Incidence of functional limitation in older adults: The impact of gender, race, and chronic conditions

被引:145
作者
Dunlop, DD
Manheim, LM
Sohn, MW
Liu, XY
Chang, RW
机构
[1] Northwestern Univ, Inst Hlth Serv Res & Policy Studies, Evanston, IL 60208 USA
[2] Northwestern Univ, Dept Stat, Evanston, IL 60208 USA
[3] Northwestern Univ, Sch Med, Multipurpose Arthrit & Musculoskeletal Dis Ctr, Chicago, IL USA
[4] Northwestern Univ, Sch Med, Div Arthrit Connect Tissue Dis, Chicago, IL USA
[5] Northwestern Univ, Sch Med, Dept Prevent Med, Chicago, IL USA
[6] Univ Chicago, Dept Hlth Studies, Chicago, IL 60637 USA
来源
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION | 2002年 / 83卷 / 07期
关键词
D O I
10.1053/apmr.2002.32817
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Objectives: To evaluate the relation of chronic conditions, gender, and race to the incidence of activities of daily living (ADLs) limitation in older adults. Design: The 2-year cumulative incidence of functional limitation was estimated from survival analysis methods by using elders without baseline functional limitations. Setting: Longitudinal Study of Aging (LSOA). Initial interviews: 1984; reinterviews: 1986, 1988, and 1990. Participants: A total of 4205 elderly subjects from the LSOA. Interventions: Not applicable. Main Outcome Measures: Dependent variables: self-reported moderate (1-2 ADLs) and severe (greater than or equal to3 ADLs) functional limitation. Independent variables: sociodemoraphics, self-reported chronic conditions, and prior levels of functional limitation. Results: Gender and race predicted moderate functional limitation onset, after controlling for age and education. Arthritis, diabetes, prior cerebrovascular disease (CVD), incontinence, and impaired vision were significant predictors of moderate functional limitation onset after controlling for demographics. Differences in the prevalence of chronic conditions appear to explain why moderate functional limitation incidence rates are higher in older women and blacks. Gender, but not race, predicted onset of severe functional limitation, after controlling for age and education. Prior moderate functional limitation, CVD, and vision impairment predicted onset of severe functional limitation after controlling for demographics. Conclusion: Prevention of functional decline should target chronic conditions and moderate functional limitation in older adults.
引用
收藏
页码:964 / 971
页数:8
相关论文
共 54 条
[1]   Dementia is the major cause of functional dependence in the elderly:: 3-year follow-up data from a population-based study [J].
Agüero-Torres, H ;
Fratiglioni, L ;
Guo, ZC ;
Viitanen, M ;
von Strauss, E ;
Winblad, B .
AMERICAN JOURNAL OF PUBLIC HEALTH, 1998, 88 (10) :1452-1456
[2]   The timing of change: Patterns in transitions in functional status among elderly persons [J].
Anderson, RT ;
James, MK ;
Miller, ME ;
Worley, AS ;
Longino, CE .
JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES, 1998, 53 (01) :S17-S27
[3]   Medicare health maintenance organizations and traditional coverage: Perceptions of health care among beneficiaries with disabilities [J].
Beatty, PW ;
Dhont, KR .
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 2001, 82 (08) :1009-1017
[4]   Decreasing disability in the 21st century: The future effects of controlling six fatal and nonfatal conditions [J].
Boult, C ;
Altmann, M ;
Gilbertson, D ;
Yu, C ;
Kane, RL .
AMERICAN JOURNAL OF PUBLIC HEALTH, 1996, 86 (10) :1388-1393
[5]   Do medicare patients with disabilities receive preventive services? A population-based study [J].
Chan, L ;
Doctor, JN ;
MacLehose, RF ;
Lawson, H ;
Rosenblatt, RA ;
Baldwin, LM ;
Jha, A .
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 1999, 80 (06) :642-646
[6]   THE RELATIONSHIP BETWEEN HEALTH AND COGNITIVE-FUNCTIONING IN A SAMPLE OF ELDERLY PEOPLE IN THE COMMUNITY [J].
CHRISTENSEN, H ;
JORM, AF ;
HENDERSON, AS ;
MACKINNON, AJ ;
KORTEN, AE ;
SCOTT, LR .
AGE AND AGEING, 1994, 23 (03) :204-212
[7]  
CORMAN JM, 1996, GERONTOLOGIST, V36, P15
[8]  
COX BG, 1985, METHODOLOGIST ISSUES
[9]   Further evidence on recent trends in the prevalence and incidence of disability among older Americans from two sources: The LSOA and the NHIS [J].
Crimmins, EM ;
Saito, Y ;
Reynolds, SL .
JOURNALS OF GERONTOLOGY SERIES B-PSYCHOLOGICAL SCIENCES AND SOCIAL SCIENCES, 1997, 52 (02) :S59-S71
[10]   CHANGING MORTALITY AND MORBIDITY RATES AND THE HEALTH-STATUS AND LIFE EXPECTANCY OF THE OLDER POPULATION [J].
CRIMMINS, EM ;
HAYWARD, MD ;
SAITO, Y .
DEMOGRAPHY, 1994, 31 (01) :159-175