RT Journal Article
SR Electronic
T1 Functional disability and social participation restriction associated with chronic conditions in middle-aged and older adults
JF Journal of Epidemiology and Community Health
JO J Epidemiol Community Health
FD BMJ Publishing Group Ltd
SP 381
OP 389
DO 10.1136/jech-2016-207982
VO 71
IS 4
A1 Lauren E Griffith
A1 Parminder Raina
A1 Mélanie Levasseur
A1 Nazmul Sohel
A1 Hélène Payette
A1 Holly Tuokko
A1 Edwin van den Heuvel
A1 Andrew Wister
A1 Anne Gilsing
A1 Christopher Patterson
YR 2017
UL http://jech.bmj.com/content/71/4/381.abstract
AB Background We examine the population impact on functional disability and social participation of physical and mental chronic conditions individually and in combination.Methods Cross-sectional, population-based data from community-dwelling people aged 45 years and over living in the 10 Canadian provinces in 2008–2009 were used to estimate the population attributable risk (PAR) for functional disability in basic (ADL) and instrumental (IADL) activities of daily living and social participation restrictions for individual and combinations of chronic conditions, stratified by age and gender, after adjusting for confounding variables.Results Five chronic conditions (arthritis, depression, diabetes, heart disease and eye disease) made the largest contributions to ADL-related and IADL-related functional disability and social participation restrictions, with variation in magnitude and ranking by age and gender. While arthritis was consistently associated with higher PARs across gender and most age groups, depression, alone and in combination with the physical chronic conditions, was associated with ADL and IADL disability as well as social participation restrictions in the younger age groups, especially among women. Compared to women, the combinations of conditions associated with higher PARs in men more often included heart disease and diabetes.Conclusions Our findings suggest that in community-dwelling middle-aged and older adults, the impact of combinations of mental and physical chronic conditions on functional disability and social participation restriction is substantial and differed by gender and age. Recognising the differences in the drivers of PAR by gender and age group will ultimately increase the efficiency of clinical and public health interventions.