Development of and recovery from difficulty with activities of daily living: an analysis of national data.
BACKGROUND
National-level data are needed on predictors of mild physical impairment among older adults to assist policy makers with resource allocation.


METHODS
We analyzed data on adults above age 64 from the Medicare Current Beneficiary Survey (MCBS) with no activity of daily living (ADL) difficulties at baseline ( n = 14,226). Five ADLs were measured annually and recovery was defined as regaining complete ADL function at follow-up.


RESULTS
The strongest correlates of ADL difficulty were use of antipsychotic medications (adjusted odds ratio [AOR] = 1.93, 95% confidence interval [CI] = 1.44 to 2.58), instrumental ADL difficulty (AOR = 1.90, 95% CI = 1.74 to 2.07), and fair-poor general health (AOR = 1.59, 95% CI = 1.42 to 1.78). Only the number of incident ADL difficulties was associated with recovery (AOR = 0.02, 95% CI = 0.01 to 0.02).


CONCLUSIONS
Identifying factors associated with development of mild physical impairment could help direct patients toward preventive care programs to preempt decline in physical function.
Federman
Alex D
AD
Division of General Internal Medicine, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1087, New York, NY 10029, USA. alex.federman@mssm.edu
Penrod
Joan D
JD
Livote
Elayne
E
Hebert
Paul
P
Keyhani
Salomeh
S
Doucette
John
J
Siu
Albert L
AL
D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000375:Aging / Q000502:physiology*; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D002908:Chronic Disease; D016001:Confidence Intervals; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000523:psychology; D008603:Mental Health; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D011594:Psychometrics; D014481:United States
D000928:Antidepressive Agents