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Functional transitions among the elderly: Patterns, predictors, and related hospital use

Author

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  • Mor, V.
  • Wilcox, V.
  • Rakowski, W.
  • Hiris, J.

Abstract

Objectives. This paper describes 6-year rates and correlates of functional change in the elderly, as well as associated hospital use. Methods. The Longitudinal Study on Aging (n = 7527) and matched Medicare claims were used to calculate 6-year functional status transition rates and hospital use rates. A hierarchical measure that incorporated activities of daily living, instrumental activities of daily living, and competing risks of institutionalization and death was used to assess functional status. Multinomial logistic regression was used to predict 1990 status. Results. The functional status of 12% of men and women 70 to 79 years of age who were initially impaired in instrumental activities of daily living improved, and about half of the initially independent people in that age group remained so. Multivariate analyses revealed that age, baseline functioning, self-rated health, and comorbidity predicted 1990 status. Both baseline functioning and functional change were related to hospitalization. Conclusions. This study supports others that have shown some long-term functional improvement, but more commonly decline, in the elderly. Furthermore, it documents the link between functional decline and increased hospital use.

Suggested Citation

  • Mor, V. & Wilcox, V. & Rakowski, W. & Hiris, J., 1994. "Functional transitions among the elderly: Patterns, predictors, and related hospital use," American Journal of Public Health, American Public Health Association, vol. 84(8), pages 1274-1280.
    • Handle: RePEc:aph:ajpbhl:1994:84:8:1274-1280_0
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    Cited by:

    1. M. Denton & S. French & A. Gafni & A. Joshi & C. Rosenthal & D. Willison, 1998. "Preparations for Independence and Financial Security in Later Life: A Conceptual Framework and Application to Canada," Independence and Economic Security of the Older Population Research Papers 31, McMaster University.
    2. H. Eme Ichoku & William Fonta & Michael Thiede, 2011. "Socioeconomic gradients in self-rated health: a developing country case study of Enugu State, Nigeria," Economic Change and Restructuring, Springer, vol. 44(3), pages 179-202, August.
    3. Chunshan Zhou & Jing Chen & Shaojian Wang, 2018. "Does Migrant Status and Household Registration Matter? Examining the Effects of City Size on Self-Rated Health," Sustainability, MDPI, vol. 10(7), pages 1-15, June.
    4. Masood A. Badri & Guang Yang & Mugheer Al Khaili & Muna Al Bahar & Asma Al Rashdi & Layla Al Hyas, 2021. "Hierarchical Regression of Wellbeing and Self-Rated Health among Older Adults in Abu Dhabi," IJERPH, MDPI, vol. 18(15), pages 1-12, July.
    5. James R Muruthi & Sarah G Spafford & Maggie L Osa & Alicia DeLouize & Paul Kowal & Richard Biritwum & J Josh Snodgrass, 2022. "Suicidal ideation in older Ghanaian women: The roles of bodily pain, functional limitation, and chronic health conditions," International Journal of Social Psychiatry, , vol. 68(3), pages 555-563, May.
    6. Hung-Hao Chang & Rodolfo Nayga & Kung-Chi Chan, 2011. "Gendered Analyses of Nutrient Deficiencies Among the Elderly," Journal of Family and Economic Issues, Springer, vol. 32(2), pages 268-279, June.
    7. Margaret A. Denton & Parminder Raina & Jason Lian & Amiram Gafni & Anju Joshi & Susan French & Carolyn Rosenthal & Don Willison, 1997. "The Role of Health and Age in Financial Preparations for Later Life," Independence and Economic Security of the Older Population Research Papers 21, McMaster University.
    8. Rebecca T Brown & David Guzman & Lauren M Kaplan & Claudia Ponath & Christopher T Lee & Margot B Kushel, 2019. "Trajectories of functional impairment in homeless older adults: Results from the HOPE HOME study," PLOS ONE, Public Library of Science, vol. 14(8), pages 1-16, August.
    9. Septi Kurnia Lestari & Nawi Ng & Paul Kowal & Ailiana Santosa, 2019. "Diversity in the Factors Associated with ADL-Related Disability among Older People in Six Middle-Income Countries: A Cross-Country Comparison," IJERPH, MDPI, vol. 16(8), pages 1-12, April.
    10. Qian, Yuting & Chen, Shanquan & Lin, Zhuoer & Yu, Zexuan & Wang, Mengxiao & Hou, Xiaohui & Chen, Xi, 2023. "The Growing Gap of Unmet Need: Assessing the Demand for, and Supply of, Home-Based Support for Older Adults with Disabilities in 31 Countries," IZA Discussion Papers 16411, Institute of Labor Economics (IZA).
    11. Liang, Jersey & Wang, Chia-Ning & Xu, Xiao & Hsu, Hui-Chuan & Lin, Hui-Shen & Lin, Yu-Hsuan, 2010. "Trajectory of functional status among older Taiwanese: Gender and age variations," Social Science & Medicine, Elsevier, vol. 71(6), pages 1208-1217, September.
    12. Pasqualini, M. & Lanari, D. & Minelli, L. & Pieroni, L. & Salmasi, L., 2017. "Health and income inequalities in Europe: What is the role of circumstances?," Economics & Human Biology, Elsevier, vol. 26(C), pages 164-173.
    13. Parminder Raina & Steven Dukeshire & Larry W. Chambers & Joan Lindsay, 1997. "Sensory Impairments among Canadians 55 years and Older: An Analysis of 1986 and 1991 Health and Activity Limitation Survey," Independence and Economic Security of the Older Population Research Papers 18, McMaster University.
    14. Esme Fuller-Thomson & Jason Ferreirinha & Katherine Marie Ahlin, 2023. "Temporal Trends (from 2008 to 2017) in Functional Limitations and Limitations in Activities of Daily Living: Findings from a Nationally Representative Sample of 5.4 Million Older Americans," IJERPH, MDPI, vol. 20(3), pages 1-11, February.
    15. Margie E Lachman & Stefan Agrigoroaei, 2010. "Promoting Functional Health in Midlife and Old Age: Long-Term Protective Effects of Control Beliefs, Social Support, and Physical Exercise," PLOS ONE, Public Library of Science, vol. 5(10), pages 1-9, October.

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