The Relationship between Disease and Function and Perceived Health in Very Frail Elders

Mulrow, Cynthia D.; Gerety, Meghan B.; Cornell, John E.; Lawrence, Valerie A.; Kanten, Deanna N.

doi:10.1111/j.1532-5415.1994.tb07484.x

Cited by 88 publications

(55 citation statements)

References 29 publications

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“…This finding seems in contrast with the notion that nursing home residents typically have multiple functional dependencies and frequent comorbid conditions [35], and it disagrees with previous findings in different settings. For example, Van Dijk et al [39], examining specifically nursing home residents with dementia, found they had more comorbidity relative to patients less cognitively impaired.…”

Section: Discussioncontrasting

confidence: 56%

“…Among patients diagnosed with dementia, functional status seems to relate to the severity of cognitive impairment, regardless of coexistent diseases [32][33][34]. On the other hand, despite etiology encompassing social, behavioral and environmental factors [35][36][37], the most important determinant of functional status remains the presence of comorbidity [38].…”

Section: Discussionmentioning

confidence: 99%

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Comorbidity and Drug Use in Cognitively Impaired Elderly Living in Long-Term Care

Landi

Gambassi²,

Lapane³

et al. 1998

Dement Geriatr Cogn Disord

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Cognitive impairment is associated with an increased mortality in older people. The prevalence and impact of comorbidity on functional status and mortality of demented patients has not been fully elucidated. Using a population-based data set, we describe the prevalence of cognitive impairment, functional status, principal comorbid conditions and 1-year survival for over 300,000 patients admitted to the nursing homes in five US states. Sixty-one percent of patients have some level of cognitive impairment, and this correlates with the degree of physical frailty. Severer cognitive impairment is associated with a higher mortality rate. Yet, patients with cognitive impairment appear to have fewer comorbid conditions and are less likely to receive medications and special treatments than residents with normal cognitive status. Additional studies are needed to understand whether demented patients may paradoxically be considered healthier or, instead, are only neglected.

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Section: Discussioncontrasting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Comorbidity and Drug Use in Cognitively Impaired Elderly Living in Long-Term Care

Landi

Gambassi²,

Lapane³

et al. 1998

Dement Geriatr Cogn Disord

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“…Disability was measured using the subscale somatic autonomy (17 items concerning perceived physical functioning) of the Dutch version of the Sickness Impact Profile (SIP) (De Bruin, 1996). The SIP was developed for patients with chronic diseases and is also used in nursing home populations (Rothman et al, 1989;Gerety et al, 1994;Mulrow et al, 1994). Cronbach's alpha of the Dutch version of the subscale somatic autonomy was 0.85 (Van Campen and Kerkstra, 1998).…”

Section: Measurement Instrumentsmentioning

confidence: 99%

The impact of depression and anxiety on well being, disability and use of health care services in nursing home patients

Smalbrugge

Pot

Jongenelis

et al. 2006

Int. J. Geriat. Psychiatry

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“…Identification of medical conditions associated with the most functional limitations would enable more accurate estimates of the potential benefits of intervention or disease prevention methods. In recent years, population studies have examined different aspects of the relationship between diseases and disability in the community (1-4) as well as in nursing homes (5). Some are crosssectional studies, which only examine associations, while longitudinal studies will identify predisposing factors.…”

mentioning

confidence: 99%

Impact of Chronic Diseases on Functional Limitations in Elderly Chinese Aged 70 Years and Over: A Cross-Sectional and Longitudinal Survey

Woo

et al. 1998

The Journals of Gerontology Series A: Biological Sciences and M

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Objective. To examine the association of some common medical conditions with functional limitation in elderly Chinese aged 70 years and over, to estimate the percentage of disability attributable to individual diseases, and to attempt to identify predisposing factors by documenting the development of functional limitation over an 18-month period in those subjects with a particular disease who were independent initially. Subjects and Method.The cross-sectional data set consisted of 2,032 (999 M, 1,033 F) subjects aged 70 years and over recruited by random sampling (stratified by age and sex) of all recipients of old-age and disability allowance, which covers over 90% of the elderly population. Information regarding medical condition and functional assessment of ten basic activities of daily living using the Barthel Index were obtained by personal interviews and physical assessment of the respondents at their places of residence. The longitudinal data set consisted of 1,334 subjects with no functional limitation at baseline who were alive after 18 months. Functional status was reassessed.Results. After adjusting for age and sex, diseases associated with severe functional limitation (Barthel Index <15) were dementia, stroke, Parkinson's disease, and fractures. Those associated with mild to moderate functional limitation were the same, with the addition of asthma and diabetes mellitus. The attributable fraction for severe limitation was highest for stroke, dementia, and fractures. Stroke and arthritis were identified as diseases predisposing to mild to moderate functional limitation over an 18-month period among those subjects who were independent initially.Conclusion. Stroke, dementia, and fractures were the main chronic diseases associated with severe functional limitation in elderly Hong Kong Chinese. Attempts to reduce the disability burden in this population should target these diseases. W ITH the aging of population in many countries, increasing attention is drawn to the rising health care costs as a result of the increased prevalence of many diseases with age. Apart from costs of hospitalization and drug expenditures, a proportion of the costs arises from disability or functional limitations attributable to diseases. The impact of functional limitation may be measured in terms of resources required from health and social service providers, as well as quality of life for individuals. Therefore it is important to examine the relationship between disease and disability. Identification of medical conditions associated with the most functional limitations would enable more accurate estimates of the potential benefits of intervention or disease prevention methods. In recent years, population studies have examined different aspects of the relationship between diseases and disability in the community (1-4) as well as in nursing homes (5). Some are crosssectional studies, which only examine associations, while longitudinal studies will identify predisposing factors.As in other Western countries, the population in Hon...

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The Relationship between Disease and Function and Perceived Health in Very Frail Elders

Cited by 88 publications

References 29 publications

Comorbidity and Drug Use in Cognitively Impaired Elderly Living in Long-Term Care

Comorbidity and Drug Use in Cognitively Impaired Elderly Living in Long-Term Care

The impact of depression and anxiety on well being, disability and use of health care services in nursing home patients

Impact of Chronic Diseases on Functional Limitations in Elderly Chinese Aged 70 Years and Over: A Cross-Sectional and Longitudinal Survey

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