Newly reported chronic conditions and onset of functional dependency

Abstract

Objectives: To examine the relationship between newly reported chronic conditions and subsequent functional dependency in older adults.

Design: Three-year cohort study.

Setting: United States.

Participants: A national sample of Americans age 65 and older (N=4,968) who participated in the Medicare Current Beneficiary Survey.

Measurements: Self-reports of new physician diagnoses between baseline and 12 months and functional dependency onset at 12-, 24-, and 36-month follow-up. Functional dependency is defined as needing help with or being unable to perform one or more activities of daily living or residence in a long-term care facility.

Results: After 12 months of follow-up, 29.8% of participants reported one or more newly diagnosed conditions, increasing to 48.7% at 24 months and 61.3% at 36 months. Number of newly reported conditions was associated with greater probability of functional dependency; this association was strongest at 12 months. The odds of becoming functionally dependent were nearly twice as great in participants who reported one new chronic condition (odds ratio (OR)=1.9, 95% confidence interval (CI)=1.3-2.8), more than four times as great in those who reported two new chronic conditions (OR=4.3, 95%=CI 2.7-6.9), and 13 times as great in those who reported three or more new chronic conditions (OR=13.0, 95%=CI 6.5-26.3) as in those who reported no new chronic conditions. Newly reported dementia, stroke, psychological disorders, low body mass index, and obesity were significantly and consistently related to functional dependency throughout all 3 years of observation (OR=2.1-14.1).

Conclusion: Findings from this study demonstrate the strong relationship between newly diagnosed chronic conditions and functional dependency and highlight the potential benefit of prevention in older adults.