title: Causes of decreased activity of daily life in elderly patients who need daily living care.
abstract: OBJECTIVE
  The causes of decreased activity of daily life (ADL) in elderly patients include cerebrovascular diseases, bone fracture by falls, and dementia. The present study was conducted among elderly patients with decreased ADL who were hospitalized in nursing wards in order to investigate the causes of becoming early bedridden and to determine precautionary measures against decreased ADL.
  
  
  METHODS
  The study subjects were 224 elderly patients with decreased ADL (mean age: 83.3 ± 8.0 years) and 49 outpatients without decreased ADL (mean age: 76.8 ± 5.3 years). Current age, age at the start of ADL decrease, medical history and history of smoking were investigated.
  
  
  RESULTS
  In the groups with decreased ADL, current age and the age of becoming bedridden in non-diabetic versus diabetic groups were 84.7 ± 7.9 versus 80.3 ± 7.5 and 82.7 ± 8.3 versus 77.6 ± 8.0 years, respectively, both showing significantly lower values in the diabetic group (P < 0.05). Multiple regression analysis revealed that sex difference and diabetes were the factors determining the age of becoming early bedridden. Diabetic patients with smoking habit were significantly younger than diabetic and non-diabetic patients without smoking habit.
  
  
  CONCLUSIONS
  Sex difference, smoking habit and presence of diabetes mellitus are independent risk factors of becoming early bedridden. Therefore, the major targets of medical care among elderly should be diabetic men with a smoking habit to lower the risks of decreased ADL.
authors.affiliation: Department of Internal and Geriatric Medicine, Kobe University Graduate School of Medicine, Kobe, Japan. ko_h.yoshino@kohnan.or.jp
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yoshino
authors.forename: Takashi
authors.initials: T
authors.lastname: Sakurai
authors.forename: Kazuo
authors.initials: K
authors.lastname: Hasegawa
authors.forename: Koichi
authors.initials: K
authors.lastname: Yokono
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001510:Bed Rest; D002561:Cerebrovascular Disorders / Q000451:nursing; D003704:Dementia / Q000451:nursing; D003920:Diabetes Mellitus / Q000451:nursing; D005260:Female; D050723:Fractures, Bone / Q000451:nursing; D006801:Humans; D008297:Male; D009735:Nursing Homes