title: Functional Independence in Late-Life: Maintaining Physical Functioning in Older Adulthood Predicts Daily Life Function after Age 80.
abstract: BACKGROUND
  We examined physical functioning (PF) trajectories (maintaining, slowly declining, and rapidly declining) spanning 15 years in older women aged 65-80 and protective factors that predicted better current levels and less decline in functional independence outcomes after age 80.
  
  
  METHODS
  Women's Health Initiative extension participants who met criteria (enrolled in either the clinical trial or observational study cohort, >80 years at the data release cutoff, PF survey data from initial enrollment to age 80, and functional independence survey data after age 80) were included in these analyses (mean [SD] age = 84.0 [1.4] years; N = 10,478). PF was measured with the SF-36 (mean = 4.9 occasions). Functional independence was measured by self-reported level of dependence in basic and instrumental activities of daily living (ADLs and IADLs) (mean = 3.4 and 3.3 occasions).
  
  
  RESULTS
  Maintaining consistent PF in older adulthood extends functional independence in ADL and IADL in late-life. Protective factors shared by ADL and IADL include maintaining PF over time, self-reported excellent or very good health, no history of hip fracture after age 55, and no history of cardiovascular disease. Better IADL function is uniquely predicted by a body mass index less than 25 and no depression. Less ADL and IADL decline is predicted by better self-reported health, and less IADL decline is uniquely predicted by having no history of hip fracture after age 55.
  
  
  CONCLUSIONS
  Maintaining or improving PF and preventing injury and disease in older adulthood (ages 65-80) has far-reaching implications for improving late-life (after age 80) functional independence.
authors: Department of Social Sciences and Health Policy and alvaugha@wakehealth.edu.
authors: Leslie
authors: L
authors: Vaughan
authors: Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.
authors: Xiaoyan
authors: X
authors: Leng
authors: Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo - SUNY, New York.
authors: Michael J
authors: MJ
authors: La Monte
authors: Department of Medicine, Vanderbilt University.
authors: Hilary A
authors: HA
authors: Tindle
authors: Department of Family and Child Nursing, University of Washington, Seattle.
authors: Barbara B
authors: BB
authors: Cochrane
authors: Department of Social Sciences and Health Policy and.
authors: Sally A
authors: SA
authors: Shumaker
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D057187:Independent Living; D009043:Motor Activity / Q000502:physiology*; D011788:Quality of Life; D014481:United States; D016387:Women's Health
keywords: ADL; Aging; IADL; Physical function; Successful aging