Dependence on long-term care is a state of highest physical, mental and social vulnerability. This vulnerability results from the accumulation of chronic diseases and functional limitations. A consequence of this is the deterioration of functional health, the ability to execute activities of daily living independently (e.g. mobility, self-care, and housekeeping). So far, little is known about the "point of accumulation" of both risk factors and lack of resources, where the need for long-term care becomes evident. There is also still a lack of empirical evidence regarding the constellation of protective factors needed to lower the risk of long-term care and of loss in functional health. In particular, knowledge about psychological, social, behavioural, and environmental influences and their interplay is still scarce

Part of the Project "Health Trajectories Into Old Age - Ways Into Need for Long-Term Care" funded by the National Association of Statutory Health Insurance Funds (GKV-Spitzenverband)

The German Centre of Gerontology (DZA) and the Institute of Medical Sociology and Rehabilitation Science at the Charité Universitätsmedizin Berlin are cooperating on this project, which seeks to identify age-related trajectories of functional health and their predictors (DZA) as well as to identify factors that are associated with the need for long-term care (Charité). For this purpose, the team at Charité Universitätsmedizin will use new data from the Medical Service of the Health Funds (MDK). The team at the German Centre of Gerontology will use longitudinal data from the German Ageing Survey (DEAS) to analyze functional health trajectories and identify factors that influence changes in functional health, cognitive decline, and the development of frailty. The following research questions are in the focus of our research:

  • Which risk and protective factors are associated with changes in functional health?
  • Are there cohort differences in the age-related trajectories of functional health?
  • What are the mechanisms underlying decline of functional health in late adulthood?
  • Which interventions can delay or buffer age-related declines of functional health?


Funding Source

National Association of Statutory Health Insurance Funds

This project is part of the model programme for the further development of long-term care insurance according to §8 section 3 SGB XI (Modellprogramm zur Weiterentwicklung der Pflegeversicherung gemäß §8 Abs. 3 SGB XI).


Project Duration

March 2018 to August 2021

Project Partner

Charité Universitätsmedizin Berlin - Institute of Medical Sociology and Rehabilitation Science

Project Members