Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-25T19:51:25.310Z Has data issue: false hasContentIssue false

A Health Profile of Community-Living Nonagenarians in Canada*

Published online by Cambridge University Press:  31 March 2010

Andrew V. Wister*
Affiliation:
Department of Gerontology, Simon Fraser University
Deanna Wanless
Affiliation:
Alberta Centre on Aging, University of Alberta
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à: Andrew V. Wister, Ph.D., Department of Gerontology, Simon Fraser University, Vancouver, BC V6B 5K3. ([email protected])

Abstract

Due to increasing life expectancy over time, persons who live into their nineties, known as nonagenarians, are an important and growing segment of the Canadian population. In 2001, there were 130,325 nonagenarians (compared to 3,795 centenarians), and it is estimated that they will top 400,000 by 2026. This paper provides a health profile and an exploratory analysis of selected social determinants of health for community-living nonagenarians, using the 2001 Canadian Community Health Survey (Statistics Canada, 2003). Perceived health, a selection of prevalent chronic illnesses, and several health behaviours are examined. One dominant pattern is the tendency for male nonagenarians to be in better health than their female counterparts. This finding is consistent with research on centenarians and is discussed in terms of a mortality selection effect. Other key findings include the strength of sense of belonging, income, and physical activity as potential social determinants of health, connected to particular dimensions of health status.

Résumé

Parce que l'espérance de vie ne cesse de s'allonger, le segment démographique des nonagénaires, formé des personnes âgées de 90 ans ou plus, occupe une place grandissante dans la population canadienne. Des 130325 qu'ils étaient en 2001 (en compagnie de 3795 centenaires), les nonagénaires seront plus de 400000 en 2026. L'article fait le point sur la santé de ce segment de la population et il analyse certains déterminants sociaux de la santé des nonagénaires vivant dans la communauté d'après l'Enquête sur la santé dans les collectivités canadiennes de 2001. La santé apparente, certaines maladies chroniques courantes et plusieurs comportements hygiéniques sont examinés. L'un des traits prédominants mis en évidence est celui voulant que les hommes nonagénaires soient en meilleure santé que les femmes du même âge. Cette constatation abonde dans le même sens que la recherche sur les centenaires, et elle est examinée sous l'angle de l'effet de sélection de la mortalité. En outre, il ressort de l'étude que la force du sentiment d'appartenance, le revenu et l'activité physique seraient des déterminants sociaux de la santé reliés à des aspects particuliers de l'état de santé.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

The authors are grateful to the reviewers for their helpful comments.

