Recovery in instrumental activities of daily living (IADLs): findings from the Medical Research Council Cognitive Function and Ageing Study (MRC CFAS).

OBJECTIVE

to provide evidence for predictors of recovery in instrumental activities of daily living (IADLs) among disabled older people living in the community.

DESIGN

MRC CFAS recruited a sample of 13,004 individuals aged 65 years and above from five communities in the UK. Participants underwent a baseline interview between 1990 and 1994 and were re-assessed 2 years later.

PARTICIPANTS

the participants who reported that they were unable to perform any IADL without difficulty or help at baseline ('disabled') were included in the analysis.

METHODS

logistic regression was used to estimate odds ratios (OR) for improvement from disabled to non-disabled state at follow-up ('recovery').

RESULTS

at baseline, 50% reported disability of whom 9% reported independent function at follow-up. Women (OR = 0.4) and participants aged > or =75 years (OR = 0.2) were least likely to recover, followed by those with poor self-rated health (OR = 0.5), using at least one medication (OR = 0.6) and having more than or equal to two co-morbidities (OR = 0.6).

CONCLUSION

a minority of participants reporting disability at baseline then reported independent function at 2 years. It may be important to focus on those who seem least likely to recover once they have become disabled. Several factors that have been shown to increase the risk of disability were inversely associated with recovery, suggesting that intervention programmes could target these same factors.