 |
The 130th Annual Meeting of APHA |
|
The 130th Annual Meeting of APHA |
Hiroko H. Dodge, PhD1, Changyu Shen, BS2, Rajesh S Pandav, MB, BS, MPH3, and Mary Ganguli, MD, MPH3. (1) Dept. of Epidemiology, University of Pittsburgh, 127 Parran Hall, 130 DeSoto Street, Pittsburgh, PA 15261, 412-624-5331, Dodge@edc.pitt.edu, (2) Dept. of Biostatistics, University of Pittsburgh, 127k Parran Hall, 130 DeSoto Street, Pittsburgh, PA 15261, (3) Department of Psychiatry, School of Medicine, University of Pittsburgh, Western Psychiatric Institute and Clinic, 3811 O'Hara Street, Pittsburgh, PA 15213
Alzheimer's disease (AD) is by definition associated with increased functional disability, and has been shown consistently to shorten life expectancy in affected individuals. We applied the concept of Active Life Expectancy (ALE) to estimate the duration of survival spent with different levels of disability in persons with AD. ALE is a concept used in demography to measure the health and functional status of national populations. It has also been used in epidemiology to examine the effects of demographic and risk factor variables on ALE, but not to determine the effect of particular disorders. In an ongoing 10+ year prospective study of dementias, participants provided information including their ability to perform instrumental activities of daily living (IADLs) at biennial data collection waves. AD was diagnosed by standard criteria. We first estimated the transitional probabilities among the various disability levels and death based on multinomial logit models combining each subject's wave-to-wave transitions as an independent observation. Covariate status (age, sex, education, AD status, and disability status) was defined at the starting point of each observation as they were predictor variables for the transition in disability status or death two years later. Based on these transitional probabilities, we constructed increment-decrement life tables, starting from age70. Overall, women survived longer than men but spent the gained survival years with 2-5 disabilities (among the non-demented) or 6-7 disabilities (among those with AD). Our findings are relevant to natural history and also resource planning. ALE may be a useful new dimension in examining disease outcomes.
Learning Objectives:
Keywords: Dementia, Community
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.