Europe is experiencing a rapid increase in the numbers and proportions of the very old, and the number of older adults with chronic or longstanding diseases and functional limitations is rising. Between 1980 and 2025, the population aged 80 years and over is projected to increase 2·15 times, from in million in 1980 to 23·7 million. As those aged 80 years and over have been the most rapidly growing age-group, it is evident that the prevalence of physical and mental disabilities is of concern. Many suffer from chronic conditions which compromise daily living, although a substantial group are in good health and with little disability.203 Nevertheless as the average age increases, more people need some form of assistance with the activities of daily living, such as bathing, dressing, eating, preparing meals and errands (ADL). Reaching the age of 80 years does not necessarily mean losing one's independence; nevertheless the risk increases with age.