Cited by 306Aging, Health, and DisabilityFrailty in Older AdultsChronic Disease Management Strategies

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Restricted Activity among Community-Living Older Persons: Incidence, Precipitants, and Health Care Utilization

Gill, Thomas M., Desai, Mayur M., Gahbauer, Evelyne A., Holford, Theodore R., Williams, Christianna S.·2001·Annals of Internal Medicine

DOI 10.7326/0003-4819-135-5-200109040-00007

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Abstract

BACKGROUND: Restricted activity is a potentially important indicator of health and functional status. Yet, relatively little is known about the incidence, precipitants, or health care utilization associated with restricted activity among older persons. OBJECTIVE: To more accurately estimate the rate of restricted activity among community-living older persons, to identify the health-related and non-health-related problems that lead to restricted activity, and to determine whether restricted activity is associated with increased health care utilization. DESIGN: Prospective cohort study. SETTING: New Haven, Connecticut. PARTICIPANTS: 754 nondisabled members of a large health plan, 70 years of age or older, who were categorized according to their risk for disability (low, intermediate, or high). MEASUREMENTS: Occurrence of restricted activity (defined as having stayed in bed for at least half a day or having cut down on one's usual activities because of an illness, injury, or another problem), problems leading to restricted activity, and health care utilization were ascertained during monthly telephone interviews for up to 2 years. RESULTS: In median follow-up of 15 months, 76.6% of participants reported restricted activity during at least 1 month and 39.3% reported restricted activity during 2 consecutive months. The rates of restricted activity per 100 person-months were 19.0 episodes for all participants and 16.9, 27.3, and 22.7 episodes for participants at low, intermediate, and high risk for disability, respectively. Of the 24 prespecified health-related and non-health-related problems, the rates per 100 person-months of restricted activity ranged from 0.1 episode for "problem with alcohol" to 65.5 episodes for "been fatigued." On average, participants identified 4.5 different problems as a cause for their restricted activity. Health care utilization was substantially greater during months with restricted activity than months without restricted activity. The corresponding rates per 100 person-months were 63.8 and 45.1 for physician office visits, 12.5 and 1.0 for emergency department visits, 14.1 and 0.3 for hospital admissions, and 67.6 and 45.1 for any health care utilization (P < 0.001 for each pairwise comparison). CONCLUSIONS: Restricted activity is common among community-living older persons, regardless of risk for disability, and it is usually attributable to several concurrent health-related problems. Although restricted activity is associated with a substantial increase in health care utilization, older persons with restricted activity often do not seek medical attention.

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Authors: Gill, T. M., Desai, M. M., Gahbauer, E. A., Holford, T. R., & Williams, C. S.
Affiliations: Yale University (US)
ORCID: Gill, Thomas M.
Desai, Mayur M.
Holford, Theodore R.
Venue: Annals of Internal Medicine
Publisher: American College of Physicians
Published: 2001-09-04
Volume: 135
Issue: 5
Pages: 313-321
ISSN: 0003-4819 (ISSN-L)
1539-3704
DOI: 10.7326/0003-4819-135-5-200109040-00007
OpenAlex: W2082921236
Cited by: 306
References: 31
Citations by year: 2026: 3 · 2025: 4 · 2024: 12 · 2023: 8 · 2022: 7 · 2021: 10 · 2020: 14 · 2019: 9 · 2018: 17 · 2017: 15 · 2016: 13 · 2015: 20 · 2014: 18 · 2013: 18 · 2012: 9
FWCI: 13.17
Type: journal article
Language: en
Open access: closed
Licence: www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
Locations: Annals of Internal Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5k23ag000759-02)
National Institute on Aging (1RO1AG17560-01A1, K23AG00759, R01AG017560)
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Aging, Health, and Disability
Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
Keywords: older adults, community-dwelling older adults, health care utilization, disability risk, functional status, fatigue, physician visits, emergency department visits, hospitalization, incidence, health insurance beneficiaries, alcohol problems, bed rest, health indicators, health services research
MeSH terms: Activities of Daily Living, Aged, Aged, 80 and over, Female, Persons with Disabilities, Health Services, Humans, Male, Risk Factors, Cohort Studies, Risk Assessment

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Restricted Activity among Community-Living Older Persons: Incidence, Precipitants, and Health Care Utilization

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