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The Gerontologist 40:137-146 (2000)
© 2000 The Gerontological Society of America

Rethinking Functional Limitation Pathways

Fredric D. Wolinsky, PhDa,b,c, Eric S. Armbrecht, BSb and Kathleen W. Wyrwich, PhDa

a Saint Louis University School of Public Health, St. Louis, MO
b Saint Louis University School of Public Health, St. Louis, MO
c Saint Louis University School of Medicine, St. Louis, MO

Correspondence: Fredric D. Wolinsky, PhD, Saint Louis University School of Public Health, 3663 Lindell Boulevard, Suite 240B, St. Louis, MO 63108-3342. E-mail: wolinsky{at}slu.edu.

Decision Editor: Vernon L. Greene, PhD

Functional limitation has received considerable attention in gerontology and geriatrics. Much of this work has focused on single-wave transitions devoid of context rather than on the pattern of transitions over time that constitute trajectories. This Forum article suggests that it is time for a different way of looking at functional limitation pathways. It focuses on trajectories. Responses to three Rosow and Breslau 1966 and two Nagi 1976 items, asked of 12,998 older adults who participated in up to seven waves of data collection as part of the Established Populations for the Epidemiologic Study of the Elderly, are used to illustrate this approach, emphasizing both its conceptual and pragmatic advantages. The results provide greater clarity in terms of those who become functionally limited, take on more functional limitations, or recover as well as those who are likely to be lost to follow-up and in terms of the outcomes associated with those individuals over time.

Key Words: Trajectories • Transitions • Functional limitations • Health status • Older adults




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