Risk factors for functional decline in older adults with arthritis

被引:166
作者
Dunlop, DD
Semanik, P
Song, J
Manheim, LM
Shih, V
Chang, RW
机构
[1] Northwestern Univ, Feinberg Sch Med, Inst Hlth Serv Res & Policy Studies, Chicago, IL 60611 USA
[2] Northwestern Univ, Multidisciplinary Clin Res Ctr Rheumatol, Chicago, IL USA
[3] Rehabil Inst Chicago, Chicago, IL 60611 USA
来源
ARTHRITIS AND RHEUMATISM | 2005年 / 52卷 / 04期
关键词
D O I
10.1002/art.20968
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective. Functional limitation is a major factor in medical costs. This study was undertaken to evaluate the prevalence of functional limitation among adults with arthritis and the frequency of functional decline over 2 years, and to investigate factors amenable to public health intervention that predict functional decline. Methods. Longitudinal data (1998-2000) from a cohort of 5,715 adults ages 65 years or older with arthritis from a national probability sample were analyzed. Function was defined based on ability to perform basic activities of daily living (ADL) tasks and instrumental ADL. Adjusted odds ratios (ORs) from a multiple logistic regression model were used to estimate the associations between functional decline and comorbid conditions, health behaviors, and economic factors. Results. Overall, 19.7% of this cohort had functional limitation at baseline, including 12.9% with ADL limitations. Over the subsequent 2 years, function declined in 13.6% of those at risk. Functional decline was most frequent among women (15.0%) and minorities (18.0% Hispanics, 18.7% African Americans) with arthritis. Lack of regular vigorous physical activity, the most prevalent risk factor (64%), almost doubled the odds of functional decline (adjusted OR 1.9, 95% confidence interval 1.5-2.4) after controlling for all risk factors. It was found that if all subjects engaged in regular vigorous physical activity, the expected functional decline could be reduced as much as 32%. Other significant predictors included older age, cognitive impairment, depressive symptoms, diabetes, physical limitations, no alcohol use, stroke, and vision impairment. Conclusion. Lack of regular vigorous physical activity is a potentially modifiable risk factor that could substantially reduce functional decline and associated health care costs. Prevention/intervention programs should include regular vigorous physical activity, weight maintenance, and medical intervention for health needs.
引用
收藏
页码:1274 / 1282
页数:9
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