SELF-REPORT OF DIFFICULTY IN PERFORMING FUNCTIONAL ACTIVITIES IDENTIFIES A BROAD RANGE OF DISABILITY IN OLD-AGE

OBJECTIVE: To describe a broad range of physical disability by examini ng the association between a four-level measure of disability, based o n self-report of difficulty in performing functional activities, and p reviously identified risk factors for disability. DESIGN: Cross-sectio nal. SETTING: Community-based. PARTICIPANTS: A total of 2373 noninstit utionalized men and women aged 65 and older from the Veneto Region of Italy. MEASUREMENTS: Odds ratios for the association of the four level s of disability (none, mild, moderate, and ADL disability) differentia ted by this new measure with known risk factors for physical disabilit y. MAIN RESULTS: This summary measure of physical disability distingui shed older persons with disability from the population typically class ified as nondisabled. Twenty-one percent of study participants were id entified as having Activities of Daily Living (ADL) disability (define d as self-report of difficulty in one or more ADLs), and an additional 40% had mild or moderate disability based on degree of difficulty in Instrumental Activities of Daily Living (IADLs) and physical functiona l activities. Hip fracture and lower extremity performance were strong ly independently associated with each level of disability. The associa tion of a range of established risk factors for disability and health care utilization measures with the levels of disability identified in our study, and the trend toward increasing odds with increasing disabi lity, provide evidence of the construct validity of this measure. CONC LUSIONS: Self-report of difficulty in performing functional activities identifies older persons with physical disability not ascertained by self-report of the need for help,