Restricted Activity in the Elderly is Common, Yet Many do not Seek Medical Care, Yale Researchers Find
Restricted activity-staying in bed for at least half a day or cutting down on activities because of an illness or injury-affects about 76 percent of elderly people, yet many do not seek medical attention, Yale researchers report in a new study.
“Restricted activity is an important indicator of health and functional status,” said lead investigator Thomas M. Gill, M.D., associate professor of medicine at Yale School of Medicine. “By understanding the causes of restricted activity, we can develop better preventive strategies to delay the onset and progression of disability among older people.”
Published in the September 4 issue of Annals of Internal Medicine, the study’s goal was to more accurately estimate the rate of restricted activity among older people living in the community; to identify the problems that lead to restricted activity; and to determine whether restricted activity is associated with increased health care utilization.
Gill and his co-authors used monthly telephone calls for an average of 15 months to follow a group of 754 people aged 70 and over living in the Greater New Haven area. Results show that 76.6 percent of participants reported restricted activity during at least one month and 39.3 percent reported restricted activity during two consecutive months. On average, participants identified 4.5 different causes for their restricted activity including fatigue, pain or stiffness in joints, pain or stiffness in back and dizziness or unsteadiness while standing.
The team further found differences in gender. Women had higher rates of restricted activity than men and identified more problems as a cause of their restricted activity.
“These findings are consistent with previous reports demonstrating a higher burden of chronic disease and disability among women than among men and highlight the compelling need for preventive and therapeutic interventions to improve the health and functional status of older women,” Gill said.
While study participants were more likely to use health care services during months with restricted activity, they often did not seek medical attention when they restricted their activity. In fact, Gill said participants reported that about one-third of their doctor visits during months with restricted activity were for routine follow-up.
“The great number of symptoms leading to restricted activity, coupled with recent evidence that a coordinated self-care program may be an effective strategy for managing many chronic conditions and symptoms, provide physicians and other health care providers with a unique opportunity to improve the health and well-being of their older patients,” Gill said.
“Restricted activity should not be accepted as a normal part of aging by patients, families or physicians,” Gill added. “When restricted activity persists, older people should see their physician for an evaluation; and physicians should be attentive to the multiple potential causes for restricted activity among their older patients.”
Gill’s co-authors include Mayur M. Desai of the Department of Epidemiology and Public Health at Yale School of Medicine and the Department of Veterans Affairs Connecticut Healthcare System; and Evelyne A. Gahbauer, Theodore R. Holford and Christianna S. Williams of the Department of Epidemiology and Public Health at Yale School of Medicine.
The study was supported by grants from the Robert Wood Johnson Foundation, the Paul Beeson Physician Faculty Scholars Program, the Patrick and Catherine Weldon Donaghue Medical Research Foundation and the National Institute on Aging.
Gill can be reached at 425-453-5694 or firstname.lastname@example.org