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J Clin Epidemiol. 2007 Jan;60(1):79-85. Epub 2006 Oct 2.

Perceived causes of disability added prognostic value beyond medical conditions and functional status.

Author information

1
Division of Hematology-Oncology, UCLA Department of Medicine, Los Angeles, CA 90095-1687, USA. anaeim@mednet.ucla.edu

Abstract

OBJECTIVE:

This study's objective was to determine the incremental benefit of respondent subjective attribution of functional decline beyond relying solely on disease burden in predicting survival.

STUDY DESIGN AND SETTINGS:

A total of 9447 older adults from the Second Longitudinal Study on Aging, a probability sample of community dwelling adults aged 70 or older, were evaluated. Survival was based on status at follow-up interview 3-4 years after baseline interview. Logistic regression was performed using demographic variables and coexisting diseases as a baseline, then adding functional status measures (ADL, IADL) and individual subjective attribution of functional limitation in subsequent models.

RESULTS:

The predictions improved significantly with the addition of functional status measures (P<0.001) and the individual subjective attribution of functional limitation (P<0.001). For example, the probability of mortality for individuals with cancer was 17.3%, but 28.8% of those with cancer and functional limitations died as did 50% of those with cancer who reported functional limitations attributable to cancer.

CONCLUSION:

Among persons who can make a specific attribution of their functional limitation, the attribution may have value as a marker of severity of disease and serve as a good predictive measure for mortality, especially in specific illnesses such as cancer.

PMID:
17161758
DOI:
10.1016/j.jclinepi.2005.11.026
[Indexed for MEDLINE]

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