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This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2007.128132v1 98/7/1256    most recent 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 Google Scholar Articles by Murabito, J. M. Articles by D’Agostino, R. B. PubMed PubMed Citation Articles by Murabito, J. M. Articles by D’Agostino, R. B., Sr Related Collections Aging Disability Epidemiology

Joanne M. Murabito, MD, ScM, Michael J. Pencina, PhD, Lei Zhu, MA, Margaret Kelly-Hayes, EdD, RN, Peter Shrader, MA and Ralph B. D’Agostino, Sr, PhD

Joanne M. Murabito, Michael J. Pencina, Margaret Kelly-Hayes, and Ralph B. D’Agostino Sr are with the National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, MA. Joanne M. Murabito is with the Department of Medicine, Section of General Internal Medicine, Boston University School of Medicine, Boston, MA. Margaret Kelly-Hayes is with the Department of Neurology, Boston University School of Medicine, Boston. Michael J. Pencina, Lei Zhu, Peter Shrader, and Ralph B. D’Agostino Sr are also with the Department of Mathematics and Statistics, Boston University, Boston.

Correspondence: Requests for reprints should be sent to Joanne M. Murabito, MD, ScM, 73 Mount Wayte Ave, Suite 2, Framingham, MA 01702-5827 (e-mail: murabito{at}bu.edu).

Objectives. We sought to determine change in the prevalence of functional limitations and physical disability among the community-dwelling elderly population across 3 decades.

Methods. We studied original participants of the Framingham Heart Study, aged 79 to 88 years, at examination 15 (1977–1979; 177 women, 103 men), examination 20 (1988–1990; 159 women, 98 men) and examination 25 (1997–1999; 174 women, 119 men). Self-reported functional limitation was defined using the Nagi scale, and physical disability was defined using the Rosow-Breslau and Katz scales.

Results. Functional limitations declined across examinations from 74.6% to 60.5% to 37.9% (P < .001) among women and from 54.2% to 37.8% to 27.8% (P<.001) among men. Physical disability declined from 74.5% to 48.5% to 34.6% (P < .001) among women and 42.3% to 33.3% to 22.8% (P = .009) among men. Among women, improvements in functional limitations (P = .05) were greater from examination 20 to 25, whereas for physical disability (P=.02), improvements were greater from examination 15 to 20. Improvements in function were constant across the 3 examinations in men.

Conclusions. Among community-dwelling elders, the prevalence of functional limitations and physical disability declined significantly in both women and men from the 1970s to the 1990s. This may in part be due to improvements in technological devices used to maintain independence. Further work is needed to identify the underlining causes of the decline so preventative measures can be established that promote independence for the elderly population.