title: Association of chronic diseases and impairments with disability in older adults: a decade of change?
abstract: BACKGROUND
  Little is known about how the relationship between chronic disease, impairment, and disability has changed over time among older adults.
  
  
  OBJECTIVE
  To examine how the associations of chronic disease and impairment with specific disability have changed over time.
  
  
  METHODS
  Repeated cross-sectional analysis, followed by examining the collated sample using time interaction variables, of 3 recent waves of the Health and Retirement Study.
  
  
  METHODS
  The subjects included 10,390, 10,621 and 10,557 community-dwelling adults aged 65 years and above in 1998, 2004, and 2008.
  
  
  METHODS
  : Survey-based history of chronic diseases including hypertension, heart disease, heart failure, stroke, diabetes, cancer, chronic lung disease, and arthritis; impairments, including cognition, vision, and hearing; and disability, including mobility, complex activities of daily living (ADL), and self-care ADL.
  
  
  RESULTS
  Over time, the relationship of chronic diseases and impairments with disability was largely unchanged; however, the association between hypertension and complex ADL disability weakened from 1998 to 2004 and 2008 [odds ratio (OR) = 1.24; 99% confidence interval (CI), 1.06-1.46; OR = 1.07; 99% CI, 0.90-1.27; OR = 1.00; 99% CI, 0.83-1.19, respectively], as it did for hypertension and self-care disability (OR = 1.32; 99% CI, 1.13-1.54; OR=0.97; 99% CI, 0.82-1.14; OR = 0.99; 99% CI, 0.83-1.17). The association between diabetes and self-care disability strengthened from 1998 to 2004 and 2008 (OR = 1.21; 99% CI, 1.01-1.46; OR = 1.37; 99% CI, 1.15-1.64; OR = 1.52; 99% CI, 1.29-1.79), as it also did for lung disease and self-care disability (OR = 1.64; 99% CI, 1.33-2.03; OR = 1.63; 99% CI, 1.32-2.01; OR = 2.11; 99% CI, 1.73-2.57).
  
  
  CONCLUSIONS
  Although relationships between diseases, impairments, and disability were largely unchanged, disability became less associated with hypertension and more with diabetes and lung disease.
authors.affiliation: Department of Geriatrics and Palliative Medicine, Mount Sinai School of Medicine, New York, NY 10029, USA. william.hung@mssm.edu
authors.forename: William W
authors.initials: WW
authors.lastname: Hung
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Ross
authors.forename: Kenneth S
authors.initials: KS
authors.lastname: Boockvar
authors.forename: Albert L
authors.initials: AL
authors.lastname: Siu
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000375:Aging; D002318:Cardiovascular Diseases / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology*; D003072:Cognition Disorders / Q000453:epidemiology; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005260:Female; D006306:Health Surveys; D034381:Hearing Loss / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D008297:Male; D051346:Mobility Limitation; D012111:Residence Characteristics; D012140:Respiratory Tract Diseases / Q000453:epidemiology; D012648:Self Care; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014786:Vision Disorders / Q000453:epidemiology