References

Andersen-Ranberg, K., Schroll, M., & Jeune, B. (2001). Healthy centenarians do not exist, but autonomous centenarians do: A population-based study of morbidity among Danish centenarians. Journal of the American Geriatrics Society, 49, 900908.CrossRefGoogle Scholar
Barer, M.L., Evans, R.G., Hertzman, C., & Lomas, J. (1987). Aging and health care utilization: New evidence on old fallacies. Social Science and Medicine, 24, 851862.CrossRefGoogle ScholarPubMed
Barzilai, N. (2003). Discovering the secrets of successful longevity. Journal of Gerontology: Medical Sciences, 58A, 225226.Google Scholar
Béland, Y. (2002). Canadian Community Health Survey: Methodological overview. Health Reports, 13, 914.Google ScholarPubMed
Berkman, L.F., & Kawachi, I. (2000). Social epidemiology. New York: Oxford University Press.CrossRefGoogle Scholar
Braus, P. (1992). Lifestyles of the nonagenarians. American Demographics, 14(11), 2728.Google Scholar
Bury, M., & Holme, A. (1991). Life after ninety. London: Routledge.Google Scholar
Canadian Public Health Association (1997). Health impacts of social and economic conditions: Implications for public policy. Ottawa, ON: CPHA.Google Scholar
Chappell, N., Gee, E., McDonald, L., & Stones, M. (2003). Aging in contemporary Canada. Toronto: Prentice Hall.Google Scholar
Coles, L.S. (2004). Demography of human supercentenarians. Journal of Gerontology: Biological Sciences, 59A, 579586.Google Scholar
DeMaris, A. (1995). A tutorial in logistic regression. Journal of Marriage and the Family, 57, 956968.CrossRefGoogle Scholar
Evert, J., Lawler, E., Bogan, H., & Perls, T. (2003). Morbidity profiles of centenarians: Survivors, delayers, and escapers. Journal of Gerontology: Medical Sciences, 58A, 232237.Google Scholar
Fees, B.S., Martin, P., & Poon, L.W. (1999). A model of loneliness in older adults. Journal of Gerontology: Psychological Sciences, 54B, P231P239.CrossRefGoogle Scholar
Forette, B. (1999). Are common risk factors relevant in the eldest old?. In Robine, J.M., Forette, B., Franceschi, C., & Allard, M. (Eds.), The paradoxes of longevity (pp. 7780). Germany: Springer.Google Scholar
Franceschi, C. (2001, July). Towards a more integrated analysis of male exceptional longevity in Sardinia. Paper presented at the 17th World Congress of the International Association of Gerontology, Vancouver, BC.Google Scholar
Frank, J., & Mustard, J.F. (1991). The determinants of health. Toronto, ON: Canadian Institute of Advanced Research.Google Scholar
Fries, J.F. (1983). Compression of morbidity. Milbank Memorial Fund Quarterly, 61, 397419.CrossRefGoogle ScholarPubMed
Fries, J.F. (2003). Measuring and monitoring success in compressing morbidity, Part 2. Annals of Internal Medicine, 139(5), 455459.CrossRefGoogle Scholar
Gavrilov, L., & Gavrilova, N. (2001). The reliability theory of aging and longevity. Journal of Theoretical Biology, 21, 527545.CrossRefGoogle Scholar
Gerber, M. (1999). The French paradox: Nutrition and longevity. In Robine, J.M., Forett, B., Franceschi, C., & Allard, M. (Eds.), The paradoxes of longevity (pp. 8192). Germany: Springer.CrossRefGoogle Scholar
Gruenewald, T.L., Seeman, T.E., Ryff, C.D., Karlamangla, A.S., & Singer, B.H. (2006). Combinations of biomarkers predictive of later life mortality. Proceedings of the National Academy of Sciences, 103, 1415814163.CrossRefGoogle ScholarPubMed
Health Canada (2002). The social determinants of health: An overview of the implications for policy and the role of the health sector. Retrieved 15 December 2006 from http://www.phac-aspc.gc.ca/ph-sp/phdd/pdf/overview_implications/01_overview_e.pdf.Google Scholar
Hogan, D.B., Elby, E.M., & Fung, T.S. (1999). Disease, disability and age in cognitively intact seniors: Results from the Canadian study of health and aging. Journal of Gerontology: Medical Sciences, 54A(2), M77M82.Google Scholar
Hogan, D.B., Fung, T.S., & Elby, E.M. (1999). Health, function and survival of a cohort of very old Canadians: Results from the second wave of the Canadian Study of Health and Aging. Canadian Journal of Public Health, 90(5), 338342.CrossRefGoogle ScholarPubMed
Jeune, B. (2000). What can we learn from centenarians?. In Martin, P., Rott, Ch., Hagberg, B., & Morgan, K. (Eds.), Centenarians: Autonomy versus dependence in the oldest old (pp. 924). New York: Springer.Google Scholar
Jeune, B., & Vaupel, J.W. (1999). (Eds.). Validation of exceptional longevity. Odense, Denmark: Odense University Press.Google Scholar
Klinger, A. (1990). Results of the demographic study of the oldest people. In Beregi, E. (Ed.), Centenarians in Hungary: A sociomedical and demographic study (pp. 121). Switzerland: Karger.Google Scholar
Lomas, J. (1998). Social capital and health: Implications for public health and epidemiology. Social Science and Medicine, 47(9), 11811188.CrossRefGoogle ScholarPubMed
McPherson, B.D. (2004). Aging as a social process: Canadian perspectives. Toronto: Oxford University Press.Google Scholar
Menard, S.W. (2002). Applied logistic regression analysis. Thousand Oaks, CA: Sage.CrossRefGoogle Scholar
Mor, V. (2005). The compression of morbidity hypothesis: A review of research and prospects for the future. Journal of the American Geriatrics Society, 53, S308S309.CrossRefGoogle ScholarPubMed
Murphy, B. (2002). Why women bury men: The longevity gap in Canada. Winnipeg, MB: Shillingford.Google Scholar
Nybo, H., Gaist, D., Jeune, B., McGue, M., Vaupel, J.W., & Christensen, K. (2001). Functional status and self-rated health in 2,262 nonagenarians: The Danish 1905 cohort survey. Journal of the American Geriatrics Society, 49, 601609.CrossRefGoogle ScholarPubMed
