Older Adults Recover More Quickly From Disabilities Than Previously Thought
Along with wisdom, old age unfortunately also brings an increased prevalence of disability. In a 1997 census report, over 4.5 million (14.2%) Americans 65 and older reported having difficulty carrying out activities of daily living (ADLs).
Disability is strongly correlated with health status. And older individuals often have chronic health conditions, such as ]]>arthritis]]> , ]]>osteoporosis]]> , ]]>hypertension]]> , and ]]>diabetes]]> , increasing their risk of an illness or injury that leads to disability.
Previous research has shown that many newly disabled older individuals eventually recover their independence. But most of these studies waited a long time between the onset of disability and follow up, making it difficult to accurately pinpoint the rate and time of their recovery.
Now, a new study in the April 7, 2004 issue of the Journal of the American Medical Association has found that newly disabled older individuals recover their independent functioning much more quickly than previously reported. But the study also found that recovery from disability is often brief, indicating that these individuals are at a high risk for subsequent disabilities.
About the Study
This study included 754 community-dwelling individuals aged 70 and older living in the greater New Haven, Connecticut area. To qualify for the study participants had to be fully functioning in four key ADLs: bathing, dressing, walking inside the house, and transferring from a chair.
Research nurses conducted comprehensive in-home assessments of the participants at baseline, 18, and 36 months, where they collected information on:
- Walking speed (a measure of frailty)
- Demographic characteristics
- Diagnosed chronic conditions
- Cognitive function
After the initial assessments, the researchers called the participants every month to assess disability status, for up to 53 months. Disability was defined as needing personal assistance with one or more key ADLs.
The researchers compared the baseline characteristics of the participants who did and didn't experience disability. Among those who did experience disability, they evaluated the likelihood of recovery based on: age, sex, cognitive function, physical frailty, and the severity of their initial disability.
Fifty-six percent of the participants experienced disability during the follow-up period. Disability was associated with older age, physical frailness, lower cognitive function, and more chronic conditions. Of the 421 participants who experienced disability, 81% recovered (regained their independence in all four ADLs) within 12 months, with 65% recovering within just two months.
Overall, 57% maintained their independence for at least six months. But among those who experienced disability for three or more consecutive months, only one third maintained their independence for at least six months. Individuals who were initially cognitively impaired, physically frail, or disabled in 3-4 ADLs, were the less likely to recover than those who were not.
How Does This Affect You?
This study suggests that the majority of older individuals do recover from disabilities—and usually within the first six months. This is a much higher recovery rate than previous studies had suggested, implying that these earlier studies may have followed up their participants too late.
But the finding that recovery was often short-lived highlights the importance of taking measures to prevent subsequent disability—as well as disability in the first place. The debilitating effect, particularly the psychological impact, of requiring help with routine activities such as dressing and bathing, is enormous. And for those without anyone to help take care of them, disability may mean moving into a nursing home, a monumental turn of events in a person’s life.
Our nation is aging at a rate unprecedented in its history. Americans 85 and older have become our fastest growing population. The findings from this study, therefore, affect us all. You can help your loved ones, and yourself, stay independent by recognizing the modifiable risk factors that may affect a person’s susceptibility to disability—such as mood, nutritional status, physical strength and chronic illness—and taking action to minimize the likelihood of a catastrophic, disabling event.
National Council on the Aging
National Institute on Aging
National Institutes of Health
Hardy SE, Gill TM. Recovery From Disability Among Community-Dwelling Older Persons. JAMA. 2004; 291(13): 1596-1602.
Statistics. A Profile of Older Americans: 2002. Health, Health Care, and Disability. Administration on Aging. Available at: http://www.aoa.gov/prof/Statistics/profile/12.asp . Accessed on April 7, 2004.
Last reviewed Apr 8, 2004 by ]]>Richard Glickman-Simon, MD]]>
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