The effects of specific medical conditions on the functional limitations of elders in the Framingham Study.

American journal of public health - Tập 84 Số 3 - Trang 351-358 - 1994
Andrew A. Guccione1, David T. Felson, Jennifer J. Anderson, John M. Anthony, Yuqing Zhang, Peter W.F. Wilson, Margaret Kelly‐Hayes, Philip A. Wolf, Bernard E. Kreger, W B Kannel
1Arthritis Center, Boston University School of Medicine, MA.

Tóm tắt

OBJECTIVES. The purpose of this study was to identify associations between specific medical conditions in the elderly and limitations in functional tasks; to compare risks of disability across medical conditions, controlling for age, sex, and comorbidity; and to determine the proportion of disability attributable to each condition. METHODS. The subjects were 709 noninstitutionalized men and 1060 women of the Framingham Study cohort (mean age 73.7 +/- 6.3 years). Ten medical conditions were identified for study: knee osteoarthritis, hip fracture, diabetes, stroke, heart disease, intermittent claudication, congestive heart failure, chronic obstructive pulmonary disease, depressive symptomatology, and cognitive impairment. Adjusted odds ratios were calculated for dependence on human assistance in seven functional activities. RESULTS. Stroke was significantly associated with functional limitations in all seven tasks; depressive symptomatology and hip fracture were associated with limitations in five tasks; and knee osteoarthritis, heart disease, congestive heart failure, and chronic obstructive pulmonary disease, were associated with limitations in four tasks each. CONCLUSIONS. In general, stroke, depressive symptomatology, hip fracture, knee osteoarthritis, and heart disease account for more physical disability in noninstitutionalized elderly men and women than other diseases.

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Tài liệu tham khảo

Verbrugge LM, Lepkowski JM, Konkol LL. Levels of disability among US adults with arthritis. J GerontoL 1991;46:S71-S83.

Kaplan GA. Epidemiologic observations on the compression of morbidity. JAging Health. 1991;3:155-171.

Mor V, Murphy J, Masterson-Allen S, etal. Risk of functional decline among well elders. J Clin EpidemioL 1989;42:895-904.

10.2105/AJPH.79.6.703

10.1093/geronj/45.3.M101

10.1111/j.1532-5415.1985.tb02855.x

Pinsky JL, 1991, JAgingHealth., 3, 247

Nickel JT, Chirikos TN. Functional disability of elderly patients with long-term coronary heart disease: a sex-stratified analysis. J GerontoL 1990;45:S60-S68.

10.2105/AJPH.80.11.1363

Harris T, Kovar MG, Suzman R, Kleinman JC, Feldman JJ. Longitudinal study Public Health. 1989;79:698-702. of physical ability in the oldest-old. Am J

Cook NR, 1989, Epidemiol., 130, 66

10.1093/geronj/45.5.M163

Berkman LF, Berkman CS, Kasl S, etal. cal health and functioning in the elderly. Depressive symptoms in relation to physi-Am JEpidemiol. 1986;124:372-388.

disability. Am J Public Health. 1990;80:

945-949.

Yelin EH, Spitz PP. Transitions in health stroke: the Framingham Study. Arch Phys need for institutionalization following Med Rehabil. 1988;69:415-418.

10.1016/0895-4356(88)90157-6

10.1093/geronj/45.1.M3

10.1093/oxfordjournals.aje.a115051

10.1001/jama.1989.03430070055030

Lair T, Lefkowitz D. Mental Health and Functional Status of Residents of Nursing and Personal Care Homes. Rockville, Md: Public Health Service; September 1990. DHHS publication PHS 90-3470. National Medical Expenditure Survey Research Findings 7, Agency for Health Care Policy and Research.

Kellgren JH, Lawrence JS. Atlas of Standard Radiographs: The Epidemiology of Chronic Rheumatism. Vol 2. Oxford, England: Blackwell Scientific Publications; 1963.

Samet JM. Definitions and methodology in COPD research. In: Hensley MJ, Saunders NA, eds. Clinical Epidemiology of Chronic Obstructive Pulmonary Disease. New York, NY: Marcel Dekker Inc; 1989:1-22.

10.1212/WNL.42.1.115

Folstein MF, Folstein SE. Syndromes of altered mental state. In: Hazzard WR, Andres R, Bierman EL, Blass JP, eds. Principles of Geriatric Medicine and Gerontology. 2nd ed. New York, NY: McGraw-Hill Inc; 1990:1089-1101.

10.1177/014662167700100306

Rosow I, Breslau N. A Guttman health scale for the aged. JGerontoL 1966;21:556-559.

10.2307/3349677

10.2105/AJPH.71.11.1202

10.2105/AJPH.82.6.841

10.1002/sim.4780030206

10.1001/jama.1989.03430070062031

10.2307/3350223