Risk Factors for Functional Decline in Older Adults with Arthritis
| Autor: | Rowland W. Chang, Pamela A. Semanik, Dorothy D. Dunlop, Larry M. Manheim, Jing Song, Vivian C. Shih |
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| Jazyk: | angličtina |
| Rok vydání: | 2005 |
| Předmět: |
Gerontology
Male medicine.medical_specialty Activities of daily living Frail Elderly Immunology Comorbidity Logistic regression Article Disability Evaluation Rheumatology Risk Factors Activities of Daily Living medicine Prevalence Immunology and Allergy Humans Pharmacology (medical) Disabled Persons Risk factor Geriatric Assessment Aged Aged 80 and over business.industry Public health Arthritis Odds ratio medicine.disease Cohort Disease Progression Female Illinois Psychomotor Disorders Psychomotor disorder business |
| Popis: | Functional limitation is a major factor in medical costs. This study was undertaken to evaluate the prevalence of functional limitation among adults with arthritis and the frequency of functional decline over 2 years, and to investigate factors amenable to public health intervention that predict functional decline.Longitudinal data (1998-2000) from a cohort of 5,715 adults ages 65 years or older with arthritis from a national probability sample were analyzed. Function was defined based on ability to perform basic activities of daily living (ADL) tasks and instrumental ADL. Adjusted odds ratios (ORs) from a multiple logistic regression model were used to estimate the associations between functional decline and comorbid conditions, health behaviors, and economic factors.Overall, 19.7% of this cohort had functional limitation at baseline, including 12.9% with ADL limitations. Over the subsequent 2 years, function declined in 13.6% of those at risk. Functional decline was most frequent among women (15.0%) and minorities (18.0% Hispanics, 18.7% African Americans) with arthritis. Lack of regular vigorous physical activity, the most prevalent risk factor (64%), almost doubled the odds of functional decline (adjusted OR 1.9, 95% confidence interval 1.5-2.4) after controlling for all risk factors. It was found that if all subjects engaged in regular vigorous physical activity, the expected functional decline could be reduced as much as 32%. Other significant predictors included older age, cognitive impairment, depressive symptoms, diabetes, physical limitations, no alcohol use, stroke, and vision impairment.Lack of regular vigorous physical activity is a potentially modifiable risk factor that could substantially reduce functional decline and associated health care costs. Prevention/intervention programs should include regular vigorous physical activity, weight maintenance, and medical intervention for health needs. (c) 2005, American College of Rheumatology. |
| Databáze: | OpenAIRE |
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