CHRONIC CONDITIONS THAT LEAD TO FUNCTIONAL LIMITATION IN THE ELDERLY

Background. The role of chronic medical conditions in elderly persons' loss of functional abilities is intuitively important but not well de fined. This analysis was designed to identify chronic medical conditio ns that lead to the development of severe functional limitation. Metho ds. Functionally intact members of a multistage probability sample (n = 6,862) of all noninstitutionalized U.S. civilians age 70 years or ol der were interviewed in 1984. Based on data from the National Death In dex and from follow-up telephone interviews in 1988 with survivors, su bjects were classified as functionally intact, functionally limited (u nable to perform one or more of seven essential activities), or deceas ed. Results. After adjusting for the effects of exercise habits and de mographic, socioeconomic, and psychosocial factors, we found that the best predictors of the development of functional limitation were cereb rovascular disease (OR = 2.14; 95% CL = 1. 16, 3.98) and arthritis (OR = 1.51; 95% CL = 1.08, 2.11). The contribution of coronary artery dis ease also approached statistical significance (OR = 1.49; 95% CL = 0.9 9, 2.27). Conclusion. In the future, the primary prevention or effecti ve treatment of cerebrovascular disease, arthritis, and possibly coron ary artery disease may produce a modest reduction in the incidence of severe functional limitation.