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Unmet Need for ADL Assistance Is Associated With Mortality Among Older Adults With Mild Disability.

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Date
2015-09
Authors
He, Shuang
Craig, Bruce A
Xu, Huiping
Covinsky, Kenneth E
Stallard, Eric
Thomas, Joseph
Hass, Zach
Sands, Laura P
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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 article
Subject
Activities of daily living
Mortality
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
Permalink
https://hdl.handle.net/10161/14897
Published Version (Please cite this version)
10.1093/gerona/glv028
Publication 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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