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Aging News & Information
Geriatric Conditions May Hinder Half of All Senior
Citizens in Daily Activities
Same level of dependency as older patients with chronic diseases
 Aug. 8, 2007 - A new study says half of America’s
senior citizens – those age 65 and older – have one or more conditions
that can hinder their ability to perform activities of daily living,
such as bathing and dressing.
Researchers at the University of Michigan Health
System analyzed the responses of more than 11,000 participants in the
national Health and Retirement Study in 2000.
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They found that 50 percent of older adults had a
moderate to severe form of at least one of the following conditions,
which they describe as “geriatric conditions” -
● cognitive impairment,
● falls,
● incontinence,
● low body mass index,
● dizziness,
● vision impairment or
● hearing impairment.
The researchers also studied whether the
respondents had difficulty with activities of daily living (bathing,
dressing, eating, toileting or transferring) and needed assistance to
complete the tasks.
They found that people with geriatric conditions
had about the same level of dependency when performing activities of
daily living as older patients with chronic diseases, including heart
disease, chronic lung disease, diabetes, cancer, musculoskeletal
conditions, stroke and psychiatric problems.
The study – which appears in the Aug. 7 issue of
the Annals of Internal Medicine – fills a major gap in research about
older patients, according to the authors.
Although conditions such as incontinence and falls
have been studied extensively, the total impact of geriatric conditions
on health and disability in the older adult population has not been
investigated, notes lead author Christine Cigolle, M.D., MPH, lecturer
in the U-M Health System Department of Family Medicine and a physician
in the Veterans Affairs Ann Arbor Healthcare System’s Geriatric
Research, Education and Clinical Center (GRECC).
“The focus in medicine has long been on diseases,
and how to diagnose and treat them. But that focus often isn’t helpful
in regard to older adults; they tend to have one or more of these
geriatric conditions, which are not considered diseases and can be
missed by physicians,” Cigolle says.
“Our study is the first to look at all seven of
these common conditions together, and we found that they are very common
and increase dramatically in prevalence with age,” she says. “To me,
that says that clinicians need to ask patients about these issues. In
many situations, they may be able to help manage the condition before it
leads to disability.”
In the medical world, experts have debated how to
categorize conditions such as the ones in this study. Some are called
geriatric syndromes, while others fall outside of categories typically
used by physicians.
The lack of consistent terminology has been one
obstacle to the appropriate diagnosis and treatment of these conditions,
says senior author Caroline Blaum, M.D., M.S., associate professor in
the Division of Geriatric Medicine at U-M and a research scientist at
the Veterans Affairs Ann Arbor Healthcare System GRECC.
Such obstacles need to be overcome so that older
adults can receive the best health care possible, she says. “Geriatric
conditions are integral to the health and function of older adults and
should be addressed in their care,” Blaum notes.
The researchers found a strong link between the
conditions and dependence on others to help with activities of daily
living.
Just 2.6 percent of survey participants without any
of the geriatric conditions were dependent on others for help with
activities. That percentage jumped to 8.1 among people with one of the
conditions, 19.4 among people with two conditions, and 45 among people
with three or more conditions.
All conditions increased in prevalence with
advancing age. Overall, 39 percent of people ages 65-69 were found to
have one or more of the conditions. The percentage rose to 82 among
people ages 90 and older. Among older adults with cognitive impairment,
for instance, 55 percent were 80 or older.
Additionally, compared to those with no geriatric
conditions, people with increasing numbers of conditions were older,
female, from a minority ethnic group, unmarried, and had less education
and a lower net worth.
The data used in this study are from the 2000 wave
of the Health and Retirement Study (HRS), a biennial longitudinal health
interview survey of adults ages 50 years and older in the United States.
The HRS is sponsored by the National Institute on Aging and performed by
the Institute for Social Research at U-M.
Editor's Notes:
In addition to Cigolle and Blaum, authors of the
study were Kenneth M. Langa, M.D., Ph.D., of the U-M Medical School
Department of Internal Medicine, the U-M Institute for Social Research
and the Ann Arbor VA Center for Practice Management and Outcomes
Research; and Mohammed U. Kabeto, M.S., and Zhiyi Tian, M.A., M.S., of
the Department of Internal Medicine.
The study was supported by grants from the John A.
Hartford Foundation and the National Institute on Aging and by the Ann
Arbor VA GRECC.
Reference: Annals of Internal Medicine, Aug. 7,
2007, Vol. 147, pages 156-164. “Geriatric Conditions and Disability: The
Health and Retirement Study.”
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