Disability and Recovery of Independent Function in Obstructive Lung Disease: The Cardiovascular Health Study
| Autor: | Vincent S. Fan, Rachel M Thomas, Stephen Thielke, Paul L. Enright, Gina S. Lovasi, Jerry A. Krishnan, Paula Diehr, Anthony Wilsdon, Mark V Avdalovic, Vishesh K. Kapur, Graham Barr, Sachin Yende, Emily Locke |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
Activities of daily living Outcome Assessment Respiratory System Psychological intervention Chronic airflow obstruction Cardiorespiratory Medicine and Haematology Severity of Illness Index Disability Evaluation Pulmonary Disease Chronic Obstructive 0302 clinical medicine Activities of Daily Living Outcome Assessment Health Care 030212 general & internal medicine Longitudinal Studies Lung Cardiac Rehabilitation medicine.diagnostic_test Rehabilitation Obstructive lung disease 3. Good health Cardiovascular Diseases Respiratory Female Independent Living Risk assessment Pulmonary and Respiratory Medicine Spirometry medicine.medical_specialty Chronic Obstructive Motor Activity Risk Assessment Article Pulmonary Disease 03 medical and health sciences Clinical Research Severity of illness medicine Humans Muscle Strength Aged Disability business.industry Prevention Recovery of Function medicine.disease United States Health Care 030228 respiratory system Relative risk Physical therapy Exercise Test business Independent living |
| Zdroj: | Respiration; international review of thoracic diseases, vol 88, iss 4 |
| Popis: | Background: Chronic obstructive lung disease frequently leads to disability. Older patients may experience transitions between states of disability and independence over time. Objective: To identify factors associated with transition between states of disability and independent function in obstructive lung disease. Methods: We analyzed data on 4,394 participants in the Cardiovascular Health Study who completed prebronchodilator spirometry. We calculated the 1-year probability of developing and resolving impairment in ≥1 instrumental activity of daily living (IADL) or ≥1 activity of daily living (ADL) using transition probability analysis. We identified factors associated with resolving disability using relative risk (RR) regression. Results: The prevalence of IADL impairment was higher with moderate (23.9%) and severe (36.9%) airflow obstruction compared to normal spirometry (22.5%; p < 0.001). Among participants with severe airflow obstruction, 23.5% recovered independence in IADLs and 40.5% recovered independence in ADLs. In the adjusted analyses, airflow obstruction predicted the development of IADL, but not ADL impairment. Participants with severe airflow obstruction were less likely to resolve IADL impairment [RR 0.67 and 95% confidence interval (CI) 0.49-0.94]. Compared to the most active individuals (i.e. who walked ≥28 blocks per week), walking less was associated with a decreased likelihood of resolving IADL impairment (7-27 blocks: RR 0.81 and 95% CI 0.69-0.86 and Conclusions: Disability is common in older people, especially in those with severe airflow obstruction. Increased physical activity and muscle strength are associated with recovery. Research is needed on interventions to improve these factors among patients with obstructive lung disease and disability. |
| Databáze: | OpenAIRE |
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