BACKGROUND: The WHO International Classification of Functioning, Disability and Health (ICF) is now the dominant model for exploring the social consequences of a health condition. This paper investigates the association of the different ICF disability domains with mortality. METHODS: Data are from the British Women Heart and Health Study, a large (n=4157) prospectively studied cohort of women randomly selected from 23 towns aged 64-83 years in 2003. Scores were calculated to describe the cumulative load of impairments, limitations and restrictions within each ICF domain. Cox proportional hazards regression was used to calculate mortality HRs per unit score increase within each ICF domain. Adjustments were made for age, town, living status, socioeconomic status, lifestyle behaviours and health conditions. RESULTS: Each ICF domain was associated with mortality after controlling for lifestyle factors and health conditions. However, only complex activities (HR=1.09, 95% CI 1.01 to 1.18) and participation (HR=1.10, 95% CI 1.04 to 1.16) were independent predictors of mortality following adjustment for all other disability domains and potential confounders. CONCLUSIONS: Results suggest that difficulties with complex activities or social participation could be used to identify and target women at high risk of dying. Interventions to facilitate complex activities or improve social participation may help to delay mortality in elderly women.
BACKGROUND: The WHO International Classification of Functioning, Disability and Health (ICF) is now the dominant model for exploring the social consequences of a health condition. This paper investigates the association of the different ICF disability domains with mortality. METHODS: Data are from the British Women Heart and Health Study, a large (n=4157) prospectively studied cohort of women randomly selected from 23 towns aged 64-83 years in 2003. Scores were calculated to describe the cumulative load of impairments, limitations and restrictions within each ICF domain. Cox proportional hazards regression was used to calculate mortality HRs per unit score increase within each ICF domain. Adjustments were made for age, town, living status, socioeconomic status, lifestyle behaviours and health conditions. RESULTS: Each ICF domain was associated with mortality after controlling for lifestyle factors and health conditions. However, only complex activities (HR=1.09, 95% CI 1.01 to 1.18) and participation (HR=1.10, 95% CI 1.04 to 1.16) were independent predictors of mortality following adjustment for all other disability domains and potential confounders. CONCLUSIONS: Results suggest that difficulties with complex activities or social participation could be used to identify and target women at high risk of dying. Interventions to facilitate complex activities or improve social participation may help to delay mortality in elderly women.
Authors: Minkyoung Choi; David Prieto-Merino; Caroline Dale; Eveline Nüesch; Antoinette Amuzu; Ann Bowling; Shah Ebrahim; Juan P Casas Journal: Qual Life Res Date: 2012-12-15 Impact factor: 4.147
Authors: Jessica L Maxwell; Julie J Keysor; Jingbo Niu; Jasvinder A Singh; Barton L Wise; Laura Frey-Law; Michael C Nevitt; David T Felson Journal: Phys Ther Date: 2013-06-27
Authors: Josephine E Prynn; Sarah Polack; Islay Mactaggart; Lena Morgon Banks; Shaffa Hameed; Carlos Dionicio; Shailes Neupane; Gvs Murthy; Joseph Oye; Jonathan Naber; Hannah Kuper Journal: Int J Environ Res Public Health Date: 2021-06-29 Impact factor: 3.390
Authors: Lotte A H Hermsen; Caroline B Terwee; Stephanie S Leone; Babette van der Zwaard; Martin Smalbrugge; Joost Dekker; Henriëtte E van der Horst; Ross Wilkie Journal: BMJ Open Date: 2013-08-23 Impact factor: 2.692