Journal Article

Prognostic Effect of Prior Disability Episodes among Nondisabled Community-living Older Persons

Thomas M. Gill and Brenda F. Kurland

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 158, issue 11, pages 1090-1096
Published in print December 2003 | ISSN: 0002-9262
Published online December 2003 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwg237
Prognostic Effect of Prior Disability Episodes among Nondisabled  Community-living Older Persons

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The objective of this prospective cohort study, conducted in 1998–2002 in New Haven, Connecticut, was to determine the prognostic effect of prior episodes of disability. The analytical sample included 580 community-living persons aged 71 years or older who were nondisabled during an 18-month face-to-face assessment (i.e., zero-time). During monthly telephone interviews, participants were assessed for disability in activities of daily living. The primary explanatory variable was a history of disability in the year prior to zero-time as determined from the monthly interviews. The primary outcome was time to onset of disability over a 3-year period subsequent to zero-time. In Cox proportional hazards analyses that adjusted for several potential confounders, a prior history of disability was found to be significantly associated with development of any disability (i.e., ≥1 month) and persistent disability (i.e., ≥2 months); hazard ratios were 2.0 (95% confidence interval: 1.4, 2.7) and 2.0 (95% confidence interval: 1.3, 2.9), respectively. These strong associations were maintained after participants who had a prior history of chronic disability were excluded. Results demonstrate the long-term, deleterious effect of short-term disability among community-living older persons. More frequent assessments of functional status may be warranted in epidemiologic studies and clinical trials when disability is a primary focus.

Keywords: activities of daily living; aged; cohort studies; disability evaluation; Abbreviations: ADL, activities of daily living; CI, confidence interval.

Journal Article.  4898 words.  Illustrated.

Subjects: Public Health and Epidemiology

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