Original StudyComparisons Between Older Men and Women in the Trajectory and Burden of Disability Over the Course of Nearly 14 Years
Section snippets
Study Population
Participants were members of the Precipitating Events Project, a longitudinal study of community-living persons, aged 70 years or older, who were nondisabled (ie, required no personal assistance) at baseline in four basic activities of daily living: bathing, dressing, walking inside the house, and transferring from a chair.5 Exclusion criteria included significant cognitive impairment with no available proxy,6 inability to speak English, diagnosis of a terminal illness with a life expectancy
Results
Table 1 provides the baseline characteristics of the 265 men and 487 women in our analytic sample. The men were more highly educated, whereas the women had higher levels of disability in instrumental and mobility activities and were more likely to live alone, be physically frail, have depressive symptoms, and be obese. There were no gender differences according to age, race/ethnicity, number of chronic conditions, cognitive impairment, or low physical activity.
Based on a total disability score
Discussion
In this prospective longitudinal study, which included monthly assessments of 13 basic, instrumental, and mobility activities, we identified five distinct trajectories of disability over intervals of 18 months, and we compared these trajectories and the overall burden of disability over the course of 13.5 years between older men and women. Four major findings warrant comment. First, women were more likely than men to experience trajectories that were characterized by moderate and severe levels
Acknowledgments
We thank Denise Shepard, BSN, MBA, Andrea Benjamin, BSN, Paula Clark, RN, Martha Oravetz, RN, Shirley Hannan, RN, Barbara Foster, the late Alice Van Wie, BSW, Patricia Fugal, BS, and Amy Shelton, MPH, for assistance with data collection; Wanda Carr and Geraldine Hawthorne, BS, for assistance with data entry and management; Peter Charpentier, MPH, for design and development of the study database and participant tracking system; Linda Leo-Summers, MPH, for assistance with Fig. 1, Fig. 2; and
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This study was funded by grants from the National Institute on Aging (R37AG17560, R01AG031850, K24AG021507). The study was conducted at the Yale Claude D. Pepper Older Americans Independence Center (P30AG21342).