Blood pressure in the very old.

Seven hundred and twenty-four people (541 female, 183 male), aged 84-88 years and living at home in the city of Tampere, Finland, accepted our invitation to be examined in the outpatient department of the local geriatric hospital. These subjects were re-examined annually, and their fate was followed for 3 years. The blood pressure level was a prognostic sign for mortality during the first year after its measurement. The lowest mortality rate was found among those subjects with systolic blood pressure between 140 and 169 mmHg and diastolic blood pressure between 70 and 99 mmHg. Blood pressures outside of these ranges were associated with increased mortality rates, particularly cardiac and coronary mortality. The mortality rate was especially high among those whose systolic blood pressure had decreased to low levels in the year before, but was lower in those whose systolic blood pressure had decreased from high to middle levels (140-169 mmHg) than in those with consistently high systolic blood pressure. Eventual institutionalization was more common in those with low systolic blood pressure.

Mortality and high haematrocrit in the very aged.

A series of 543 people, aged 85 years or more was studied and divided into groups according to haematocrit value. The mortality of the subjects was followed over the next 5 years. The mortality in the lowest haematocrit groups was highest during the whole observation period. Further, in the haematocrit bracket greater than or equal to 0.48, the mortality in the first year was higher than in those with haematocrit 0.40-0.47. In the second year this increased mortality had disappeared and in the third-fifth years decreased mortality was found with high haematocrit. Initially high haematocrit also decreased during the observation period. Since the increased mortality associated with high haematocrit disappeared it cannot be based on any chronic disease but on some disappearing factor, e.g. simply the high haematocrit itself.

Body weight and the three-year prognosis in very old people.

We studied prospectively the three-year prognosis of persons aged 84-88 years living in their own homes in the city of Tampere, Finland in 1981-84. Out of the target population 722 persons (64 per cent), 181 of them male (25 per cent), participated in the initial survey. A re-examination was carried out annually for the next three years. Increased mortality was observed for subjects with body mass index less than or equal to 22.0 kg/m2, statistically significantly in women but not in men. Mortality was not increased in those with body mass index greater than or equal to 30.0 kg/m2 in either sex. Low body mass index was associated with mortality due to stroke. Low body mass index was related to permanent hospitalization and also to failure to cope with living at home. On average, body weight was somewhat reduced during the follow-up period. Both a loss and a gain in weight by two kilograms or more during the first follow-up year were associated with increased mortality but not with institutionalization during the next two years.