Understanding the linkages between perceived causative impairment and activity limitations among older people living in the community: A population-based assessment

Objective: The aim of this study was to better understand the linkages between impairment and activity limitation among groups of elderly community-living persons. Design: This study used a United States population-based complex survey with weights used to make accurate population prevalence estimates from the 1994 National Health Interview Survey on Disability. Included were 2429 persons 70 yrs or older with one or more activity of daily living or instrumental activity of daily living-only activity limitations. Limitations were addressed according to the impairment(s) perceived to be causing them. Results: Musculoskeletal impairments accounted for more than one-third of all perceived causes. The odds of having any activity of daily living limitations for persons whose limitations were attributed to musculoskeletal impairments and to brain or behavioral impairments were 2.12 times (95% confidence interval, 1.63-2.76) and 3.00 times (95% confidence interval, 2.23-4.03) the odds for the reference group of cardiopulmonary and hematology impairment. Conclusions: Although musculoskeletal impairments were the most common cause of activity limitation, impairments associated with brain or behavioral disturbance were perceived as most disabling.