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Determinants of Maintenance and Recovery of Function in a Representative Older Community-Resident Biracial Sample.

Publication ,  Journal Article
Fillenbaum, GG; Sloane, R; Burchett, BM; Hall, K; Pieper, CF; Whitson, HE; Colón-Emeric, CS
Published in: J Am Med Dir Assoc
August 2020

OBJECTIVES: Focus on decline in performance of activities of daily living (ADL) has not been matched by studies of recovery of function. Advised by a broad conceptual model of physical resilience, we ascertain characteristics that identify (1) maintenance, (2) decline, and (3) recovery of personal self-maintenance activities over six years in an older, community representative, African American and white sample. DESIGN: Longitudinal study, analyses included descriptive statistics and repeated measures proportional hazards. SETTING/PARTICIPANTS: Community-representative participants of the Duke Established Populations for Epidemiologic Studies of the Elderly (EPESE), unimpaired at baseline (n = 3187; 46% white, 54% African American; 64% female, 36% male), followed annually for up to 6 years. MEASURES: Data included information on basic activities of daily living (BADL), demographic characteristics, health status, social services provided and received, household size, neighborhood safety, and survival status. RESULTS: Over 6 years, ∼75% remained unimpaired, of whom 30% were unimpaired when they dropped out or died. Of ∼25% who became impaired, just under half recovered. Controlled analyses indicated that those who became impaired were in poorer health, younger, and more likely to be African American. Characteristics of recovery included younger age, not hospitalized in the previous year, and larger household size. CONCLUSIONS/IMPLICATIONS: Maintenance of health status facilitated continued unimpaired BADL. While decline was associated with poorer health, younger age, and being African American, recovery was also associated with younger age, together with larger household size, and no further deterioration in health as measured here. Maintenance of good health is preferred, but following decline in functioning, increased effort to improve health and avoid further decline, which takes into account not only physical but also personal social conditions, is needed.

Duke Scholars

Published In

J Am Med Dir Assoc

DOI

EISSN

1538-9375

Publication Date

August 2020

Volume

21

Issue

8

Start / End Page

1141 / 1147.e1

Location

United States

Related Subject Headings

  • White People
  • Recovery of Function
  • Male
  • Longitudinal Studies
  • Humans
  • Health Status
  • Geriatrics
  • Female
  • Aged
  • Activities of Daily Living
 

Citation

APA
Chicago
ICMJE
MLA
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Fillenbaum, G. G., Sloane, R., Burchett, B. M., Hall, K., Pieper, C. F., Whitson, H. E., & Colón-Emeric, C. S. (2020). Determinants of Maintenance and Recovery of Function in a Representative Older Community-Resident Biracial Sample. J Am Med Dir Assoc, 21(8), 1141-1147.e1. https://doi.org/10.1016/j.jamda.2019.12.021
Fillenbaum, Gerda G., Richard Sloane, Bruce M. Burchett, Katherine Hall, Carl F. Pieper, Heather E. Whitson, and Cathleen S. Colón-Emeric. “Determinants of Maintenance and Recovery of Function in a Representative Older Community-Resident Biracial Sample.J Am Med Dir Assoc 21, no. 8 (August 2020): 1141-1147.e1. https://doi.org/10.1016/j.jamda.2019.12.021.
Fillenbaum GG, Sloane R, Burchett BM, Hall K, Pieper CF, Whitson HE, et al. Determinants of Maintenance and Recovery of Function in a Representative Older Community-Resident Biracial Sample. J Am Med Dir Assoc. 2020 Aug;21(8):1141-1147.e1.
Fillenbaum, Gerda G., et al. “Determinants of Maintenance and Recovery of Function in a Representative Older Community-Resident Biracial Sample.J Am Med Dir Assoc, vol. 21, no. 8, Aug. 2020, pp. 1141-1147.e1. Pubmed, doi:10.1016/j.jamda.2019.12.021.
Fillenbaum GG, Sloane R, Burchett BM, Hall K, Pieper CF, Whitson HE, Colón-Emeric CS. Determinants of Maintenance and Recovery of Function in a Representative Older Community-Resident Biracial Sample. J Am Med Dir Assoc. 2020 Aug;21(8):1141-1147.e1.
Journal cover image

Published In

J Am Med Dir Assoc

DOI

EISSN

1538-9375

Publication Date

August 2020

Volume

21

Issue

8

Start / End Page

1141 / 1147.e1

Location

United States

Related Subject Headings

  • White People
  • Recovery of Function
  • Male
  • Longitudinal Studies
  • Humans
  • Health Status
  • Geriatrics
  • Female
  • Aged
  • Activities of Daily Living