PROSPECTIVE-STUDY ON THE RELATION BETWEEN LIVING ARRANGEMENT AND CHANGE IN FUNCTIONAL HEALTH-STATUS OF ELDERLY WOMEN

Limited prospective data exist on how living arrangements are associat ed with change in functional health. This study evaluated whether elde rly women living alone were less likely to experience functional decli ne when compared with women who lived with others. A total of 619 comm unity-dwelling, white women from Baltimore, Maryland, aged 65-99 years at baseline were questioned annually from 1984 to 1986. Functional he alth was measured as the sum of limitations in seven physical and seve n instrumental activities of daily living (Instrumental ADL), A total of 148 women experienced functional decline over the 2 years, primaril y as a deterioration in Instrumental ADL, The association between livi ng arrangement and change in Instrumental ADL depended on the level of physical impairment, Among women without severe impairment, Instrumen tal ADL deterioration was significantly less for those living alone co mpared with those living with spouses (odds ratio (OR) = 0.60, 95% con fidence interval (CI) 0.45-0.92) or nonspouse others (OR = 0.62, 95% C I 0.45-0.96), For women with severe impairment, however, those living alone had a greater decline in Instrumental ADL, especially when compa red with those living with nonspouse others (OR = 5.13, 95% CI 1.23-21 .28), These results suggest that, unless severely physically impaired, women living independently have less deterioration in functional heal th when compared with peers in alternate living arrangements.