OBJECTIVES: The International Classification of Functioning, Disability and Health (ICF) advocates a multifactorial and multifaceted conceptualization of disability. The objective of this study was to ascertain major medical, environmental and personal determinants of severe/extreme disability among the elderly population in Spain. The assessment scheme was consistent with the ICF model of disability. METHODS: Nine populations contributed probabilistic or geographically-defined samples following a two-phase screening design. The Mini-Mental State Examination and the 12-item version of the World Health Organization-Disability Assessment Schedule, 2(nd) ed. (WHO-DAS II), were used as cognitive and disability screening tools, respectively. Positively screened individuals underwent clinical work-up for dementia and were administered the 36-item version of the WHO-DAS II to estimate ICF disability levels. We used logistic regression for the purposes of data combination, adjusted for age and sex in all analyses. RESULTS: The sample was composed of 503 participants aged ≥ 75 years. Alzheimeŕs disease and depression were highly predictive of severe/extreme disability (OR: 17.40, 3.71). Good access to social services was strongly associated with a low level or absence of disability (OR: 0.05 to 0.18). Very difficult access to services and having dementia or another psychiatric disorder were associated with an increase in disability (OR: 66.06). There was also a significant interaction effect between access to services and neurological disorders (OR: 12.74). CONCLUSIONS: Disability is highly prevalent among the Spanish elderly and is influenced by medical, social and personal factors. Disability could potentially be reduced by ensuring access to social services, preventing dementia and stroke, and treating depression.
OBJECTIVES: The International Classification of Functioning, Disability and Health (ICF) advocates a multifactorial and multifaceted conceptualization of disability. The objective of this study was to ascertain major medical, environmental and personal determinants of severe/extreme disability among the elderly population in Spain. The assessment scheme was consistent with the ICF model of disability. METHODS: Nine populations contributed probabilistic or geographically-defined samples following a two-phase screening design. The Mini-Mental State Examination and the 12-item version of the World Health Organization-Disability Assessment Schedule, 2(nd) ed. (WHO-DAS II), were used as cognitive and disability screening tools, respectively. Positively screened individuals underwent clinical work-up for dementia and were administered the 36-item version of the WHO-DAS II to estimate ICF disability levels. We used logistic regression for the purposes of data combination, adjusted for age and sex in all analyses. RESULTS: The sample was composed of 503 participants aged ≥ 75 years. Alzheimeŕs disease and depression were highly predictive of severe/extreme disability (OR: 17.40, 3.71). Good access to social services was strongly associated with a low level or absence of disability (OR: 0.05 to 0.18). Very difficult access to services and having dementia or another psychiatric disorder were associated with an increase in disability (OR: 66.06). There was also a significant interaction effect between access to services and neurological disorders (OR: 12.74). CONCLUSIONS: Disability is highly prevalent among the Spanish elderly and is influenced by medical, social and personal factors. Disability could potentially be reduced by ensuring access to social services, preventing dementia and stroke, and treating depression.
Authors: Mandip S Dhamoon; Leslie A McClure; Carole L White; Kamakshi Lakshminarayan; Oscar R Benavente; Mitchell S V Elkind Journal: Neurology Date: 2015-02-06 Impact factor: 9.910
Authors: Carmen Rodríguez-Blázquez; Javier Damián; María José Andrés-Prado; Javier Almazán-Isla; Enrique Alcalde-Cabero; Maria João Forjaz; Juan Manuel Castellote; Jesús González-Enríquez; Pablo Martínez-Martín; Magdalena Comín; Jesús de Pedro-Cuesta Journal: BMJ Open Date: 2016-06-14 Impact factor: 2.692
Authors: J Almazán-Isla; M Comín-Comín; E Alcalde-Cabero; C Ruiz; E Franco; R Magallón; J Damián; J de Pedro-Cuesta; L A Larrosa-Montañes Journal: Int J Equity Health Date: 2017-01-09
Authors: Javier Virues-Ortega; Saturio Vega; Manuel Seijo-Martinez; Pedro Saz; Fernanda Rodriguez; Angel Rodriguez-Laso; Susana Perez de Las Heras; Raimundo Mateos; Pablo Martinez-Martin; Ignacio Mahillo-Fernandez; Josep Garre-Olmo; Jordi Gascon; Francisco Jose Garcia-Garcia; Manuel Fernandez-Martinez; Felix Bermejo-Pareja; Alberto Bergareche; Julian Benito-Leon; Jesus de Pedro-Cuesta Journal: BMC Geriatr Date: 2017-01-31 Impact factor: 3.921