title: Promoting declines in the prevalence of late-life disability: comparisons of three potentially high-impact interventions.
abstract: Although the prevalence of late-life disability has been declining, how best to promote further reductions remains unclear. This article develops and then demonstrates an approach for comparing the effects of interventions on the prevalence of late-life disability. We review evidence for three potentially high-impact strategies: physical activity, depression screening and treatment, and fall prevention. Because of the large population at risk for falling, the demonstrated efficacy of multi-component interventions in preventing falls, and the strong links between falls and disability, we conclude that, in the short run, multi-component fall-prevention efforts would likely have a higher impact than either physical activity or depression screening and treatment. However, longer-term comparisons cannot be made based on the current literature and may differ from short-run conclusions, since increases in longevity may temper the influences of these interventions on prevalence. Additional research is needed to evaluate longer-term outcomes of interventions, including effects on length and quality of life.
authors.affiliation: University of Medicine and Dentistry of New Jersey, New Brunswick, NJ 08903, USA. vfreedman@umdnj.edu
authors.forename: Vicki A
authors.initials: VA
authors.lastname: Freedman
authors.forename: Nancy
authors.initials: N
authors.lastname: Hodgson
authors.forename: Joanne
authors.initials: J
authors.lastname: Lynn
authors.forename: Brenda C
authors.initials: BC
authors.lastname: Spillman
authors.forename: Timothy
authors.initials: T
authors.lastname: Waidmann
authors.forename: Anne M
authors.initials: AM
authors.lastname: Wilkinson
authors.forename: Douglas A
authors.initials: DA
authors.lastname: Wolf
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D003863:Depression / Q000517:prevention & control; D006233:Persons with Disabilities; D015444:Exercise; D016330:Frail Elderly; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D040242:Risk Reduction Behavior; D016896:Treatment Outcome