Geriatric conditions and disability: the Health and Retirement Study.
BACKGROUND
Geriatric conditions, such as incontinence and falling, are not part of the traditional disease model of medicine and may be overlooked in the care of older adults. The prevalence of geriatric conditions and their effect on health and disability in older adults has not been investigated in population-based samples.


OBJECTIVE
To investigate the prevalence of geriatric conditions and their association with dependency in activities of daily living by using nationally representative data.


METHODS
Cross-sectional analysis.


METHODS
Health and Retirement Study survey administered in 2000.


METHODS
Adults age 65 years or older (n = 11 093, representing 34.5 million older Americans) living in the community and in nursing homes.


METHODS
Geriatric conditions (cognitive impairment, falls, incontinence, low body mass index, dizziness, vision impairment, hearing impairment) and dependency in activities of daily living (bathing, dressing, eating, transferring, toileting).


RESULTS
Of adults age 65 years or older, 49.9% had 1 or more geriatric conditions. Some conditions were as prevalent as common chronic diseases, such as heart disease and diabetes. The association between geriatric conditions and dependency in activities of daily living was strong and significant, even after adjustment for demographic characteristics and chronic diseases (adjusted risk ratio, 2.1 [95% CI, 1.9 to 2.4] for 1 geriatric condition, 3.6 [CI, 3.1 to 4.1] for 2 conditions, and 6.6 [CI, 5.6 to 7.6] for > or =3 conditions).


CONCLUSIONS
The study was cross-sectional and based on self-reported data. Because measures were limited by the survey questions, important conditions, such as delirium and frailty, were not assessed. Survival biases may influence the estimates.


CONCLUSIONS
Geriatric conditions are similar in prevalence to chronic diseases in older adults and in some cases are as strongly associated with disability. The findings suggest that geriatric conditions, although not a target of current models of health care, are important to the health and function of older adults and should be addressed in their care.
University of Michigan, the Ann Arbor Veterans Affairs Healthcare System Geriatric Research, Education and Clinical Center, and the Ann Arbor Veterans Affairs Center for Practice Management and Outcomes Research, Ann Arbor, Michigan 48109, USA.
Christine T
CT
Cigolle
Kenneth M
KM
Langa
Mohammed U
MU
Kabeto
Zhiyi
Z
Tian
Caroline S
CS
Blaum
D000058:Accidental Falls / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002908:Chronic Disease; D003072:Cognition Disorders / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004244:Dizziness / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D005853:Geriatrics / Q000706:statistics & numerical data*; D006311:Hearing Disorders / Q000453:epidemiology; D006801:Humans; D008297:Male; D015995:Prevalence; D012179:Retirement; D014549:Urinary Incontinence / Q000453:epidemiology; D014786:Vision Disorders / Q000453:epidemiology