title: Multiple chronic conditions and limitations in activities of daily living in a community-based sample of older adults in New York City, 2009.
abstract: BACKGROUND
  Nationally, 60% to 75% of older adults have multiple (2 or more) chronic conditions (MCCs), and the burden is even higher among low-income, racial/ethnic minority populations. MCCs limit activities of daily living (ADLs), yet this association is not well characterized outside of clinical populations. We examined the association of MCCs with ADLs in a racially/ethnically diverse population of low-income older adults living in New York City public housing.
  
  
  METHODS
  A representative sample of 1,036 New York City Housing Authority residents aged 65 or older completed a telephone survey in June 2009. We examined the association of up to 5 chronic conditions with basic ADL (BADL) limitations, adjusting for potential confounders by using logistic regression.
  
  
  RESULTS
  Of respondents, 28.7% had at least 1 BADL limitation; 92.9% had at least 1 chronic condition, and 79.0% had MCCs. We observed a graded association between at least 1 BADL limitation and number of chronic conditions (using 0 or 1 condition as the reference group): adjusted odds ratio (AOR) for 3 conditions was 2.2 (95% confidence interval [CI], 1.3-3.9); AOR for 4 conditions, 4.3 (95% CI, 2.5-7.6); and AOR for 5 conditions, 9.2 (95% CI, 4.3-19.5).
  
  
  CONCLUSIONS
  Prevalence of BADL limitations is high among low-income older adults and increases with number of chronic conditions. Initiating prevention of additional conditions and treating disease constellations earlier to decrease BADL limitations may improve aging outcomes in this population.
authors.affiliation: New York City Department of Health and Mental Hygiene, Gotham Center, CN# 34A, 42-09 28th St, 10th Floor, Queens, New York 11101-4132. E-mail: nlralph@gmail.com.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Ralph
authors.forename: Thelma J
authors.initials: TJ
authors.lastname: Mielenz
authors.forename: Hilary
authors.initials: H
authors.lastname: Parton
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Flatley
authors.forename: Lorna E
authors.initials: LE
authors.lastname: Thorpe
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002908:Chronic Disease / Q000453:epidemiology*; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008913:Minority Groups / Q000706:statistics & numerical data; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D011203:Poverty; D015995:Prevalence; D011638:Public Housing / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires