title: Risk factors for functional decline in a population aged 75 years and older without total dependence: A one-year follow-up.
abstract: estimation of functional loss incidence and identification of risk factors associated with new disability onset in people aged 75 and older without severe dependence in a rural primary care setting.
  
  
  
  Prospective cohort study of a representative sample of people aged 75 years or older without severe dependence (Barthel Index>20 and Lawton Index>1) at a primary care center, with a 12-month follow-up. The baseline geriatric assessment recorded activities of daily living (ADL), sociodemographic information, numbers of drugs prescribed, previous hospital admissions and falls, cognitive function, hearing and visual capacity, body mass index, blood pressure, and the Short Physical Performance Battery to evaluate lower limb function. ADL was re-assessed after 12 months, defining functional loss as a fall of ≥10 points on the Barthel Index and/or ≥2 instrumental activities of the Lawton Index. Bivariate and multivariate analyses using logistic regression models were conducted to identify factors independently associated with functional loss.
  
  
  
  Mean age was 81.7 years, 58.7% of patients were men, and 23.4% presented functional loss at the 12-month follow-up. Variables identified as independent predictors of functional loss were hospital admissions (aOR 3.92; 95%CI: 1.35-11.39), cognitive impairment (aOR 2.60; 95%CI: 1.39-4.92) and lower limbs functional limitation (aOR 2.01; 95%CI: 1.02-3.97).
  
  
  
  Our results support the use of performance batteries in primary care for identifying elderly persons at risk of functional decline; and they also highlight the relevance of appropriate management of hospital admissions and planned discharges in order to preserve patients' functional status.
authors.affiliation: Clinical Research Unit, Althaia Xarxa Assistencial Universitària de Manresa, Dr. Joan Soler, 1-3, 08243 Manresa, Barcelona, Spain; Programa de Doctorat en Salut Pública i Metodologia de la Recerca, Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva, Facultat de Medicina, Edifici M, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain; Department of Clinical Epidemiology, Hospitalari Universitari de Vic, Francesc Pla "El Vigatà", 1, 08500 Vic Barcelona, Spain. Electronic address: aarnau@althaia.cat.
authors.forename: Anna
authors.initials: A
authors.lastname: Arnau
authors.affiliation: Servei de Geriatria i Cures Palliatives, Hospitalari Universitari de Vic-Hospital Universitari de la Santa Creu, Rambla Hospital, 52, 08500 Vic Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Espaulella
authors.affiliation: Equip d'Assitència Primària Vic, Primary Care Center El Remei, Pla del Remei, 10-12, 08500 Vic Barcelona, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: Serrarols
authors.affiliation: Equip d'Assitència Primària Vic, Primary Care Center El Remei, Pla del Remei, 10-12, 08500 Vic Barcelona, Spain.
authors.forename: Judit
authors.initials: J
authors.lastname: Canudas
authors.affiliation: Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, Feixa Llarga, 08907 L'Hospitalet del Llobregat, Barcelona, Spain.
authors.forename: Francesc
authors.initials: F
authors.lastname: Formiga
authors.affiliation: Programa de Doctorat en Salut Pública i Metodologia de la Recerca, Departament de Pediatria, d'Obstetrícia i Ginecologia i de Medicina Preventiva, Facultat de Medicina, Edifici M, Universitat Autònoma de Barcelona, 08193 Bellaterra, Barcelona, Spain; Health Services Research Group, IMIM (Hospital del Mar Medical Research Institute), Doctor Aiguader, 88, 08003 Barcelona, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Spain.
authors.forename: Montserrat
authors.initials: M
authors.lastname: Ferrer
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000150:complications; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006760:Hospitalization; D006801:Humans; D035002:Lower Extremity / Q000503:physiopathology; D008297:Male; D012307:Risk Factors; D013030:Spain; D016138:Walking / Q000502:physiology
keywords: Activities of daily living; Aged; Aged 80 and over; Cohort study; Disability