Prognostic value of disability on mortality: 15-year follow-up of the Bambuí cohort study of aging

Arch Gerontol Geriatr. 2018 Jan:74:112-117. doi: 10.1016/j.archger.2017.10.011. Epub 2017 Oct 20.

Abstract

Background: Disability is a concern in the context of population ageing. The extent of an individual's disability is a major determinant of whether or not they require long-term care or survival time. We investigated the effect of three disability domains as predictors of all-cause mortality over 15-year follow-up in a Brazilian socioeconomically disadvantaged and multiracial older adult population.

Methods: We estimated Cox proportional hazards models using data from 1333 community-dwelling individuals aged 60 and older from the Bambuí Cohort Study of Ageing. Disability was defined as a great difficulty or not being able to perform one and two or more activities in each domain: mobility, instrumental activities of daily living (IADL) and basic activities of daily living (BADL).

Results: The overall mortality rate was 46.1 per 1000 person-years at risk (pyrs) and it was higher in men. Among men, the fully adjusted Hazard Ratios (HRs) were 1.92 (95%CI: 1.43-2.58), 2.07 (95%CI: 1.53-2.79) and 1.65 (95%CI: 1.11-2.45), and among women 1.75 (95%CI: 1.38-2.21), 1.43 (95%CI: 1.11-1.84) and 1.43 (95%CI: 1.05-1.95), for two or more disability in mobility tasks, IADLs and BADLs, respectively, compared to those with no difficulty or some difficulty to perform all the tasks.

Conclusion: A similar risk of death for mobility, IADL and BADL in both genders was found, suggesting that any of these domains can be used to identify risk of all-cause mortality among older adults. The number of activities with limitations in each domain was an important factor.

Keywords: Brazil; Cohort studies; Disability; Mortality.

MeSH terms

  • Activities of Daily Living
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Disabled Persons*
  • Female
  • Follow-Up Studies
  • Humans
  • Independent Living
  • Male
  • Mortality*
  • Prognosis