Abstract
Surveys of the oldest old population are associated with several design issues. Place of residence and possible physical or cognitive impairments make it difficult to maintain a representative study population. Based on a Swedish nationally representative survey among individuals 77+, the present study analyze the potential bias of not using proxy interviews and excluding the institutionalized part of the population in surveys of the oldest old. The results show that compared to directly interviewed people living at home, institutionalized and proxy interviewed individuals were older, less educated and more likely to be female. They had more problems with health, mobility and ADL, and a significantly increased mortality risk. If the study had excluded the institutionalized part of the population and/or failed to use proxy interviews, the result would have been severely biased and resulted in underestimated prevalence rates for ADL, physical mobility and psychologic problems. This could not be compensated for weighting the data by age and sex. The results from this study imply that accurate population estimates require a representative study population, in which all individuals are included regardless of their living conditions, health status, and cognitive ability.
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References
Asakawa K, Feeny D, Senthilselvan A, Johnson JA, Rolfson D (2009) Do the determinants of health differ between people living in the community and in institutions? Soc Sci Med 69:345–353
Chatfield MD, Brayne CE, Matthews FE (2005) A systematic literature review of attrition between waves in longitudinal studies in the oldest shows a consistent pattern of dropout between differing studies. J Clin Epidemiol 58:13–19
Crimmins E, Saito Y (2001) Trends in healthy life expectancy in the United States, 1970–1990: gender, racial, and educational differences. Soc Sci Med 52:1629–1641
Dillman DA, Christian LM (2005) Survey mode as a source of instability in responses across surveys. Field Methods 17(1):30–52
Fors S, Lennartsson C, Lundberg O (2009) Childhood living conditions, socioeconomic position in adulthood, and cognition in later life: exploring the associations. J Gerontol: Soc Sci 64B:S750–S757
Freedman V, Aykan H, Martin L (2002) Another look at aggregate changes in severe cognitive impairment: further investigation into the cumulative effects of three survey design issues. J Gerontol: Soc Sci 57B:S126–S131
Freedman V, Crimmins E, Schoeni R, Spillman B, Aykan H, Kramarow E, Land K, Lubitz J, Manton K, Martin L et al (2004) Resolving inconsistencies in trends in old-age disability: report from a technical working group. Demography 41:417–441
Gudex C, Lafortune G (2000) An inventory of health and disability-related surveys in OECD countries. OECD Labour Market and Social Policy Occasional Papers, No. 44, OECD Publisher
Hardy S, Allore H, Studenski S (2009) Missing data: a special challenge in aging research. J Am Geriatr Soc 57:722–729
Huber M, Hennessy P (2005) Long-term care for older people. OECD Publishing
Lafortune G, Balestat G (2007) Trends in severe disability among oldest people: assessing the evidence in 12 OECD countries and the future implications. OECD Health Working Papers, No. 26, OECD Publishing
Larsson K, Thorslund M, Kåreholt I (2006) Are public care and services for older people targeted according to need? Applying the behavioural model on longitudinal data of a Swedish urban older population. Eur J Ageing 3:22–33
Lundberg O, Thorslund M (1996) Fieldwork and measurement considerations in surveys of the oldest old. Soc Indic Res 37:165–187
Magaziner J, Bassett S, Hebel J, Gruber-Baldini A (1996) Use of proxies to measure health and functional status in epidemiologic studies of community-dwelling women aged 65 years and older. Am J Epidemiol 143:283–292
Manton K, Suzman R (1992) Conceptual issues in the design and analysis of longitudinal surveys of the health and functioning of the oldest old. In: Suzman R, Willis D, Manton K (eds) The Oldest Old. Oxford University Press, New York, pp 89–122
Martikainen P, Nihtilä E, Moustgaard H (2008) The effects of socioeconomic status and health on transitions in living arrangements and mortality: a longitudinal analysis of oldest Finnish men and women from 1997 to 2002. J Gerontol: Soc Sci 63B:S99–S109
Martin LG, Schoeni RF, Andreski PM (2010) Challenges in estimating trends in late-life disability from the American community survey. J Gerontol: Med Sci 65A:M517–M518
Moe JO, Hagen TP (2011) Trends and variation in mild disability and functional limitations among older adults in Norway, 1986–2008. Eur J Ageing 8:49–61
NBHW (2009) Folkhälsorapport 2009 (Public health report 2009). National Board of Health and Welfare, Västerås
Neumann P, Araki S, Gutterman E (2000) The use of proxy respondents in studies of older adults: lessons, challenges and opportunities. J Am Geriatr Soc 48:1646–1654
Noël-Miller C (2010) Spousal loss, children, and the risk of nursing home admission. J Gerontol: Soc Sci 65B:S370–S380
Parker MG, Thorslund M (2007) Health trends in the oldest population: getting better and getting worse. Gerontologist 47:150–158
Rodgers W, Herzog A (1992) Collecting data about the oldest old: problems and procedures. In: Suzman R, Willis D, Manton K (eds) The oldest old. Oxford University Press, New York, pp 135–156
Segal ME, Gillard M, Schall RR (1996) Telephone and in-person proxy agreement between stroke patients and caregivers for the functional independence measure. Am J Phys Med Rehabil 75(3):208–212
Smith KV, Goldman N (2011) Measuring health status: self-, interviewer, and physician reports of overall health. J Aging Health 23:242–266
Statistics Sweden (2001) Statistical yearbook of Sweden 2002. Statistics Sweden, Örebro
Wallace R, Kohout F, Colsher P (1992) Observations on interview surveys of the oldest old. In: Suzman R, Willis D, Manton K (eds) The oldest old. Oxford University Press, New York, pp 123–134
Wolf D, Hunt K, Knickman J (2005) Perspectives on the recent decline in disability at older ages. Milbank Q 83:365–395
Acknowledgments
This work was supported by the Swedish Council for Working Life and Social Research, grants 2006-1622 and 2010-1684. The data collection for the 2002 SWEOLD was funded by the Swedish Research Council, grant 2001-6651.
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Kelfve, S., Thorslund, M. & Lennartsson, C. Sampling and non-response bias on health-outcomes in surveys of the oldest old. Eur J Ageing 10, 237–245 (2013). https://doi.org/10.1007/s10433-013-0275-7
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DOI: https://doi.org/10.1007/s10433-013-0275-7