Elderly Disability

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As the life expectancy in the United States rises, the number of elderly in the population has also expanded. These increases have led to the oldest-old (people aged 90 and older) to become the fastest growing age group in the country. The oldest-old face many unique challenges because of their age, one of which is disability. Disability in the elderly has major impact upon society 1 and will continue will be a growing burden in years to come.

Although there is evidence from many studies that disability rate is declining in the U.S.2, the rapid expansion of the oldest-old age group will continue to pose health care challenges for future generations. Disability prevalence rates are very high in the oldest-old3 and even reached 97% in centenarians4. These high rates of disability will have a tremendous financial impact in the future as people living with disability have much higher health care expenditures5.

Because of the growing concern associated with disability in the elderly, many researchers have examined factors that may be associated with the risk disability in the elderly. These factors have ranged widely, including functional limitations6-9, level of physical activity10, 11, depression12-15, cognitive status13, 16, 17, comorbidities18, 19, falls6, 20, self-rated health21, 22, social interaction23 and others24.

Understanding the incidence of disability in the oldest-old is a critical step in identifying methods of reducing disability in this at-risk age group. We examined incident disability in a large cohort of participants aged 90 and older, The 90+ Study. As part of their participation in The 90+ Study, participants are followed longitudinally, with detailed information about functional abilities obtained ye...

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...verestimate disability, especially in the elderly47.

This manuscript details the alarming increase in disability in the oldest old. With the rapid growth of this age group, issues associated with functional loss with have a tremendous financial impact throughout the world. The study has identified several risk factors associated with increased disability incidence, several of which may be modifiable. This is especially critical, as CHF is the most expensive medical illness in the United States and represents over 5% of the total health care budget48. With the prevalence and incidence of CHF rapidly rising in the United States49, it will be critical to prepare for the dramatic increase in disability as a result. Reduction of risk factors for CHF, such as hypertension and high cholesterol, would likely be beneficial in reducing incident disability in the oldest old.
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