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Titolo:
PHYSICAL-DISABILITY IN OLDER ADULTS - A PHYSIOLOGICAL APPROACH
Autore:
FRIED LP; ETTINGER WH; LIND B; NEWMAN AB; GARDIN J; BURKE GL; ELSTER A; FURBERG D; HAPONIK E; HEISS G; KITZMAN D; KLOPFENSTEIN HS; LAMB M; LEFKOWITZ DS; LYLES MF; MITTELMARK MB; NUNN C; RILEY W; TELL GS; TOOLE JF; TUCKER B; BOMMER W; BERNICK C; DUXBURY A; HAAN M; HIRSCH C; KELLERMAN P; LEE M; POIRIER V; ROBBINS J; SCHENKER M; BRYAN RN; COMSTOCK G; CHABOT J; COMSTOCK GW; GERMAN PS; HILL J; KITTNER SJ; KUMANYIKA S; LEVINE D; LIMA J; POWE NR; PRICE TR; SZKLO M; TOCKMAN M; BUSBYWHITEHEAD MJ; IVES DG; JUNGREIS CA; KNEPPER L; KULLER LH; MCDONALD RH; MEILAHN E; MEYER P; NEWMAN A; ORCHARD T; RUTAN GH; SCHULZ R; SMITH E; WOLFSON SK; ANTONCULVER H; GARDIN JM; KNOLL M; KUROSAKI T; WONG N; GOTTDIENER J; HAUSNER E; HECHT G; OLEARY DH; POLAK JF; FUNK L; BOVILL E; CORNELL E; TRACY RP; ENRIGHT P; CALHOUN K; CALHOUN H; FESER B; RAUTAHARJU F; RAUTAHARJU P; BORHANI NO; FITZPATRICK AL; LIND BK; KRONMAL RA; PSATY BM; SISCOVICK DS; SHEMANSKI L; FISHER L; LONGSTRETH W; RAGUNATHAN T; WAHL PW; YANEZ D; BILD DE; MANOLIO TA; SAVAGE PJ; SMITH P;
Indirizzi:
JOHNS HOPKINS HLTH INST,WELCH CTR PREVENT EPIDEMIOL & CLIN RES,2024 EMONUMENTS BALTIMORE MD 21205 JOHNS HOPKINS MED INST,DEPT MED BALTIMORE MD 21205 JOHNS HOPKINS MED INST,DEPT EPIDEMIOL BALTIMORE MD 21205 WAKE FOREST UNIV,BOWMAN GRAY SCH MED,DEPT INTERNAL MED & PUBL HLTH SCI WINSTON SALEM NC 00000 UNIV WASHINGTON,DEPT BIOSTAT SEATTLE WA 98195 MED COLL PENN,DEPT MED PHILADELPHIA PA 19129 UNIV CALIF IRVINE,MED CTR,DIV CARDIOL IRVINE CA 92717
Titolo Testata:
Journal of clinical epidemiology
fascicolo: 7, volume: 47, anno: 1994,
pagine: 747 - 760
SICI:
0895-4356(1994)47:7<747:PIOA-A>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
INSTRUMENTAL ACTIVITIES; CARDIOVASCULAR HEALTH; DECLINE; DISEASE; ELDERS;
Keywords:
AGED; DISABILITY; EPIDEMIOLOGY; GERIATRICS; OUTCOME ASSESSMENT; RISK FACTORS;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
25
Recensione:
Indirizzi per estratti:
Citazione:
L.P. Fried et al., "PHYSICAL-DISABILITY IN OLDER ADULTS - A PHYSIOLOGICAL APPROACH", Journal of clinical epidemiology, 47(7), 1994, pp. 747-760

Abstract

Measures of physical function have been developed primarily to assesshealth status, prognosis, and service needs. They are now, increasingly, being used as outcome measures in studies seeking to determine thecauses of disability. However, the extent to which these standardizedmeasures, as they currently are constituted, are meaningful for the evaluation of underlying pathophysiology is not defined. To assess evidence for an etiologic rationale for these measures, we evaluated self-report of difficulty in physical function in the Cardiovascular HealthStudy, a study of 5201 men and women 65 years and older in four U.S. communities. We determined (by factor analysis) that self-reported difficulty with each of 17 tasks of daily life aggregates in four groups;i.e. difficulty in one task is associated with having difficulty in the other tasks in the group. These groups include (1) activities primarily dependent on mobility and exercise tolerance; (2) complex activities heavily dependent on cognition and sensory input; (3) selected basic self-care activities; and (4) upper extremity activities. Groups 2 and 3 are similar, but not identical, to Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL), respectively. We then tested whether these groupings were associated with different underlying impairments. Multiple logistic regression analyses indicatethat there are constellations of physiologic and disease characteristics significantly (p < 0.01) associated with difficulty in each of these four groups of activities, among 15 chronic diseases and conditionsascertained. Some diseases are uniquely associated with difficulty inone group of tasks; some overlap, and are associated with 2, 3 or 4 groups of tasks. The associations found with difficulty in performing tasks in groups 2 and 3 were frequently stronger than those with the larger groups of ADL or IADL tasks, suggesting increased specificity of associations found with these new groupings. These results suggest that re-grouping of tasks of daily life may provide a more refined physiologically-based outcome measure for use in evaluating causes of disability. The ability to define risk factors for disability may be enhanced by choosing outcome measures with a demonstrated physiologic rationale.

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Documento generato il 24/10/20 alle ore 09:03:17