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Clinical Diagnosis and Disability Among Community Dwellers Aged 75 and Over: The Sydney Older Persons Study
Author(s) -
Waite Louise M.,
Creasey Helen,
Grayson David A.,
Edelbrock Dorothy,
Cullen John S.,
Brooks William S.,
Casey Barney J.,
Bennett Hayley P.,
Broe G. Anthony
Publication year - 2001
Publication title -
australasian journal on ageing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.63
H-Index - 34
eISSN - 1741-6612
pISSN - 1440-6381
DOI - 10.1111/j.1741-6612.2001.tb00356.x
Subject(s) - activities of daily living , dementia , medicine , parkinsonism , disease , gerontology , psychiatry , medical diagnosis , population , international classification of functioning, disability and health , rehabilitation , physical therapy , environmental health , pathology
Objectives : Disability is an important predictor of health and community service utilisation. Understanding its pathogenesis has implications for planning of future health services. The aim of our study was to examine the contribution of systemic, psychiatric and neurodegenerative diseases to disability in an “old‐old” population.Methods : 647 men and women over the age of 75 participated in the Sydney Older Person's Study. Disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and mobility was assessed using self report, informant and clinician assessments. Diagnoses of systemic, psychiatric, neurodegenerative diseases were made by clinicians. Individual disease contribution to disability was assessed using multiple regression analysis. Contribution to disability by the groups of systemic, neurodegenerative and psychiatric diagnoses was assessed, using hierarchical regression. Results : Neurodegenerative diseases were the major contributors to ADL impairment. Systemic and psychiatric diseases played a role in IADL and mobility impairment, as did the neurodegenerative diseases. Of the neurodegenerative diseases, dementia/cognitive impairment and Parkinsonism/gait slowing particularly contributed to disability. Self‐report under‐identified the role of the neurodegenerative diseases in disability. It also introduced a gender effect, that the clinical measures did not share to the same extent.Conclusions : Neurodegenerative diseases are important contributors to disability and assessments and diagnosis of neurodegenerative diseases should be included in disability assessments. Self report under‐identifies the importance of these conditions.