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Instrumental Activities of Daily Living as a Potential Marker of Frailty A Study of 7364 Community-Dwelling Elderly Women (the EPIDOS Study)

TLDR
The results confirmed that women with disability on at least one IADL item are frailer because they had more associated disorders, poorer cognitive function and more frequent falls.
Abstract
Background. A number of clinical conditions have been shown to be associated with frailty in elderly people. We hypothesized that incapacities on the Instrumental Activities of Daily Living (IADLs) scale could make it possible to identify this population. We investigated the associations between IADL incapacities and the various known correlates of frailty in a cohort of community-dwelling elderly women. Methods. Cross-sectional analysis was carried out on the data from 7364 women aged over 75 years (EPIDOS Study). The IADL was the dependent variable. Sociodemographic, medical, and psychological performance measures were obtained during an assessment visit. Falls in the previous 6 months and fear of falling were also ascertained. Body composition was measured by dual-energy x-ray absorptiometry. The factors associated with disability in at least one IADL were included in a logistic regression model. Results. Thirty-two percent of the population studied had disability in at least one IADL item. This group was significantly older (81.7 � 4.1 yr vs 79.8 � 3.4 yr), had more frequent histories of heart disease, stroke, depression or diabetes, and was socially less active ( p � .001). These associations persisted after multivariate analysis. Cognitive impairment as assessed by the Pfeiffer test (Pfeiffer score � 8) was closely associated with disabilities on the IADL (OR 3.101, 95% confidence interval [CI] 2.19‐4.38). Falls and fear of falling were also more frequent in the group of women with an abnormal IADL ( p � .001) but only fear of falling remained significantly associated with incapacities on at least one IADL item after logistic regression (OR 1.47, 95% CI 1.28‐1.69). Women with disability on at least one IADL item also had lower bone mineral density, this was independent of the other factors. Conclusion. Our results confirmed that women with disability on at least one IADL item are frailer because they had more associated disorders, poorer cognitive function and more frequent falls. Disabilities on this scale could be a good tool for identifying individuals at risk of frailty among elderly persons living at home and in apparent good health. This finding requires confirmation by longitudinal studies.

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Journal ArticleDOI

The Development of Fear of Falling Among Community-Living Older Women: Predisposing Factors and Subsequent Fall Events

TL;DR: Fear of falling develops due to a combination of predisposing factors and subsequent fall events among community-living older women, and preventive efforts to reduce fear of falling may also decrease the likelihood of falling.
Journal ArticleDOI

Factors contributing to frailty: literature review.

TL;DR: A theoretical framework that includes bio-psycho-social-spiritual factors as contributors to frailty is recommended as the most useful framework for gerontological nursing.
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Associations of visual function with physical outcomes and limitations 5 years later in an older population: the Beaver Dam eye study

TL;DR: The Beaver Dam Eye Study as discussed by the authors examined the association of performance-based measures of visual functioning with the occurrence of falls, fractures, physical outcomes, and limitations in an older population.
Journal ArticleDOI

Cognitive functioning as a predictor of functional disability in later life.

TL;DR: People with lower levels of cognitive functioning were more likely to die or become disabled than those with higher levels of cognition and changes in cognitive functioning might serve as an early indicator of neurologic and medical factors.
References
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Journal ArticleDOI

Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living

M. P. Lawton, +1 more
- 21 Sep 1969 - 
TL;DR: Two scales first standardized on their own population are presented, one of which taps a level of functioning heretofore inadequately represented in attempts to assess everyday functional competence, and the other taps a schema of competence into which these behaviors fit.
Journal ArticleDOI

A short portable mental status questionnaire for the assessment of organic brain deficit in elderly patients

TL;DR: A 10‐item Short Portable Mental Status Questionnaire (SPMSQ), easily administered by any clinician in the office or in a hospital, has been designed, tested, standardized and validated.
Journal ArticleDOI

Lower-Extremity Function in Persons over the Age of 70 Years as a Predictor of Subsequent Disability

TL;DR: Among nondisabled older persons living in the community, objective measures of lower-extremity function were highly predictive of subsequent disability.
Journal ArticleDOI

Human aging: usual and successful

TL;DR: Research on the risks associated with usual aging and strategies to modify them should help elucidate how a transition from usual to successful aging can be facilitated.
Journal ArticleDOI

Falls, Injuries Due to Falls, and the Risk of Admission to a Nursing Home

TL;DR: Among older people living in the community falls are a strong predictor of placement in a skilled-nursing facility; interventions that prevent falls and their sequelae may therefore delay or reduce the frequency of nursing home admissions.
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