Tags

Type your tag names separated by a space and hit enter

Risk factors for functional decline in nonagenarians: a one-year follow-up. The NonaSantfeliu study.
Gerontology. 2007; 53(4):211-7.G

Abstract

BACKGROUND

Disability and a decline in functional capacity are common in old age.

OBJECTIVE

To determine predictors of functional decline in nonagenarians' basic activities of daily living (ADL) after 1 year of follow-up.

METHODS

A sample of 97 nonagenarians subjects not previously severely dependent (Barthel Index >59) was evaluated. This sample included 72 women (74.2%) and the mean (SD) age was 93.4 +/- 2.7 years. The following data were collected: sociodemographic data, Barthel Index (BI), Lawton-Brody Index (LI), Mental State Examination (MEC), a short version of the Mini-Nutritional Assessment, comorbidity (Charlson Index), lower-extremity function, Gait Rating Scale from the Tinetti Performance-Oriented Mobility Scale and prevalent chronic diseases. Subjects who had a 10-point or higher decline in the BI in 1 year were compared to subjects who had no decline or a maximum decline of 9 points. In addition, subjects whose total BI score fell below 60 were compared to the group of subjects who maintained scores between 60 and 100. The Student's t test, the chi(2) or the Fisher's exact test, and a multiple logistic regression analysis (with the identified risk factors of age and gender) were performed.

RESULTS

39 nonagenarians experienced a 10-point or higher decline in the BI in 1 year. A lower LI score (p = 0.003) and visual impairment (p = 0.01) were associated with functional decline. The multiple regression analysis showed that there was a significant association with LI (odds ratio (OR) 0.74, confidence interval 95% 0.60-0.91, p < 0.005). The 18 nonagenarians who had a BI <60 had a BI >60 at baseline. Lower scores on the LI (p = 0.004) and on the MEC (p = 0.01), a history of a previous stroke (p = 0.009) and higher Charlson Index scores (p = 0.03) were associated with recently acquired, severe dependency. A multiple regression analysis showed a significant association between LI (OR 0.65, 0.47-0.89, p < 0.008) and a history of previous strokes (OR 3.39, 1.01-11.34, p < 0.04).

CONCLUSIONS

According to the definition used to describe functional basic ADL decline, poor performance in instrumental ADL at baseline and a history of a stroke appear to be independent risk factors. Prevention strategies could be intensified in this subgroup of nonagenarians.

Authors+Show Affiliations

Geriatric Unit, Internal Medicine Service, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain. fformiga@csub.scs.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17351324

Citation

Formiga, Francesc, et al. "Risk Factors for Functional Decline in Nonagenarians: a One-year Follow-up. the NonaSantfeliu Study." Gerontology, vol. 53, no. 4, 2007, pp. 211-7.
Formiga F, Ferrer A, Pérez-Castejon JM, et al. Risk factors for functional decline in nonagenarians: a one-year follow-up. The NonaSantfeliu study. Gerontology. 2007;53(4):211-7.
Formiga, F., Ferrer, A., Pérez-Castejon, J. M., Olmedo, C., & Pujol, R. (2007). Risk factors for functional decline in nonagenarians: a one-year follow-up. The NonaSantfeliu study. Gerontology, 53(4), 211-7.
Formiga F, et al. Risk Factors for Functional Decline in Nonagenarians: a One-year Follow-up. the NonaSantfeliu Study. Gerontology. 2007;53(4):211-7. PubMed PMID: 17351324.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for functional decline in nonagenarians: a one-year follow-up. The NonaSantfeliu study. AU - Formiga,Francesc, AU - Ferrer,Assumpta, AU - Pérez-Castejon,Juan Manel, AU - Olmedo,Claudia, AU - Pujol,Ramón, Y1 - 2007/03/13/ PY - 2006/03/28/received PY - 2007/01/19/accepted PY - 2007/3/14/pubmed PY - 2007/9/19/medline PY - 2007/3/14/entrez SP - 211 EP - 7 JF - Gerontology JO - Gerontology VL - 53 IS - 4 N2 - BACKGROUND: Disability and a decline in functional capacity are common in old age. OBJECTIVE: To determine predictors of functional decline in nonagenarians' basic activities of daily living (ADL) after 1 year of follow-up. METHODS: A sample of 97 nonagenarians subjects not previously severely dependent (Barthel Index >59) was evaluated. This sample included 72 women (74.2%) and the mean (SD) age was 93.4 +/- 2.7 years. The following data were collected: sociodemographic data, Barthel Index (BI), Lawton-Brody Index (LI), Mental State Examination (MEC), a short version of the Mini-Nutritional Assessment, comorbidity (Charlson Index), lower-extremity function, Gait Rating Scale from the Tinetti Performance-Oriented Mobility Scale and prevalent chronic diseases. Subjects who had a 10-point or higher decline in the BI in 1 year were compared to subjects who had no decline or a maximum decline of 9 points. In addition, subjects whose total BI score fell below 60 were compared to the group of subjects who maintained scores between 60 and 100. The Student's t test, the chi(2) or the Fisher's exact test, and a multiple logistic regression analysis (with the identified risk factors of age and gender) were performed. RESULTS: 39 nonagenarians experienced a 10-point or higher decline in the BI in 1 year. A lower LI score (p = 0.003) and visual impairment (p = 0.01) were associated with functional decline. The multiple regression analysis showed that there was a significant association with LI (odds ratio (OR) 0.74, confidence interval 95% 0.60-0.91, p < 0.005). The 18 nonagenarians who had a BI <60 had a BI >60 at baseline. Lower scores on the LI (p = 0.004) and on the MEC (p = 0.01), a history of a previous stroke (p = 0.009) and higher Charlson Index scores (p = 0.03) were associated with recently acquired, severe dependency. A multiple regression analysis showed a significant association between LI (OR 0.65, 0.47-0.89, p < 0.008) and a history of previous strokes (OR 3.39, 1.01-11.34, p < 0.04). CONCLUSIONS: According to the definition used to describe functional basic ADL decline, poor performance in instrumental ADL at baseline and a history of a stroke appear to be independent risk factors. Prevention strategies could be intensified in this subgroup of nonagenarians. SN - 1423-0003 UR - https://www.unboundmedicine.com/medline/citation/17351324/Risk_factors_for_functional_decline_in_nonagenarians:_a_one_year_follow_up__The_NonaSantfeliu_study_ L2 - https://www.karger.com?DOI=10.1159/000100780 DB - PRIME DP - Unbound Medicine ER -