Effect of arthritis in middle age on older-age functioning.

TitleEffect of arthritis in middle age on older-age functioning.
Publication TypeJournal Article
Year of Publication2008
AuthorsCovinsky, KE, Lindquist, K, Dunlop, DD, Gill, TM, Yelin, E
JournalJ Am Geriatr Soc
Volume56
Issue1
Pagination23-8
Date Published2008 Jan
ISSN Number1532-5415
Call Numbernewpubs20080229_Covinsky_etal.pdf
KeywordsActivities of Daily Living, Arthritis, Chronic disease, Confidence Intervals, Female, Follow-Up Studies, Humans, Male, Middle Aged, Mobility Limitation, Prognosis, Prospective Studies, Risk Factors, Severity of Illness Index, Surveys and Questionnaires, Time Factors, Walking
Abstract

OBJECTIVES: To examine whether symptomatic arthritis in middle age predicts the earlier onset of functional difficulties (difficulty with activities of daily living (ADLs) and walking) that are associated with loss of independence in older persons.

DESIGN: Prospective longitudinal study.

SETTING: The Health and Retirement Study, a nationally representative sample of persons aged 50 to 62 at baseline who were followed for 10 years.

PARTICIPANTS: Seven thousand five hundred forty-three subjects with no difficulty in mobility or ADL function at baseline.

MEASUREMENTS: Arthritis was measured at baseline according to self-report. The primary outcome was time to persistent difficulty in one of five ADLs or mobility (walking several blocks or up a flight of stairs). Difficulty with ADLs or mobility was assessed according to subject interview every 2 years. Analyses were adjusted for other comorbid conditions, body mass index, exercise, and demographic characteristics.

RESULTS: Twenty-nine percent of subjects reported arthritis at baseline. Subjects with arthritis were more likely to develop persistent difficulty in mobility or ADL function over 10 years of follow-up (34% vs 18%, adjusted hazard ratio (HR)=1.63, 95% confidence interval (CI)=1.43-1.86). When each component of the primary outcome was assessed separately, arthritis was also associated with persistent difficulty in mobility (30% vs 16%, adjusted HR=1.55, 95% CI=1.41-1.71) and persistent difficulty in ADL function (13% vs 5%, adjusted HR=1.85, 95% CI=1.58-2.16).

CONCLUSION: Middle-aged persons who report a history of arthritis are more likely to develop mobility and ADL difficulties as they enter old age. This finding highlights the need to develop interventions and treatments that take a life-course approach to preventing the disabling effect of arthritis.

DOI10.1111/j.1532-5415.2007.01511.x
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/18184204?dopt=Abstract

Endnote Keywords

arthritis/Activities of Daily Living/Mobility

Endnote ID

18620

Alternate JournalJ Am Geriatr Soc
Citation Key7205
PubMed ID18184204
PubMed Central IDPMC2875135
Grant List5P60AR053308-020 / AR / NIAMS NIH HHS / United States
P60 AR053308 / AR / NIAMS NIH HHS / United States
U01 AG009740 / AG / NIA NIH HHS / United States
P60 AR053308-01 / AR / NIAMS NIH HHS / United States
K24AG029812 / AG / NIA NIH HHS / United States
U01AG009740 / AG / NIA NIH HHS / United States
K24AG021507 / AG / NIA NIH HHS / United States
R01AG023626 / AG / NIA NIH HHS / United States
R01 AG023626 / AG / NIA NIH HHS / United States
K24 AG021507 / AG / NIA NIH HHS / United States
K24 AG029812 / AG / NIA NIH HHS / United States