Association of mobility limitations with incident disability among older adults: a population-based study

Heiland, Emerald G.; Welmer, Anna-Karin; Wang, Rui; Santoni, Giola; Angleman, Sara; Fratiglioni, Laura; Qiu, Chengxuan

doi:10.1093/ageing/afw076

Cited by 62 publications

(49 citation statements)

References 31 publications

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“…We found that all three measures of physical performance had independent associations with disability, similar to the recent findings for the associations of walking speed and standing balance with subsequent disability (Heiland et al, 2016). The different measures reflect the function of different physiological systems, as previously suggested by the finding in NSHD of independent associations with all-cause mortality rates .…”

Section: Interpretation Of Findingssupporting

confidence: 88%

“…A strength of the current study is that the baseline data were collected at age 53 (with follow-up 16 years later), whereas previous work has typically involved baseline assessment in the seventh (Nueesch et al, 2015;den Ouden et al, 2013) and eighth (Covinsky et al, 2006;Clark et al, 2012;Perera et al, 2016;Heiland et al, 2016) decades of life (with correspondingly shorter follow-up times). We used several stages of multivariable logistic regression to produce clinical prediction models for disability.…”

Section: Methodological Considerationsmentioning

confidence: 99%

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13can Measures of Physical Performance in Mid-Life Improve the Clinical Prediction of Disability in Early Old Age? Findings From a British Birth Cohort Study

2018

Age and Ageing

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Background: Poor performance in physical tests such as grip strength and walking speed is a risk factor for disability in old age, although whether such measures improve the discrimination of clinical prediction models when traditional clinical risk factors are already known is not clear. The prevalence of disability in mid-life is relatively low and hence screening in this age group may present an opportunity for early identification of those at increased future risk who may benefit most from preventative interventions. Methods: Data were drawn from two waves of the Medical Research Council National Survey of Health and Development. We examined whether several chronic conditions, poor health behaviours and lower scores on three measures of physical performance (grip strength, chair rise speed and standing balance time) at age 53 were associated with self-reported mobility and/or personal care disability at age 69. We used the area under the curve statistic (AUC) to assess model discrimination. Results: At age 69, 44% (826/1855) of participants reported mobility and/or personal care disability.Our final clinical prediction model included sex, knee osteoarthritis, taking 2+ medications, smoking, increased BMI and poor performance in all three physical tests, with an AUC of 0.740 compared with 0.708 for a model which did not include the performance measures. Conclusion: Measures of physical performance in midlife improve discrimination in clinical prediction models for disability over 16 years. Importantly, these and similar measures are also potential targets of future diet, exercise and pharmacological intervention in mid-life.

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Section: Interpretation Of Findingssupporting

confidence: 88%

Section: Methodological Considerationsmentioning

confidence: 99%

13can Measures of Physical Performance in Mid-Life Improve the Clinical Prediction of Disability in Early Old Age? Findings From a British Birth Cohort Study

2018

Age and Ageing

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“…After subgrouping for a lower unit (per 0.1 m/s, per 1 m/s and per SD) in gait speed, a lower gait speed of 0.1 m/s was not associated with worsening ADL (OR = 1.64, 95% CI: 0.80–3.38, I 2 = 85.0) while a lower gait speed of 1.0 m/s and 1 SD was associated with worsening ADL (OR = 4.40, 95% CI: 1.34–14.48, I 2 = 52.1; OR = 1.85, 95% CI: 1.44–2.36, I 2 = 62.8). Six articles pooling gait speed (low vs. high) with ADL favoured worsening in ADL (OR = 2.33, 95% CI: 1.58–3.44, I 2 = 94.2) ( Figure B). Four articles evaluating the association between gait speed (low vs. high) with IADL demonstrated worsening in IADL (OR = 1.93, 95% CI: 1.69–2.21, I 2 = 0.0) ( Figure B).…”

Section: Resultsmentioning

confidence: 99%

“…Three articles were pooled demonstrating a strong association between one leg balance (low vs. high) and a decline in ADL (OR = 2.74, 95% CI: 1.31–5.72, I 2 = 88.5) ( Figure A). Two articles reported timed up and go (slow vs. fast) with ADL ( Figure B).…”

Section: Resultsmentioning

confidence: 99%

Muscle mass, strength, and physical performance predicting activities of daily living: a meta‐analysis

