ABSTRACT
OBJECTIVE: Care of elderly demands more and more resources. The purpose of this study was to compare the health of the elderly and the differences in utilisation of services. DESIGN: Health status was measured using the Short Form 36, the Barthel Index of Activities of Daily Living, the Abbreviated Mental Test and the Hospital Anxiety and Depression Scale. Information was also obtained on health and social service utilisation. SETTING: Eight European districts. SUBJECTS: 4004 elderly aged 70-94 years were studied. RESULTS: General health perception measured with SF-36 was significantly better in men than in women and in elderly living outside institutions. Measured with the Barthel scale, the elderly living in the southern districts were more disabled. Women were more disabled than men. Depression and anxiety were common, but inadequately treated and strongly linked with disability. There was a north-south difference also in mental disability, people in the north feeling healthier. CONCLUSION: Cultural differences probably explain most of the differences observed. However, treating depression and anxiety more adequately could help elderly people to avoid early institutionalisation.