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A changing relationship between disability and survival in the elderly population: differences by age
Rosa Lamarca1, Montserrat Ferrer, Per Kragh Andersen
1Health Services Research Unit, Institut Municipal d'Investigació Mèdica (IMIM-IMAS), Carrer del Doctor Aiguader 80, E-08003, Barcelona, Spain.
Journal of Clinical Epidemiology
|December 19, 2003
Summary
Disability increases with age in older adults, impacting mortality risk differently by gender. Elderly women with disabilities require targeted interventions due to higher rates and lower recovery.
Area of Science:
- Gerontology
- Public Health
- Epidemiology
Background:
- Longitudinal studies often assume constant disability, which may not reflect reality in elderly populations.
- Understanding disability transitions is crucial for accurate mortality risk assessment.
Purpose of the Study:
- To examine the association between disability and mortality in older adults, considering changes in disability over time.
- To investigate how disability transitions influence mortality risk in the elderly.
Main Methods:
- Followed 1,294 participants (aged 65+) for a median of 8 years, measuring activities of daily living (ADLs).
- Utilized survival analysis with disability as a time-dependent variable, accounting for age and gender.
Main Results:
- Disability rates increased significantly over the follow-up period for both men and women.
- Mortality risk associated with basic ADLs dependency varied by age and gender, with higher risks for women at younger ages.
- Recovery from disability was low, particularly for women.
Conclusions:
- Disability progresses over time, and its association with mortality is dynamic and gender-specific.
- Elderly disabled women represent a vulnerable group needing focused interventions.
- Treating disability as a time-dependent variable is essential to accurately estimate its impact on mortality.