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Updated: Jun 14, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

Disability occurrence and proximity to death.

Bart Klijs¹, Johan P Mackenbach, Anton E Kunst

¹Department of Public Health, Erasmus MC, Rotterdam, The Netherlands. b.klijs@erasmusmc.nl

Disability and Rehabilitation

|April 9, 2010

Summary

Disability in daily living activities is more strongly linked to nearing death than to age itself. This suggests future increases in life expectancy may shift the disability burden to older individuals.

Area of Science:

Gerontology
Public Health
Epidemiology

Background:

Understanding factors influencing disability is crucial for public health planning.
Age is traditionally considered a primary risk factor for disability.
The relationship between proximity to death and disability requires further investigation.

Purpose of the Study:

To determine if proximity to death is a stronger predictor of disability occurrence than chronological age.
To analyze the association between disability and both age and proximity to death.

Main Methods:

Utilized data from the Dutch GLOBE longitudinal study, including self-reported disability and vital status over six annual waves and a 12-year mortality follow-up.
Employed Logit and Poisson regression models to assess the relationship between disability occurrence, age, and proximity to death.

Related Experiment Videos

Last Updated: Jun 14, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

Main Results:

Regression models incorporating proximity to death demonstrated a better fit for activities of daily living (ADL) disability compared to age-based models.
ADL disability prevalence and incidence increased significantly with proximity to death (20.0% and 18.9% annually, respectively), as did severity (4.1% annually).
While functional impairments showed a stronger relation to age, ADL disability prevalence increased more sharply with age in older cohorts (23.0% annually for >70 years).

Conclusions:

The significant association between ADL disability and proximity to death indicates a substantial portion of the disability burden may be concentrated in the final years of life.
Projected increases in life expectancy may lead to a greater proportion of disability occurring at older ages.
These findings have implications for healthcare resource allocation and long-term care planning.