FUNCTIONAL TRANSITIONS AMONG THE ELDERLY - PATTERNS, PREDICTORS, AND RELATED HOSPITAL USE

Objectives. This paper describes 6-year rates and correlates of functi onal change in the elderly, as well as associated hospital use. Method s. The Longitudinal Study on Aging (n = 7527), and matched Medicate cl aims were used to calculate 6-year functional status transition rates and hospital use rates. A hierarchical measure that incorporated activ ities of daily living, and competing risks of institutionalization and death was used to assess functional status. Multinomial logistic regr ession was used to predict 1990 status. Results. The functional status of 12% of men and women 70 to 79 years of age who were initially impa ired in instrumental activities of daily living improved, and about ha lf of the initially independent people in that age group remained so. Multivariate analyses revealed that age, baseline functioning, self-ra ted health, and comorbidity predicted 1990 status. Both baseline funct ioning and functional change were related to hospitalization. Conclusi ons. This study supports others that have shown some long-term functio nal improvement, but more commonly decline in the elderly. Furthermore , it documents the link between functional decline and increased hospi tal use.