HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) Submit a response Purchase Article View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kelly-Hayes, M Articles by Odell, P M Search for Related Content PubMed PubMed Citation Articles by Kelly-Hayes, M Articles by Odell, P M

Functional limitations and disability among elders in the Framingham Study.

M Kelly-Hayes, A M Jette, P A Wolf, R B D'Agostino and P M Odell

Department of Neurology, Boston University School of Medicine, MA 02118.

BACKGROUND. The measurement of physical disability as an indication of the impact of disease is commonly seen in research. However, these measures often do not clearly differentiate between functional limitations and daily performance of an activity. METHODS. We measured the differences between self-reported disability and observed functional limitations in six activities of daily living tasks among community-dwelling elders. The value of functional limitations vs disability measures in determining risk factors for disablement was ascertained. RESULTS. Systematic differences were found among the 1453 participants. At least 89% of the time when a difference was identified, the subjects ranked disability greater than the functional limitations observed. For those who were cognitively impaired, discrepancies occurred up to 11% of the time. In determining risk factors for disablement, we found that neurological impairments were associated with both functional limitations and disability, while sociocultural factors were associated with disability only. CONCLUSIONS. Our findings suggest that physical functional limitations and disability in the elderly are two distinct concepts and that the measure of choice should be determined by research objectives and the type of population being studied.

This article has been cited by other articles:

				Q.-L. Xue, L. P. Fried, T. A. Glass, A. Laffan, and P. H. M. Chaves Life-Space Constriction, Development of Frailty, and the Competing Risk of Mortality: The Women's Health and Aging Study I Am. J. Epidemiol., January 15, 2008; 167(2): 240 - 248. [Abstract] [Full Text] [PDF]

				J. K. Johnson, L.-Y. Lui, and K. Yaffe Executive Function, More Than Global Cognition, Predicts Functional Decline and Mortality in Elderly Women J. Gerontol. A Biol. Sci. Med. Sci., October 1, 2007; 62(10): 1134 - 1141. [Abstract] [Full Text] [PDF]

				S. L. Willis, S. L. Tennstedt, M. Marsiske, K. Ball, J. Elias, K. M. Koepke, J. N. Morris, G. W. Rebok, F. W. Unverzagt, A. M. Stoddard, et al. Long-term Effects of Cognitive Training on Everyday Functional Outcomes in Older Adults JAMA, December 20, 2006; 296(23): 2805 - 2814. [Abstract] [Full Text] [PDF]

				P. Sainio, S. Koskinen, M. Heliovaara, T. Martelin, T. Harkanen, H. Hurri, S. Miilunpalo, and A. Aromaa Self-reported and test-based mobility limitations in a representative sample of Finns aged 30+ Scand J Public Health, August 1, 2006; 34(4): 378 - 386. [Abstract] [PDF]

				Z. Zimmer, N. Chayovan, H.-S. Lin, and J. Natividad How Indicators of Socioeconomic Status Relate to Physical Functioning of Older Adults in Three Asian Societies Research on Aging, March 1, 2004; 26(2): 224 - 258. [Abstract] [PDF]

				M. P. LaPlante, H. S. Kaye, T. Kang, and C. Harrington Unmet Need for Personal Assistance Services: Estimating the Shortfall in Hours of Help and Adverse Consequences J. Gerontol. B. Psychol. Sci. Soc. Sci., March 1, 2004; 59(2): S98 - 108. [Abstract] [Full Text] [PDF]

				L. I. Iezzoni, R. B. Davis, J. Soukup, and B. O'Day Quality Dimensions That Most Concern People With Physical and Sensory Disabilities Arch Intern Med, September 22, 2003; 163(17): 2085 - 2092. [Abstract] [Full Text] [PDF]

				C. F. M. de Leon, J. M. Guralnik, and K. Bandeen-Roche Short-Term Change in Physical Function and Disability: The Women's Health and Aging Study J. Gerontol. B. Psychol. Sci. Soc. Sci., November 1, 2002; 57(6): S355 - 365. [Abstract] [Full Text] [PDF]

				L. I. IEZZONI, R. B. DAVIS, J. SOUKUP, and B. O'DAY Satisfaction with quality and access to health care among people with disabling conditions Int. J. Qual. Health Care, October 1, 2002; 14(5): 369 - 381. [Abstract] [Full Text] [PDF]

				P. L. Owens, E. H. Bradley, S. M. Horwitz, C. M. Viscoli, W. N. Kernan, L. M. Brass, P. M. Sarrel, and R. I. Horwitz Clinical Assessment of Function among Women with a Recent Cerebrovascular Event: A Self-Reported versus Performance-Based Measure Ann Intern Med, June 4, 2002; 136(11): 802 - 811. [Abstract] [Full Text] [PDF]

				Z. Zimmer, A. I. Hermalin, and H.-S. Lin Whose Education Counts? The Added Impact of Adult-Child Education on Physical Functioning of Older Taiwanese J. Gerontol. B. Psychol. Sci. Soc. Sci., January 1, 2002; 57(1): S23 - 32. [Abstract] [Full Text] [PDF]

				V. Vaccarino, S. V. Kasl, J. Abramson, and H. M. Krumholz Depressive symptoms and risk of functional decline and death in patients with heart failure J. Am. Coll. Cardiol., July 1, 2001; 38(1): 199 - 205. [Abstract] [Full Text] [PDF]

				A. Rosen, J. Wu, B.-H. Chang, D. Berlowitz, C. Rakovski, A. Ash, and M. Moskowitz Risk Adjustment for Measuring Health Outcomes: An Application in VA Long term Care American Journal of Medical Quality, July 1, 2001; 16(4): 118 - 127. [Abstract] [PDF]

				L. I. Tezzoni, E. P. McCarthy, R. B. Davis, L. Harris-David, and B. O'Day Use of Screening and Preventive Services Among Women With Disabilities American Journal of Medical Quality, July 1, 2001; 16(4): 135 - 144. [Abstract] [PDF]

				E. M. Simonsick, J. D. Kasper, J. M. Guralnik, K. Bandeen-Roche, L. Ferrucci, R. Hirsch, S. Leveille, T. Rantanen, and L. P. Fried Severity of Upper and Lower Extremity Functional Limitation: Scale Development and Validation With Self-Report and Performance-Based Measures of Physical Function J. Gerontol. B. Psychol. Sci. Soc. Sci., January 1, 2001; 56(1): 10S - 19. [Abstract] [Full Text]

				R. Angel, G. V. Ostir, M. L. Frisco, and K. S. Markides Comparison of a Self-Reported and a Performance-Based Assessment of Mobility in the Hispanic Established Population for Epidemiological Studies of the Elderly Research on Aging, November 1, 2000; 22(6): 715 - 737. [Abstract] [PDF]

				K.-f. M. Cheung Effectiveness of Social Work Treatment and Massage Therapy for Nursing Home Clients Research on Social Work Practice, March 1, 1999; 9(2): 229 - 247. [Abstract] [PDF]

				M. A. Al-Mahadi and A. G. Elzubier Assessment of the functional status of elderly subjects in Qassim Region, Saudi Arabia The Journal of the Royal Society for the Promotion of Health, October 1, 1997; 117(5): 313 - 318. [Abstract]

				J. M. Guralnik, L. Ferrucci, E. M. Simonsick, M. E. Salive, and R. B. Wallace Lower-Extremity Function in Persons over the Age of 70 Years as a Predictor of Subsequent Disability N. Engl. J. Med., March 2, 1995; 332(9): 556 - 562. [Abstract] [Full Text] [PDF]