title: Activity of daily living staging, chronic health conditions, and perceived lack of home accessibility features for elderly people living in the community.
abstract: OBJECTIVE
  To examine the cross-sectional associations between activity of daily living (ADL) limitation stage and specific physical and mental conditions, global perceived health, and unmet needs for home accessibility features of community-dwelling adults aged 70 and older.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Community.
  
  
  METHODS
  Nine thousand four hundred forty-seven community-dwelling persons interviewed through the Second Longitudinal Study of Aging (LSOA II).
  
  
  METHODS
  Six ADLs organized into five stages ranging from no difficulty (0) to unable (IV).
  
  
  RESULTS
  ADL stage showed strong ordered associations with perceived health, dementia severe enough to require proxy use, and history of stroke. For example, the relative risks (RRs) defined as risk of being at Stages I, II, III, or IV divided by risk of being at Stage 0 for those with dementia ranged from 3.2 (95% confidence interval (CI)=2.4-4.4) to 41.9 (95% CI=19.6-89.6) times the RRs for those without dementia. The RR ratios (RRR) comparing respondents who perceived unmet need for accessibility features in the home to those without these perceptions peaked at Stage III (RRR=17.8, 95% CI=13.0-24.5) and then declined at Stage IV. All models were adjusted for age, sex, and race.
  
  
  CONCLUSIONS
  ADL stages showed clinically logical associations with other health-related concepts, supporting external validity. Findings suggest that specificity of chronic conditions will be important in developing strategies for disability reduction. People with partial rather than complete ADL limitation appeared most vulnerable to unmet needs for home accessibility features.
authors.affiliation: Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA. mstinema@exchange.upenn.edu
authors.forename: Margaret G
authors.initials: MG
authors.lastname: Stineman
authors.forename: Dawei
authors.initials: D
authors.lastname: Xie
authors.forename: Qiang
authors.initials: Q
authors.lastname: Pan
authors.forename: Jibby E
authors.initials: JE
authors.lastname: Kurichi
authors.forename: Debra
authors.initials: D
authors.lastname: Saliba
authors.forename: Joel
authors.initials: J
authors.lastname: Streim
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001107:Architectural Accessibility; D002318:Cardiovascular Diseases / Q000503:physiopathology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000503:physiopathology; D009369:Neoplasms / Q000503:physiopathology; D010024:Osteoporosis / Q000503:physiopathology; D011795:Surveys and Questionnaires