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Modifiable Risks of Incident Functional Dependence in Hispanic and Non-Hispanic White Elders

The San Luis Valley Health and Aging Study

^a Department of Preventive Medicine and Biometrics, University of Colorado School of Medicine, Denver

Correspondence: Lucinda L. Bryant, PhD,MSHA,MBA, Center for Health Services Research, Division of Health Care Policy and Research, University of Colorado Health Sciences Center, 1355 S. Colorado Boulevard, Suite 306, Denver, CO 80222. E-mail: lucinda.bryant{at}uchsc.edu.

Decision Editor: Laurence G. Branch, PhD

Purpose: This study identified modifiable risks associated with incident functional dependence, compared their effects, and estimated the percent risk attributable to each factor, by ethnicity. Design and Methods: The prospective study cohort comprised 751 rural Hispanic and non-Hispanic White elders from southern Colorado who reported no dependence in basic and instrumental activities of daily living (ADLs and IADLs) at baseline. Logistic regression modeled the effects of physical inactivity, nutritional risk, smoking, and falls on incident disability 22 months later, with and without adjustment for baseline ADL and IADL difficulty. Population attributable risk percentages assessed these modifiable risks by ethnicity. Results: Each risk factor multiplied the likelihood of incident dependence by 1.4 or more, adjusted for covariates. Attributable risk percentages ranged from 8% to 32% depending on risk factor, ethnicity, and baseline ADL and IADL difficulty status. Attributable risk was generally greater among Hispanic elders, the result of higher prevalence of most of the risk factors. Implications: Interventions targeted at inadequate nutrition, inactivity, smoking, and preventable falls offer opportunities to reduce incident functional disability, especially among Hispanic elders.

Key Words: Cohort study • Ethnic disparities • Attributable risk • Aging • Functional disability

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