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. 2005 Apr;52(4):1274-82.
doi: 10.1002/art.20968.

Risk factors for functional decline in older adults with arthritis

Dorothy D Dunlop  1 , Pamela Semanik, Jing Song, Larry M Manheim, Vivian Shih, Rowland W Chang
Affiliations

Risk factors for functional decline in older adults with arthritis

Dorothy D Dunlop et al. Arthritis Rheum. 2005 Apr.

Abstract

Objective: Functional limitation is a major factor in medical costs. This study was undertaken to evaluate the prevalence of functional limitation among adults with arthritis and the frequency of functional decline over 2 years, and to investigate factors amenable to public health intervention that predict functional decline.

Methods: Longitudinal data (1998-2000) from a cohort of 5,715 adults ages 65 years or older with arthritis from a national probability sample were analyzed. Function was defined based on ability to perform basic activities of daily living (ADL) tasks and instrumental ADL. Adjusted odds ratios (ORs) from a multiple logistic regression model were used to estimate the associations between functional decline and comorbid conditions, health behaviors, and economic factors.

Results: Overall, 19.7% of this cohort had functional limitation at baseline, including 12.9% with ADL limitations. Over the subsequent 2 years, function declined in 13.6% of those at risk. Functional decline was most frequent among women (15.0%) and minorities (18.0% Hispanics, 18.7% African Americans) with arthritis. Lack of regular vigorous physical activity, the most prevalent risk factor (64%), almost doubled the odds of functional decline (adjusted OR 1.9, 95% confidence interval 1.5-2.4) after controlling for all risk factors. It was found that if all subjects engaged in regular vigorous physical activity, the expected functional decline could be reduced as much as 32%. Other significant predictors included older age, cognitive impairment, depressive symptoms, diabetes, physical limitations, no alcohol use, stroke, and vision impairment.

Conclusion: Lack of regular vigorous physical activity is a potentially modifiable risk factor that could substantially reduce functional decline and associated health care costs. Prevention/intervention programs should include regular vigorous physical activity, weight maintenance, and medical intervention for health needs. (c) 2005, American College of Rheumatology.

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Figures

Figure 1
Figure 1
Prevalence of Functional Limitation of Arthritis Cohort Aged 65 or older (N=5715) Stratified by Gender from the 1998 Health and Retirement Survey
Figure 2
Figure 2. Two-Year Functional Decline by Baseline Functional Status of 1998–2000 HRS Arthritis Cohort Aged 65 or Older (n=4922)
See this image and copyright information in PMC

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