Interrelationships among disablement concepts.

BACKGROUND Understanding interrelationships among disablement concepts is critical to the design of future disability treatment and prevention interventions. METHODS This study uses cross-sectional data to examine the relationships among physiologic impairments, functional limitations, and disability in a moderately disabled sample of 207 community-dwelling older adults. RESULTS As hypothesized, the data revealed statistically significant curvilinear relationships of upper and lower extremity strength and balance with mobility in this older sample. Multivariate analyses further clarified the hypothesized causal mechanism among the disablement concepts by demonstrating that most of the association of muscle strength and balance with disability was through the intermediary role of mobility limitations. CONCLUSIONS The findings from this study highlight the value of clinical trials that focus on prevention or treatment of mobility limitations as a means of preventing disability; our findings underscore the need for future research that examines the effects of other variables believed to influence disablement in late life.

[1]  Ware J.E.Jr.,et al.  THE MOS 36- ITEM SHORT FORM HEALTH SURVEY (SF- 36) CONCEPTUAL FRAMEWORK AND ITEM SELECTION , 1992 .

[2]  S B Roberts,et al.  Exercise training and nutritional supplementation for physical frailty in very elderly people. , 1994, The New England journal of medicine.

[3]  L. Lipsitz,et al.  Leg extensor power and functional performance in very old men and women. , 1992, Clinical science.

[4]  W. Rakowski,et al.  Functional transitions among the elderly: patterns, predictors, and related hospital use. , 1994, American journal of public health.

[5]  A. Jette,et al.  Functional and behavioral consequences of sarcopenia , 1997, Muscle & nerve. Supplement.

[6]  M. Sussman,et al.  SOCIOLOGY AND REHABILITATION , 1967 .

[7]  M. E. Cress,et al.  Relationship Between Physical Performance and Self‐Perceived Physical Function , 1995, Journal of the American Geriatrics Society.

[8]  S. Cummings,et al.  Correlates of Impaired Function in Older Women , 1994 .

[9]  L. Ferrucci,et al.  Departures from linearity in the relationship between measures of muscular strength and physical performance of the lower extremities: the Women's Health and Aging Study. , 1997, The journals of gerontology. Series A, Biological sciences and medical sciences.

[10]  S. Furner,et al.  Medical conditions differentially affect the development of IADL disability: implications for medical care and research. , 1995, The Gerontologist.

[11]  E D Richardson,et al.  Impairments in physical performance and cognitive status as predisposing factors for functional dependence among nondisabled older persons. , 1996, The journals of gerontology. Series A, Biological sciences and medical sciences.

[12]  M. Brown,et al.  The relationship of strength to function in the older adult. , 1995, The journals of gerontology. Series A, Biological sciences and medical sciences.

[13]  E H Wagner,et al.  Evidence for a non-linear relationship between leg strength and gait speed. , 1996, Age and ageing.

[14]  A M Jette,et al.  Disentangling the disablement process. , 1996, The journals of gerontology. Series B, Psychological sciences and social sciences.

[15]  D. Kleinbaum,et al.  Applied Regression Analysis and Other Multivariate Methods , 1978 .

[16]  S. Z. Nagi.  Some conceptual issues in disability and rehabilitation , 1965 .

[17]  C. Sherbourne,et al.  The MOS 36-Item Short-Form Health Survey (SF-36) , 1992 .

[18]  A M Jette,et al.  The disablement process. , 1994, Social science & medicine.

[19]  S. Weisberg.  Applied Linear Regression , 1981 .

[20]  U. Sonn,et al.  Functional balance tests in 76-year-olds in relation to performance, activities of daily living and platform tests. , 1995, Scandinavian journal of rehabilitation medicine.

[21]  Bonnie K. Lind,et al.  Physical disability in older adults: a physiological approach. Cardiovascular Health Study Research Group. , 1994, Journal of clinical epidemiology.

[22]  P. Wolf,et al.  The effects of specific medical conditions on the functional limitations of elders in the Framingham Study. , 1994, American journal of public health.

[23]  B. Lateur,et al.  The importance of skeletal muscle strength to physical function in older adults , 1991 .

[24]  R. J. Johnson,et al.  Changes in functional status and the risks of subsequent nursing home placement and death. , 1993, Journal of gerontology.

[25]  J. Judge,et al.  The Relationship Between Physical Performance Measures and Independence in Instrumental Activities of Daily Living , 1996 .

[26]  L. D. de Witte,et al.  The sickness impact profile: SIP68, a short generic version. First evaluation of the reliability and reproducibility. , 1994, Journal of clinical epidemiology.

[27]  A M Jette,et al.  Functional limitations and disability among elders in the Framingham Study. , 1992, American journal of public health.

[28]  L. Ferrucci,et al.  Progressive versus catastrophic disability: a longitudinal view of the disablement process. , 1996, The journals of gerontology. Series A, Biological sciences and medical sciences.

[29]  Diane Podsiadlo,et al.  The Timed “Up & Go”: A Test of Basic Functional Mobility for Frail Elderly Persons , 1991, Journal of the American Geriatrics Society.

[30]  R B Wallace,et al.  Maintaining mobility in late life. II. Smoking, alcohol consumption, physical activity, and body mass index. , 1993, American journal of epidemiology.

[31]  J R Morris,et al.  The Sickness Impact Profile: Conceptual Formulation and Methodology for the Development of a Health Status Measure , 1976, International journal of health services : planning, administration, evaluation.

[32]  R W Bohannon,et al.  Normative values for isometric muscle force measurements obtained with hand-held dynamometers. , 1996, Physical therapy.

[33]  U. Sonn,et al.  Instrumental activities of daily living related to impairments and functional limitations in 70-year-olds and changes between 70 and 76 years of age. , 1995, Scandinavian journal of rehabilitation medicine.

[34]  A. Boland.  Disability in America: Toward a National Agenda for Prevention , 1992 .

[35]  S. Studenski,et al.  Functional reach: a new clinical measure of balance. , 1990, Journal of gerontology.