Self‐Reported Causes of Physical Disability in Older People: The Cardiovascular Health Study

Ettinger, Walter H.; Fried, Linda P.; Harris, Tamara B.; Shemanski, Lynn; Schulz, Richard; Robbins, John; Group, CHS Collaborative Research

doi:10.1111/j.1532-5415.1994.tb06206.x

Cited by 257 publications

(184 citation statements)

References 16 publications

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“…The finding that many older adults consider decline to be an expected part of aging is consistent with previous studies showing that older adults consider "old age" to be a causal factor in health conditions 9,10,12 and disability. 11,24,25 This study extends these findings by demonstrating a strong relationship between older age and lower expectations that persists despite controlling for a number of possible confounders including health-related quality of life and medical comorbidity. This compelling finding may reflect a cohort effect; the oldest people in this sample were adults during the depression of the 1930s and World War II and may view aging differently from the 65-and 70-year-olds in our sample.…”

Section: Discussionsupporting

confidence: 70%

Do Older Adults Expect to Age Successfully? The Association Between Expectations Regarding Aging and Beliefs Regarding Healthcare Seeking Among Older Adults

Sarkisian¹,

Hays²,

Mangione³

2002

J American Geriatrics Society

221

186

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OBJECTIVES:To measure expectations regarding aging among community-residing-older adults, identify characteristics associated with having low expectations regarding aging, and examine whether expectations regarding aging are associated with healthcare-seeking beliefs for age-associated conditions. DESIGN: Self-administered mail survey. SETTING: Greater Los Angeles. PARTICIPANTS: Four hundred twenty-nine of 588 (73%) randomly selected community-residing adults aged 65 to 100 (mean age 76) cared for by 20 primary care physicians; 54% were women, and 76% were white. MEASUREMENTS: T he Expectations Regarding AgingSurvey, a validated survey measuring expectations regarding aging; 13 items measuring care seeking beliefs; and validated measures of health status. RESULTS: More than 50% of participants felt it was an expected part of aging to become depressed, to become more dependent, to have more aches and pains, to have less ability to have sex, and to have less energy. After adjusting for sociodemographic and health characteristics using multivariate regression, older age was independently associated with lower expectations regarding aging ( P Ͻ . 001), as was having lower physical and mental health-related quality of life. Having lower expectations regarding aging was independently associated with placing less importance on seeking health care ( P ϭ .049). CONCLUSIONS: Most older adults in this sample did not expect to achieve the model of successful aging in which high cognitive and physical functioning is maintained. Older age was independently associated with lower expectations regarding aging. Furthermore, having low expectations regarding aging was independently associated with not believing it important to seek health care.

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Section: Discussionsupporting

confidence: 70%

Do Older Adults Expect to Age Successfully? The Association Between Expectations Regarding Aging and Beliefs Regarding Healthcare Seeking Among Older Adults

Sarkisian¹,

Hays²,

Mangione³

2002

J American Geriatrics Society

221

186

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“…These comorbidities have been previously shown to affect functioning among older persons. [14][15][16][17][18] …”

Section: Comorbidity Ascertainmentmentioning

confidence: 99%

Leg symptoms, the ankle-brachial index, and walking ability in patients with peripheral arterial disease

