Læknablaðið : fylgirit - 01.03.1983, Blaðsíða 94

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COMPARATIVE DISEASE PATTERNS
IN THE ELDERLY AND THE VERY OLD
A RETEROSPECTIVE AUTOPSY STUDY
Ársæll Jónsson, Jónas Hallgrímsson
Introduction
Although the maximum life span potential of man has not changed
during the past 100.000 years, the average length of human life has
increased by more than 30 years in the Western countries during the
20th century alone (1.2). In Iceland the life expectancy at birth
has risen from 44.4 years for males and 57.5 years for females at
the turn of the last century to 73.5 and 79.5 years in 1980 (3).
The growing number of the elderly and the very old people in parti-
cular has presented increased and unexpected demands on the health
services in these countries. An analysis of diseases at old age
should be helpful for the planning of the health care for the
elderly and the very old.
Our study is based on a comparison of 100 autopsies on people aged
90 years and older and 100 autopsies on people 70 years and younger.
The direct causes of death were analysed and an attempt was made to
throw light on other diseases causing symptoms needing special
attention and care. The results of this study could give guide-
lines for the reorganization of care for the elderly and the very
old.
Material and methods
In Iceland the autopsy rate is high, relatively unselected and
therefore well suited for population studies.
The Department of Pathology at the University of Iceland is the
only one of its kind in Iceland and most of the autopsies carried
out in the country are performed there. Slightly more than 50% of
the Icelandic population live in the capital, Reykjavík, and
surrounding communities. Most of the larger medical facilities,
including the largest hospitals and the laboratory for legal
medicine are in Reykjavík and they draw patients from all areas of
the country. The autopsy records from the Department of Pathology
therefore give reliable information on a population basis. During
the period 1966-1979, the total autopsy rate in the country, all
ages included, was 38 per cent for males and 30 per cent for
females (4). During the same period the autopsy rate for persons
80 years and older was 18 per cent for males and 16 per cent for
females.
One hundred consecutive autopsy reports of persons older than 90
years of age were analysed. The newest report were from 1977 and
the oldest from 1965.
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