Predictors of Functional Decline among the Oldest Old in China

The Chinese oldest old population is projected to grow from 18 million in 2006 to 27 million by 2020. It is important to understand factors contributing to the decline in physical functioning among the oldest old in order to anticipate care need in the coming years. We used two waves of data (1998 and 2000) from the Chinese Longitudinal Healthy Longevity Survey (CLHLS), the first longitudinal survey of a nationally representative sample of the oldest old. Baseline in-home interviews were conducted in 22 randomly selected provinces in China. Information on socio-demographic characteristics, lifestyle, diet, and family support, activities of daily living (ADL), cognitive functioning, and chronic medical conditions were collected. A total of 6541 adults aged between 80 and 99 were included in the study. The average age was 89 years and 53% of the sample was female. Twenty percent of the sample currently smokes and 31% reported exercising on a regular basis. The great majority (72%) was independent in all six ADLs. At the 2000 follow-up, 30% died and 11% dropped out. Multinomial logistic regression model showed that significant predictors of functional decline or death included: older age, baseline ADL disability, poor self-rated health, recent illness, pulmonary conditions, and past alcohol consumption. Protective factors included being married, better education, and being physically active. These findings suggest that socioeconomic and health status factors continue to affect the development of functional limitations among the oldest old in China. Public health messages need to promote physical activities even among the oldest old.