Workshop on Disability in America A New Look: Summary and Background Papers (2006) / Chapter Skim
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Appendix H Aspects of Disability Across the Life Span: Risk Factors for Disability in Late Life--Jack M. Guralnik
Appendix H Aspects of Disability Across the Life Span: Risk Factors for Disability in Late Life--Jack M. Guralnik
Pages 157-165
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From page 157... ...
who undertake large population studies can use to measure disability and the steps from disease to disability in a valid, reliable manner. This paper describes classic epidemiologic research on risk factors for disability and points out some of the challenges in trying to sort out the main causes of disability in the older population.
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. Among the chronic conditions that have been shown in epidemiologic studies to be associated with disability are heart disease and stroke, osteoarthritis, hip fracture, diabetes, peripheral artery disease, chronic obstructive pulmonary disease, cancer, visual impairment, depression, and cognitive impairment.
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As shown in Table H-1, for limitations related to the ability to walk one-half mile, do heavy housework, or bathe, women reported arthritis as the main cause for each of these limitations. For men, arthritis was the top reported cause for limitations in walking one-half mile; but for heavy housework, heart disease is slightly more important as a cause, and for limitations in bathing, stroke has a slightly greater role than arthritis.
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Two examples of this work involve diabetes and low socioeconomic status as risk factors for disability. For diabetes, we first looked at the association between diabetes and several different functional or disability outcomes: mobility problems, ADL disability, and severe walking limitation (i.e., an inability to walk or walking less than 0.4 meters per second)
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One way that we have measured functional limitations uses the SPPB mentioned earlier, an approach first used in the EPESE study (Guralnik et
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Colleagues and I have evaluated, using annual interviews over a 6year period, what we call severe catastrophic and severe progressive disability, defined as follows: • Severe disability: the individual needs help with three or more of six ADLs (eating, dressing, bathing, transferring, using the toilet, and walking across a small room) • Catastrophic severe disability: an individual with severe disability in whom no ADL disability was identified in the preceding two interviews • Progressive severe disability: an individual with severe disability in whom one or two ADLs were identified in the preceding interview We found that catastrophic disability is more common in the young old.
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life tables, National Center for Health Statistics. factors should not be forgotten, as they may affect the progression of potentially disabling conditions.
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Series A, Biological Sciences and Medical Sciences 1996;51:M123-M130. Guralnik JM, LaCroix AZ, Abbott RD, et al.
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From page 165... ...
:556–561. Guralnik JM, Ferrucci F, Pieper CF, Leveille SG, Markides KS, Ostir GV, Studenski S, Berkman LF, Wallace RB.
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