Lifestyle risk factors and utilization of preventive services in disabled elderly adults in the community

Lifestyle risk factor counseling and preventive health services are important to disabled elderly adults to prevent adverse health outcomes. We aimed to examine the prevalence of lifestyle risk factors and utilization of preventive health services in community-dwelling 2,982 adults, aged 60 years or older, with or without disability, in Southeastern Pennsylvania in 2004. The severity of disability was classified as no [independent activities of daily living (ADL) and instrumental activities of daily living (IADL)], some (independent ADL, dependent IADL), and severe limitation (dependent ADL). The prevalence of lifestyle risk factors (cigarette smoking, obesity, binge alcohol use, unhealthy diet, and physical inactivity) and utilization rate of a comprehensive list of preventive health services (risk factor counseling, disease management, vaccination, and cancer screening) were measured, across the disability categories. The prevalence of disability was 14.6% for some limitation and 10.3% for severe limitation. As disability increases, participants with unhealthy diet, physical inactivity, and obesity became more prevalent (8.8, 15.7, and 25.2% for no, some, and severe limitation, respectively) and fewer osteoporosis screenings were performed (51.5, 38.8, and 37.8%). Utilization of other services did not vary significantly across the disability categories, but participants with some or severe limitation were less likely than those without to receive needed health services overall (19.3% or 16.2 vs. 24.2%; P for trend = .047). In conclusion, disabled elderly adults have more undesirable lifestyle risk factors, but are less likely to receive needed health services than nondisabled counterparts. More attention is needed to this vulnerable population.