title: Geriatric impairments and disability: the cardiovascular health study.
abstract: OBJECTIVE
  To determine the relative importance of geriatric impairments (in muscle strength, physical capacity, cognition, vision, hearing, and psychological status) and chronic diseases in predicting subsequent functional disability in longitudinal analyses.
  
  
  METHODS
  Longitudinal data from the Cardiovascular Health Study were analyzed. Multivariable Cox hazards regression modeling was used to analyze associations between time-dependent predictors and onset of disability in activities of daily living (ADLs) and mobility.
  
  
  METHODS
  Four communities across the United States (Sacramento County, CA; Washington County, MD; Forsyth County, NC; and Allegheny County, PA).
  
  
  METHODS
  Five thousand eight hundred eighty-eight elderly persons.
  
  
  METHODS
  Data were collected annually through in-person examinations.
  
  
  RESULTS
  ADL disability developed in 15% of participants and mobility disability in 30%. A single multivariable model was developed that included demographics, marital status, body mass index, and number of impairments and diseases. The hazard ratios (HRs) of having one, two, and three or more geriatric impairments (vs none) for the outcome of ADL disability were 2.12 (95% confidence interval (CI)=1.63-2.75), 4.25 (95% CI=3.30-5.48), and 7.87 (95% CI=6.10-10.17), respectively, and for having one, two, and three or more chronic diseases were 1.75 (95% CI=1.41-2.19), 2.45 (95% CI=1.95-3.07), and 3.26 (95% CI=2.53-4.19), respectively. Similarly, the HRs of having one, two, and three or more impairments for the outcome of mobility disability were 1.48 (95% CI=1.27-1.73), 2.08 (95% CI=1.77-2.45), and 3.70 (95% CI=3.09-4.42), respectively, and for having one, two, and three or more diseases were 2.06 (95% CI=1.76-2.40), 2.80 (95% CI=2.36-3.31), and 4.20 (95% CI=3.44-5.14), respectively.
  
  
  CONCLUSIONS
  Number of geriatric impairments was more strongly associated than number of chronic diseases with subsequent ADL disability and nearly as strongly associated with the subsequent mobility disability.
authors.affiliation: Section of General Medicine, Department of Internal Medicine, School of Medicine, Yale University, New Haven, Connecticut, USA. sarwat.chaudhry@yale.edu
authors.forename: Sarwat I
authors.initials: SI
authors.lastname: Chaudhry
authors.forename: Gail
authors.initials: G
authors.lastname: McAvay
authors.forename: Yuming
authors.initials: Y
authors.lastname: Ning
authors.forename: Heather G
authors.initials: HG
authors.lastname: Allore
authors.forename: Anne B
authors.initials: AB
authors.lastname: Newman
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Gill
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000072038:Cardiac Rehabilitation; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D008297:Male; D009017:Morbidity / Q000639:trends; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology