Do the Tenets of Late-Life Disability Apply to Middle Age?

Editorials5 December 2017Do the Tenets of Late-Life Disability Apply to Middle Age?Thomas M. Gill, MDThomas M. Gill, MDFrom Yale School of Medicine, New Haven, Connecticut.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M17-2550 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The correlates, consequences, and causes of disability are of fundamental concern to a U.S. population whose age structure is shifting dramatically. In 2030, the number of persons aged 65 years and older is projected to be twice as high as it was in 2000, growing from 35 million to 74 million and representing nearly 21% of the U.S. population (1). Regardless of the type of activity assessed, the prevalence of disability increases with advancing age and is consistently higher among women than men. To highlight its importance, disability has been identified as a universal outcome, and older persons consistently indicate ...References1. Federal Interagency Forum on Aging-Related Statistics.. Older Americans 2016: key indicators of well-being. Washington, DC: U.S. Government Printing Office; August 2016. Google Scholar2. Fried TR, Tinetti ME, Iannone L, O'Leary JR, Towle V, Van Ness PH. Health outcome prioritization as a tool for decision making among older persons with multiple chronic conditions [Letter]. Arch Intern Med. 2011;171:1854-6. [PMID: 21949032] doi:10.1001/archinternmed.2011.424 CrossrefMedlineGoogle Scholar3. Gill TM. Disentangling the disabling process: insights from the precipitating events project. Gerontologist. 2014;54:533-49. [PMID: 25035454] doi:10.1093/geront/gnu067 CrossrefMedlineGoogle Scholar4. Brown RT, Diaz-Ramirez LG, Boscardin WJ, Lee SJ, Steinman MA. Functional impairment and decline in middle age. A cohort study. Ann Intern Med. 2017;167:761-8. doi:10.7326/M17-0496. LinkGoogle Scholar5. Fong TG, Fearing MA, Jones RN, Shi P, Marcantonio ER, Rudolph JL, et al. Telephone interview for cognitive status: creating a crosswalk with the Mini-Mental State Examination. Alzheimers Dement. 2009;5:492-7. [PMID: 19647495] doi:10.1016/j.jalz.2009.02.007 CrossrefMedlineGoogle Scholar6. Gill TM, Gahbauer EA, Murphy TE, Han L, Allore HG. Risk factors and precipitants of long-term disability in community mobility: a cohort study of older persons. Ann Intern Med. 2012;156:131-40. [PMID: 22250144]. doi:10.7326/0003-4819-156-2-201201170-00009 LinkGoogle Scholar7. Spector WD, Fleishman JA. Combining activities of daily living with instrumental activities of daily living to measure functional disability. J Gerontol B Psychol Sci Soc Sci. 1998;53:S46-57. [PMID: 9469179] CrossrefMedlineGoogle Scholar8. Wiener JM, Hanley RJ, Clark R, Van Nostrand JF. Measuring the activities of daily living: comparisons across national surveys. J Gerontol. 1990;45:S229-37. [PMID: 2146312] CrossrefMedlineGoogle Scholar9. Gill TM, Robison JT, Tinetti ME. Difficulty and dependence: two components of the disability continuum among community-living older persons. Ann Intern Med. 1998;128:96-101. [PMID: 9441588] LinkGoogle Scholar10. Gill TM, Guralnik JM, Pahor M, Church T, Fielding RA, King AC, et al. Effect of structured physical activity on overall burden and transitions between states of major mobility disability in older persons: secondary analysis of a randomized trial. Ann Intern Med. 2016;165:833-40. doi:10.7326/M17-0529. LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Yale School of Medicine, New Haven, Connecticut.Disclaimer: The organization funding this study had no role in the preparation, review, or approval of the editorial.Grant Support: Dr. Gill is the recipient of an Academic Leadership Award (K07AG043587) from the National Institute on Aging and is supported by the Yale Claude D. Pepper Older Americans Independence Center (P30AG21342).Disclosures: The author has disclosed no conflicts of interest. Form can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M17-2550.Corresponding Author: Thomas M. Gill, MD, Yale School of Medicine, Adler Geriatric Center, 874 Howard Avenue, New Haven, CT 06519; e-mail, thomas.[email protected]edu.This article was published at Annals.org on 14 November 2017. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoFunctional Impairment and Decline in Middle Age Rebecca T. 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A new neuroscientific paradigm of cognitive trainingMoving prevention of functional impairment upstream: is middle age an ideal time for intervention?Independent AgingAdaptation for Growth Via Learning New Skills as a Means to Long-Term Functional Independence in Older Adulthood: Insights From Emerging Adulthood 5 December 2017Volume 167, Issue 11Page: 818-819KeywordsDisabilitiesForecastingFrailtyGeriatricsHospitalizationsMedical risk factorsMortalityObesityStrokeWalking ePublished: 31 October 2017 Issue Published: 5 December 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...