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American Journal of Public Health logoLink to American Journal of Public Health
. 1994 Mar;84(3):351–358. doi: 10.2105/ajph.84.3.351

The effects of specific medical conditions on the functional limitations of elders in the Framingham Study.

A A Guccione 1, D T Felson 1, J J Anderson 1, J M Anthony 1, Y Zhang 1, P W Wilson 1, M Kelly-Hayes 1, P A Wolf 1, B E Kreger 1, W B Kannel 1
PMCID: PMC1614827  PMID: 8129049

Abstract

OBJECTIVES. The purpose of this study was to identify associations between specific medical conditions in the elderly and limitations in functional tasks; to compare risks of disability across medical conditions, controlling for age, sex, and comorbidity; and to determine the proportion of disability attributable to each condition. METHODS. The subjects were 709 noninstitutionalized men and 1060 women of the Framingham Study cohort (mean age 73.7 +/- 6.3 years). Ten medical conditions were identified for study: knee osteoarthritis, hip fracture, diabetes, stroke, heart disease, intermittent claudication, congestive heart failure, chronic obstructive pulmonary disease, depressive symptomatology, and cognitive impairment. Adjusted odds ratios were calculated for dependence on human assistance in seven functional activities. RESULTS. Stroke was significantly associated with functional limitations in all seven tasks; depressive symptomatology and hip fracture were associated with limitations in five tasks; and knee osteoarthritis, heart disease, congestive heart failure, and chronic obstructive pulmonary disease, were associated with limitations in four tasks each. CONCLUSIONS. In general, stroke, depressive symptomatology, hip fracture, knee osteoarthritis, and heart disease account for more physical disability in noninstitutionalized elderly men and women than other diseases.

