Cohort differences in disease and disability in the young-old: findings from the MRC Cognitive Function and Ageing Study (MRC-CFAS)

Non-overlapping cohorts of men and women aged 65–69 years in 1991/2 (n = 689) and 1996/7 (n = 687) were compared on: self-reported diseases and conditions; self-rated health; mobility limitation; disability by logistic regression and four-year survival by Cox Proportional Hazards Regression models, with adjustments for differences in socio-economic and lifestyle factors.Survival was similar between cohorts (HR: 0.91, 95% CI: 0.62 to 1.32). There was a significant increase in the number of conditions reported between cohorts, with more participants reporting 3 or more conditions in the new cohort (14.2% vs. 10.1%). When individual conditions were considered, there was a 10% increase in the reporting of arthritis and a significant increase in the reporting of chronic airways obstruction (OR: 1.36, 95% CI: 1.04 to 1.78).This study provides evidence of rising levels of ill-health, as measured by the prevalence of self-reported chronic conditions, in the newer cohorts of the young-old. Though changes in diagnosis or reporting of disease cannot, as yet, be excluded, to better understand whether our findings reflect real increases in ill-health, investment should be made into improved population-based databases, linking self-report and objective measures of health and function, and including those in long-term care.Projections of health and social care need are highly sensitive to assumptions about trends in health and disability, particularly whether life expectancy is increasing slower than healthy life expectancy [1]. The picture from the international literature is mixed, with countries reporting the prevalence of disability to be increasing (Sweden [2]), stagnating (Australia [3], or decreasing (US [4], France [5], Finland [6], Japan [7]) and different evolutions reported for subgroups (men and women in Spain [8] and Denmark [9]) or for mild rather than severe disability (Netherlands [10], Japan [11]). Despite improved levels of functioning in the US, recent cohorts h