Population attributable risk for functional disability associated with chronic conditions in Canadian older adults.
OBJECTIVE
to investigate the population impact on functional disability of chronic conditions individually and in combination.


METHODS
data from 9,008 community-dwelling individuals aged 65 and older from the Canadian Study of Health and Aging (CSHA) were used to estimate the population attributable risk (PAR) for chronic conditions after adjusting for confounding variables. Functional disability was measured using activity of daily living (ADL) and instrumental activity of daily living (IADL).


RESULTS
five chronic conditions (foot problems, arthritis, cognitive impairment, heart problems and vision) made the largest contribution to ADL- and IADL-related functional disabilities. There was variation in magnitude and ranking of population attributable risk (PAR) by age, sex and definition of disability. All chronic conditions taken simultaneously accounted for about 66% of the ADL-related disability and almost 50% of the IADL-related disability.


CONCLUSIONS
in community-dwelling older adults, foot problems, arthritis, cognitive impairment, heart problems and vision were the major determinants of disability. Attempts to reduce disability burden in older Canadians should target these chronic conditions; however, preventive interventions will be most efficient if they recognize the differences in the drivers of PAR by sex, age group and type of functional disability being targeted.
Griffith
Lauren
L
Department of Clinical Epidemiology and Biostatistics, McMaster University, DTC-314, 1280 Main Street West, Hamilton, ON, Canada, L8S 4L8. griffith@mcmaster.ca
Raina
Parminder
P
Wu
Hongmei
H
Zhu
Bin
B
Stathokostas
Liza
L
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001168:Arthritis / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology*; D003072:Cognition Disorders / Q000453:epidemiology; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005534:Foot Diseases / Q000453:epidemiology; D006331:Heart Diseases / Q000453:epidemiology; D016852:Housing for the Elderly; D006801:Humans; D008297:Male; D011634:Public Health / Q000706:statistics & numerical data; D012111:Residence Characteristics; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014786:Vision Disorders / Q000453:epidemiology