MORBIDITY, COMORBIDITY, AND THEIR ASSOCIATION WITH DISABILITY AMONG COMMUNITY-DWELLING OLDEST-OLD IN ISRAEL

Background. The impact of chronic conditions on the development of dis ability has not yet been comprehensively studied among the elderly pop ulation living in Israel. This study evaluates the prevalence of disab ility and morbidity among the community-dwelling oldest-old population and examines the association between medical conditions, comorbidity, and disability in basic and instrumental activities of daily living ( ADLs, IADLs). Method. The data are based on a national random stratifi ed sample of 1,820 Israeli Jewish individuals 75-94 years old. of whom 1,487 lived in the community.Results. Nineteen percent of the populat ion was disabled in ADLs and 36% in IADLs. Disability rose with age an d was higher for women and among individuals of Middle Eastern and Nor th African origin. Stepwise logistic regression indicates that the var iables associated with disability in ADLs and IADLs were older age, Mi ddle Eastern or North African origin, living with others, and the foll owing conditions: stroke, hip fracture, diabetes, osteoporosis, anemia , and heart attack. In addition, lower education and suffering from ur inary or kidney diseases, respiratory disease, and/or Parkinson's dise ase were related to disability in ADLs; being a woman and suffering fr om heart diseases other than heart attack were related to disability i n IADLs. Comorbidity was related to increased disability only for indi viduals with three or more conditions. Conclusions. The identification of medical conditions and sociodemographic variables related to limit ations in functioning may serve as a basis for health promotion and di sease prevention in elders by attempting to reduce the incidence and d isabling consequences of known disabling conditions.