Longer life - better life? Studies on mortality, morbidity and quality of life among elderly people

Abstract: Background: Life expectancy has been increasing, but whether or not the added years are years with good health and quality of life have been vividly debated. Knowledge of the health conditions among elderly is of increasing importance.Aim:- To analyse differences in mortality and morbidity in three cohorts of 70-year olds with special regard to the impact of social factors. - To compare health information from interviews and medical records. - To investigate what elderly people consider being important for their quality of life. - To determine predictors for suicide among the old elderly (75+).Methods: Paper I and II: Random samples of 70-year old people born in 1901/02 (n=973), 1906/07 (n=1036) and 1911/12 (n=619). They were examined and interviewed regarding social background, social network and health. Death records were obtained up to and including 1998. Paper III-V: 85 elderly suicide cases (65 years of age and above) and 153 randomly selected control persons were interviewed in persons or by proxy, and their medical records were reviewed.Results: The later born cohorts had lower mortality compared to the first-born cohort. Participants not living in an institution, non-smokers and those with one or more diseases were among those who had lower mortality in the later born cohorts. There were fewer 70-year olds not feeling healthy, fewer having many symptoms and there were indications of better physical functioning in the later born cohorts. Medical records gave better information concerning specific diseases, while interview data provided better measures of impairments. Elderly persons consider health, social relations, functional ability and activities to be important to the quality of life. Family discord, severe physical illness, loneliness and depression were risk factors for suicide in the old elderly. Conclusions: Good years seem to have been added - although we live longer with diseases. More good years can be gained with improvements in life style behavior and with continued improvements in health services and medical treatment. It is important to recognize and treat depressions among elderly people, especially in the context of severe illness and impairment.