title: Does a falling level of activity predict disability development in community-dwelling elderly people?
abstract: OBJECTIVE
  To investigate the predictive value of self-reported decline in weight, exhaustion, walking difficulty, grip strength and physical activity on development of disabilities in community-dwelling elderly people.
  
  
  METHODS
  A one-year follow-up study.
  
  
  METHODS
  Participants were recruited via four Dutch general practitioners.
  
  
  METHODS
  Community-dwelling elderly people aged 70 years or older.
  
  
  METHODS
  A total of 687 participants received a questionnaire at baseline regarding weight loss, exhaustion, walking difficulty, grip strength, physical activity and disability. The same questionnaire was sent to them after one year follow-up. Disability was operationalized in two ways: as increased dependence and as increased difficulty in daily activities. Univariate and multivariate logistic regression analyses were used to determine whether self-reported decline in five physical indicators at baseline predicted development of dependence or increased difficulty in daily activities after one year. The analyses were controlled for age, gender and baseline disability.
  
  
  RESULTS
  Four hundred and one participants with a mean age of 76.9 years (SD 5.2) were included in the analyses. Eighty-four of them reported increased dependence (21%) and 76 reported increased difficulty (19%) in daily activities at one-year follow-up. All physical indicators, except weight loss, were significant univariate predictors of disability. Multivariate analyses revealed that self-reported decrease in physical activity (e.g. walking, cycling, gardening) was a significant predictor of development of dependence (odds ratio (OR) = 1.89, 95% confidence interval (CI) = 1.02-3.51) and development of difficulty (OR = 1.98, 95% CI = 1.05-3.71) in daily activities.
  
  
  CONCLUSIONS
  Community-dwelling elderly people who report decreased physical activity have a higher risk to develop disability at one-year follow-up.
authors.affiliation: School for Public Health and Primary Care (CAPHRI), Maastricht University, Maastricht, The Netherlands. j.vermeulen@maastrichtuniversity.nl
authors.forename: Joan
authors.initials: J
authors.lastname: Vermeulen
authors.forename: Marieke D
authors.initials: MD
authors.lastname: Spreeuwenberg
authors.forename: Ramon
authors.initials: R
authors.lastname: Daniëls
authors.forename: Jacques C L
authors.initials: JC
authors.lastname: Neyens
authors.forename: Erik
authors.initials: E
authors.lastname: Van Rossum
authors.forename: Luc P
authors.initials: LP
authors.lastname: De Witte
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005221:Fatigue / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D011237:Predictive Value of Tests; D012111:Residence Characteristics; D057566:Self Report; D015431:Weight Loss
keywords: Activities of daily living; disability; elderly; people; prediction