Unmet Need for ADL Assistance Is Associated With Mortality Among Older Adults With Mild Disability.
Abstract
BACKGROUND: Unmet need for assistance with activities of daily living (ADLs) disability
is associated with increased risk for future hospitalization. To further explore the
association between unmet ADL need and future health outcomes, we examined the association
between unmet need for ADL assistance and 1-year mortality. METHODS: A prospective
study of 6,730 community-living Medicare recipients was conducted among respondents
to the 1994, 1999, and/or 2004 National Long Term Care Survey. Only those who reported
having one or more ADL disabilities were included. Time to death within 1 year after
the community survey was determined from Centers for Medicare and Medicaid Services
vital statistics records. The community interviews provided demographic, health, and
ADL information. RESULTS: Unadjusted 1-year death rates were 8.7%, 10.6%, 11.4%, 19.2%,
and 27.3%, respectively, for respondents with disabilities in 1, 2, 3, 4, and 5 ADLs.
Overall, 21.3% reported unmet need for assistance for one or more ADL disabilities.
After controlling for demographic and health characteristics, we found a significant
interaction between unmet ADL need and level of ADL disability (p = .018). Post hoc
analyses revealed that unmet ADL need was associated with increased risk for mortality
only for those with one (hazard ratio = 1.96; 95% CI = 1.29-2.87) or two ADL disabilities
(hazard ratio = 1.37; 95% CI = 1.07-1.75), but not for those with three or more ADL
disabilities. CONCLUSION: Future studies are needed to determine whether these findings
are replicable and, if so, whether physiologic or process of care variables explain
why ADL is associated with mortality only for those with mild disability.
Type
Journal articleSubject
Activities of daily livingMortality
Unmet need.
Activities of Daily Living
Aged, 80 and over
Disabled Persons
Female
Health Surveys
Humans
Male
Mortality
Needs Assessment
Proportional Hazards Models
Prospective Studies
United States
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https://hdl.handle.net/10161/14897Published Version (Please cite this version)
10.1093/gerona/glv028Publication Info
He, Shuang; Craig, Bruce A; Xu, Huiping; Covinsky, Kenneth E; Stallard, Eric; Thomas,
Joseph; ... Sands, Laura P (2015). Unmet Need for ADL Assistance Is Associated With Mortality Among Older Adults With
Mild Disability. J Gerontol A Biol Sci Med Sci, 70(9). pp. 1128-1132. 10.1093/gerona/glv028. Retrieved from https://hdl.handle.net/10161/14897.This is constructed from limited available data and may be imprecise. To cite this
article, please review & use the official citation provided by the journal.
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