Independence in Instrumental Activities of Daily Living and its effect on mortality

Factors relating to six-year mortality in a representative sample of sevent y-year-old Jerusalem residents (N=605) were investigated using logistic reg ression techniques. Around 16.3% of the study population died during the si x-year post-interview period. Bivariate analysis found elevated mortality r elated to being male, having move than one IADL dysfunction, more than two ADL dysfunctions, financial problems, no social support in times of emergen cies, bad self-rated health status, cognitive impairment, confinement to be d during the fortnight prior to interview, and lack of regular exercise. Lo gistic regression controlling for gender, various clinical diagnoses, finan cial stare, social support and smoking status showed IADL (ROR=4.57, 95% CI 1.51, 13.90), cognitive impairment (ROR=3.99, 95% CI 1.85, 8.59) and havin g been bed-sick a week or more during the preceding fortnight (ROR=6.60, 95 % CI 1.00, 43.86) to be independent predictors of mortality. All persons wh o had a cognitive problem and were dysfunctional in more than two IADL cate gories, and 93.8% of persons who had been bed-sick and had move than one IA DL dysfunction died during the study period. Combined measures of these thr ee easily obtainable variables could prove a cheap and efficient method of identifying at-risk elderly persons in order to provide them with specific programs aimed at decreasing functional decline, and hence mortality. (C) 1 999, Editrice Kurtis.