title: Age at disability onset and self-reported health status.
abstract: BACKGROUND
  The critical importance of improving the well-being of people with disabilities is highlighted in many national health plans. Self-reported health status is reduced both with age and among people with disabilities. Because both factors are related to health status and the influence of the age at disability onset on health status is unclear, we examined the relationship between disability onset and health status.
  
  
  METHODS
  The U.S. 1998-2000 Behavioral Risk Factor Surveillance system (BRFSS) provided data on 11,905 adults with disability. Bivariate logistic regression analysis modeled the relationship between age at disability onset (based on self-report of duration of disability) and fair/poor self-perceived health status, adjusting for confounding variables.
  
  
  RESULTS
  Key variables included demographics and other measures related to disability and general health status. Disability onset after 21 years of age showed significant association with greater prevalence of fair/poor health compared to early disability onset, even adjusting for current age and other demographic covariates. Compared with younger onset, the adjusted odds ratios (OR) were ages 22-44: OR 1.52, ages 45-64: OR 1.67, and age > or =65: OR 1.53.
  
  
  CONCLUSIONS
  This cross-sectional study provides population-level, generalizable evidence of increased fair or poor health in people with later onset disability compared to those with disability onset prior to the age of 21 years. This finding suggests that examining the general health of people with and those without disabilities might mask differences associated with onset, potentially relating to differences in experience and self-perception. Future research relating to global health status and disability should consider incorporating age at disability onset. In addition, research should examine possible differences in the relationship between age at onset and self-reported health within specific impairment groups.
authors.affiliation: College of Public Health and Health Professions, University of Florida, PO Box 100231 Gainesville, FL 32610, USA. jamoom@phhp.ufl.edu
authors.forename: Eric W
authors.initials: EW
authors.lastname: Jamoom
authors.forename: Willi
authors.initials: W
authors.lastname: Horner-Johnson
authors.forename: Rie
authors.initials: R
authors.lastname: Suzuki
authors.forename: Elena M
authors.initials: EM
authors.lastname: Andresen
authors.forename: Vincent A
authors.initials: VA
authors.lastname: Campbell
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D040343:Behavioral Risk Factor Surveillance System; D006233:Persons with Disabilities; D005260:Female; D006304:Health Status; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D014481:United States