title: The impact of multiple impairments on disability in community-dwelling older people.
abstract: BACKGROUND
  we have tested the hypothesis that the co-occurrence of common impairments (motor and cognitive impairments, vision and hearing loss, depressive symptoms) of later life have exacerbating effects on disability [activities and instrumental activities of daily living, social and role function, (in)activity].
  
  
  METHODS
  data were drawn from a community-based sample of 624 people aged 57 and older.
  
  
  RESULTS
  motor impairments and depressive symptoms were associated with all disability measures, even when the effects of other impairments, age and gender were controlled. This indicates independent, predominant effects of motor impairments and depressive symptoms. Although several significant first-order interaction effects (indicating exacerbation) of impairments on disability were found, they were not very strong, but vision and hearing losses exacerbate the impact of the other impairments on disability.
  
  
  CONCLUSIONS
  impairments, particularly motor impairments and depressive symptoms, largely act 'solo', by main effects on disability. Only a few combinations including vision or hearing loss further exacerbate the effects of other impairments on disability.
authors.affiliation: Northern Centre for Healthcare Research (NCH) and Department of Health Sciences, University of Groningen, Groningen, The Netherlands. g.kempen@medsoc.unimaas.nl
authors.forename: G I
authors.initials: GI
authors.lastname: Kempen
authors.forename: L M
authors.initials: LM
authors.lastname: Verbrugge
authors.forename: S S
authors.initials: SS
authors.lastname: Merrill
authors.forename: J
authors.initials: J
authors.lastname: Ormel
mesh_terms: D000203:Activities of Daily Living / Q000145:classification*; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D004185:Disability Evaluation; D005260:Female; D034381:Hearing Loss / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D012307:Risk Factors; D012803:Sick Role; D014786:Vision Disorders / Q000453:epidemiology