Disability in activities of daily living among the elderly

The rise in number and proportion of older people, and the functional disab ility that is associated with increasing age, generate concern regarding th e societal consequences of a large number of disabled elderly persons. Ther efore, measuring disability in terms of activities of daily living has beco me routine in surveys of older people in most studies on ageing. Despite me thodological obstacles, research into functional ability in the elderly has progressed during the past few decades. A high prevalence of functional di sability in the elderly is consistently reported, although considerable var iation has been found among studies. In contrast to functionally independen t elderly, disabled elderly have been found to make increased use of home h elp services, and have higher institutionalization rates and premature mort ality. Factors that are consistently reported as being associated with incr eased functional disability are older age, female sex, lower educational le vel, lack of exercise, chronic disease and impaired cognition. Among the ch ronic diseases, dementia is a progressive and disabling condition that acco unts for a large proportion of the disability in elderly populations. A com bination of various strategies must be employed in the approach to reductio n of disability in the elderly population. More research is needed to gain a better understanding of risk and protective factors, so that we will be a ble to detect persons at early stages of disability, and to plan for servic es or rehabilitation for severely disabled persons. Curr Opin Psychiatry 14 :355-359. (C) 2001 Lippincott Williams & Wilkins.