Progressive versus catastrophic disability: A longitudinal view of the disablement process

Luigi Ferrucci, Jack M. Guralnik, Eleanor Marie Simonsick, Marcel E. Salive, Chiara Corti, Jean Langlois

Research output: Contribution to journalArticle

Abstract

Background. There is little epidemiologic data on the development of disability over time in older persons. This study uses prospective data from cohorts followed annually for 60 to 7 years to identify persons who developed severe disability and to characterize the time course of their disabling process and subsequent mortality. Methods. Incidence rates of severe disability, defined as need for help in three or more activities of daily living (ADLs), were estimated for 6.640 persons who had not reported severe disability at baseline and at the first four annual follow-up visits. Among persons developing severe disability, those who reported no need for help in ADLs in previous interviews were defined as cases of catastrophic disability, and those who had previously reported some disability in ADLs were defined as cases of progressive disability. Results. Overall, 212 subjects developed progressive and 227 developed catastrophic disability. The rates of progressive disability and catastrophic disability were 11.3 and 12.1 cases per 1,000 person years, respectively. For both types of disability, incidence rates increased exponentially with age, but the increase was steeper for progressive disability. At ages 70-74, less than 25% of severe disability was progressive, while over age 85 progressive disability represented more than half of severe disability. Incidence rates of total and both types of severe disability were similar in men and women. Mortality after severe disability onset was extremely high. Survival time was unrelated to age at disability onset and type of disability but was significantly longer in women than in men (median 3.44 vs 2.12 years; p <.0001). Conclusion. Tracking the development of disability provides new and important insights into the disability experience in older men and women that are potentially relevant in planning preventive, intervention, and long-term care strategies.

Original languageEnglish (US)
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Volume51
Issue number3
StatePublished - May 1996
Externally publishedYes

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Activities of Daily Living
Incidence
Mortality
Long-Term Care
Age of Onset
Prospective Studies
Interviews
Survival

ASJC Scopus subject areas

  • Aging

Cite this

Progressive versus catastrophic disability : A longitudinal view of the disablement process. / Ferrucci, Luigi; Guralnik, Jack M.; Simonsick, Eleanor Marie; Salive, Marcel E.; Corti, Chiara; Langlois, Jean.

In: Journals of Gerontology - Series A Biological Sciences and Medical Sciences, Vol. 51, No. 3, 05.1996.

Research output: Contribution to journalArticle

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