Wang

Yao

Zirek

et al. 2019

J cachexia sarcopenia muscle

356

258

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Background Activities of daily living (ADLs) and instrumental activities of daily living (IADLs) are essential for independent living and are predictors of morbidity and mortality in older populations. Older adults who are dependent in ADLs and IADLs are also more likely to have poor muscle measures defined as low muscle mass, muscle strength, and physical performance, which further limit their ability to perform activities. The aim of this systematic review and meta‐analysis was to determine if muscle measures are predictive of ADL and IADL in older populations. Methods A systematic search was conducted using four databases (MEDLINE, EMBASE, Cochrane, and CINAHL) from date of inception to 7 June 2018. Longitudinal cohorts were included that reported baseline muscle measures defined by muscle mass, muscle strength, and physical performance in conjunction with prospective ADL or IADL in participants aged 65 years and older at follow‐up. Meta‐analyses were conducted using a random effect model. Results Of the 7760 articles screened, 83 articles were included for the systematic review and involved a total of 108 428 (54.8% female) participants with a follow‐up duration ranging from 11 days to 25 years. Low muscle mass was positively associated with ADL dependency in 5/9 articles and 5/5 for IADL dependency. Low muscle strength was associated with ADL dependency in 22/34 articles and IADL dependency in 8/9 articles. Low physical performance was associated with ADL dependency in 37/49 articles and with IADL dependency in 9/11 articles. Forty‐five articles were pooled into the meta‐analyses, 36 reported ADL, 11 reported IADL, and 2 reported ADL and IADL as a composite outcome. Low muscle mass was associated with worsening ADL (pooled odds ratio (95% confidence interval) 3.19 (1.29–7.92)) and worsening IADL (1.28 (1.02–1.61)). Low handgrip strength was associated with both worsening ADL and IADL (1.51 (1.34–1.70); 1.59 (1.04–2.31) respectively). Low scores on the short physical performance battery and gait speed were associated with worsening ADL (3.49 (2.47–4.92); 2.33 (1.58–3.44) respectively) and IADL (3.09 (1.06–8.98); 1.93 (1.69–2.21) respectively). Low one leg balance (2.74 (1.31–5.72)), timed up and go (3.41 (1.86–6.28)), and chair stand test time (1.90 (1.63–2.21)) were associated with worsening ADL. Conclusions Muscle measures at baseline are predictors of future ADL and IADL dependence in the older adult population.

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“…Functional disability is common in older adults, and it is often episodic and is associated with a high risk of subsequent health decline [4]. Mobility limitation, a one-leg balance stand less than five seconds or walking speed less than 0.8 m per second, predict future disability among older people [5]. An unhealthy lifestyle, characterized by physical inactivity, an unhealthy diet, and smoking, are also reported to be associated with greater hazard of disability among older people [6].…”

Section: Introductionmentioning

confidence: 99%

Gender differences in functional disability and self-care among seniors in Bangladesh

et al. 2017

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BackgroundDisability among older adults is a public health concern. To date there are no in-depth and comprehensive analyses on older adults’ disabilities in Bangladesh. This study investigated gender differences in the prevalence of disability and the socio-demographic factors associated with disability among older adults in Bangladesh.MethodsThis research used a sample of 4176 elderly males and females aged 60 years and over from a nationally representative data set- Bangladesh’s 2010 Household Income and Expenditure Survey. The study used both household level and individual level data and applied a wealth index, which was constructed based on household assets using principal component analysis. The Washington Group’s short set of questions on disability were used to measure disability. Chi-square tests and ordinal logistic regression models were fit.ResultsForty-two percent of older had some form of functional disability, including 5% of elderly with severe/extreme functional disability. Seven percent of older adults had a self-care disability, including 3% of elderly with a severe/extreme form of self-care disability. Elderly females suffered from all the studied disabilities, including functional and self-care disabilities in higher percentages, and had higher odds ratios of having both functional disability and self-care disability compared to elderly males. The study also identified some significant factors affecting functional disability and self-care disability, namely age, having a chronic condition, wealth status and place of residence, including divisional differences.ConclusionsPrograms aimed at reducing functional disability among seniors, particularly elderly females, should be granted the highest priority in Bangladesh.Electronic supplementary materialThe online version of this article (doi:10.1186/s12877-017-0577-2) contains supplementary material, which is available to authorized users.

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Association of mobility limitations with incident disability among older adults: a population-based study

Abstract: balance and walking speed tests are simple clinical procedures that can indicate hierarchical risk of ADL dependence in older adults.

Cited by 62 publications

References 31 publications

13can Measures of Physical Performance in Mid-Life Improve the Clinical Prediction of Disability in Early Old Age? Findings From a British Birth Cohort Study

13can Measures of Physical Performance in Mid-Life Improve the Clinical Prediction of Disability in Early Old Age? Findings From a British Birth Cohort Study

Muscle mass, strength, and physical performance predicting activities of daily living: a meta‐analysis

Gender differences in functional disability and self-care among seniors in Bangladesh

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