title: ICF participation restriction is common in frail, community-dwelling older people: an observational cross-sectional study.
abstract: OBJECTIVE
  To determine the extent of participation restriction in a sample of frail older people, and to identify the domains of participation that are most restricted. A secondary aim was to determine which health and demographic factors were associated with participation restriction.
  
  
  METHODS
  An observational cross-sectional study.
  
  
  METHODS
  Adults recently discharged from an aged care and rehabilitation service in Australia who were enrolled in a clinical trial.
  
  
  METHODS
  One hundred and eighty-one community-dwelling adults aged over 70 years (mean age 84, standard deviation 5.7) who met the Cardiovascular Health Study criteria for frailty, had a Mini Mental State Examination score over 18 and a predicted life expectancy exceeding 12 months.
  
  
  METHODS
  Participation restriction was evaluated using the Reintegration to Normal Living Index.
  
  
  RESULTS
  Eighty percent of subjects reported participation restriction in at least one aspect of their life. Restricted participation was most prevalent in the areas of work in the home or community (114/181, 63%) and community mobility (92/181, 51%), and least common with regard to interpersonal relationships (9/181, 5%). Multivariate regression analysis showed that grip strength, mood, number of medical conditions and mobility were independently and significantly (P<0.05) associated with participation restriction, and explained 29% of the variance in participation restriction. Cognition and living alone were not significantly associated with participation restriction.
  
  
  CONCLUSIONS
  Participation restriction was common in this sample of frail, community-dwelling older people. It was associated with factors from multiple levels of the International Classification of Functioning, Disability and Health. Further research is suggested to investigate the causes and treatment of participation restriction.
authors.affiliation: The George Institute for Global Health, The University of Sydney, PO Box M201, Missenden Road, Sydney, NSW 2050, Australia. nfairhall@georgeinstitute.org.au
authors.forename: N
authors.initials: N
authors.lastname: Fairhall
authors.forename: C
authors.initials: C
authors.lastname: Sherrington
authors.forename: S E
authors.initials: SE
authors.lastname: Kurrle
authors.forename: S R
authors.initials: SR
authors.lastname: Lord
authors.forename: I D
authors.initials: ID
authors.lastname: Cameron
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006801:Humans; D057187:Independent Living; D007398:Interpersonal Relations; D051346:Mobility Limitation; D026761:Physical Therapy Specialty / Q000379:methods*; D012648:Self Care; D014937:Work