Prognostic factors of disability in older people: a systematic review.

AIM

To systematically review the evidence on the influence of sociodemographic, lifestyle, and (bio)medical variables on the course of prevalent disability and transition rates to different outcome categories in community-dwelling older people.

METHOD

Articles were identified through searches of PubMed, EMBASE, and PsycINFO databases and reference lists of relevant articles. Prospective population studies that assessed disability at baseline and reported on associations between potential prognostic variables and disability were included. Methodological quality of studies was assessed by standardised criteria, after which relevant data were extracted. A synthesis of the available evidence was carried out.

RESULTS

Nine cohort studies reported transition rates and eight cohort studies presented multivariate analyses on prognostic factors. There was some heterogeneity among studies in definition and assessment of disability. There is moderate to strong evidence that higher age, cognitive impairment, vision impairment, and poor self-rated health are prognostic factors of disability.

CONCLUSION

Prognostic factors, partly modifiable, are identified that should be taken into account in targeting treatment and care for older people with disabilities. Further conceptual and methodological standardisation is required in order to enable a meta-analysis and obtain higher levels of evidence.