SEARCH · PubMed Health

Results for “Disability”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 721 records · Page 40Linked to original sources

PubMed2003

Socio-demographical examinations on disability prevalence and rehabilitation status in southwest of Turkey.

PURPOSE: Disability is one of the most important social issues in the community. In contrast to the developed countries, Turkey has, unfortunately, no goods records on the current issues of disability such as the number of disabled and handicapped, and their socio-demographic properties due to the lack of sufficient studies in the specified area. The present study was, therefore, aimed to determine the status of disabled in the entire region of Isparta and to establish relationships between the distinctive disability properties in order for a better understanding of its important aspects. MATERIALS AND METHODS: Data were collected in 2002 from 3500 people residing throughout the region by the gradual sampling method according to the evaluation criteria of International Classification of Impairments, Disabilities and Handicaps (ICIDH) by WHO. RESULTS: The disability prevalence in the studied group was found to be 5.3%, and 4.8% of the disabled were previously rehabilitated. Forty one percent of the disabled were found to have two types of disability. In the study, it was shown that the disability prevalence significantly increased by the age. The disabled were shown to be under-educated and not benefit from the rehabilitation services in one hand, and there were insufficient activities of rehabilitation established in the region in other hand. CONCLUSIONS: We concluded that the medical and social rehabilitation services must be initiated and freely provided to these local people, particularly to those young disables whose life will greatly change to a better living standard.

Adolescent↗

PubMed1999

Measuring disability, the agreement between self evaluation and observation of performance.

PURPOSE: In 1981, eight countries and the World Health Organization (WHO) reached consensus about applying a similar disability questionnaire in their health surveys that was related to the ICIDH. In 1992 a revised version, the WHO-disability questionnaire, was recommended. In this paper the concurrent validity of 10 items of the questionnaire is evaluated by measuring the agreement with observed performance of corresponding tasks. METHOD: The disability questionnaire was sent to 750 subjects. From the respondents (468) 93 were selected, based on their reported disability, and 10 performance tasks were observed. The agreement was measured for individual items and for all items together in distinguishing between persons with no, or at least one disability. RESULTS: A low to moderate agreement was found between self reported and observed disability. In general, observation resulted in lower disability ratings. Among 24% of those who reported at least one disability, no disability was observed. Persons among whom at least one disability was observed, only 2% (n = 1) reported no disability in the questionnaire. CONCLUSIONS: Although the concurrent validity is low to moderate between the results of the WHO-disability questionnaire and observation, the questionnaire is highly sensitive for detecting persons with at least one disability. The specificity of the questionnaire must be increased by additional questions.

Activities of Daily Living↗

PubMed2002

Changes in the prevalence of disability pension in Iceland 1976-1996.

AIMS: The objectives were to determine changes in the prevalence of disability pension in Iceland and its distribution according to gender, age, and main diagnoses. METHODS: The study includes all persons receiving either full or partial disability pension in 1976 and 1996. The age-standardized risk ratio between the years 1976 and 1996 was calculated for all disability pensions and for full disability pension only. RESULTS: The prevalence of all disability pensions decreased significantly among both men and women in 1996 as compared with 1976. When the figures were disaggregated, however, theyrevealed an increased risk of full disability pension and a decreased risk of partial disability pension. Th e prevalence of full disability pension had increased in most disease categories. CONCLUSION: The decreased prevalence of disability pension in 1996 as compared with 1976 is noteworthy, as unemployment was increasing during the years immediately preceding 1996. It seems likely, however, that the decrease of partial disability pension and increase of full disability pension is a reflection of increased competition for work in the labour market as well as increased attractiveness of full disability pension due to new supplementary sickness insurance benefits linked to full disability pension.

Adolescent↗

PubMed2001

Profile of arthritis disability.

Using the 1994-95 National Health Interview Supplement Disability Supplement, the authors study levels of disabilities and accommodations among US adults with arthritis disability, compared to people with disability due to other conditions. Arthritis-disabled people are defined in two ways. One definition covers a broad range of arthritis and rheumatic conditions, and the other concentrates solely on arthritis. The authors find that arthritis-disabled people have more total disabilities than other-disabled peop e. However, their disabilities are less severe, have shorter durations, and accumulate more gradually over time. Despite more disabilities, people with arthritis disability use fewer assistive and service accommodations than other-disabled people. They do use more mobility aids. Because arthritis is the leading chronic condition for middle-aged and older adults, th s profile of extensive but mild-to-moderate disability is experienced by many millions of adults. Accommodations for arthritis may also be extensive but aimed more toward self-care than toward assistive and medical services.

Activities of Daily Living↗

PubMed2006

The dynamic nature of mobility disability in older persons.

