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Disability and Frailty

This study examines the prevalence of disability among different levels of functional ability based on dementia status in community institutions. It explores the association between dementia and impaired mobility and provides insights into the conceptualization of frailty.

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Disability and Frailty

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  1. Disability and Frailty

  2. Prevalence of Various Levels of Functional Ability by Dementia Status Community Institutions Normal Dementia 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

  3. The association of dementia with disability Proportion with impaired mobility Age Source: J. Graham Am J Epidemiol 1999;150:1045

  4. 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+).

  5. 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

  6. CSHA Researchers have Contributed to the Conceptualization of Frailty: • Static definition: ADL problems  cognitive problems,  poor self-rated health • Balance conception: Deficits: ADL/IADL, Cognitive problems Assets: Assistance, SES, Confidence Sources: K. Rockwood et al., J Amer Geriatr Soc 1996;44:578-582 Lancet 1999;353:205-6

  7. Percentage of Canadian population classified as frail by different definitions • Static: ADL + IADL • Balance definition • ,  Static: ADL + Cognition  Balance;Static: ADL/IADL  Static: ADL only  Static: ADL only

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