The most striking demographic change in Switzerland over the last century has been the rapid growth, both absolute and relative, of the oldest-old (80+) population. Rather than scrutinizing the pathologies of very old age, the Swiss Interdisciplinary Longitudinal Study on the Oldest Old (SWILSOO) investigates the health trajectories of the oldest old and analyzes various aspects of their daily life. SWILSOO is a two-cohort longitudinal study on aging in the French-speaking region of Switzerland, covering sociology, social and cognitive psychology, social medicine, and econometrics. The two cohorts were assessed on an approximately yearly basis, the first for nine waves, with 340 participants at inception, and the second for five waves, initially with 377 participants.
Two conclusions can be drawn from the results obtained so far. The first is that the main characteristic of the very old is neither their state of dependence nor their illnesses but their condition of frailty, which affects them in different ways. The health status of people at a very advanced age varies greatly, ranging from robust to frail and perhaps even dependent. Secondly, each type of health status (robustness, frailty, dependence) is associated with a radically distinct everyday lifeworld, involving specific relational ties, social activities and health risks.
This long-term study of octogenarians demonstrates that many received ideas concerning the oldest-old, such as the idea that a long life inevitably culminates in dependence, are false. Dependence is a risk - more frequent among women and persons of lower socio-economic status - but it is not ineluctable.
Abstracts of SWILSOO publications are available at http://cig.unige.ch/recherches/publications.html
Principal applicant Institution: Christian J. Lalive d’Epinay, Ph.D., Dr. h.c., honorary professor. Center for Interdisciplinary Gerontology, University of GenevaSubject: Since the beginning of the 21st century, a growing number of people live beyond the age of 80. By following two cohorts of octogenarians over a period of ten years, Swilsoo explored the territory of very old age. Goals:1) To reconstruct the current architecture of the final stages of long lives, with their typical life events and transitions; 2) To identify the environmental factors and processes affecting positively or negatively old people’s autonomy, physical and mental integrity, and participation in society; Analyse the impact of life and health events on the individuals and, conversely, the way the elders, with their resources and in their social environment, react and try to regulate the disruptive events.Design:Follow-up (1994-2004) of two cohorts (the first, n=340, over ten years ; the second, n=371, over five years). Samples stratified by gender, two geographical areas and seven five-year age strata (?). Every 12 to18 months, interviews with a close-ended questionnaire (2,496); in-depth interviews (79).Some results:The common denominator of the oldest old is neither dependence nor illness but (a) a wide diversity of health conditions and (b) frailty, defined as a multisystemic process of reduction in reserve capacity. While frailty impinges sooner or later on all the very old, chronic dependence as the very last stage of life is a risk, not a fatality. This risk increases with advancing old age and is unevenly distributed, women and elders of lower socio-economic status being more at risk. The elders’ health status (robust, frail or dependent) moulds their life world and its main dimensions: time and the relation to the future, space in the sense of the geographical world of their daily life, the risk density of everyday life, family, affective and social life, range and quality of activities. Isolated elders are very few in number and as a rule are people with no descendants. Descendants form the most important instrumental and affective resource in very old age. Events reported as important by the elders mainly relate to two domains of life: health and family (usually bereavement). The huge majority of the changes reported have a negative valence, but some have a positive one. According to the elders’ perception of their own life, losses largely prevail over gains.Meaningful activities protect against cognitive decline. Activities, family life and friendship protect against the loss of autonomy and independency. The general trend towards declining health does not impact the feeling of well-being to the same degree, thanks to the elders’ ability to apply psychological buffering mechanisms.Significance: This research offers a wealth of fresh and unique information and knowledge to professionals and others concerned with the realities and problems of very old age.Publications: over 100 publications. See http://cig.unige.ch/recherches/swilsoo.htmlSince the beginning of the 21st century, a growing number of people live beyond the age of 80. By following two cohorts of octogenarians over a period of ten years, Swilsoo explored the territory of very old age.