Impact of joint impairment on disability-specific domains at four years

The objective of this study was to assess the longitudinal impact of joint impairment on overall disability and crossing domain-specific thresholds fo r physical activity, mobility, dexterity, instrumental activities of daily living (IADL), and activities of daily living (ADL) that are associated wit h use of long-term care. This 4-year longitudinal study observed 484 person s older than age 60. Logistic regression assessed the contribution of demog raphics, psychological mediators, lower- and upper-extremity joint impairme nt, and comorbidities to increased domain-specific self-reported disability above a threshold associated with use of long-term care. Lower-extremity j oint impairment and age predicted crossing thresholds by year 4 in physical activity, mobility, IADL, and ADL disability that were associated with use of long-term care. Lower-extremity joint impairment is a strong risk facto r for future disability that is associated with use of long-term care. I CL IN EPIDEMOL 51;12:1253-1261, 1998. (C) 1998 Elsevier Science Inc.