title: Ten-year change in disability prevalence and related factors in two generations of French elderly community dwellers: data from the PAQUID study.
abstract: OBJECTIVE
  Some studies have reported a decline in disability prevalence in older people, but few data were available for Europe, especially for France. Our aim was to study the 10-year evolution of disability prevalence in elderly community dwellers and related factors.
  
  
  METHODS
  Two generations of subjects aged 75 to 84, participants in the PAQUID (Personnes Agées QUID) cohort were compared. The first generation included 1496 subjects (born between 1903 and 1912) and the second 910 subjects (born between 1913 and 1922). Three domains of disability were assessed: mobility, Activities of Daily Living (ADL) and Instrumental ADL (IADL). Logistic regressions were used to explain the effect of generation on disability, controlling for sociodemographic characteristics, impairment, life-style, medical care, and social support.
  
  
  RESULTS
  The percentage of subjects fully independent increased from 13.5 to 23.3% (p < 0.001). A large decline in disability prevalence independent of the controlled factors was observed for mobility in both genders [Odds Ratio for the second generation (OR(G2)) = 0.48, 95% CI 0.38-0.60]. When adjusting for age and education, the risk of IADL disability was significantly lower in women in the second generation (ORG2 0.61, 95% CI 0.49-0.77), and the generation effect was strengthened when adjusting for the other covariates, but unchanged in men (ORG2 1.09, 95% CI 0.81-1.48). There was no significant change for ADL.
  
  
  CONCLUSIONS
  A significant decline in disability prevalence was observed over 10 years, which was not explained by the selected covariates. These aggregate changes differed by gender, education, and the domain of disability considered.
authors.affiliation: INSERM U593, Case 11, Université Victor Segalen Bordeaux 2, 146, rue Léo Saignat, 33076 Bordeaux Cedex, France. Karine.Peres@isped.u-bordeaux2.fr
authors.forename: Karine
authors.initials: K
authors.lastname: Pérès
authors.forename: Catherine
authors.initials: C
authors.lastname: Helmer
authors.forename: Luc
authors.initials: L
authors.lastname: Letenneur
authors.forename: Hélène
authors.initials: H
authors.lastname: Jacqmin-Gadda
authors.forename: Pascale
authors.initials: P
authors.lastname: Barberger-Gateau
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D004493:Education; D005260:Female; D005602:France / Q000453:epidemiology; D015577:Geriatric Assessment / Q000379:methods*; D006299:Health Services for the Aged; D006801:Humans; D008019:Life Style; D008137:Longitudinal Studies; D008297:Male; D051346:Mobility Limitation; D015999:Multivariate Analysis; D015995:Prevalence; D012737:Sex Factors; D012944:Social Support