Geriatric Syndromes and Incident Disability in Older Women: Results from the Women's Health Initiative Observational Study

Objectives To determine how the number of geriatric syndromes is associated with incident disability in community-based populations of older adults. Design Longitudinal analysis from the Women's Health Initiative Observational Study (WHI-OS). Setting Community. Participants Twenty-nine thousand five hundred forty-four women aged 65 and older enrolled in the WHI-OS and free of disability in activities of daily living (ADLs) at baseline. Measurements Geriatric syndromes (high depressive symptoms, dizziness, falls, hearing or visual impairment, osteoporosis, polypharmacy, syncope, sleep disturbance, and urinary incontinence) were self-reported at baseline and 3-year follow-up. Disability was defined as dependence in any ADL and was assessed at baseline and follow-up. Chronic diseases were measured according to a modified Charlson Index. Results Geriatric syndromes were common in this population of women; 76.3% had at least one syndrome at baseline. Greater number of geriatric syndromes at baseline was significantly associated with greater risk of incident ADL disability at follow-up (P.001). Adjusted risk ratios were 1.21 (95% confidence interval (CI)=0.781.87) for a single syndrome and 6.64 (95% CI=4.1510.62) for five or more syndromes compared with no syndromes. These results were only slightly attenuated after adjustment for number of chronic diseases or pain. Conclusion Geriatric syndromes are significantly associated with onset of disability in older women; this association is not simply a result of chronic disease or pain. A better understanding of how these conditions contribute to disablement is needed. Geriatric syndrome assessment should be considered along with chronic disease management in the prevention of disability in older women.