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All‐Cause 1‐, 5‐, and 10‐Year Mortality in Elderly People According to Activities of Daily Living Stage
Author(s) -
Stineman Margaret G.,
Xie Dawei,
Pan Qiang,
Kurichi Jibby E.,
Zhang Zi,
Saliba Debra,
HenrySánchez John T.,
Streim Joel
Publication year - 2012
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 - 10.1111/j.1532-5415.2011.03867.x
Subject(s) - medicine , activities of daily living , life expectancy , hazard ratio , proportional hazards model , gerontology , confidence interval , demography , stage (stratigraphy) , physical therapy , environmental health , population , paleontology , sociology , biology
Objectives To examine the independent association between five stages of activities of daily living ( ADL s) and mortality after accounting for known diagnostic and sociodemographic risk factors. Design For five stages of ADL s (0 to IV ), determined according to the severity and pattern of ADL limitations, unadjusted life expectancies and adjusted associations with mortality were estimated using a Cox proportional hazards regression model. Setting Community. Participants Nine thousand four hundred forty‐seven participants aged 70 and older from the second Longitudinal Study of Aging. Measurements One‐, 5‐, and 10‐year survival and time to death. Results Median life expectancy was 10.6 years for participants with no ADL limitations and 6.5, 5.1, 3.8, and 1.6 years for those at ADL stages I, II , III , and IV , respectively. The sociodemographic‐ and diagnostic‐adjusted hazard of death at 1 year was five times as great at stage IV as at stage 0 (hazard ratio = 5.6, 95% confidence interval = 3.8–8.3). The associations between ADL stage and mortality declined over time but remained statistically significant at 5 and 10 years. Conclusion ADL stage continued to explain mortality risk after adjusting for known risk factors including advanced age, stroke, and cancer. ADL stages might aid clinical care planning and policy as a powerful prognostic indicator particularly of short‐term mortality, improving on current ADL measures by profiling activity limitations of relevance to determining community support needs.