• 10/66 and all that 04 December 2017 | View comments

  • 3rd December 2017 | By David Jolley

    The November issue of Age and Ageing includes two studies, which are beautiful in their simplicity and their roots in history by their methodologies.

    Bringing them to the attention of our seminar group, I was saddened to find that I was the only one present to be a member of the BGS (British Geriatrics Society). Almost all psycho-geriatricians of the 1970s became members – we worked closely with physician colleagues (‘Geriatricians’) – we fought battles together, developed joint services in the community, in clinics and in beds, and we did clinical and other research together.

    Some of this survives and is a blessing but changes in services and personnel have weakened the links. Would it be that the generous vigour which comes with the union can become widespread again.

    A paper from the 10/66 group describes a study which uses data from 16,940 individuals aged 65+ living in China, India, Cuba, Dominican Republic, Peru, Venezuela, Mexico or Puerto Rica. In so doing it demonstrates the power based in the 10/66 initiative by its durability, recruitment numbers and diversity of populations included.

    The 66 refers to the percentage of people with dementia living in low and middle income countries. The 10 to the percentage of published population based studies of dementia conducted in these countries at the time that the study group was formed https://www.alz.co.uk/1066/. Their work has probably changed those ratios a little – and made for learning and improvements to services world-wide.

    Findings were that self-rating of health amongst these older people from the several countries showed an interesting pattern: in most instances more than half these populations rated their general health as good on a three point scale, no more than 10% rated their health as poor.

    Perception of health was better in towns than in the countryside and better in men than in women. There was a very strong positive association between a rating of good health and survival over four years. Such a simple question. Such a powerful predictor of health and survival.

    The second paper comes from Newcastle with an analysis of the relationship between grip strength and survival over 9.6 years by 845 people aged 85 years or older at the beginning of the study. Grip strength was measured by a hand-held dynamometer http://www.taheeltech.com/product/hand-held-electronic-dynamometer/. Weaker grip and progressive weakening after the baseline measure, were strongly associated with reduced survival. Again a simple measure with powerful and useful predictive value.

    When I began to read about psychiatric studies, we learned the techniques of Kraepelin, Bleuler and other classical, clinical researchers: Later I was reading Felix Post. Their methods required clinical observations with minimal equipment and careful follow up. These most recent papers in Age and Ageing use the same formula. It is so refreshing to see the well-tried, modest approach bearing fruit in this day when hi-tech may sometimes seem to be essential for any progress to be achieved.

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