title: Development of and recovery from difficulty with activities of daily living: an analysis of national data.
abstract: 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.
authors.affiliation: 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
authors.forename: Alex D
authors.initials: AD
authors.lastname: Federman
authors.forename: Joan D
authors.initials: JD
authors.lastname: Penrod
authors.forename: Elayne
authors.initials: E
authors.lastname: Livote
authors.forename: Paul
authors.initials: P
authors.lastname: Hebert
authors.forename: Salomeh
authors.initials: S
authors.lastname: Keyhani
authors.forename: John
authors.initials: J
authors.lastname: Doucette
authors.forename: Albert L
authors.initials: AL
authors.lastname: Siu
mesh_terms: 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
chemical_list: D000928:Antidepressive Agents