title: Health and function in the old and very old.
abstract: This report advocates conceptual separation and parallel assessment of medically diagnosed health conditions and functional disability in clinical and epidemiological studies of the aged. Data from a study of urban elderly are presented to demonstrate how this can be done and to reexamine the meaning of self-reported illness and disability. One hundred thirteen subjects 74 to 95 years old, recruited from a longitudinal study of a representative sample of the elderly population of Cleveland, Ohio, participated in structured interviews and epidemiologically based medical examinations, conducted by a physician-nurse team at the place of residence. The presence or absence of 11 common chronic conditions was determined according to preestablished criteria, by self-report and, separately, by medical diagnostic evaluation. Functional disability was estimated by self-report and by physician-nurse assessment, using established measures of mobility and activities of daily living. Results indicate that interview self-report can provide useful estimates of the prevalence of medical conditions and functional disabilities in elderly populations, although self-report alone is not a sufficiently sensitive measure to be used for case-finding or diagnosis. When functional disabilities are matched against the specific medical conditions that cause them and disease-specific mortality is also taken into account, a three-dimensional classification results that has implications for future clinical and survey work with the elderly.
authors.affiliation: Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, Ohio 44106.
authors.forename: A B
authors.initials: AB
authors.lastname: Ford
authors.forename: S J
authors.initials: SJ
authors.lastname: Folmar
authors.forename: R B
authors.initials: RB
authors.lastname: Salmon
authors.forename: J H
authors.initials: JH
authors.lastname: Medalie
authors.forename: A W
authors.initials: AW
authors.lastname: Roy
authors.forename: S S
authors.initials: SS
authors.lastname: Galazka
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003933:Diagnosis; D005260:Female; D005853:Geriatrics; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans