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Study looks at events that lead to disability among the elderly

Illnesses and injuries leading to either hospitalization or restricted activity are strongly associated with the development of disability for older persons living in the community, regardless of their physical condition, according to a study in the November 3 issue of JAMA.

The authors provide as background information that while the prevalence of disability is decreasing, there are currently more than 7 million chronically disabled individuals aged 65 years or older in the United States. "Disability is associated with increased mortality and leads to additional adverse outcomes, such as nursing home placement and greater use of formal and informal home services, all of which place a substantial burden on older persons, informal caregivers, and health care resources. In the aggregate, the additional cost of medical and long-term care for newly disabled U.S. elderly individuals is estimated to be $26 billion per year."

Thomas M. Gill, M.D., and colleagues from Yale University School of Medicine, New Haven, Conn., assessed 754 people aged 70 years or older, who were not disabled (not requiring personal assistance) in four essential activities of daily living: bathing, dressing, walking inside the house, and transferring from a chair. Participants were categorized into 2 groups according to the presence of physical frailty and were followed up with monthly telephone interviews for up to 5 years to determine exposure to intervening events (illnesses or injuries) and the occurrence of disability.

"During the 5-year follow-up period, disability developed among 417 (55.3 percent) participants, 372 (49.3 percent) were hospitalized and 600 (79.6 percent) had at least one episode of restricted activity," the authors found. " participants who developed disability were significantly more likely to have been hospitalized or to have had restricted activity than those who did not develop disability."

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Contact: Karen Peart
203-432-1326
JAMA and Archives Journals
2-Nov-2004


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