Age Distribution and Risk Factors for the Onset of Severe Disability Among Community-Dwelling Older Adults With Functional Limitations

Abstract
This study examines age distribution and risk factors for the onset of severe disability among community-dwelling older adults with functional limitations. Data were obtained from the initial community-dwelling sample (n = 6,088) of the National Long-Term Care Survey in 1982 and the follow-up interviews in 1984, 1989, 1994, and 1999. Multiple proportional hazard regression was conducted using age at onset of severe disability as the dependent variable. Explanatory variables included chronic diseases and sociodemographic and personal characteristics. Of the 3,485 elders who were not severely disabled initially, 1,364 were identified as developing severe disability over time. The onset age ranged from 66 to 109 years with the peak occurring at 82 to 83 years. The predictors for earlier onset of severe disability were paralysis, arthritis, obesity, hypertension, and middle education level (Grades 9-12). These findings provide practical implications for identifying at-risk individuals and developing health behavior interventions to delay onset of severe disability.