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1 Yale University School of Medicine, Department of Internal Medicine, New Haven, Connecticut.
2 University of Washington School of Public Health, Department of Biostatistics, Seattle.
Background. The onset of disability in activities of daily living (ADLs) is considered a sentinel event in the life of an older person, but recent evidence suggests that newly disabled elders have high rates of recovery. We performed a longitudinal study to determine the burden and patterns of ADL disability among previously nondisabled, community-living older persons.
Methods. We studied 754 community-living persons, aged 70 years or older, who were categorized into three groups according to their risk for disability (low, intermediate, high). Participants were interviewed each month for 2 years to determine the presence and severity of disability in four key ADLs: bathing, dressing, walking, or transferring.
Results. Among the 690 nondecedents, the rates of any disability were 17.7%, 48.7%, and 65.2%, respectively, for the low-, intermediate-, and high-risk groups. Whereas only 6.9% of nondecedents in the low-risk group had more than 1 month of disability, 38.2% and 50.6% of nondecedents in the intermediate- and high-risk groups (i.e., physically frail), respectively, had multiple months and/or episodes of disability. The patterns of disability were quite diverse, with no single pattern representing the disability experience of more than half the decedents or nondecedents in any of the risk groups.
Conclusions. Disability among community-living older persons, particularly those who are physically frail, is a highly dynamic process with considerable diversity. Our results provide strong evidence to support an emerging paradigm of disability as a reversible, and often recurrent, event.
This article has been cited by other articles: (Search Google Scholar for Other Citing Articles)
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  T. M. Gill and E. A. Gahbauer Overestimation of Chronic Disability Among Elderly Persons Archives of Internal Medicine, December 12, 2005; 165(22): 2625 - 2630. [Abstract] [Full Text] [PDF]
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 T. M. Gill, H. G. Allore, T. R. Holford, and Z. Guo Hospitalization, Restricted Activity, and the Development of Disability Among Older Persons JAMA, November 3, 2004; 292(17): 2115 - 2124. [Abstract] [Full Text] [PDF]
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S. E. Hardy and T. M. Gill Recovery From Disability Among Community-Dwelling Older Persons JAMA, April 7, 2004; 291(13): 1596 - 1602. [Abstract] [Full Text] [PDF]
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 T. M. Gill and B. F. Kurland Prognostic Effect of Prior Disability Episodes among Nondisabled Community-living Older Persons Am. J. Epidemiol., December 1, 2003; 158(11): 1090 - 1096. [Abstract] [Full Text] [PDF]
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| All GSA journals | The Gerontologist |
| Journals of Gerontology Series B: Psychological Sciences and Social Sciences | |
