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APHA Scientific Session and Event Listing

Recorded presentation

Jasvinder A. Singh, MBBS, MPH and Kristin L. Nichol, MD, MPH, MBA. Medicine, Minneapolis VA Medical Center, One Veterans Drive, Rheumatology (111 R), Minneapolis, MN 55417, 612-467-4190, jasvinder.singh@va.gov

Objective: To assess the association of aging and functional limitation in a cohort of veterans at VA medical facilities.

Methods: Cross-sectional, mailed survey of all 70,991 veterans with a inpatient or outpatient encounter at a Veterans Integrated Service Network (VISN)-13 medical facility between 10/1/97 and 3/31/98 supplemented by Cohort data from the Veterans Affairs (VA) administrative databases. We used a validated survey instruments to assess HRQoL using validated Short Form-36 for Veterans (SF-36V) and 6 Activities of Daily Living (ADL): bathing, dressing, eating, sitting/rising from a chair, walking, using the toilet. Age was categorized as <55, 55-64, 65-74, 75-84 and >=85 years and ADL limitation as limitation of no ADLs (none), 1-2 ADLs (moderate) or >=3 ADLs (severe). Student's t-test and chi square tests were used for unadjusted comparisons. We used multivariable logistic regression analyses to obtain estimates of odds of limitation for each ADL (adjusted for demographic, smoking status, comorbidity and utilization characteristics) with age category as the main predictor and each ADL limitation as the outcome (veterans <55 years = reference category). Results: 40,508 veterans (58%) responded to the survey. Difficulty in walking (50%) or transferring from chair (38%) were the most common limitations. Mean (±SD) ADL limitation in each age-category was: <55 years, 1.4±1.9; 55-64 years, 1.5±1.8; 65-74 years, 1.5±1.8; 75-84 years, 1.8±1.9; and >=85 years, 2.5±1.9. A significantly greater proportion of older veterans had moderate or severe ADL limitations compared to younger veterans respectively: <55 years, 28% and 23%; 55-64 years, 32% and 24%; 65-74 years, 33% and 22%; 75-84 years, 34% and 28%; and >=85 years, 34% and 43%. Age was associated with ADL limitation after adjustment for socio-demographic, comorbidity, health care utilization variables and smoking status. Multivariable-adjusted odds ratios for various ADL limitation for each age category as compared to veterans <55 years ranged from: 55-64 years, 0.8-1.0; 65-74 years, 0.8-1.0; 75-84 years, 1.0-1.4, and >85 years, 2.5-4.4.

Conclusions: Functional limitation increases significantly with age in veterans older than 75 years. Very old age is independently associated with functional limitation in veterans after adjusting for demographic, smoking status, comorbidity and utilization differences in veterans. Collecting information about functional status could permit physicians to target interventions to older veterans with moderate and severe functional disability.

Learning Objectives:

• To understand the variation of functional limitation in veterans in different age groups
• To understand the indepedent relationship of age to functional limiation after adjustment for demographic, disease burden and health care access variables

Keywords: Veterans, Disability

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation