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Comparative Study
. 2007 Aug 15;57(6):1058-66.
doi: 10.1002/art.22906.

Racial/ethnic differences in activities of daily living disability in older adults with arthritis: a longitudinal study

Jing Song  1 , Huan J Chang, Manasi Tirodkar, Rowland W Chang, Larry M Manheim, Dorothy D Dunlop
Affiliations
Comparative Study

Racial/ethnic differences in activities of daily living disability in older adults with arthritis: a longitudinal study

Jing Song et al. Arthritis Rheum. .

Abstract

Objective: To investigate racial/ethnic differences in disability onset among older Americans with arthritis. Factors amenable to clinical and public health intervention that may explain racial/ethnic differences in incident disability were examined.

Methods: We analyzed longitudinal data (1998-2004) from a national representative sample of 5,818 non-Hispanic whites, 1,001 African Americans, 228 Hispanics interviewed in Spanish (Hispanic/Spanish), and 210 Hispanics interviewed in English (Hispanic/English), with arthritis and age >or=51 years who did not have baseline disability. Disability in activities of daily living (ADL) was identified from report of inability, avoidance, or needing assistance to perform >or=1 ADL task.

Results: Over the period of 6 years, 28.0% of African Americans, 28.5% of Hispanic/Spanish, 19.1% of Hispanic/English, and 16.2% of whites developed disability. The demographic-adjusted disability hazard ratios (AHR) were significantly greater among African Americans (AHR 1.94, 95% confidence interval [95% CI] 1.51-2.38) and Hispanic/Spanish (AHR 2.03, 95% CI 1.35-2.71), but not significantly increased for Hispanic/English (AHR 1.41, 95% CI 0.82-2.00) compared with whites. Differences in health factors (comorbid conditions, functional limitations, and behaviors) explained over half the excess risk among African Americans and Hispanic/Spanish. Medical access factors (education, income, wealth, and health insurance) were substantial mediators of racial/ethnic differences in all minority groups.

Conclusion: Racial/ethnic differences in the development of disability among older adults with arthritis were largely attenuated by health and medical access factors. Lack of health insurance was particularly problematic. At the clinical level, treatment of comorbid conditions, functional limitations, and promotion of physical activity and weight maintenance should be a priority to prevent the development of disability, especially in minority populations.

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Figures

Figure 1
Figure 1
Disablement Process Model
Figure 2
Figure 2
Six-year Cumulative Rates of Onset Disability among Older Americans with Arthritis from Health and Retirement Study Participants Aged 51+
See this image and copyright information in PMC

References

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