title: Factors Affecting Functional Impairment among Elderly Germans - Results of a Longitudinal Study.
abstract: To investigate causal factors of functional impairment in old age in a longitudinal approach.
  
  
  
  A population-based prospective cohort study.
  
  
  
  Elderly individuals were recruited via GP offices at six study centers in Germany. They were observed every 1.5 years over six waves.
  
  
  
  Three thousand two hundred fifty-six people aged 75 years and older at baseline.
  
  
  
  Functional impairment was quantified by the Lawton and Brody Instrumental Activities of Daily Living scale (IADL) and the Barthel-Index (BI).
  
  
  
  Fixed effects regressions revealed that functional impairment (IADL; BI) increased significantly with ageing (β=-.2; β=-1.1), loss of a spouse (β= .5; β=-3.1), not living alone in private household (β=-1.2; β=-5.5), depression (solely significant for IADL: β= .6) and dementia (β=-2.3; β=-18.2). The comorbidity score did not affect functional impairment.
  
  
  
  Our findings underline the relevance of changes in sociodemographic variables as well as the occurrence of depression or dementia for functional impairment. While several of these causal factors for functional decline in the oldest old are inevitable, some may not be, such as depression. Therefore, developing interventional strategies to prevent depression might be a fruitful approach in order to delay functional impairment in old age.
authors.affiliation: Dr. André Hajek, University Medical Center, Hamburg-Eppendorf, Hamburg Center for Health Economics, Department of Health Economics and Health Services Research, Telephone +49 40 7410 52877; Fax +49 40 7410 40261, E-mail: a.hajek@uke.de.
authors.forename: A
authors.initials: A
authors.lastname: Hajek
authors.forename: T
authors.initials: T
authors.lastname: Luck
authors.forename: C
authors.initials: C
authors.lastname: Brettschneider
authors.forename: T
authors.initials: T
authors.lastname: Posselt
authors.forename: C
authors.initials: C
authors.lastname: Lange
authors.forename: B
authors.initials: B
authors.lastname: Wiese
authors.forename: S
authors.initials: S
authors.lastname: Steinmann
authors.forename: S
authors.initials: S
authors.lastname: Weyerer
authors.forename: J
authors.initials: J
authors.lastname: Werle
authors.forename: M
authors.initials: M
authors.lastname: Pentzek
authors.forename: A
authors.initials: A
authors.lastname: Fuchs
authors.forename: J
authors.initials: J
authors.lastname: Stein
authors.forename: H
authors.initials: H
authors.lastname: Bickel
authors.forename: E
authors.initials: E
authors.lastname: Mösch
authors.forename: M
authors.initials: M
authors.lastname: Wagner
authors.forename: K
authors.initials: K
authors.lastname: Heser
authors.forename: W
authors.initials: W
authors.lastname: Maier
authors.forename: J M
authors.initials: JM
authors.lastname: Scherer
authors.forename: S G
authors.initials: SG
authors.lastname: Riedel-Heller
authors.forename: H-H
authors.initials: HH
authors.lastname: König
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology* / Q000523:psychology; D060825:Cognitive Dysfunction / Q000503:physiopathology*; D015331:Cohort Studies; D015897:Comorbidity; D003704:Dementia / Q000503:physiopathology* / Q000517:prevention & control; D003863:Depression / Q000523:psychology*; D005260:Female; D005858:Germany; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies
keywords: Functional impairment; dementia; depression; longitudinal study; older people