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Health Differences in Advanced Old Age

Published online by Cambridge University Press:  14 November 2008

Elisabeth Steinhagen-Thiessen  and
Markus Borchelt
Elisabeth Steinhagen-Thiessen
Affiliation:
Freie Universitaät Berlin, Universitätsklinikum Rudolf Virchow (Charlottenburg), Spandauer Damm 130, 14050 Berlin, Germany.
Markus Borchelt
Affiliation:
Freie Universitaät Berlin, Universitätsklinikum Rudolf Virchow (Charlottenburg), Spandauer Damm 130, 14050 Berlin, Germany.
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Abstract

The first part of this paper provides a general outline of objectives and methods of the Internal Medicine and Geriatrics Unit of the Berlin Aging Study (BASE). Based on a multi-dimensional conceptualization of health, objective and laboratory data collected about different organ systems, e.g. cardiovascular and musculoskeletal, and functional capacity are complemented by qualitative clinical diagnoses and judgements as well as self-reported health problems and functional limitations. Some of the central questions that can be addressed using these data relate to understanding the nature and processes of differential ageing. The second part of the paper includes initial analyses of inter-individual health differences in advanced old age (70 to 105 years). Initial findings indicated that heterogeneity in somatic morbidity and functional capacity was at least as large in old adults (70 to 84 years) as in very old adults (85 to 105 years), even though higher rates of somatic morbidity and lower levels of functional capacity were observed in the very old. Chronological age and morbidity as well as psychosocial and demographic factors were found to be independent predictors of functional capacity in advanced old age. Additionally, the relative importance of psychosocial factors was found to be a function of age with lower predictive ability among the very old. In conclusion, these initial findings support the hypothesis of significant health differences in advanced old age due to differential ageing.

Type
Research Article
Information
Ageing & Society , Volume 13 , Issue 4 , December 1993 , pp. 619 - 655
Copyright
Copyright © Cambridge University Press 1993

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References

Andersen, R. and Newman, J. F. 1973. Societal and individual health determinants of medical care utilization in the United States. The Milbank Memorial Fund Quarterly, 51, 95–124.CrossRefGoogle ScholarPubMed
Assmann, G. 1987. Lipoproteins and apolipoproteins in the prediction of coronary artery disease. In Schlierf, G. and Mörl, H. (eds) Expanding Horizons in Atherosclerosis Research. Springer, New York.Google Scholar
Avorn, J. and Gurwitz, J. 1990. Principles of pharmacology. In Cassel, C. K., Riesenberg, D. E., Sorensen, L. B. and Walsh, J. R. (eds) Geriatric Medicine, second edition. Springer, New York.Google Scholar
Baltes, M. M., Mayr, U., Borchelt, M., Maas, I. and Wilms, H.-U. 1993. Everyday competence in old and very old age: an interdisciplinary perspective. Ageing and Society, this issue.CrossRefGoogle Scholar
Baltes, P. B., Mayer, K.-U., Helmchen, H. and Steinhagen-Thiessen, E. 1993. The Berlin Aging Study: overview and design. Ageing and Society, this issue.CrossRefGoogle Scholar
Baum, B. J. 1989. Salivary gland fluid secretion during aging. Journal of the American Geriatrics Society, 37, 453–458.CrossRefGoogle ScholarPubMed
Baum, B. J. and Bodner, L. 1983. Aging and oral motor function: evidence for altered performance among older persons. Journal of Dental Research, 62, 2–6.CrossRefGoogle ScholarPubMed
Beck, J. 1988. Trends in oral disease and health. Gerodontology, 7, 21–25.CrossRefGoogle ScholarPubMed
