For elderly people, becoming disabled does not necessarily mark the end of their ability to live independently, according to a new study by researchers at the School of Medicine, which shows that nearly one-third of disabled older people living in the community recover their ability to perform essential activities of daily living (such as bathing or dressing) over a two-year period.
"There is a misperception among the lay public as well as the medical community about the ability of older persons to recover from disability, that once an older person becomes disabled and dependent, it means a ticket to a nursing home," says Dr. Thomas M. Gill, assistant professor of medicine (geriatrics) at the medical school. "But our study showed that a substantial minority do regain their function."
The Yale scientists studied 213 residents of New Haven, who were all 72 years of age or older and who required help from another person to perform such functions as bathing, dressing, walking, eating, toileting or grooming. Participants were followed for up to two years to determine whether they recovered the ability to perform these activities independently. The research was published in the December issue of the Journal of General Internal Medicine and was funded, in part, by the Claude D. Pepper Older Americans Independence Center.
Nearly 30 percent of the people studied did regain their independence. However, all participants were not equally likely to recover, the team discovered. In fact, the strongest predictor of recovery was age, note the researchers, with participants aged 85 or younger being eight times more likely to regain independence in their daily activities than those aged 86 and older. Other factors associated with recovery include intact cognitive function (including memory), high mobility and good nutrition -- factors that may serve as markers of resiliency in the elderly population, says Gill.
While this is good news for the "young old," those up to age 85, he notes, "This finding raises a red flag that the 'old old' group needs more aggressive treatment or rehabilitation." It may be even better to target special preventive efforts to forestall the onset of disability in the first place, he adds. The National Institute on Aging estimates that $15 billion is spent annually for long-term care for those unable to remain in the community because they can't perform essential activities of daily living. Even a small reduction in this number of people would translate into large health-care savings, Gill points out, and this is particularly important because the number of Americans older than 85 could reach 15.3 million by 2050 -- a figure five times higher than that population group today.