Transcript CSHA Follow

Disability and Frailty
Canadian Study
of Health and Aging
Prevalence of Various Levels of Functional
Ability by Dementia Status
Community
Normal
Dementia
%
%
Institutions
Normal
Dementia
%
%
Good function
65.8
6.6
7.1
0.0
Mild disability
20.2
14.8
10.8
0.3
Moderate
12.1
30.8
39.5
2.5
Severe
1.3
21.2
27.3
12.3
Total disability
0.6 26.5
15.3
84.9
Canadian Study
of Health and Aging
The association of dementia with
disability
Proportion
with impaired
mobility
1
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0
Dementia
CIND
Normal
60
70
80
90
100
Age
Source: J. Graham Am J Epidemiol 1999;150:1045
Canadian Study
of Health and Aging
Selected CSHA Results on Disability
• Graham et al. (1999) modeled frailty in terms of the more
rapid cumulation of functional deficits than normal. Such
people are ‘functionally older’ than others. Using this
approach, they distinguished normal aging from the
effects of disease
• Hogan et al. (1999) described changes in function over 5
years. 68% of subjects reported a functional decline; 27%
of people remained the same. They described predictors
of functional decline, and reported functioning among the
very old (85+).
Canadian Study
of Health and Aging
Disability (continued)
• Moghal et al. (1994, 1995) reported the prevalence of
movement disorders (tremor, Parkinson’s disease) in
community and institutional residents
• Rockwood et al. (1999) proposed a brief approach for
classifying frailty
• Thomas et al. (1998) reported on the number of distinct
dimensions of ADL and IADL disabilities
Canadian Study
of Health and Aging
CSHA Researchers have Contributed to
the Conceptualization of Frailty:
1. Static definition: ADL problems  cognitive
problems,  poor self-rated health
2. Balance conception:
Deficits:
ADL/IADL,
Cognitive
problems
Sources: K. Rockwood et al.,
J Amer Geriatr Soc 1996;44:578-582
Lancet 1999;353:205-6
Assets:
Assistance,
SES,
Confidence
Canadian Study
of Health and Aging
Percentage of Canadian
population classified as frail by
different definitions
90
80
70
 Static: ADL + IADL
 Balance definition
,  Static: ADL + Cognition
 Balance; Static: ADL/IADL
60
50
40
30
 Static: ADL only
 Static: ADL only
20
10
0
65 -
75 -
85 +
Canadian Study
of Health and Aging