|
E-mail this page to a friend!
Chronic Disability in Senior Citizens Greatly
Overestimated
Dec. 13, 2005 - The rates of chronic disability in
older Americans has been substantially overestimated by about forty
percent, researchers at Yale School of Medicine report in the December
12 Archives of Internal Medicine.
"Our projections yielded about two million fewer
chronically disabled older Americans in 1999, relative to the published
estimate of seven million," said Thomas M. Gill, M.D., who co-authored
the study with Evelyne A. Gahbauer, M.D.
Gill, associate professor of medicine/geriatrics,
obtained his findings using data from the "Yale PEP Study," which seeks
to better understand how older persons manage day-to-day activities and
remain independent at home.
Titled "Epidemiology of Disability and Recovery in
Older Persons," the PEP study includes 754 participants age 70 or older
from the Greater New Haven area. Over the last eight years, participants
have shared their experiences during a series of home assessments and
monthly telephone interviews focusing on essential activities of daily
living, such as bathing, dressing and walking.
The National Institute on Aging last month awarded
Gill a $3.2 million MERIT award for outstanding research to continue his
"PEP" study to better understand how older persons manage day-to-day
activities and remain independent at home.
Patients in this study were classified as having
chronic disability based on the presence of disability during
consecutive monthly interviews immediately before or after the fourth
comprehensive assessment.
Of the 552 participants, 16.1 to 17.2 percent met
criteria for chronic disability, leading to a national estimate ranging
from 4.9 to 5.3 million chronically disabled older Americans.
Gill said accurate estimates of chronic disability
are important for a variety of reasons. From a policy perspective, these
estimates are often used to inform decisions regarding the current and
future health care needs of older persons and to forecast the likely
demand for long-term care. From an epidemiologic perspective, the causes
of chronic disability, including pre-disposing risk factors and
subsequent precipitants, may differ from those of short-term disability.
"From a personal perspective, the likelihood of
recovery is considerably lower for chronic disability than for
short-term disability; and chronic disability likely confers a higher
risk of subsequent morbidity and mortality," said Gill.
"Given the dynamic nature of disability, new
strategies are needed to adequately capture the true burden of chronic
disability among elderly persons."
Other results from PEP
In the PEP study, over the last eight years,
participants have shared their experiences during a series of home
interviews and monthly telephone interviews focusing on essential
activities of daily living, such as bathing, dressing and walking.
Based on this information, Gill and his team, have
written many articles for leading medical journals." Through this
effort, older New Haven residents are helping the whole country," said
Gill.
The findings to date reveal that disability often
begins after a serious illness or injury and changes may appear after a
hospital stay or even after a few days in bed.
Gill has also found that many older people recover
from these disabling episodes and resume their usual activities. He said
regular exercise helps with the recovery of independence. In addition,
four out of 10 participants experience chronic pain; older persons use a
number of different strategies to reduce the level of their pain.
"Our results have provided strong evidence to
support the idea that disability is a reversible and often recurrent
event," said Gill. "PEP addresses an important problem in the lives of
many older Americans and their families. By better understanding
disability, we hope to develop new ways to maintain and restore
independence among older persons."
In granting MERIT awards, the NIH identifies
researchers "whose research productivity and accomplishments are
distinctly superior and who are highly likely to continue to perform in
an outstanding manner."
Gill's research team includes Theodore R. Holford,
Susan Dwight Bliss Professor of Public Health; Heather Allore, associate
research scientist, Zhenchao Guo, M.D. and Ling Han, M.D.,
biostatisticians; Evelyne Gahbauer, M.D., senior data manager, Denise
Shepard, project coordinators and Joanne McGloin, project director.
Click here to Search SeniorJournal.com for more on
this subject
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
