Publication Type
Journal Article
Version
publishedVersion
Publication Date
4-2015
Abstract
Objective: To examine whether disaggregated activities of daily living (ADL) limitations better predict the risk of nursing home admission compared to conventionally used ADL disability counts. Data Sources: We used panel data from the Health and Retirement Study (HRS) for years 1998–2010. The HRS is a nationally representative survey of adults older than 50 years (n = 18,801). Study Design: We fitted Cox regressions in a continuous time survival model with age at first nursing home admission as the outcome. Time-varying ADL disability types were the key explanatory variables. Principal Findings: Of the six ADL limitations, bathing difficulty emerged as the strongest predictor of subsequent nursing home placement across cohorts. Eating and dressing limitations were also influential in driving admissions among more recent cohorts. Using simple ADL counts for analysis yielded similar adjusted R2s; however, the amount of explained variance doubled when we allowed the ADL disability measures to time-vary rather than remain static. Conclusions: Looking beyond simple ADL counts can provide health professionals insights into which specific disability types trigger long-term nursing home use. Functional disabilities measured closer in time carry more prognostic power than static measures.
Keywords
Long-term care, disability, aging, hazard rates, ADLs
Discipline
Finance and Financial Management | Gerontology | Medicine and Health Sciences
Research Areas
Finance
Publication
Health Services Research
Volume
50
Issue
2
First Page
560
Last Page
578
ISSN
1475-6773
Identifier
10.1111/1475-6773.12235
Publisher
Health Research and Educational Trust
Citation
FONG, Joelle H. Y.; MITCHELL, Olivia S.; and KOH, Benedict S. K..
Disaggregating Activities of Daily Living Limitations for Predicting Nursing Home Admission. (2015). Health Services Research. 50, (2), 560-578.
Available at: https://ink.library.smu.edu.sg/lkcsb_research/4832
Copyright Owner and License
Publisher
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Additional URL
https://doi.org/10.1111/1475-6773.12235
Included in
Finance and Financial Management Commons, Gerontology Commons, Medicine and Health Sciences Commons