Restricted Activity: Key Indicator of Decline or “Just Having a Bad Day”?

Editorials4 September 2001Restricted Activity: Key Indicator of Decline or “Just Having a Bad Day”?Edward R. Marcantonio, MD, SMEdward R. Marcantonio, MD, SMDr. Marcantonio: Hebrew Rehabilitation Center for Aged; Boston, MA 02131Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-5-200109040-00014 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail As most older persons age, quality of life becomes increasingly important relative to quantity of life. The good news is that the average 65-year-old person will be functionally independent for the next 15 to 20 years of life (1). Disability is much more of a problem for persons 85 years of age or older; in this group, which is expanding most rapidly, almost 50% of people require assistance in basic activities of daily living (bathing, dressing, using the toilet, ambulation, and eating) (2, 3). However, the transition from independence to dependence is highly heterogeneous. No age or set of medical ...References1. Rice DP. Beneficiary profile: yesterday, today, and tomorrow. Health Care Financ Rev. 1996;18:23-46. [PMID: 10167858] MedlineGoogle Scholar2. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged: the index of activities of daily living: a standardized measure of biological and psychosocial function. JAMA. 1963;185:914-9. CrossrefMedlineGoogle Scholar3. Gornick ME, Warren JL, Eggers PW, Lubitz JD, De Lew N, Davis MH, et al . Thirty years of Medicare: impact on the covered population. Health Care Financ Rev. 1996;18:179-237. [PMID: 10173021] MedlineGoogle Scholar4. Gill TM, Desai MM, Gahbauer EA, Holford TR, Williams CS. Restricted activity among community-living older persons: incidence, precipitants, and health care utilization. Ann Intern Med. 2001;135:313-21. LinkGoogle Scholar5. National Health Interview Survey, National Center for Health Statistics. Current Estimates from the National Health Interview Survey: United States, 1984. Vital and Health Statistics, Series 10, No. 156. Hyattsville, MD: U.S. Department of Health and Human Services, Public Health Service, Office of Health Research, Statistics, and Technology, National Center for Health Statistics; 1986. DHHS publication no. PHS 86-1584. Google Scholar6. Wagner EH, LaCroix AZ, Grothaus L, Leveille SG, Hecht JA, Artz K, et al . Preventing disability and falls in older adults: a population-based randomized trial. Am J Public Health. 1994;84:1800-6. [PMID: 7977921] CrossrefMedlineGoogle Scholar7. Leveille SG, Wagner EH, Davis C, Grothaus L, Wallace J, LoGerfo M, et al . Preventing disability and managing chronic illness in frail older adults: a randomized trial of a community-based partnership with primary care. J Am Geriatr Soc. 1998;46:1191-8. [PMID: 9777899] CrossrefMedlineGoogle Scholar8. Reuben DB, Frank JC, Hirsch SH, McGuigan KA, Maly RC. A randomized clinical trial of outpatient comprehensive geriatric assessment coupled with an intervention to increase adherence to recommendations. J Am Geriatr Soc. 1999;47:269-76. [PMID: 10078887] CrossrefMedlineGoogle Scholar9. Gill TM, Williams CS, Tinetti ME. The combined effects of baseline vulnerability and acute hospital events on the development of functional dependence among community-living older persons. J Gerontol A Biol Sci Med Sci. 1999;54:M377-83. [PMID: 10462171] CrossrefMedlineGoogle Scholar10. Rakowski W, Julius M, Hickey T, Verbrugge LM, Halter JB. Daily symptoms and behavioral responses. Results of a health diary with older adults. Med Care. 1988;26:278-97. [PMID: 3352325] CrossrefMedlineGoogle Scholar11. Verbrugge LM, Ascione FJ. Exploring the iceberg. Common symptoms and how people care for them. Med Care. 1987;25:539-69. [PMID: 3695661] CrossrefMedlineGoogle Scholar12. Brody EM, Kleban MH. Day-to-day mental and physical health symptoms of older people: a report on health logs. Gerontologist. 1983;23:75-85. [PMID: 6601038] CrossrefMedlineGoogle Scholar13. Tinetti ME, Mendes de Leon CF, Doucette JT, Baker DI. Fear of falling and fall-related efficacy in relationship to functioning among community-living elders. J Gerontol. 1994;49:M140-7. [PMID: 8169336] CrossrefMedlineGoogle Scholar14. Scholes D, LaCroix AZ, Wagner EH, Grothaus LC, Hecht JA. Tracking progress toward national health objectives in the elderly: what do restricted activity days signify? Am J Public Health. 1991;81:485-8. [PMID: 2003629] CrossrefMedlineGoogle Scholar15. Kosorok MR, Omenn GS, Diehr P, Koepsell TD, Patrick DL. Restricted activity days among older adults. Am J Public Health. 1992;82:1263-7. [PMID: 1503169] CrossrefMedlineGoogle Scholar16. Kroenke K, Laine C. Investigating symptoms: frontiers in primary care research. Ann Intern Med. 2001;134(Part 2):801-930. LinkGoogle Scholar17. Jones R. Self care [Editorial]. BMJ. 2000;320:596. [PMID: 10698860] CrossrefMedlineGoogle Scholar18. Lorig KR, Sobel DS, Stewart AL, Brown BW, Bandura A, Ritter P, et al . Evidence suggesting that a chronic disease self-management program can improve health status while reducing hospitalization: a randomized trial. Med Care. 1999;37:5-14. [PMID: 10413387] CrossrefMedlineGoogle Scholar19. . Dorland's Illustrated Medical Dictionary. 26th ed. Philadelphia: WB Saunders; 1981. Google Scholar Author, Article, and Disclosure InformationAffiliations: Dr. Marcantonio: Hebrew Rehabilitation Center for Aged; Boston, MA 02131Corresponding Author: Edward R. Marcantonio, MD, SM, Department of Medicine, Research and Training Institute, Hebrew Rehabilitation Center for Aged, 1200 Centre Street, Boston, MA 02131. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRestricted Activity among Community-Living Older Persons: Incidence, Precipitants, and Health Care Utilization Thomas M. Gill , Mayur M. Desai , Evelyne A. Gahbauer , Theodore R. Holford , and Christianna S. Williams Metrics Cited ByBurden of Restricted Activity and Associated Symptoms and Problems in Late Life and at the End of LifeEstablishing a Hierarchy for the Two Components of Restricted ActivityOptimizing Reserve in Hospitalized ElderlyLow Use of Durable Medical Equipment By Chronically Disabled ElderlyEducation, Prevention, and the Translation of Research into PracticeA 3 Week Geriatric Education Program for 4 th Year Medical Students at Dalhousie University 4 September 2001Volume 135, Issue 5Page: 374-376KeywordsDisabilitiesElderlyGeriatricsHealth care utilizationRelative riskResearch designRisk managementSigns and symptomsUrinary incontinenceWalking ePublished: 4 September 2001 Issue Published: 4 September 2001 CopyrightCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...