et al. 1999

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OBJECTIVE:To determine how functional status and walking ability are related to both severity of lower extremity peripheral arterial disease (PAD) and PAD-related leg symptoms. DESIGN:Cross-sectional study. SETTING: Academic medical center. PARTICIPANTS:Patients aged 55 years and older diagnosed with PAD in a blood flow laboratory or general medicine practice ( n ‫؍‬ 147). Randomly selected control patients without PAD were identified in a general medicine practice ( n ‫؍‬ 67). MEASUREMENTS: Severity of PAD was measured with the ankle-brachial index (ABI). All patients were categorized according to whether they had (1) no exertional leg symptoms; (2) classic intermittent claudication; (3) exertional leg symptoms that also begin at rest (pain at rest), or (4) exertional leg symptoms other than intermittent claudication or pain at rest (atypical exertional leg symptoms). Participants completed the 36-Item Short-Form Health Survey (SF-36) and the Walking Impairment Questionnaire (WIQ). The WIQ quantifies patient-reported walking speed, walking distance, and stairclimbing ability, respectively, on a scale of 0 to 100 (100 ‫؍‬ best). MAIN RESULTS:In multivariate analyses patients with atypical exertional leg symptoms, intermittent claudication, and pain at rest, respectively, had progressively poorer scores for walking distance, walking speed, and stair climbing. The ABI was measurably and independently associated with walking distance (regression coefficient ‫؍‬ 2.87/0.1 ABI unit, p ‫؍‬ .002) and walking speed (regression coefficient ‫؍‬ 2.09/0.1 ABI unit, p ‫؍‬ .015) scores. Among PAD patients only, pain at rest was associated independently with all WIQ scores and six SF-36 domains, while ABI was an independent predictor of WIQ distance score. CONCLUSIONS:Both PAD-related leg symptoms and ABI predict patient-perceived walking ability in PAD.KEY WORDS: peripheral arterial disease; functioning; walking impairment; leg pain.

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“…On the other hand, many subjects reporting disability do ascribe their functional limitation to cardiovascular symptoms typi-cal of CF, such as dyspnoea (Ettinger et al, 1994). Furthermore, CF in the Framingham study had the lowest prevalence ever observed in the community (largely < 3%) (Pinsky et al, 1990).…”

Section: Discussionmentioning

confidence: 92%

Variable effect of comorbidity on the association of chronic cardiac failure with disability in community-dwelling older persons

Marchionni

Bari

Fumagalli

et al. 1996

Archives of Gerontology and Geriatrics

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The effect of cardiac failure (CF) and comorbidity on disability in older persons was studied in a cross-sectional survey. The whole population aged 65 + years (n = 652; 628 eligible) living in a small town near Florence (Italy) was enrolled. Finally, 459 individuals (73.0% of eligible) underwent a multidimensional evaluation. CF was defined as a NYHA H-IV class in the presence of an obviously abnormal ECG. Disability was assessed by the 14-item WHO scale. Comorbid conditions that had a prevalence > 5% and might be considered pathophysiologically unrelated to CF were also identified. The univariate association of CF with disability was analyzed. Multivariate associations were estimated as well, by taking simultaneously into account the effect of comorbid conditions that had an independent effect on disability and were considered as either confounders or effect modifiers of that association. Prevalence of CF [6.1% in the whole study population) was higher with advancing age (> 75 years: 8.3 versus 65-74 years: 4.5%, odds ratio, OR: 1.93, 95% Marchionni et al. , Arch. Gerontol. Geriatr. 23 (1996) 283 292 confidence interval, CI: 1.02 4.18), in the presence of hypertension (OR: 2.87, 95% CI: 1.32-6.23), and among individuals who were living alone (OR: 2.44, 95% CI: 1.10-5.56). CF was associated with a higher prevalence of disability (38.5 versus 19.5%; OR 2.67, 95% CI: 1.21 5.92). Comorbidity modified the association of CF with disability following two patterns: while the independent effect of CF on the prevalence of disability was similar in the absence or in the presence of chronic obstructive pulmonary disease, hearing impairment, gastrointestinal tract disease, or osteoarthritis, such effect was much larger in the presence than in the absence of visual impairment, previous stroke, or urinary incontinence. The composite pathophysiological pathways of such different interactions are still to be elucidated.

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Self‐Reported Causes of Physical Disability in Older People: The Cardiovascular Health Study

Cited by 257 publications

References 16 publications

Do Older Adults Expect to Age Successfully? The Association Between Expectations Regarding Aging and Beliefs Regarding Healthcare Seeking Among Older Adults

Do Older Adults Expect to Age Successfully? The Association Between Expectations Regarding Aging and Beliefs Regarding Healthcare Seeking Among Older Adults

Leg symptoms, the ankle-brachial index, and walking ability in patients with peripheral arterial disease

Variable effect of comorbidity on the association of chronic cardiac failure with disability in community-dwelling older persons

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