title: Associating the onset of motor impairments with disability progression in nursing home residents.
abstract: OBJECTIVE
  To evaluate the association between the onset of movement impairments and disability progression in nursing home residents.
  
  
  METHODS
  Retrospective cohort analysis of data from the State of New York Minimal Data Set, version 2.0, between November 1998 and October 1999. Participants were nursing home residents (n = 84,346) in the State of New York. Items defined as "functional limitation in range of motion" and "lack of voluntary movement" served as measures of movement impairments. Scores on the activities of daily living summary scale served as a measure of disability. Age, sex, measures of cognition, depression, and measures of medical stability served as adjustment variables.
  
  
  RESULTS
  After adjusting for age, sex, cognition, depression, and measures of medical stability, the onset of either singular or combined movement impairments in voluntary movement or range of motion was associated with a concurrent step-wise loss in activities of daily living (P < 0.001). The progression in activities of daily living loss occurred regardless of location or limb type.
  
  
  CONCLUSIONS
  This study directly links the onset of movement impairments with disability progression. These findings have important implications for physiatrists and other practitioners of geriatric rehabilitation.
authors.affiliation: Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital and the Hebrew Rehabilitation Center for Aged, Research and Training Institute, Boston, Massachusetts 02131, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Bean
authors.forename: Dan K
authors.initials: DK
authors.lastname: Kiely
authors.forename: Suzanne G
authors.initials: SG
authors.lastname: Leveille
authors.forename: John
authors.initials: J
authors.lastname: Morris
mesh_terms: D000203:Activities of Daily Living; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D006233:Persons with Disabilities; D018450:Disease Progression; D005260:Female; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006707:Homes for the Aged; D006801:Humans; D008297:Male; D009069:Movement Disorders / Q000150:complications*; D018908:Muscle Weakness / Q000209:etiology*; D009518:New York; D009735:Nursing Homes; D016059:Range of Motion, Articular; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index