Bell, B., Rose, C. L. and Damon, A. 1972. The normative aging study: An interdisciplinary and longitudinal study of health and aging. Aging and Human Development, 3, 5–17.CrossRefGoogle Scholar
Bierman, E. L. 1985. Arteriosclerosis and aging. In Finch, C. E. and Schneider, E. L. (eds) Handbook of the Biology of Aging. Van Nostrand Reinhold Company, New York.Google Scholar
Borchelt, M., Fischer, J. and Steinhagen-Thiessen, E. 1991. Differential somatic multimorbidity in the old and oldest old. Paper presented at the International Congress of the International Association of Biomedical Gerontology, IABG, Ancona, Italy.Google Scholar
Borchelt, M., Fischer, J., Wernicke, T. and Steinhagen-Thiessen, E. 1992. Profiles of polypharmacy in the very old: benefits and costs. Paper presented at the 45th Annual Scientific Meeting of the Gerontological Society of America, Washington, D.C.Google Scholar
Borchelt, M., Linden, M., Fischer, J. and Geiselmann, B. 1991. Impact of multimedication on health status of the very old. Paper presented at the 44th Annual Scientific Meeting of the Gerontological Society of America, San Francisco, California.Google Scholar
Borchelt, M. and Steinhagen-Thiessen, E. 1991. Diagnose, Prophylaxe und Therapie der Osteoporose. Therapeutische Umschau, 48, 316–321.Google Scholar
Borchelt, M. and Steinhagen-Thiessen, E. 1992. Physical performance and sensory functions as determinants of independence in activities of daily living in the old and the very old. Annals of the New York Academy of Sciences, 673, 350–361.CrossRefGoogle ScholarPubMed
Bouquot, J. E. 1986. Common oral lesions found during a mass screening examination. Journal of the American Dentistry Association, 112, 50–57.CrossRefGoogle ScholarPubMed
Branch, L. G. and Jette, A. M. 1982. A prospective study of long-term care institutionalization among the aged. American Journal of Public Health, 72, 1373–1379.CrossRefGoogle ScholarPubMed
Branch, L. G., Katz, S., Kniepmann, K. and Papsidero, J. A. 1984. A prospective study of functional status among community elders. American Journal of Public Health, 74, 266–268.CrossRefGoogle ScholarPubMed
Brody, J. A. and Schneider, E. L. 1986. Diseases and disorders of aging: A hypothesis. Journal of Chronic Diseases, 39, 871–876.CrossRefGoogle Scholar
Callahan, C. M. 1993. Psychiatric symptoms in elderly patients due to medications. In Rowe, J. W. and Ahronheim, J. C. (eds) Annual Review of Gerontology and Geriatrics: Vol. 12. Focus on Medications and the Elderly. Springer, New York.Google Scholar
Clark, G. T. and Mulligan, R. 1984. A review of the prevalence of temporomandibular dysfunction. Gerodontology, 3, 231–236.CrossRefGoogle ScholarPubMed
Cornoni-Huntley, J., Brock, D. B., Ostfeld, A. M., Taylor, J. O. and Wallace, R. B. 1986. Established Populations for Epidemiologic Studies of the Elderly (EPESE): Resource Data Book, U.S. Department of Health and Human Services Publication No. 86– 2443, Public Health Service, Rockville, Maryland.Google Scholar
Dambacher, M. A. 1982. Praktische Osteologie. Thieme Verlag, Stuttgart.Google Scholar
Eckstein, R., Huhn, D., Schneider, B., Heim, M. U., Peltz, F., Müller, R., Edlmann, M., Löhr, G. and Mempel, W. 1985. Beeinflussung immunfunktioneller Parameter bei Histiozytose-X durch Thymostimulin. Arzneimittel-Forschung/Drug Research, 35, 155–162.Google ScholarPubMed
Epstein, F. H. 1987. Coronary heart disease epidemiology - perspectives. In Schlierf, G. and Mörl, H. (eds) Expanding Horizons in Atherosclerosis Research. Springer, New York.Google Scholar
Feinstein, A. R., Josephy, B. R. and Wells, C. K. 1986. Scientific and clinical problems in indexes of functional disability. Annals of Internal Medicine, 105, 413–420.Google Scholar