O'Connor, D.W., Pollitt, P.A., Brook, C.P.B., & Reiss, B.B. (1989). A community survey of mental and physical infirmity in nonagenarians. Age and Ageing, 18, 411414.CrossRefGoogle ScholarPubMed
Parker, M., Ahacic, K., & Thorslund, M. (2005). Health changes among Swedish oldest old: Prevalence rates from 1992 and 2002 show increasing health problems. Journal of Gerontology Medical Sciences, 60A, 13511355.CrossRefGoogle Scholar
Perls, T.T. (1995). The influence of demographic selection upon the oldest old. Journal of Geriatric Psychiatry, 28(1), 3356.Google Scholar
Perls, T., Kunkel, L.M., & Puca, A.A. (2002). The genetics of exceptional human longevity. Journal of the American Geriatrics Society, 50, 359368.CrossRefGoogle ScholarPubMed
Prus, S. (1999). Changes in economic status and inequity during later life: A quantitative analysis of Canadian data. Unpublished doctoral dissertation, Simon Fraser University, Burnaby, BC.Google Scholar
Ravaglia, G., Fort, P., Maioli, F., Boschi, F., Cicognani, A., Bernardi, M., et al. (1997). Determinants of functional status in health Italian nonagenarians and centenarians: A comprehensive functional assessment by the instruments of geriatric practice. Journal of the American Geriatric Society, 45, 11961202.CrossRefGoogle Scholar
Robinson, J.R., Young, T.K., Roos, N.P., & Gelskey, D.E. (1997). Estimating the burden of disease: Comparing administrative data and self-reports. Medical Care, 35, 932947.CrossRefGoogle ScholarPubMed
Roos, N.P., Havens, B., & Black, C. (1993). Living longer but doing worse: Assessing health status in elderly persons at two points in Manitoba, Canada, 1971 and 1983. Social Science and Medicine, 36, 273282.CrossRefGoogle ScholarPubMed
Serra-Majem, L., Roman, B., & Estruch, R. (2006). Scientific evidence of interventions using a Mediterranean diet: A systematic review. Nutrition Reviews, 64(2), S27S47.CrossRefGoogle ScholarPubMed
Shaw, M., Dorling, D., Gordon, D., & Davey-Smith, G. (1999). The widening gap: Health inequalities and policy in Britain. Bristol, UK: Policy Press.Google Scholar
Smith, D.W.E. (1999). Resistance to causes of death: A study of cancer mortality resistance in the oldest old. In Robine, J.M., Forette, B., Franceschi, C., & Allard, M. (Eds.), The paradoxes of longevity (pp. 6171). Germany: Springer.CrossRefGoogle Scholar
Statistics Canada (1999). Health among older adults. Health Reports, 11(3), 4761.Google Scholar
Statistics Canada (2001). Population projections for Canada, Provinces and Territories 2000–2006. (Catalogue No. 91–520). Ottawa, ON: Ministry of Industry.Google Scholar
Statistics Canada (2002a). Age (122) and sex (3) for population, for Canada, provinces, territories, census metropolitan areas and census agglomerations, 2001 census—100% data. (Catalogue No. 95F0300XCB2001001). Retrieved 6 December 2004 from http://www12.statcan.ca/english/census01/products/standard/themes/ListProducts.cfm?TEMPORAL=2001&APATH=7&VID=4532&FL=NA&FREE=0&DETAIL=1.Google Scholar
Statistics Canada (2002b). Profile of the Canadian population by age and sex: Canada ages. Analysis Series Retrieved 6 December 2004 from http://www12.statcan.ca/english/census01/Products/Analytic/companion/age/canada.cfm.Google Scholar
Statistics Canada (2003). The Canadian community health survey (CCHS): Extending the wealth of health data in Canada. Retrieved 30 January 2003 from http://www.statcan.ca/english/concepts/health/cchsinfo.htm.Google Scholar
Statistics Canada (2004). Canadian Community Health Survey. Retrieved 9 September 2004 from http://statcan.ca/english/sdds/3226.htm.Google Scholar
Stessman, J., Hammerman-Rozenberg, R., Maaravi, Y., Azoulai, D., & Cohen, A. (2005). Strategies to enhance longevity and independent function: The Jerusalem Longitudinal Study. Mechanisms of Ageing and Development, 126, 327331.CrossRefGoogle ScholarPubMed
Strawbridge, W.J., Wallhagen, M.I. (2003). Self-rated successful aging: Correlates and predictors. In Poon, L.W., Gueldner, S.H., & Sprouse, B.M. (Eds.), Successful aging and adaptation with chronic diseases. (pp. 124). New York: Springer.Google Scholar
von Strauss, E., Fratiglioni, L., Viitanen, M., Forsell, Y., & Winbald, B. (2000). Morbidity and comorbidity in relation to functional status: A community-based study of the oldest old(90+ years). Journal of the American Geriatrics Society, 48, 14621469.CrossRefGoogle ScholarPubMed
Thatcher, R. (1999). The demography of centenarians in England and Wales. Population Trends, 96, 512.Google Scholar
Vaupel, J.W., Jeune, B. (1995). The emergence and proliferation of centenarians. In Jeune, B., & Vaupel, J.W. (Eds.), Exceptional longevity: From prehistory to present (pp. 186204). Odense, Denmark: Odense University Press.Google Scholar
Veenstra, G. (2002). Social capital and health. Social Science and Medicine, 54, 849868 (plus wealth, income inequality and regional health governance).CrossRefGoogle ScholarPubMed
Vierck, E., & Hodges, K. (2003). Aging: Demographics, health, and health services. Westport, CT: Greenwood Press.Google Scholar
Wanless, D. (2005). Health differentials among elderly women: A rural-urban analysis. Unpublished master's thesis, Simon Fraser University, Vancouver, BC.Google Scholar
Wilmoth, J.R., Horiuchi, S. (1999). Do the oldest old grow old more slowly?. In Robine, J.M., Forette, B., Franceschi, C., & Allard, M. (Eds.), The paradoxes of longevity (pp. 3560). Germany: Springer.CrossRefGoogle Scholar
Wister, A., Gutman, G., Adams, R., & Chou, B. (2006). Factbook of aging in British Columbia. (4th ed.). Vancouver, BC: Gerontology Research Centre.Google Scholar
Wister, A.V. (2005). Baby boomer health dynamics: How are we aging?. Toronto, ON: University of Toronto Press.CrossRefGoogle Scholar