What is the problem and what is known about it so far?
To live independently, people must be able to do basic activities of daily living (ADLs), such as taking a bath, putting on clothes, or getting out of a chair or bed, without help from another person. The inability to perform ADLs, also known as “functional impairment,” is common in older adults. Studies suggest that functional impairment is also common in middle-aged adults. It is not clear how many middle-aged adults have functional limitations. For those who have problems with ADLs, it is also unclear how long these problems last.
Why did the researchers do this particular study?
To determine the proportion of middle-aged adults in whom a new functional limitation developed and whether the problem got better, got worse, or stayed the same.
Who was studied?
6874 middle-aged adults who were living in the community. These adults did not have problems performing ADLs when they entered the study.
How was the study done?
The study participants were interviewed by telephone at baseline and every 2 years. At each interview, they were asked whether they had any problems doing basic ADLs, and they answered questions about their general health, medical conditions, and health behaviors. The researchers examined how many participants had a new functional impairment during follow-up. For participants in whom impairment developed, the researchers described those whose impairment got better, those whose impairment got worse, and those whose impairment stayed the same.
What did the researchers find?
Difficulty with at least 1 ADL developed in about 1 in 4 participants between the ages of 50 and 64 years. Two years after functional impairment developed, 50% of participants continued to have limitations and 37% recovered. In 9%, the impairment worsened, and 4% died. During 10 years of follow-up, 28% of participants recovered from their initial episode and remained independent, whereas about 20% had further episodes, with worsening functional impairment, and 19% died.
What were the limitations of the study?
The information provided by the participants on their activity limitations was not verified objectively.
What are the implications of the study?
Functional impairment, or difficulty doing basic ADLs, is common during middle age. Of the middle-aged adults in whom a functional limitation developed, some had further impairment or died during follow-up. These findings suggest that functional impairment may not be a short-term problem during middle age.