Felder, R. S. 1990. Oral diseases. In Cassel, C. K., Riesenberg, D. E., Sorensen, L. B. and Walsh, J. R. (eds) Geriatric Medicine, second edition. Springer, New York.Google Scholar
Felson, D. T., Naimark, A. and Anderson, J. 1987. The prevalence of knee osteoarthritis in the elderly: the Framingham osteoarthritis study. Arthritis and Rheumatism, 30, 914–918.CrossRefGoogle ScholarPubMed
Fimmel, S., Kage, A., Köttgen, E., Nitschke, I. and Borchelt, M. 1991. Serum level of trace elements depending on nutrition of the elderly. Paper presented at the 44th Annual Scientific Meeting of the Gerontological Society of America, San Francisco, California.Google Scholar
Fischer, J., Kage, A., Hilke, W., Borchelt, M., Steinhagen-Thiessen, E. and Köttgen, E. 1992. Risk factors for coronary artery disease in the very old. Paper presented at the 45th Annual Scientific Meeting of the Gerontological Society of America, Washington, D.C.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. 1975. Mini mental state. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Fried, L. P., Storer, D. J., King, D. E. and Lodder, F. 1991. Diagnosis of illness presentation in the elderly. Journal of the American Geriatrics Society, 39, 117–123.CrossRefGoogle ScholarPubMed
Fries, J. F. 1980. Aging, natural death, and compression of morbidity. The Mew England Journal of Medicine, 303, 130–135.CrossRefGoogle ScholarPubMed
Garfein, A. J. and Herzog, A. R. 1990. Successful aging among the young-old, old-old, and oldest-old. Paper presented at the 43rd Annual Meeting of the Gerontological Society of America, Boston, Massachusetts.Google Scholar
Geiselmann, B., Helmchen, H. and Nuthmann, R. Demented subjects' competence to consent to participate in field studies: the Berlin Aging Study (BASE). Medicine and Law, in press.Google Scholar
Gerok, W. and Brandstädter, J. 1992. Normales, krankhaftes und optimales Altern: Variations- und Modifikationsspielräume. In Baltes, P. B. and Mittelstrass, J. (eds) Zukunft des Alterns und gesellschaftliche Entwicklung. de Gruyter, Berlin.Google Scholar
Globerson, A., Sharp, A., Fridkis-Hareli, M., Kukulansky, T., Abel, L., Knyszynski, A. and Eren, R. 1992. Aging in the T-lymphocyte compartment: A developmental view. Annals of the New York Academy of Sciences, 673, 240–251.CrossRefGoogle ScholarPubMed
Goldsmith, N. F., Johnston, J. O., Picetti, G. and Garcia, C. 1973. Bone mineral in the radius and vertebral osteoporosis in an insured population. Journal of Bone and Joint Surgery, 55A, 1276.CrossRefGoogle Scholar
Goldstein, J. L., Hazzard, W. R., Schrott, H. G., Bierman, E. L. and Motulsky, A. G. 1973. Hyperlipidemia in coronary heart disease. I. Lipid levels in 500 survivors of myocardial infarction. Journal of Clinical Investigations, 52, 1533–1543.CrossRefGoogle ScholarPubMed
Good, R. A. and Yunis, E. J. 1974. Association of autoimmunity, immunodeficiency and aging in man, rabbits and mice. Federation Proceedings, 33, 2040–2050.Google ScholarPubMed
Guralnik, J. M., Branch, L. G., Cummings, S. R. and Curb, J. D. 1989. Physical performance measures in aging research. Journal of Gerontology: Medical Sciences, 44, 141–146.CrossRefGoogle ScholarPubMed
Hand, J. S. and Whitehill, J. M. 1986. The prevalence of oral mucosal lesions in an elderly population. Journal of the American Dentistry Association, 112, 73–76.Google Scholar
Harman, D. 1991. The aging process: major risk factor for disease and death. Proceedings of the National Academy of Sciences, 88, 5360–5363.CrossRefGoogle ScholarPubMed
Harris, T., Kovar, M. G., Suzman, R., Kleinman, J. C. and Feldman, J. J. 1989. Longitudinal study of physical ability in the oldest-old. American Journal of Public Health, 79, 698–702.CrossRefGoogle ScholarPubMed
Hazzard, W. R. 1987. Aging, lipoprotein metabolism and atherosclerosis: A clinical conundrum. In Bates, S. R. and Gangloff, E. C. (eds) Atherogenesis and Aging. Springer, New York.Google Scholar
Heikkinen, E. et al. 1984. Functional capacity of men born in 1906–10, 1926–30, and 1946–50: A Basic Report. University of Jyväskylä, Jyväskylä, Finland.Google ScholarPubMed
Helmchen, H. and Linden, M. 1993. The differentiation between depression and dementia in the very old. Ageing and Society, this issue.CrossRefGoogle Scholar
Hughes, S. L., Gibbs, J., Edelman, P., Singer, R. and Chang, R. W. 1992. Joint impairment and hand function in the elderly. Journal of the American Geriatrics Society, 40, 871–877.CrossRefGoogle ScholarPubMed
Hunt, R. J., Srisilapanan, P. and Beck, J. D. 1985. Denture-related problems and prosthodontic treatment needs in the elderly. Gerodontics, 1, 226–230.Google ScholarPubMed
Idler, E. L., Kasl, S. V. and Lemke, J. H. 1990. Self-evaluated health and mortality among the elderly in New Haven, Connecticut, and Iowa and Washington counties, Iowa, 1982–1986. American Journal of Epidemiology, 131, 91–103.CrossRefGoogle ScholarPubMed
International classification of diseases, injuries, and causes of death (ICD) (German version). 1988. Kohlhammer, Cologne.Google Scholar
Jette, A. M., Branch, L. G. and Berlin, J. 1990. Musculoskeletal impairments and physical disablement among the aged. Journal of Gerontology: Medical Sciences, 45, M203–208.CrossRefGoogle ScholarPubMed
Kage, A., Fimmel, S., Köttgen, E. and Nitschke, I. 1991. Oligosaccharides in mucosal secretions in the elderly. Paper presented at the 44th Annual Scientific Meeting of the Gerontological Society of America, San Francisco, California.Google Scholar
Kage, A., Fimmel, S., Hopfenmüller, W., Köttgen, E. and Nitschke, I. 1992. Oligosaccharides in saliva - a risk factor in dental health? Paper presented at the 45th Annual Scientific Meeting of the Gerontological Society of America, Washington, D.C.Google Scholar
Kannel, W. B., Gordon, T. and Castelli, W. P. 1981. Role of lipids and lipoprotein fractions in assessing atherogenesis. The Framingham Study. Progressions in Lipid Research, 20, 339–348.CrossRefGoogle Scholar
Kaplan, G. A. and Camacho, T. 1983. Perceived health and mortality: a nine-year follow-up of the Human Population Laboratory cohort. American Journal of Epidemiology, 117, 292–304.CrossRefGoogle ScholarPubMed
Katz, S., Ford, A. B., Moskowitz, R. W., Jackson, B. A. and Jaffe, M. W. 1963. Studies of illness in the aged. Journal of the American Medical Association, 185, 914–919.CrossRefGoogle ScholarPubMed
Kelly-Hayes, M., Jette, A. M., Wolf, P. A., D'Agostino, R. B. and Odell, P. M.Differences between functional limitations and disability among elders in the Framingham Study. American Journal of Public Health, in press.Google Scholar
Keys, A. 1970. Coronary heart disease in seven countries. Circulation, 41, 1–21.Google Scholar
Kohn, R. R. 1971. Principles of Mammalian Aging. Prentice-Hall, Englewood Cliffs, New Jersey.Google Scholar
Kuriansky, J. and Gurland, B. 1976. The performance test of activities of daily living. International Journal of Aging and Human Development, 7, 343–352.CrossRefGoogle Scholar
LaRue, A., Bank, L., Jarvik, L. and Hetland, M. 1979. Health in old age: How do physicians' ratings and self-ratings compare? Journal of Gerontology, 34, 687–691.CrossRefGoogle ScholarPubMed
Lawton, M. P. and Brody, E. M. 1969. Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.CrossRefGoogle ScholarPubMed
Ligthart, G. J., Corberand, J. X., Fournier, C., Galanaud, P., Hijmans, W., Kennes, B., Müller-Hermelink, H. K. and Steinmann, G. G. 1984. Admission criteria for immunogerontological studies in man: The SENIEUR protocol. Mechanisms of Ageing and Development, 28, 47–55.CrossRefGoogle ScholarPubMed
