January 18, 2012

USA: Researchers Identify Risk Factors for Older Adults Who Develop Long-Term Disability

LOS ANGELES, California / Physical Therapy Products / January 17, 2012

Why Older Persons lose the ability to walk independently

NEW HAVEN, Connecticut / Yale

Relatively little is known about why older persons develop long-term disability in community mobility. Researchers at the Yale School of Medicine, New Haven, Conn, set out to identify the risk factors for long-term disability in walking a quarter of a mile and in driving a car. Their study was published in the January 2012 issue of the Annals of Internal Medicine.

“Losing the ability to walk independently not only leads to a poorer overall quality of life, but prolonged disability leads to higher rates of illness, death, depression, and social isolation,” says Thomas Gill, MD, the Humana Foundation professor of geriatric medicine and professor of medicine, epidemiology, and public health at the Yale School of Medicine.

Gill led the research team in a prospective cohort study from March 1998 to December 2009. Of the 641 participants aged 70 years and older, all were reportedly active drivers or non-disabled in walking a quarter mile. Those who were physically frail were over-sampled.

For the study, candidate risk factors were assessed every 18 months, and disability in community mobility and exposure to potential precipitants, including illnesses or injuries leading to hospitalization or restricted activity, were assessed every month. Risk factors evaluated in the study included having a chronic condition or cognitive impairment, low physical activity, slower gross motor coordination, having poor lower-extremity function, and being hospitalized. Long-term disability was considered to be any disability that lasted 6 or more consecutive months.

According to the results, 318 and 269 participants developed long-term disability in walking and driving, respectively. While seven risk factors were independently associated with walking disability, eight were associated with driving disability, with the strongest associations for each outcome found for older age and lower score on the Short Physical Performance Battery. The researchers determined that the largest differences in absolute risk were generally observed in participants with a specific risk factor who were subsequently hospitalized.

The researchers conclude that long-term disability in community mobility is common among older adults. They add that multiple risk factors increase the likelihood of long-term mobility disability.

“We’ve learned that targeted strategies are needed to prevent disability among older people living independently in the community,” Gill says.

Source: Annals of Medicine; Yale University

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