Background

Functional abilities vary widely among elderly persons. The determinants of this variation are probably multiple and include normal aging processes as well as disease expression. This study estimates the relative importance of genetic and environmental factors to variation in functional abilities in elderly persons.

Methods

We conducted a survey among all Danish twins aged 75 years and older who were identified in the population-based Danish Twin Registry. Interviews were conducted with 77% (7% by proxy responders) of the 3099 individuals in the study population. Functional abilities were assessed by validated Danish survey instruments and were scored on three scales. Heritability (proportion of the population variance attributable to genetic variation) was estimated using structural equation analyses.

Results

Structural equation analyses revealed a substantial heritability (34%-47%) for the three functional ability scores among the women aged 80 years and older compared with a more modest heritability (15%-34%) among the women aged 75-79 years. The remaining variation could be attributed to individuals' nonfamilial environments. Comparisons of the functional abilities of twins with living versus deceased co-twins also suggested a difference in the genetic influence for the two age groups. Although heritability estimates were uniformly low in the male participant sample, the size of the sample was not sufficiently large to allow for precise estimates of heritability.

Conclusion

For women we found that the effect of genetic factors on functional abilities increases with age and accounts for one third to one half of the variation among individuals aged 80 years and older. An understanding of the genetic mechanisms underlying functional abilities in the oldest individuals may enhance the possibilities for improving health in the elderly population by modifying environmental factors.