Linden, M., Geiselmann, B. and Borchelt, M. 1992. Multimorbidität, Multimedikation und Medikamentenoptimierung bei alten Patienten (Multimorbidity, multimedication, and medication optimization in elderly patients). In Lungershausen, E. (ed.) Demenz: Herausforderung für Forschung, Medizin und Gesellschaft (Dementia: A challenge in research, medicine and society). Springer, Berlin.Google Scholar
MacKay, I. R., Whittingham, S. F. and Mathews, J. D. 1977. The immunoepidemiology of aging. In Makinodan, T. and Yunis, E. (eds) Immunity and Aging. Plenum Press, New York.Google Scholar
Maddox, G. L. 1962. Some correlates of differences in self-assessment of health status among the elderly. Journal of Gerontology, 17, 180–185.CrossRefGoogle ScholarPubMed
Maddox, G. L. 1987. Aging differently. Gerontologist, 27, 557–564.CrossRefGoogle ScholarPubMed
Mahoney, F. I. and Barthel, D. W. 1965. Functional evaluation: The Barthel Index. Maryland State Medical Journal, 14, 61–65.Google ScholarPubMed
Manton, K. G. 1988. A longitudinal study of functional change and mortality in the United States. Journal of Gerontology: Social Sciences, 43, 153–161.CrossRefGoogle ScholarPubMed
Manton, K. G. and Soldo, B. J. 1985. Dynamics of health changes in the oldest old: New perspectives and evidence. Milbank Memorial Fund Quarterly: Health and Society, 63, 206–285.CrossRefGoogle ScholarPubMed
Mayer, K.-U. and Wagner, M. 1993. Socio-economic resources and differential ageing: first results from the Berlin Aging Study. Ageing and Society, this issue.CrossRefGoogle Scholar
McKinlay, J. B., McKinlay, S. M. and Beaglehole, R. 1989. A review of the evidence concerning the impact of medical measures on recent mortality and morbidity in the United States. International Journal of Health Services, 19, 181–208.CrossRefGoogle ScholarPubMed
Meier, D. 1990. Disorders of skeletal aging. In Cassel, C. K., Riesenberg, D. E., Sorensen, L. B. and Walsh, J. R. (eds) Geriatric Medicine, second edition, Springer, New York.Google Scholar
Menczel, J., Mahin, M., Robin, G., Steinberg, R. and Lender, R. 1976. Interrelationship between osteoporosis and fractures of neck of femur. In Nielsen, S. P. and Hjorting-Hansen, E. (eds) Calcified Tissues 1975. Fadl, Copenhagen.Google Scholar
Mor, V., Murphy, J., Masterson-Allen, S., Willey, C., Razmpour, A., Jackson, M. E., Greer, D. and Katz, S. 1989. Risk of functional decline among well elders. Journal of Clinical Epidemiology, 42, 895–904.CrossRefGoogle ScholarPubMed
Myers, A. M. and Huddy, L. 1986. Evaluating physical capabilities in the elderly: The relationship between ADL self-assessments and basic abilities. Canadian Journal on Aging, 4, 189–200.CrossRefGoogle Scholar
Nagi, S. Z. 1976. An epidemiology of disability among adults in the United States. Milbank Memorial Fund Quarterly, 54, 439–467.CrossRefGoogle ScholarPubMed
Nagi, S. Z., 1991. Disability concepts revisited: Implications for prevention. In Pope, A. and Taylor, A. (eds) Disability in America: Toward a National Agenda for Prevention. National Academy Press, Washington, D.C.Google Scholar
Nitschke, I. and Hopfenmüller, W. 1991. Oral hygiene habits in the elderly. Paper presented at the 44th Annual Scientific Meeting of the Gerontological Society of America, San Francisco, California.Google Scholar
Österberg, T. 1981. Odontological studies in 70-year-old people in Göteborg. Habilitations- schrift, University of Göteborg, Göteborg, Sweden.Google Scholar
Paffenbarger, R. S., Hyde, R. T. and Wing, A. L. 1987. Physical activity, other personal behaviors, cardiovascular disease, and longevity. In Bates, S. R. and Gangloff, E. C. (eds) Atherogenesis and Aging. Springer, New York.Google Scholar
Palmore, E. B. 1986. Trends in the health of the aged. Gerontologist, 26, 289–302.CrossRefGoogle ScholarPubMed
