Geriatric
health conditions have major effect on half of
all Seniors
Newswise — A broad study of
adults ages 65 and older has found that half of
them have one or more conditions that can affect
their ability to participate in activities of
daily living, such as bathing and dressing on
their own.
Researchers at the
University of Michigan Health System analyzed
the responses of more than 11,000 participants
in the national Health and Retirement Study.
They found that 50 percent of older adults had a
moderate to severe form of at least one of the
following conditions: cognitive impairment,
falls, incontinence, low body mass index,
dizziness, vision impairment or hearing
impairment.
The researchers also
studied whether the respondents had difficulty
with activities of daily living (bathing,
dressing, eating, toileting or transferring) and
needed assistance to complete the tasks. They
found that people with geriatric conditions had
about the same level of dependency when
performing activities of daily living as older
patients with chronic diseases, including heart
disease, chronic lung disease, diabetes, cancer,
musculoskeletal conditions, stroke and
psychiatric problems.
The study – which appears
in the Aug. 7 issue of the Annals of Internal
Medicine – fills a major gap in research
about older patients. Although conditions such
as incontinence and falls have been studied
extensively, the total impact of geriatric
conditions on health and disability in the older
adult population has not been investigated,
notes lead author Christine Cigolle, M.D., MPH,
lecturer in the U-M Health System Department of
Family Medicine and a physician in the Veterans
Affairs Ann Arbor Healthcare System’s Geriatric
Research, Education and Clinical Center (GRECC).
“The focus in medicine
has long been on diseases, and how to
diagnose and treat them. But that focus
often isn’t helpful in regard to older
adults; they tend to have one or more of
these geriatric conditions, which are not
considered diseases and can be missed by
physicians,” Cigolle says.
“Our study is the first to
look at all seven of these common conditions
together, and we found that they are very common
and increase dramatically in prevalence with
age,” she says. “To me, that says that
clinicians need to ask patients about these
issues. In many situations, they may be able to
help manage the condition before it leads to
disability.”
In the medical world,
experts have debated how to categorize
conditions such as the ones in this study. Some
are called geriatric syndromes, while others
fall outside of categories typically used by
physicians.
The lack of consistent
terminology has been one obstacle to the
appropriate diagnosis and treatment of these
conditions, says senior author Caroline Blaum,
M.D., M.S., associate professor in the Division
of Geriatric Medicine at U-M and a research
scientist at the Veterans Affairs Ann Arbor
Healthcare System GRECC.
Such obstacles need to be
overcome so that older adults can receive the
best health care possible, she says. “Geriatric
conditions are integral to the health and
function of older adults and should be addressed
in their care,” Blaum notes.
The researchers found a
strong link between the conditions and
dependence on others to help with activities of
daily living. Just 2.6 percent of survey
participants without any of the geriatric
conditions were dependent on others for help
with activities. That percentage jumped to 8.1
among people with one of the conditions, 19.4
among people with two conditions, and 45 among
people with three or more conditions.
All conditions increased in
prevalence with advancing age. Among older
adults with cognitive impairment, for instance,
55 percent were 80 or older. Overall, 39 percent
of people ages 65-69 were found to have one or
more of the conditions. The percentage rose to
82 among people ages 90 and older.
Additionally, compared to
those with no geriatric conditions, people with
increasing numbers of conditions were older,
female, from a minority ethnic group, unmarried,
and had less education and a lower net worth.
The data used in this study
are from the 2000 wave of the Health and
Retirement Study (HRS), a biennial longitudinal
health interview survey of adults ages 50 years
and older in the United States. The HRS is
sponsored by the National Institute on Aging and
performed by the Institute for Social Research
at U-M.
In addition to Cigolle and
Blaum, authors of the study were Kenneth M.
Langa, M.D., Ph.D., of the U-M Medical School
Department of Internal Medicine, the U-M
Institute for Social Research and the Ann Arbor
VA Center for Practice Management and Outcomes
Research; and Mohammed U. Kabeto, M.S., and
Zhiyi Tian, M.A., M.S., of the Department of
Internal Medicine.
The study was supported by
grants from the John A. Hartford Foundation and
the National Institute on Aging and by the Ann
Arbor VA GRECC.
Reference: Annals of
Internal Medicine, Aug. 7, 2007, Vol. 147,
pages 156-164. “Geriatric Conditions and
Disability: The Health and Retirement Study.”
