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Medical Care:
doi: 10.1097/MLR.0b013e318245a0e0
Original Articles

Association of Chronic Diseases and Impairments With Disability in Older Adults: A Decade of Change?

Hung, William W. MD, MPH*,†,‡; Ross, Joseph S. MD, MHS§,∥; Boockvar, Kenneth S. MD, MS*,†,‡,¶; Siu, Albert L. MD, MSPH*,†,‡

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Background: Little is known about how the relationship between chronic disease, impairment, and disability has changed over time among older adults.

Objective: To examine how the associations of chronic disease and impairment with specific disability have changed over time.

Research Design: Repeated cross-sectional analysis, followed by examining the collated sample using time interaction variables, of 3 recent waves of the Health and Retirement Study.

Subjects: The subjects included 10,390, 10,621 and 10,557 community-dwelling adults aged 65 years and above in 1998, 2004, and 2008.

Measurements: Survey-based history of chronic diseases including hypertension, heart disease, heart failure, stroke, diabetes, cancer, chronic lung disease, and arthritis; impairments, including cognition, vision, and hearing; and disability, including mobility, complex activities of daily living (ADL), and self-care ADL.

Results: Over time, the relationship of chronic diseases and impairments with disability was largely unchanged; however, the association between hypertension and complex ADL disability weakened from 1998 to 2004 and 2008 [odds ratio (OR)=1.24; 99% confidence interval (CI), 1.06–1.46; OR=1.07; 99% CI, 0.90–1.27; OR=1.00; 99% CI, 0.83–1.19, respectively], as it did for hypertension and self-care disability (OR=1.32; 99% CI, 1.13–1.54; OR=0.97; 99% CI, 0.82–1.14; OR=0.99; 99% CI, 0.83–1.17). The association between diabetes and self-care disability strengthened from 1998 to 2004 and 2008 (OR=1.21; 99% CI, 1.01–1.46; OR=1.37; 99% CI, 1.15–1.64; OR=1.52; 99% CI, 1.29–1.79), as it also did for lung disease and self-care disability (OR=1.64; 99% CI, 1.33–2.03; OR=1.63; 99% CI, 1.32–2.01; OR=2.11; 99% CI, 1.73–2.57).

Conclusions: Although relationships between diseases, impairments, and disability were largely unchanged, disability became less associated with hypertension and more with diabetes and lung disease.

© 2012 Lippincott Williams & Wilkins, Inc.


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