The cross-sectional association between severity of non-cognitive disability and self-reported worsening memory.
BACKGROUND
Research has demonstrated a clear association between cognitive decline and non-cognitive disability; however, all of these studies focus on disability as a correlate or result of some level of cognitive impairment or dysfunction. The relationship between disability and cognition is likely a complex one, that is currently incompletely described in the literature.


OBJECTIVE
Our objective was to estimate the prevalence of long-term, non-cognitive disability using a population-representative sample of adults aged 18 and older, and then estimate the association between long-term, non-cognitive disability and self-reported worsening memory.


METHODS
Using the 2009 Florida Behavioral Risk Factor Surveillance System (BRFSS), we measured the relationship between non-cognitive disability and worsening memory using multivariable logistic regression analysis weighted to account for the complex sampling design of the BRFSS. We also estimated the adjusted odds of worsening memory by disability severity, classified according to the types of assistance needed.


RESULTS
Approximately 18% (95% confidence interval = (16%, 19%)) of Floridians were living with a long-term, non-cognitive disability in 2009. Among adults with no disability during or prior to the last year, only 5% reported worsening memory. The proportion of Floridians reporting worsening memory increases with increasing severity of disability-related limitations. In a multivariable logistic regression model, odds of worsening memory increased significantly with severity of disability-related limitations.


CONCLUSIONS
These results highlight the association between non-cognitive disability and subsequent increased odds of worsening memory, independent of several other known risk factors, and a dose-response association with disability-related limitations.
University of North Texas Health Science Center, Department of Epidemiology and Biostatistics, UNTHSC-EAD 709G, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA. Electronic address: brad.cannell@unthsc.edu.
M Brad
MB
Cannell
VA Center of Innovation for Veteran-Centered & Value-Driven Care, Department of Health Services, University of Washington, 1100 Olive Way #1400, Seattle, WA 98101, USA.
Erin D
ED
Bouldin
University of North Texas Health Science Center, Department of Epidemiology and Biostatistics, 3500 Camp Bowie Blvd, Fort Worth, TX 76107, USA.
Kari
K
Teigen
Department of Epidemiology, College of Public Health Professions, University of Florida, 2004 Mowry Road, P.O. Box 100231, Gainesville, FL 32610, USA; College of Medicine, University of Florida, Gainesville, FL 32610, USA.
Wajiha Z
WZ
Akhtar
Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, USA.
Elena M
EM
Andresen
D000203:Activities of Daily Living; D003071:Cognition; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D006233:Persons with Disabilities; D005260:Female; D005431:Florida; D006801:Humans; D016015:Logistic Models; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D012307:Risk Factors; D057566:Self Report
Activities of Daily Living; BRFSS; Disability; Instrumental Activities of Daily Living; Memory impairment