Premium
Persistent Mobility Deficit in the Absence of Deficits in Activities of Daily Living: A Risk Factor for Mortality
Author(s) -
Khokhar Shafiq R.,
Stern Yaakov,
Bell Karen,
Anderson Karen,
Noe Enrique,
Mayeux Richard,
Albert Steven M.
Publication year - 2001
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1046/j.1532-5415.2001.4911251.x
Subject(s) - medicine , risk factor , activities of daily living , gerontology , physical therapy
OBJECTIVES: To investigate the extent to which self‐reported mobility deficit in the absence of impairment in activities of daily living (ADL) is associated with elevated mortality risk. DESIGN: Prospective cohort study, with annual assessments of mobility and ADL status and ongoing monitoring of vital status. SETTING: Population‐based cohort drawn from Medicare enrollees in New York City. PARTICIPANTS: One thousand two hundred ninety‐eight older adults reporting functional status at baseline (1992–1994) and 2 years later. MEASUREMENTS: Subjects reported mobility (e.g., walking, climbing stairs, and rising from a chair) and ADL (e.g., bathing, toilet use, dressing, grooming, and feeding) limitations. Two‐year functional status trajectories were noted. We used two additional follow‐up periods, at 2 and 4 years, to examine the likelihood that older people with mobility deficit may face an increased risk of death without first passing through a state of enduring ADL disability. RESULTS: At 2 years, 12.7% had incident mobility deficit without ADL disability, and 21.3% were persistently disabled in mobility without ADL disability. Relative to subjects free of disability at baseline and follow‐up, risk of mortality in the incident mobility deficit group was elevated at 2 and 4 years but did not achieve statistical significance. By contrast, for subjects with persistent mobility impairment who did not report ADL impairment, the mortality risk was significantly elevated both at 2 years (relative risk (RR) = 2.5; 95% confidence interval (CI) = 1.1–5.7)) and 4 years (RR = 2.9; 95% CI = 1.7–4.9)) of follow‐up. Mortality was significantly elevated in this group in analyses restricted to respondents with no or only one comorbid condition. CONCLUSION: Continuing, self‐reported mobility impairment in the absence of ADL deficit is a risk factor for mortality. Older people with self‐reported mobility deficit face an increased risk of mortality without first passing through enduring states of ADL disability. J Am Geriatr Soc 49:1539–1543, 2001.