Palmore, E. B., Nowlin, J. B. and Wang, H. S. 1985. Predictors of function among the old-old. A ten-year follow-up. Journal of Gerontology, 40, 242–250.Google Scholar
Piantanelli, L., Rossolini, G. and Basso, A. 1992. Biomarkers of aging and survival kinetics. Annals of the New York Academy of Sciences, 673, 9–15.Google Scholar
Pinholt, E. M., Kroenke, K., Hanley, J. F., Kussman, M. J., Twyman, P. L. and Carpenter, J. L. 1987. Functional assessment of the elderly. Archives of Internal Medicine, 147, 484–488.CrossRefGoogle ScholarPubMed
Pinsky, J. L., Branch, L. G., Jette, A. M., Haynes, S. G., Feinleib, M., Cornoni-Huntley, J C. and Bailey, K. R. 1985. Framingham Disability Study: relationship of disability to cardiovascular risk factors among persons free of diagnosed car diovascular disease. American Journal of Epidemiology, 122, 644–656.CrossRefGoogle Scholar
Pinsky, J. L., Jette, A. M., Branch, L. G., Kannel, W. B. and Feinleib, M. 1990. The Framingham Disability Study: relationships of various coronary heart disease manifestations to disability in older persons living in the community. American Journal of Public Health, 80, 1363–1367.CrossRefGoogle ScholarPubMed
Puska, P. 1987. From theory to practice: community-based studies on the prevention of coronary heart disease. In Schlierf, G. and Mörl, H. (eds) Expanding Horizons in Atherosclerosis Research. Springer, New York.Google Scholar
Radlof, L. S. 1977. The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measures, 1, 385–401.CrossRefGoogle Scholar
Reuben, D. B. and Siu, A. L. 1990. An objective measure of physical function of elderly outpatients: the physical performance test. Journal of the American Geriatrics Society, 38, 1105–1112.Google Scholar
Reuben, D. B. and Solomon, D. H. 1989. Assessment in geriatrics: of caveats and names. Journal of the American Geriatric Society, 37, 570.CrossRefGoogle ScholarPubMed
Riggs, B. L. and Melton, L. J. 1986. Involutional osteoporosis. New England Journal of Medicine, 314, 1676–1686.CrossRefGoogle ScholarPubMed
Roberts-Thomson, I., Whittingham, S., Youngchaiyud, U. and MacKay, I. R. 1974. Aging, response and mortality. Lancet, 2, 368–370.CrossRefGoogle ScholarPubMed
Rodin, J. 1986. Aging and health: effects of the sense of control. Science, 233, 1271–1276.CrossRefGoogle ScholarPubMed
Rosenwaike, I. 1985. A demographic portrait of the oldest old. Milbank Memorial Fund Quarterly/Health and Society, 63, 187–205.Google Scholar
Rosow, I. and Breslau, N. 1966. A Guttman health scale for the aged. Journal of Gerontology, 21, 556–559.CrossRefGoogle ScholarPubMed
Rowe, J. W. and Kahn, R. L. 1987. Human aging: usual and successful. Science, 237, 143–149.CrossRefGoogle ScholarPubMed
Rowe, J. W. and Minaker, K. L. 1985. Geriatric medicine. In Finch, C. E. and Schneider, E. L. (eds) Handbook of the Biology of Aging. Van Nostrand Reinhold, New York.Google Scholar
Rubenstein, L. V., Calkins, D. R., Greenfield, S., Jette, A. M., Meenan, R. F., Nevins, M. A., Rubenstein, L. Z., Wasson, J. H. and Williams, M. E. 1988. Health status assessment for elderly patients. Journal of the American Geriatrics Society, 37, 562–569.CrossRefGoogle Scholar
Scheidegger, M. J. 1987. Die St. Galler Seniorenbefragung von 1985/86. Europäische Hochschulschriften Bd. 152. Peter Lang, Berne, Switzerland.Google Scholar
Schlierf, G. and Mörl, H. (eds) 1987. Expanding Horizons in Atherosclerosis Research. Springer, New York.Google Scholar
Seeman, E., Melton, L. J. and O'Fallon, W. M. 1983. Risk factors for spinal osteoporosis in men. American Journal of Medicine, 75, 977–983.CrossRefGoogle ScholarPubMed
Shanas, E. and Maddox, G. L. 1985. Health, health resources, and the utilization of care. In Binstock, R. H. and Shanas, E. (eds) Handbook of Aging and the Social Sciences. Van Nostrand Reinhold, New York.Google Scholar
