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Racial Differences in Activities of Daily Living Limitation Onset in Older Adults With Arthritis: A National Cohort Study

  • Vivian C. Shih
    Affiliations
    Department of Physical Medicine and Rehabilitation, Rehabilitation Institute of Chicago, Chicago, IL
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  • Jing Song
    Affiliations
    Department of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, IL
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  • Rowland W. Chang
    Affiliations
    Arthritis Center, Rehabilitation Institute of Chicago, Chicago, IL

    Rheumatology Division, Department of Medicine, Department of Preventive Medicine, Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL

    Multidisciplinary Clinical Research Center in Rheumatology, Northwestern University, Chicago, IL.
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  • Dorothy D. Dunlop
    Correspondence
    Reprint requests to Dorothy D. Dunlop, PhD, Institute for Health Services Research and Policy Studies, Northwestern University, Wieboldt Rm 717, 339 E Chicago Ave, Chicago, IL 60611
    Affiliations
    Institute for Health Services Research and Policy Studies, Northwestern University Feinberg School of Medicine, Chicago, IL

    Multidisciplinary Clinical Research Center in Rheumatology, Northwestern University, Chicago, IL.
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      Abstract

      Shih VC, Song J, Chang RW, Dunlop DD. Racial differences in activities of daily living limitation onset in older adults with arthritis: a national cohort study.

      Objective

      To investigate factors that predict the onset of limitations in activities of daily living (ADLs) in adults 65 years old or older who have arthritis, in order to develop public health programs for minorities (African and Hispanic Americans) and white Americans.

      Design

      Longitudinal cohort study.

      Setting

      National probability sample.

      Participants

      Older adults with arthritis (N=3541) who participated in the 1998 and 2000 Health and Retirement Study interviews and who had no baseline ADL limitations.

      Interventions

      Not applicable.

      Main Outcome Measure

      Onset of ADL limitations was identified from reports of 1 or more ADL task limitations at 2-year follow-up.

      Results

      Onset is most frequent among African Americans (24.4%), followed by Hispanics (22.2%), and whites (16.9%). Race specific multivariate analysis showed that the strongest risk factor predicting onset of limitations across all racial and ethnic groups is physical limitations. Low household income was significant for older minorities but not for whites. Comorbid cardiovascular disease was a unique multivariate risk factor among African Americans.

      Conclusions

      Physical limitation is a strong risk factor for ADL limitation onset that is shared by all racial and ethnic groups. Early identification and treatment of physical limitations may prevent the onset of ADL limitations and thus improve quality of life. Race specific public health interventions should be considered to reduce the development of ADL limitations among older adults with arthritis.

      Key Words

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      Linked Article

      • The “Perfect Storm” for Minorities With Arthritis
        Archives of Physical Medicine and RehabilitationVol. 86Issue 11
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          We read with great interest the article by Shih et al.1 As we are physiatrists practicing within an inner-city community, we applaud Shih for demonstrating how African Americans and Hispanics are at increased risk of limitations in activities of daily living (ADLs) in association with their arthritis.
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