The development of insidious disability in activities of daily living among community-living older persons - 25/08/11
Résumé |
Purpose |
To determine how often disability in essential activities of daily living develops insidiously, and to evaluate whether the likelihood of insidious disability differs on the basis of physical frailty.
Methods |
We conducted a prospective study of 754 nondisabled, community-living persons aged 70 years or older. Participants were categorized according to the presence or absence of physical frailty, which was defined on the basis of gait speed. Participants were subsequently followed with monthly telephone interviews for 3 years to determine the occurrence of disability in bathing, dressing, walking, or transferring, and to ascertain exposure to precipitating events, which included acute hospital admissions and other illnesses, injuries, or problems leading to restricted activity.
Results |
For first episodes of disability, 73 (36%) of 203 developed insidiously among the 322 participants who were physically frail and 26 (18%) of 141 developed insidiously among the 432 participants who were not physically frail (P <0.001). Physical frailty was the only factor that was associated significantly with the development of insidious disability, with an adjusted odds ratio of 2.4 (95% confidence interval: 1.4 to 4.1). The likelihood that an episode of disability was insidious increased progressively, from 29% of the 344 first episodes to 65% of the 155 fourth or higher episodes (P for trend <0.001).
Conclusion |
Disability in essential activities of daily living often occurs insidiously, particularly among older persons who are physically frail or who have had prior episodes of disability.
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This report was funded in part by grants from the National Institute on Aging (AG17560, AG00759), the Robert Wood Johnson Foundation, the Paul Beeson Physician Faculty Scholar in Aging Research Program, and the Patrick and Catherine Weldon Donaghue Medical Research Foundation. The study was conducted at the Yale Claude D. Pepper Older Americans Independence Center (AG21342). Dr. Gill is the recipient of a Midcareer Investigator Award in Patient-Oriented Research (AG021507) from the National Institute on Aging. |
Vol 117 - N° 7
P. 484-491 - octobre 2004 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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