Prognostic factors of disability in older people: a systematic review.
OBJECTIVE
To systematically review the evidence on the influence of sociodemographic, lifestyle, and (bio)medical variables on the course of prevalent disability and transition rates to different outcome categories in community-dwelling older people.


METHODS
Articles were identified through searches of PubMed, EMBASE, and PsycINFO databases and reference lists of relevant articles. Prospective population studies that assessed disability at baseline and reported on associations between potential prognostic variables and disability were included. Methodological quality of studies was assessed by standardised criteria, after which relevant data were extracted. A synthesis of the available evidence was carried out.


RESULTS
Nine cohort studies reported transition rates and eight cohort studies presented multivariate analyses on prognostic factors. There was some heterogeneity among studies in definition and assessment of disability. There is moderate to strong evidence that higher age, cognitive impairment, vision impairment, and poor self-rated health are prognostic factors of disability.


CONCLUSIONS
Prognostic factors, partly modifiable, are identified that should be taken into account in targeting treatment and care for older people with disabilities. Further conceptual and methodological standardisation is required in order to enable a meta-analysis and obtain higher levels of evidence.
Tas
Umit
U
Department of General Practice, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands.
Verhagen
Arianne P
AP
Bierma-Zeinstra
Sita M A
SM
Odding
Else
E
Koes
Bart W
BW
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D003072:Cognition Disorders / Q000150:complications / Q000503:physiopathology*; D015331:Cohort Studies; D006233:Persons with Disabilities; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D011379:Prognosis; D014786:Vision Disorders / Q000150:complications / Q000503:physiopathology*