Modelling the association of disability according to the WHO International Classification of Functioning, Disability and Health (ICF) with mortality in the British Women's Heart and Health Study.
Modelling the association of disability according to the WHO International Classification of Functioning, Disability and Health (ICF) with mortality in the British Women's Heart and Health Study.
Background
The WHO International Classification of Functioning, Disability and Health (ICF) is now the dominant model for exploring the social consequences of a health condition. This paper investigates the association of the different ICF disability domains with mortality.
Methods
Data are from the British Women Heart and Health Study, a large (n=4157) prospectively studied cohort of women randomly selected from 23 towns aged 64–83?years in 2003. Scores were calculated to describe the cumulative load of impairments, limitations and restrictions within each ICF domain. Cox proportional hazards regression was used to calculate mortality HRs per unit score increase within each ICF domain. Adjustments were made for age, town, living status, socioeconomic status, lifestyle behaviours and health conditions.
Results
Each ICF domain was associated with mortality after controlling for lifestyle factors and health conditions. However, only complex activities (HR=1.09, 95% CI 1.01 to 1.18) and participation (HR=1.10, 95% CI 1.04 to 1.16) were independent predictors of mortality following adjustment for all other disability domains and potential confounders.
Conclusions
Results suggest that difficulties with complex activities or social participation could be used to identify and target women at high risk of dying. Interventions to facilitate complex activities or improve social participation may help to delay mortality in elderly women.
170 - 175
Dale, C.
66c336b4-2235-4088-b913-59980c30b2fd
Prieto-Merino, D.
7a463f15-3401-448a-9d93-47c789af7342
Kuper, H.
edeb0464-c9dd-400d-a561-0323d6451707
Adamson, J.
1c0797f8-093c-42ca-a254-60149be7e271
Bowling, Ann
796ca209-687f-4079-8a40-572076251936
Ebrahim, S.
cc462d6d-f796-479f-8126-7a48fcb965d4
Casas, J.P.
a2719845-fe05-4a65-ad60-d3a908582edc
February 2012
Dale, C.
66c336b4-2235-4088-b913-59980c30b2fd
Prieto-Merino, D.
7a463f15-3401-448a-9d93-47c789af7342
Kuper, H.
edeb0464-c9dd-400d-a561-0323d6451707
Adamson, J.
1c0797f8-093c-42ca-a254-60149be7e271
Bowling, Ann
796ca209-687f-4079-8a40-572076251936
Ebrahim, S.
cc462d6d-f796-479f-8126-7a48fcb965d4
Casas, J.P.
a2719845-fe05-4a65-ad60-d3a908582edc
Dale, C., Prieto-Merino, D., Kuper, H., Adamson, J., Bowling, Ann, Ebrahim, S. and Casas, J.P.
(2012)
Modelling the association of disability according to the WHO International Classification of Functioning, Disability and Health (ICF) with mortality in the British Women's Heart and Health Study.
Journal of Epidemiology & Community Health, 66 (2), .
(doi:10.1136/jech-2011-200078).
(PMID:22012963)
Abstract
Background
The WHO International Classification of Functioning, Disability and Health (ICF) is now the dominant model for exploring the social consequences of a health condition. This paper investigates the association of the different ICF disability domains with mortality.
Methods
Data are from the British Women Heart and Health Study, a large (n=4157) prospectively studied cohort of women randomly selected from 23 towns aged 64–83?years in 2003. Scores were calculated to describe the cumulative load of impairments, limitations and restrictions within each ICF domain. Cox proportional hazards regression was used to calculate mortality HRs per unit score increase within each ICF domain. Adjustments were made for age, town, living status, socioeconomic status, lifestyle behaviours and health conditions.
Results
Each ICF domain was associated with mortality after controlling for lifestyle factors and health conditions. However, only complex activities (HR=1.09, 95% CI 1.01 to 1.18) and participation (HR=1.10, 95% CI 1.04 to 1.16) were independent predictors of mortality following adjustment for all other disability domains and potential confounders.
Conclusions
Results suggest that difficulties with complex activities or social participation could be used to identify and target women at high risk of dying. Interventions to facilitate complex activities or improve social participation may help to delay mortality in elderly women.
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e-pub ahead of print date: 19 October 2011
Published date: February 2012
Organisations:
Faculty of Health Sciences
Identifiers
Local EPrints ID: 334522
URI: http://eprints.soton.ac.uk/id/eprint/334522
ISSN: 0143-005X
PURE UUID: 2d0bec17-608e-4385-af31-ee9c00495a6b
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Date deposited: 16 Mar 2012 16:05
Last modified: 14 Mar 2024 10:35
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Contributors
Author:
C. Dale
Author:
D. Prieto-Merino
Author:
H. Kuper
Author:
J. Adamson
Author:
S. Ebrahim
Author:
J.P. Casas
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