Health changes among Swedish oldest old: Prevalence rates from 1992 and 2002 show increasing health problems

Background. The health of the elderly population is of utmost importance for planning policy and resources for care services. Most surveys of the health of the elderly population show improvement, suggesting support for the compression of morbidity hypothesis. This study examines changes in the health of the Swedish population (aged 77+) from 1992 to 2002. Methods. Two nationally representative surveys of the elderly population (n = 537 and 563, respectively), including both community-based and institutionalized persons were used. Outcomes include self-reported diseases, symptoms, and activities of daily living, as well as objective tests of physical capacity, lung function, vision, and cognition. Results. None of the indicators showed improvement. A number of health indicators showed significant worsening, with or without adjustment for changes in the age and sex distribution from 1992 to 2002. Among self-reported indicators, there were significant increases in several diseases and symptoms. The objective function tests also showed significantly worse results in 2002 compared to 1992 for physical capacity, lung function, and cognition. No significant differences in activities of daily living limitations were found. Conclusions. In light of several recent studies, we expected to observe improvements in the health of the elderly population. However, this study showed no signs of improvement. On the contrary, we found a pattern of worsening health. The study included objective tests of function, implying that results are not due solely to raised expectations or changes in reporting. Possible explanations are discussed.