The disablement process: factors associated with progression of disability and recovery in French elderly people.
OBJECTIVE
To study the factors associated with progression, recovery and death from different grades of disability in elderly people.


METHODS
The sample included 3198 participants of the PAQUID ('Personnes Agées QUID') cohort, aged 65 and over and community-dwellers at baseline. Subjects were re-interviewed 1, 3, 5, 8 and 10 years after baseline. A five-state Markov model was used to estimate transition intensities between four grades of disability and toward death. We used a hierarchic scale of disability, which combines basic and instrumental activities of daily living and mobility. Several explanatory variables were investigated: medical, personal and environmental factors.


RESULTS
The factors associated with progression and/or no recovery of disability were cardiovascular diseases, stroke and diabetes, low cognition, visual impairment and dyspnoea (for pathologies and impairments), older age, female gender, low educational level (for risk factors), depression (for intra-individual factor) and being married, recent hospitalization and number of drugs (for extra-individual factors). Older age, male gender, tobacco consumption and living in an urban area were associated with mortality.


CONCLUSIONS
These findings confirm the independent contribution of each group of variables in the disablement process and stress their different impact on progression of disability or on recovery from different grades of disability.
Pérès
Karine
K
INSERM U593, University of Bordeau x 2, France. karine.peres@isped.v.bordeaux2.fr
Verret
Catherine
C
Alioum
Ahmadou
A
Barberger-Gateau
Pascale
P
D000367:Age Factors; D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities; D018450:Disease Progression; D005260:Female; D005602:France; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008297:Male; D020127:Recovery of Function; D012307:Risk Factors