Researchers Find the Ability to Perform Every Day Tasks Can Predict Remaining Years of Life
Tuesday, March 6, 2012
Summary of this Study
Researchers from the Perelman School of Medicine at the University of Pennsylvania, Philadelphia VA, Greater Los Angeles VA GRECC, UCLA/JH Borun Center for Gerontological Research, and the Hospital de la Concepcion (San German, Puerto Rico) looked at whether older adults’ abilities to engage in basic activities of daily living had any relationship to whether these individuals lived longer. The researchers determined that the types of activities that were limited, as well as the severity or degree of the limitations directly predicted mortality. These findings could serve as a way to predict life expectancy.
Why This Study Was Done
Staging systems have been developed to help doctors and patients understand how long a person may expect to live with a particular disease. Usually these staging systems include disease specific information, such as the size of a cancer, or the results of certain blood tests in liver disease. Researchers are beginning to understand that functional status, such as the ability to bathe, dress or walk can also predict how long a person can expect to survive, but refinement of these staging systems is ongoing. Rather than counting functional limitations, researchers looked at patterns of functional decline as a way to predict mortality in older adults living in the community.
What They Found
The researchers analyzed survey results from 9,272 community-dwelling adults aged 70 years and older who were participants in the second Longitudinal Study of Aging. They evaluated participants’ capacities to engage in basic activities of daily living based on 5 stages from 0 for no limitations to IV for total limitations and compared those capacities according to rates of mortality for one-, five-, and ten-year time frames.
For those with no limitations in basic activities of daily living, the median life expectancy beyond the time of their interview was 10.6 years compared to 1.6 years for those with stage IV limitations.
“We have shown that our new Activity Limitation Stages can help us think more broadly about the importance of disability and why some people survive longer than others.” said Margaret G. Stineman, MD of the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania and lead author of the study. “With the incidence of death at one year five times greater for people with total limitations compared to those with no limitation, a person’s ability to perform the basic Activities of Daily Living without difficulty can be used to predict survival in a way that is similar to the absence of particular illnesses. This suggests an opportunity to apply our new disability staging system to improve patient screening and identify areas in which people may need services to help them regain or maintain their functional abilities.”
What You Can Do
Be aware if you, or an older adult friend or family member, experience early signs of difficulties with daily activities, such as having less strength in pushing up from a chair or having difficulty bending to tie your shoes. Discuss these problems with your healthcare provider, who can recommend ways to improve strength and function or stall further decline.
For example, exercises such as yoga or tai chi may help by improving balance and flexibility.
Regular checkups by a healthcare team member trained in the special needs of older adults can help prevent small functional declines from becoming major declines and could extend years of healthy life.
This summary is from the full report titled, All-Cause 1-,5-, and 10-Year Mortality Among Elderly People According to the Activities of Daily Living Stage. It is in the March 2012 issue of the Journal of the American Geriatrics Society (JAGS). The report is authored by Margaret G. Stineman, MD, Dawei Xie, PhD, Qiang Pan, MA, Jibby E. Kurichi, MPH, Zi Zhang, MD, Debra Saliba, MD, John T. Henry-Sánchez, MD, and Joel Streim, MD.