Shock, N. W., Greulich, R. C., Andres, R., Arenberg, D., Costa, P. T., Lakatta, E. G. and Tobin, J. D. 1984. Normal Human Aging: The Baltimore Longitudinal Study of Aging, U.S. Department of Health and Human Services Publication No. 84,2450, U.S. Government Printing Office, Washington, D.C.Google Scholar
Smith, J. and Baltes, P. B. 1993. Differential psychological ageing: profiles of the old and very old. Ageing and Society, this issue.CrossRefGoogle Scholar
Steinhagen-Thiessen, E. 1986. Influence of age and training on bone and muscle tissue in humans and mice. In Bergener, M., Ermini, M. and Stähelin, H. B. (eds) Dimensions in Aging. Academic Press, London.Google Scholar
Steinhagen-Thiessen, E. and Borchelt, M. 1991. Differential aging in maintenance of functional independence: The case of gender. Paper presented at the 44th Annual Scientific Meeting of the Gerontological Society of America, San Francisco, California.Google Scholar
Steinhagen-Thiessen, E., Borchelt, M. and Fischer, J. P. 1993. The Berlin Aging Study (BASE): objectives and methods of the BASE research unit Internal Medicine and Geriatrics. In Schroots, J. J. F. (ed.) Aging, Health and Competence. Elsevier, Amsterdam.Google Scholar
Steinhagen-Thiessen, E., Gerok, W. and Borchelt, M. 1992. Innere Medizin und Geriatrie. In Bakes, P. B. and Mittelstrass, J. (eds) Zukunft des Alterns und gesellschaftliche Entwicklung. de Gruyter, Berlin.Google Scholar
Strain, L. A. 1991. Use of health services in later life: the influence of health beliefs. Journal of Gerontology, 46, 143–150.CrossRefGoogle ScholarPubMed
Svanborg, A. 1985. The Gothenburg longitudinal study of 70-year-olds: clinical reference values in the elderly. In Bergener, M., Ermini, M. and Stähelin, H. B. (eds) Thresholds in Aging. Academic Press, London.Google Scholar
Thorslund, M. and Wärneryd, B. 1990. Surveying the elderly about health, medical care and living conditions: Some issues of response inconsistency. Archives of Gerontology and Geriatrics, 11, 161–173.CrossRefGoogle ScholarPubMed
Tinetti, M. E. 1986. A performance-oriented assessment of mobility problems in elderly patients. Journal of the American Geriatrics Society, 34, 119–126.CrossRefGoogle ScholarPubMed
Vehkulahti, M. M. and Paunio, I. K. 1988. Occurrence of root caries in relation to dental health behavior. Journal of Dental Research, 67, 911–914.Google Scholar
Verbrugge, L. M. 1988. Unveiling higher morbidity for men: the story. In Riley, M. W. (ed.) Social Structures and Human Lives, Vol. 1. Sage, Newbury Park, California.Google Scholar
Vestal, R. E. and Dawson, G. W. 1985. Pharmacology and aging. In Finch, C. E. and Schneider, E. L. (eds) Handbook of the Biology of Aging. Van Nostrand Reinhold, New York.Google Scholar
Wan, T. 1985. Well-Being for the Elderly: Primary Preventive Strategies. Lexington Books, Lexington, Massachusetts.Google Scholar
Wissler, R. W. and Vesselinovitch, D. 1968. Experimental models of human atherosclerosis. Annals of the New York Academy of Science, 149, 907–922.Google Scholar
Wissler, R. W. and Vesselinovitch, D. 1987. The pathogenesis of atherosclerosis: myths and established facts about its relationship to aging. In Bates, S. R. and Gangloff, E. C. (eds) Atherosclerosis and Aging. Springer, New York.Google Scholar
Wittmann, G., Borchelt, M., Zingsem, J., Weisbach, V., Schaper, J., Steinhagen-Thiessen, E. and Eckstein, R. 1992. Immunofunction in old age: first results of BASE (Berliner Altersstudie). Paper presented at the 45th Annual Scientific Meeting of the Gerontological Society of America, Washington, D.C.Google Scholar
World Health Organisation European Collaborative Group 1986. European collaborative trial of multifactorial prevention of coronary heart disease: final report of the 6-year results. Lancet, 1, 869–872.Google Scholar