title: Perceived causes of disability added prognostic value beyond medical conditions and functional status.
abstract: OBJECTIVE
  This study's objective was to determine the incremental benefit of respondent subjective attribution of functional decline beyond relying solely on disease burden in predicting survival.
  
  
  METHODS
  A total of 9447 older adults from the Second Longitudinal Study on Aging, a probability sample of community dwelling adults aged 70 or older, were evaluated. Survival was based on status at follow-up interview 3-4 years after baseline interview. Logistic regression was performed using demographic variables and coexisting diseases as a baseline, then adding functional status measures (ADL, IADL) and individual subjective attribution of functional limitation in subsequent models.
  
  
  RESULTS
  The predictions improved significantly with the addition of functional status measures (P<0.001) and the individual subjective attribution of functional limitation (P<0.001). For example, the probability of mortality for individuals with cancer was 17.3%, but 28.8% of those with cancer and functional limitations died as did 50% of those with cancer who reported functional limitations attributable to cancer.
  
  
  CONCLUSIONS
  Among persons who can make a specific attribution of their functional limitation, the attribution may have value as a marker of severity of disease and serve as a good predictive measure for mortality, especially in specific illnesses such as cancer.
authors.affiliation: Division of Hematology-Oncology, UCLA Department of Medicine, Los Angeles, CA 90095-1687, USA. anaeim@mednet.ucla.edu
authors.forename: Arash
authors.initials: A
authors.lastname: Naeim
authors.forename: Emmett B
authors.initials: EB
authors.lastname: Keeler
authors.forename: David
authors.initials: D
authors.lastname: Reuben
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001294:Attitude to Health; D004185:Disability Evaluation; D004812:Epidemiologic Methods; D005260:Female; D015577:Geriatric Assessment; D006305:Health Status Indicators; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000401:mortality; D011379:Prognosis; D014481:United States / Q000453:epidemiology