a1 Health Needs Assessment Unit, Department of General Practice and Primary Care, St. Bartholomew's Hospital Medical College, Charterhouse Square, London EC1M 6BQ, U.K.
a2 Age Concern Institute of Gerontology, King's College, Cornwall House Annex, Waterloo Road, London SE1 8TX, U.K.
This paper describes association with changes in functional ability among very elderly people who were interviewed first in 1987 when they were aged 85+, and followed-up in 1990. It focuses, in particular, on those with severe difficulties with ADL. It was notable that while those with chronic problems with disability used more health and social services, few received services specific to rehabilitation and social support (e.g. physiotherapy, occupational therapy and social work), and substantial numbers in this group (30–45%) did not receive any chiropody services; although the provision of instrumental aid with tasks of daily living was relatively high from home help services, and, in particular, from relatives.