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Selected References

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  1. Bachman D. L., Wolf P. A., Linn R., Knoefel J. E., Cobb J., Belanger A., D'Agostino R. B., White L. R. Prevalence of dementia and probable senile dementia of the Alzheimer type in the Framingham Study. Neurology. 1992 Jan;42(1):115–119. doi: 10.1212/wnl.42.1.115. [DOI] [PubMed] [Google Scholar]
  2. Berkman L. F., Berkman C. S., Kasl S., Freeman D. H., Jr, Leo L., Ostfeld A. M., Cornoni-Huntley J., Brody J. A. Depressive symptoms in relation to physical health and functioning in the elderly. Am J Epidemiol. 1986 Sep;124(3):372–388. doi: 10.1093/oxfordjournals.aje.a114408. [DOI] [PubMed] [Google Scholar]
  3. Branch L. G., Jette A. M. The Framingham Disability Study: I. Social disability among the aging. Am J Public Health. 1981 Nov;71(11):1202–1210. doi: 10.2105/ajph.71.11.1202. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Cook N. R., Evans D. A., Scherr P. A., Speizer F. E., Vedal S., Branch L. G., Huntley J. C., Hennekens C. H., Taylor J. O. Peak expiratory flow rate in an elderly population. Am J Epidemiol. 1989 Jul;130(1):66–78. doi: 10.1093/oxfordjournals.aje.a115324. [DOI] [PubMed] [Google Scholar]
  5. Greenland S. Bias in methods for deriving standardized morbidity ratio and attributable fraction estimates. Stat Med. 1984 Apr-Jun;3(2):131–141. doi: 10.1002/sim.4780030206. [DOI] [PubMed] [Google Scholar]
  6. Guccione A. A., Felson D. T., Anderson J. J. Defining arthritis and measuring functional status in elders: methodological issues in the study of disease and physical disability. Am J Public Health. 1990 Aug;80(8):945–949. doi: 10.2105/ajph.80.8.945. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Guralnik J. M., Kaplan G. A. Predictors of healthy aging: prospective evidence from the Alameda County study. Am J Public Health. 1989 Jun;79(6):703–708. doi: 10.2105/ajph.79.6.703. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Harris T., Kovar M. G., Suzman R., Kleinman J. C., Feldman J. J. Longitudinal study of physical ability in the oldest-old. Am J Public Health. 1989 Jun;79(6):698–702. doi: 10.2105/ajph.79.6.698. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Jette A. M., Pinsky J. L., Branch L. G., Wolf P. A., Feinleib M. The Framingham Disability Study: physical disability among community-dwelling survivors of stroke. J Clin Epidemiol. 1988;41(8):719–726. doi: 10.1016/0895-4356(88)90157-6. [DOI] [PubMed] [Google Scholar]
  10. Kelly-Hayes M., Jette A. M., Wolf P. A., D'Agostino R. B., Odell P. M. Functional limitations and disability among elders in the Framingham Study. Am J Public Health. 1992 Jun;82(6):841–845. doi: 10.2105/ajph.82.6.841. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kelly-Hayes M., Wolf P. A., Kannel W. B., Sytkowski P., D'Agostino R. B., Gresham G. E. Factors influencing survival and need for institutionalization following stroke: the Framingham Study. Arch Phys Med Rehabil. 1988 Jun;69(6):415–418. [PubMed] [Google Scholar]
  12. Lavsky-Shulan M., Wallace R. B., Kohout F. J., Lemke J. H., Morris M. C., Smith I. M. Prevalence and functional correlates of low back pain in the elderly: the Iowa 65+ Rural Health Study. J Am Geriatr Soc. 1985 Jan;33(1):23–28. doi: 10.1111/j.1532-5415.1985.tb02855.x. [DOI] [PubMed] [Google Scholar]
  13. Magaziner J., Simonsick E. M., Kashner T. M., Hebel J. R., Kenzora J. E. Predictors of functional recovery one year following hospital discharge for hip fracture: a prospective study. J Gerontol. 1990 May;45(3):M101–M107. doi: 10.1093/geronj/45.3.m101. [DOI] [PubMed] [Google Scholar]
  14. Mor V., Murphy J., Masterson-Allen S., Willey C., Razmpour A., Jackson M. E., Greer D., Katz S. Risk of functional decline among well elders. J Clin Epidemiol. 1989;42(9):895–904. doi: 10.1016/0895-4356(89)90103-0. [DOI] [PubMed] [Google Scholar]
  15. Mossey J. M., Knott K., Craik R. The effects of persistent depressive symptoms on hip fracture recovery. J Gerontol. 1990 Sep;45(5):M163–M168. doi: 10.1093/geronj/45.5.m163. [DOI] [PubMed] [Google Scholar]
  16. Nagi S. Z. An epidemiology of disability among adults in the United States. Milbank Mem Fund Q Health Soc. 1976 Fall;54(4):439–467. [PubMed] [Google Scholar]
  17. Nickel J. T., Chirikos T. N. Functional disability of elderly patients with long-term coronary heart disease: a sex-stratified analysis. J Gerontol. 1990 Mar;45(2):S60–S68. doi: 10.1093/geronj/45.2.s60. [DOI] [PubMed] [Google Scholar]
  18. Pinsky J. L., Branch L. G., Jette A. M., Haynes S. G., Feinleib M., Cornoni-Huntley J. C., Bailey K. R. Framingham Disability Study: relationship of disability to cardiovascular risk factors among persons free of diagnosed cardiovascular disease. Am J Epidemiol. 1985 Oct;122(4):644–656. doi: 10.1093/oxfordjournals.aje.a114144. [DOI] [PubMed] [Google Scholar]
  19. Pinsky J. L., Jette A. M., Branch L. G., Kannel W. B., Feinleib M. The Framingham Disability Study: relationship of various coronary heart disease manifestations to disability in older persons living in the community. Am J Public Health. 1990 Nov;80(11):1363–1367. doi: 10.2105/ajph.80.11.1363. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Rosow I., Breslau N. A Guttman health scale for the aged. J Gerontol. 1966 Oct;21(4):556–559. doi: 10.1093/geronj/21.4.556. [DOI] [PubMed] [Google Scholar]
  21. Satariano W. A., Ragheb N. E., Branch L. G., Swanson G. M. Difficulties in physical functioning reported by middle-aged and elderly women with breast cancer: a case-control comparison. J Gerontol. 1990 Jan;45(1):M3–11. doi: 10.1093/geronj/45.1.m3. [DOI] [PubMed] [Google Scholar]
  22. Scherr P. A., Albert M. S., Funkenstein H. H., Cook N. R., Hennekens C. H., Branch L. G., White L. R., Taylor J. O., Evans D. A. Correlates of cognitive function in an elderly community population. Am J Epidemiol. 1988 Nov;128(5):1084–1101. doi: 10.1093/oxfordjournals.aje.a115051. [DOI] [PubMed] [Google Scholar]
  23. Stewart A. L., Greenfield S., Hays R. D., Wells K., Rogers W. H., Berry S. D., McGlynn E. A., Ware J. E., Jr Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study. JAMA. 1989 Aug 18;262(7):907–913. [PubMed] [Google Scholar]
  24. Verbrugge L. M., Gates D. M., Ike R. W. Risk factors for disability among U.S. adults with arthritis. J Clin Epidemiol. 1991;44(2):167–182. doi: 10.1016/0895-4356(91)90264-a. [DOI] [PubMed] [Google Scholar]
  25. Verbrugge L. M., Lepkowski J. M., Imanaka Y. Comorbidity and its impact on disability. Milbank Q. 1989;67(3-4):450–484. [PubMed] [Google Scholar]
  26. Verbrugge L. M., Lepkowski J. M., Konkol L. L. Levels of disability among U.S. adults with arthritis. J Gerontol. 1991 Mar;46(2):S71–S83. doi: 10.1093/geronj/46.2.s71. [DOI] [PubMed] [Google Scholar]
  27. Wells K. B., Stewart A., Hays R. D., Burnam M. A., Rogers W., Daniels M., Berry S., Greenfield S., Ware J. The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. JAMA. 1989 Aug 18;262(7):914–919. [PubMed] [Google Scholar]
  28. Yelin E. H., Katz P. P. Transitions in health status among community-dwelling elderly people with arthritis. A national, longitudinal study. Arthritis Rheum. 1990 Aug;33(8):1205–1215. doi: 10.1002/art.1780330822. [DOI] [PubMed] [Google Scholar]

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