Screening for pre-clinical disability in different residential settings.
BACKGROUND
Preventing disability and offering effective interventions to older people during early decline in function is most likely to be effective if those most at risk of progressive disablement are able to be identified. Similarly the ability to easily identify a group with similar functional profile from disparate sectors of the community is of significant benefit to researchers. This study aimed to (1) describe the use of a pre-clinical disability screening tool to select a functionally comparable group of older men and women with early functional limitation from different settings, and (2) explore factors associated with function and disability.


METHODS
Self-reported function and disability measured with the Late-Life Function and Disability Instrument along with a range of physical performance measurements were compared across residential settings and gender in a sample of 471 trial participants identified as pre-clinically disabled after being screened with the Fried pre-clinical disability tool. Factors that might lie on the pathway to progressive disablement were identified using multiple linear regression analysis.


RESULTS
We found that a sample population, screened for pre-clinical disability, had a functional status and disability profile reflecting early functional limitation, regardless of residential setting or gender. Statistical models identified a range of factors associated with function and disability which explained a greater degree of the variation in function, than disability.


CONCLUSIONS
We selected a group of people with a comparable function and disability profile, consistent with the pre-clinical stage of disability, from a sample of older Australian men and women from different residential settings using the Fried pre-clinical disability screening tool. The results suggest that the screening tool can be used with greater confidence for research, clinical and population health purposes. Further research is required to examine the validity of the tool. These findings offer insight into the type of impairment factors characterising early functional loss that could be addressed through disability prevention initiatives.


BACKGROUND
ACTRN01206000431527.
Gibson
Kate
K
1Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Day
Lesley
L
Hill
Keith D
KD
Jolley
Damien
D
Newstead
Stuart
S
Cicuttini
Flavia
F
Segal
Leonie
L
Flicker
Leon
L
D000203:Activities of Daily Living / Q000523:psychology; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000523:psychology / Q000706:statistics & numerical data; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D016852:Housing for the Elderly; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D012111:Residence Characteristics; D012307:Risk Factors; D014739:Victoria / Q000453:epidemiology