IMPACT OF CHRONIC DISEASES ON FUNCTIONAL LIMITATIONS IN ELDERLY CHINESE AGED 70 YEARS AND OVER - A CROSS-SECTIONAL AND LONGITUDINAL SURVEY

Objective. To examine the association of some common medical condition s with functional limitation in elderly Chinese aged 70 years and over , to estimate the percentage of disability attributable to individual diseases, and to attempt to identify predisposing factors by documenti ng the development of functional limitation over an 18-month period in those subjects with a particular disease who a ere independent initia lly. Subjects and Method. The cross-sectional data set consisted of 2, 032 (999 M, 1,033 Fl subjects aged 70 years and over recruited by rand om sampling (stratified by age and sex) of all recipients of old-age a nd disability allowance, which covers over 90% of the elderly populati on. Information regarding medical condition and functional assessment of ten basic activities of daily living using the Barthel Index were o btained by personal interviews and physical assessment of the responde nts at their places of residence. The longitudinal data set consisted of 1,334 subjects with no functional limitation at baseline who were a live after 18 months. Functional status was reassessed. Results. After adjusting for age and sex, diseases associated with severe functional limitation (Barthel Index <15) were dementia, stroke, Parkinson's dis ease, and fractures. Those associated with mild to moderate functional limitation (Barthel Index 15-19) were the same, with the addition of asthma and diabetes mellitus. The attributable fraction for severe lim itation was highest for stroke, dementia, and fractures. Stroke and ar thritis were identified as diseases predisposing to mild to moderate f unctional limitation over an 18-month period among those subjects who were independent initially. Conclusion. Stroke, dementia, and fracture s were the main chronic diseases associated with severe functional lim itation in elderly Hong Kong Chinese. Attempts to reduce the disabilit y burden in this population should target these diseases.