DEMENTIA IS THE MAJOR CAUSE OF FUNCTIONAL DEPENDENCE IN THE ELDERLY -3-YEAR FOLLOW-UP DATA FROM A POPULATION-BASED STUDY

Objectives. The purpose of this investigation was to study the role of dementia and other common age-related diseases as determinants of dep endence in activities of daily living (ADL) in the elderly. Methods. T he study population consisted of 1745 persons, aged 75 years and older , living in a district of Stockholm. They were examined at baseline an d after a 3-year follow-up interval. Katz's index was used to measure functional status. Functional dependence at baseline, functional decli ne, and development of functional dependence at follow-up were examine d in relation to sociodemographic characteristics and chronic conditio ns. Results. At baseline, factors associated with functional dependenc e were age, dementia, cerebrovascular disease, heart disease, and hip fracture. However, only age and dementia were associated with the deve lopment of functional dependence and decline after 3 years. In a simil ar analysis, including only nondemented subjects, Mini-Mental State Ex amination scores emerged as one of the strongest determinants. The pop ulation-attributable risk percentage of dementia in the development of functional dependence was 49%. Conclusions. In a very old population, dementia and cognitive impairment make the strongest contribution to both the development of long-term functional dependence and decline in function.