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Open Access Research article

Age, gender and disability predict future disability in older people: the Rotterdam Study

Ümit Taş1, Ewout W Steyerberg2, Sita MA Bierma-Zeinstra1, Albert Hofman3, Bart W Koes1 and Arianne P Verhagen1*

Author Affiliations

1 Department of General Practice, Erasmus MC - University Medical Centre Rotterdam, P.O. Box 2040; 3000 CA Rotterdam, the Netherlands

2 Department of Public Health, Erasmus MC - University Medical Centre Rotterdam, P.O. Box 2040; 3000 CA Rotterdam, the Netherlands

3 Department of Epidemiology and Biostatistics, Erasmus MC - University Medical Centre Rotterdam, P.O. Box 2040; 3000 CA Rotterdam, the Netherlands

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BMC Geriatrics 2011, 11:22  doi:10.1186/1471-2318-11-22

Published: 10 May 2011

Abstract

Background

To develop a prediction model that predicts disability in community-dwelling older people. Insight in the predictors of disability is needed to target preventive strategies for people at increased risk.

Methods

Data were obtained from the Rotterdam Study, including subjects of 55 years and over. Subjects who had complete data for sociodemographic factors, life style variables, health conditions, disability status at baseline and complete data for disability at follow-up were included in the analysis. Disability was expressed as a Disability Index (DI) measured with the Health Assessment Questionnaire.

We used a multivariable polytomous logistic regression to derive a basic prediction model and an extended prediction model. Finally we developed readily applicable score charts for the calculation of outcome probabilities.

Results

Of the 5027 subjects included, 49% had no disability, 18% had mild disability, 16% had severe disability and 18% had deceased at follow-up after six years. The strongest predictors were age and prior disability. The contribution of other predictors was relatively small. The discriminative ability of the basic model was high; the extended model did not enhance predictive ability.

Conclusion

As prior disability status predicts future disability status, interventive strategies should be aimed at preventing disability in the first place.

Keywords:
disability; older people; prediction model; prospective cohort