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Newly Reported Chronic Conditions and Onset of Functional Dependency

Authors

  • Jennifer L. Wolff PhD,

    1. From the *Lipitz Center for Integrated Health Care, Department of Health Policy and Management, Bloomberg School of Public Health, and Division of Geriatric Medicine and Gerontology, School of Medicine, The Johns Hopkins University, Baltimore, Maryland.
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  • Chad Boult MD, MPH, MBA,

    1. From the *Lipitz Center for Integrated Health Care, Department of Health Policy and Management, Bloomberg School of Public Health, and Division of Geriatric Medicine and Gerontology, School of Medicine, The Johns Hopkins University, Baltimore, Maryland.
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  • Cynthia Boyd MD, MPH,

    1. From the *Lipitz Center for Integrated Health Care, Department of Health Policy and Management, Bloomberg School of Public Health, and Division of Geriatric Medicine and Gerontology, School of Medicine, The Johns Hopkins University, Baltimore, Maryland.
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  • Gerard Anderson PhD

    1. From the *Lipitz Center for Integrated Health Care, Department of Health Policy and Management, Bloomberg School of Public Health, and Division of Geriatric Medicine and Gerontology, School of Medicine, The Johns Hopkins University, Baltimore, Maryland.
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  • This project was supported by the Partnership for Solutions, a national program of the Robert Wood Johnson Foundation, Princeton, New Jersey.

Address correspondence to Jennifer L. Wolff, PhD, Lipitz Center for Integrated Health Care, Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, 624 North Broadway, Room 692, Baltimore, MD 21205. E-mail: jwolff@jhsph.edu

Abstract

Objectives: To examine the relationship between newly reported chronic conditions and subsequent functional dependency in older adults.

Design: Three-year cohort study.

Setting: United States.

Participants: A national sample of Americans age 65 and older (N=4,968) who participated in the Medicare Current Beneficiary Survey.

Measurements: Self-reports of new physician diagnoses between baseline and 12 months and functional dependency onset at 12-, 24-, and 36-month follow-up. Functional dependency is defined as needing help with or being unable to perform one or more activities of daily living or residence in a long-term care facility.

Results: After 12 months of follow-up, 29.8% of participants reported one or more newly diagnosed conditions, increasing to 48.7% at 24 months and 61.3% at 36 months. Number of newly reported conditions was associated with greater probability of functional dependency; this association was strongest at 12 months. The odds of becoming functionally dependent were nearly twice as great in participants who reported one new chronic condition (odds ratio (OR)=1.9, 95% confidence interval (CI)=1.3–2.8), more than four times as great in those who reported two new chronic conditions (OR=4.3, 95%=CI 2.7–6.9), and 13 times as great in those who reported three or more new chronic conditions (OR=13.0, 95%=CI 6.5–26.3) as in those who reported no new chronic conditions. Newly reported dementia, stroke, psychological disorders, low body mass index, and obesity were significantly and consistently related to functional dependency throughout all 3 years of observation (OR=2.1–14.1).

Conclusion: Findings from this study demonstrate the strong relationship between newly diagnosed chronic conditions and functional dependency and highlight the potential benefit of prevention in older adults.

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