it is then possible to draw later. There is already research data on this from the SPRINTT study, in which HUS has also been involved.
It is important for the most elderly people to focus on rehabilitation that maintains their capacity and on rehabilitative care. Good nutrition, exercise, social lifestyle and increased environmental safety slow down the symptoms of frailty syndrome.
The improved functional capacity of those under 90 has a great significance in the terms of the economy and health policies, even later when they are between 90 and 95 years of age.
For people over 90 years of age, quality of life and functional capacity stem from
- housing and accessibility that support functional capacity
- individually planned rehabilitation interventions
- adequate care and support services
- social contacts; and
- supporting and enabling an active lifestyle
Health and wellbeing study for Helsinki residents living at home
The HEVA cohort study began in 1989 and has included a total of 6,600 subjects in the age categories of 75, 80, 85 and later, 90 and 95 years of age. Every 10 years, i.e. a follow-up organized in 1989, 1999, 2009 and 2019, questions were asked about socioeconomic status, such as education, living conditions, marital status, and diagnosed illnesses, functional capacity, mental wellbeing, and health status. A self-assessment of health and mental wellbeing predicts how elderly people’s functional capacity will develop and how they will cope with age-related difficulties. Mental wellbeing also tells us about the experienced quality of life.
Internationally, the exceptionally long and extensive HEVA study has been conducted as a collaboration between HUS, the University of Helsinki, the City of Helsinki, and the University of Oulu. Researcher Hanna Öhman has been interviewed for this article.
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