title: Modifiable impairments predict progressive disability among older persons.
abstract: Our purpose was to determine the extent to which a predetermined set of modifiable impairments predicted progression of disability.
  
  
  METHODS
  We conducted a 3-year follow-up of two community-based cohorts of older adults. The impairment areas included lower extremity, upper extremity, hearing, vision, and affect. Home management and social or productive activities were the domains of function investigated.
  
  
  RESULTS
  All five impairments were of at least borderline significance in predicting decline in both functional domains in both cohorts with the exception of hearing for home management activities. The five impairments together explained from 17% to 23% of the decline seen in the functional outcomes (partial R(2)s 0.17 to 0.23).
  
  
  CONCLUSIONS
  Five prevalent and potentially modifiable impairments explained much of the progressive disability experienced. Given the priority that older patients place on function as a health outcome, these impairments should be routinely assessed and modified.
authors.affiliation: Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, CT 06504, USA. mary.tinetti@yale.edu
authors.forename: Mary E
authors.initials: ME
authors.lastname: Tinetti
authors.forename: Heather
authors.initials: H
authors.lastname: Allore
authors.forename: Katy L B
authors.initials: KL
authors.lastname: Araujo
authors.forename: Teresa
authors.initials: T
authors.lastname: Seeman
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D015331:Cohort Studies; D003866:Depressive Disorder; D006233:Persons with Disabilities; D018450:Disease Progression; D006311:Hearing Disorders; D006801:Humans; D007326:Institutionalization; D035002:Lower Extremity; D008962:Models, Theoretical; D009069:Movement Disorders; D017063:Outcome Assessment, Health Care; D014481:United States; D034941:Upper Extremity; D014786:Vision Disorders