Restricted Activity Predicts Disability

Older people who have an occasional "bad day" are at increased risk of developing increasing disability over time, finds a new study .
It is not uncommon for people over age 70 to report restricted activity, defined as staying in bed for at least half a day and/or cutting back on usual activities at least once in the past month. Most physicians believe this is just a normal sign of aging and not necessarily something that leads to declining function.

In this study, researchers followed 680 older people who were living in their own homes to see if restricted activity might predict increasing disability and functioning. The subjects were divided into three groups according to their risk for disability in activities of daily living (ADL), such as bathing, cooking, etc. Monthly telephone interviews were conducted to determine the occurrence of restricted activity. Assessments to determine their degree of disability were conducted in the home.

Results of the 18-month study found disability scores overall worsened by about 11 percent for each additional month a person experienced restricted activity, but the association was significant only for those who initially fell into the low and intermediate risk groups. There was no association between functional decline and restricted activity in those who were already considered at high risk for functional decline at the beginning of the study.

The investigators write, "For older persons who are not otherwise at high risk for ADL disability, restricted activity is an important predictor of functional decline and not just a benign feature of old age."