Abstract:

To lay the groundwork for devising, improving, & implementing strategies to prevent or delay the onset of disability in the elderly, a systematic literature review was conducted of 78 longitudinal studies published 1985-1997 that reported statistical associations between individual base-line risk factors & subsequent functional status in community-living older persons. Functional status decline was defined as disability or physical function limitation. Risk factors were categorized into 14 domains & coded by two independent abstractors. The highest strength of evidence for an increased risk in functional status decline was found for (alphabetical order) cognitive impairment, depression, disease burden (comorbidity), increased & decreased body mass index, lower extremity functional limitation, low frequency of social contacts, low level of physical activity, no alcohol use compared to moderate use, poor self-perceived health, smoking, & vision impairment. Findings should help investigators set priorities for future research on the disablement process, plan health & social services for elderly persons, & develop more cost-effective programs for preventing disability among them.