Short-term disability fluctuations in late life

Short-term disability fluctuations in late life Abstract Objective Late-life disability is highly dynamic but within-person short-term fluctuations have not been assessed previously. We analyze how substantial such late-life disability fluctuations are and whether they are associated with time-to-death, long-term disability trajectories, frailty, and socio-demographics. Methods Monthly survey data (PEP Study) on ADL/IADL-disability (0-9) in the last years of life from 642 deceased respondents providing 56,308 observations were analyzed with a two-step approach. Observation-level residuals extracted from a Poisson mixed regression model (first step), which depict vertical short-term fluctuations from individual long-term trajectories, were analyzed with a linear mixed regression model (second step). Results Short-term disability fluctuations amounted to about one ADL/IADL limitation, increased in the last four years of life, and were closely associated with disability increases. Associations with frailty or socio-demographics characteristics were absent except for living alone. Discussion Short-term disability fluctuations in late-life were substantial, were linked to mortality-related processes, and represent a concomitant feature of disability increases in late life. disability, short-term fluctuations, intra-individual variability, health disparities, longitudinal methods This content is only available as a PDF. © The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model) http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png The Journals of Gerontology Series B: Psychological Sciences and Social Sciences Oxford University Press

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Publisher
Oxford University Press
Copyright
© The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.
ISSN
1079-5014
eISSN
1758-5368
D.O.I.
10.1093/geronb/gbz089
Publisher site
See Article on Publisher Site

Abstract

Abstract Objective Late-life disability is highly dynamic but within-person short-term fluctuations have not been assessed previously. We analyze how substantial such late-life disability fluctuations are and whether they are associated with time-to-death, long-term disability trajectories, frailty, and socio-demographics. Methods Monthly survey data (PEP Study) on ADL/IADL-disability (0-9) in the last years of life from 642 deceased respondents providing 56,308 observations were analyzed with a two-step approach. Observation-level residuals extracted from a Poisson mixed regression model (first step), which depict vertical short-term fluctuations from individual long-term trajectories, were analyzed with a linear mixed regression model (second step). Results Short-term disability fluctuations amounted to about one ADL/IADL limitation, increased in the last four years of life, and were closely associated with disability increases. Associations with frailty or socio-demographics characteristics were absent except for living alone. Discussion Short-term disability fluctuations in late-life were substantial, were linked to mortality-related processes, and represent a concomitant feature of disability increases in late life. disability, short-term fluctuations, intra-individual variability, health disparities, longitudinal methods This content is only available as a PDF. © The Author(s) 2019. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Journal

The Journals of Gerontology Series B: Psychological Sciences and Social SciencesOxford University Press

Published: Jan 8, 17

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