OBJECTIVES: To determine the rates of clinically meaningful transitions in mobility disability; evaluate how these transitions differ according to age, sex, and physical frailty; and depict the duration of the resulting episodes of mobility disability. DESIGN: Prospective cohort study. SETTING: General community in greater New Haven, Connecticut, from March 1998 to October 2004. PARTICIPANTS: Seven hundred fifty-four community-living older persons, aged 70 and older, who were nondisabled (i.e., required no personal assistance) in four activities of daily living. MEASUREMENTS: Mobility disability, defined as the inability to walk one quarter of a mile and to climb a flight of stairs, respectively without personal assistance, was assessed every month for up to 5 years. RESULTS: For both mobility tasks, rates per 1,000 person-months were higher for transitions from no disability to intermittent disability (34.7 for walking one quarter of a mile and 17.4 for climbing a flight of stairs), intermittent to continuous disability (52.0 and 42.5), continuous to intermittent disability (35.4 and 31.5), and intermittent to no disability (68.6 and 85.4) than for other transitions. Older age, female sex, and physical frailty were associated with greater likelihood of transition to states of greater disability and lower likelihood of regaining independent mobility. CONCLUSION: Mobility disability in older persons is a highly dynamic process, characterized by frequent transitions between states of independence and disability. Programs designed to enhance independent mobility should focus not only on the prevention of mobility disability but also on the restoration and maintenance of independent mobility in older persons who become disabled.

Activities of Daily Living↗

PubMed1996

Identification and assessment of students with disabilities.

Students with disabilities or suspected disabilities are evaluated by schools to determine whether they are eligible for special education services and, if eligible, to determine what services will be provided. In many states, the results of this evaluation also affect how much funding assistance the school will receive to meet the students' special needs. Special education classification is not uniform across states or regions. Students with identical characteristics can be diagnosed as disabled in one state but not in another and may be reclassified when they move across state or school district lines. Most disabilities with a clear medical basis are recognized by the child's physician or parents soon after birth or during the preschool years. In contrast, the majority of students with disabilities are initially referred for evaluation by their classroom teacher (or parents) because of severe and chronic achievement or behavioral problems. There is evidence that the prevalence of some disabilities varies by age, the high-incidence disabilities such as learning disabilities and speech-language disabilities occur primarily at the mild level, the mild disabilities exist on broad continua in which there are no clear demarcations between those who have and those who do not have the disability, and even "mild" disabilities may constitute formidable barriers to academic progress and significantly limit career opportunities. Problems with the current classification system include stigma to the child, low reliability, poor correlation between categorization and treatment, obsolete assumptions still in use in treatment, and disproportionate representation of minority students. Both African-American and Hispanic students are disproportionately represented in special education but in opposite directions. The disproportionately high number of African Americans in special education reflects the fact that more African-American students than white students are diagnosed with mild mental retardation. Though poverty, cultural bias, and inherent differences have been suggested as reasons for this disproportionate representation, there are no compelling data that fully explain the phenomenon. In most states, classification of a student as disabled leads to increased funding from the state to the school district. This article suggests a revised funding system that weights four factors (number of deficits, degree of discrepancy, complexity of intervention, and intensity of intervention) in a regression equation that would yield a total amount of dollars available to support the special education of a particular student.

Adolescent↗

PubMed2005

Changes in disability before and after myocardial infarction in older adults.

BACKGROUND: Disability in older adults is thought to occur primarily as a consequence of clinical disease episodes. However, the temporal relationship between clinical disease and disability has received little systematic attention. METHODS: Data from a prospective population-based study of 2812 older adults were analyzed to examine changes in disability before and after acute myocardial infarction. Disability outcomes included up to 9 yearly assessments of disability in activities in daily living, disability in basic physical functions, and disability in tasks requiring basic mobility and strength. RESULTS: A total of 279 myocardial infarctions occurred during 9 years of follow-up. After adjustment for age and sex, the average yearly increase in disability in activities of daily living and basic physical functions was not significantly greater in the 1-year period after myocardial infarction than in the 3-year period before myocardial infarction (P values >.20). Disability in basic mobility and strength showed a significantly greater increase in the year after myocardial infarction (P = .02). The results did not change after adjustment for comorbidity and chest pain or when restricted to incident cases of myocardial infarction or survivors. An additional exploratory analysis suggested that the rate of increase in some forms of disability may start to accelerate at about 1 year before the event, rather than after the event. CONCLUSIONS: The increase in disability after myocardial infarction may form a continuation of increases that occur before the event and challenge commonly held notions about the temporal relationship between clinical disease and disability. Changes in disability before acute disease episodes may be related to subclinical disease.

Activities of Daily Living↗

PubMed2004

Hospitalization, restricted activity, and the development of disability among older persons.

CONTEXT: Preventing the development of disability in activities of daily living is an important goal in older adults, yet relatively little is known about the disabling process. OBJECTIVES: To evaluate the relationship between 2 types of intervening events (hospitalization and restricted activity) and the development of disability and to determine whether this relationship is modified by the presence of physical frailty. DESIGN, SETTING, AND PARTICIPANTS: Prospective cohort study, conducted in the general community in greater New Haven, Conn, from March 1998 to March 2003, of 754 persons aged 70 years or older, who were not disabled (ie, required no personal assistance) in 4 essential activities of daily living: bathing, dressing, walking inside the house, and transferring from a chair. Participants were categorized into 2 groups according to the presence of physical frailty (defined on the basis of slow gait speed) and were followed up with monthly telephone interviews for up to 5 years to ascertain exposure to intervening events and determine the occurrence of disability. MAIN OUTCOME MEASURE: Disability, defined as the need for personal assistance in bathing, dressing, walking inside the house, or transferring from a chair. RESULTS: During the 5-year follow-up period, disability developed among 417 (55.3%) participants, 372 (49.3%) were hospitalized and 600 (79.6%) had at least 1 episode of restricted activity. The multivariable hazard ratios for the development of disability were 61.8 (95% confidence interval [CI], 49.0-78.0) within a month of hospitalization and 5.54 (95% CI, 4.27-7.19) within a month of restricted activity. Strong associations were observed for participants who were physically frail and those who were not physically frail. Hospital admissions for falls were most likely to lead to disability. Intervening events occurring more than a month prior to disability onset were not associated with the development of disability. The population-attributable fractions associated with new exposure to hospitalization and restricted activity, respectively, were 0.48 and 0.19; 0.40 and 0.20, respectively, for frail participants and 0.61 and 0.16, respectively, for nonfrail participants. CONCLUSIONS: Illnesses and injuries leading to either hospitalization or restricted activity represent important sources of disability for older persons living in the community, regardless of the presence of physical frailty. These intervening events may be suitable targets for the prevention of disability.

Activities of Daily Living↗

PubMed2000

A reappraisal of HAQ disability in rheumatoid arthritis.

OBJECTIVE: To investigate the course of self-reported disability in rheumatoid arthritis (RA) using the major self-report measure of functional impairment, the Health Assessment Questionnaire (HAQ). METHODS: The course of HAQ disability was assessed in 32,525 observations (1,843 patients) in which the HAQ was administered. In addition, a subset of 2,189 visits from 50 patients, followed on average for 17 years, was studied to model the effect of disease duration on the course of HAQ disability in individual patients. Linear and fractional polynomial regression as well as smoothing algorithms were applied to the group of RA patients and then to the individual course of patients. RESULTS: Group linear and nonlinear models of the effect of disease duration on HAQ disability were found to have 3 characteristics: 1) HAQ disability scores are high at disease onset rather than gradually increasing; 2) HAQ disability increases very slowly over time (0.03 units per year); and 3) all such models fit very poorly, explaining only 5% of the variance in HAQ disability scores. However, application of nonlinear models to individual patient courses (as opposed to groups of patients) explains 37% of the HAQ disability score variation. In some patients, the course of HAQ disability was either 1) chaotic (scores change without any pattern) or 2) determinable, but unrelated to time. When covariates were added to the group model, however, the course of HAQ disability became clearer, and 51% of the variance in the disability score could be explained, statistically, by pain, depression, erythrocyte sedimentation rate, and disease duration. CONCLUSION: Individual RA patients have differing, characterizable courses: 1) nonlinear, 2) chaotic, or 3) non-time determined. The model that self-reported physical disability, as measured by the HAQ, occurs as a function of disease acting over time does not fit the data well and is an inadequate model. This discrepancy may also be the result of the patient's upward reappraisal of functional ability with increasing time. The predominant determinants of HAQ disability in RA are disease activity, pain, and psychosocial factors rather than structural abnormality. Although the HAQ is a useful clinical tool and a central measure of disease outcome, it measures both process and outcome, and usually more process than outcome. Individual patient models that include all that is known about the patient--the paradigm of clinical care-may be a more effective way to examine the course of RA than are conventional group-based models.

Adult↗

PubMed2006

Variation in health conditions among groups of adults with disabilities in primary care.

The literature on the health of adults with disabilities focuses on one disability compared to a comparison group. This study allows cross disability comparisons with the hypothesis. Adults with disabilities had higher odds of having common health conditions, compared to adults without disability in the same practice. A retrospective record review of 1449 patients with disability and 2084 patients without disability included individuals with sensory impairments (n = 117), developmental disabilities (n = 692), trauma-related impairments (n = 155) and psychiatric impairments (n = 485). The only two health conditions with statistically significantly increased odds for all groups with disabilities were dementia and epilepsy. Patients with developmental disabilities were less likely to have coronary artery disease, cancer, and obesity. Those with sensory impairments had increased odds for congestive heart failure, diabetes, transient ischemic attacks and death. Patients with trauma disabilities had increased odds for chronic obstructive pulmonary disease, and depression. Finally, psychiatric patients had increased odds for most of the investigated condition. In conclusion, there were many similarities in the risk for common health conditions such as asthma, cancer, coronary artery disease, depression, hypertension, and obesity, among patients with and without disability. Some of the conditions with increased odds ratios, including depression, seizures, and dementia are secondary to the primary disability.

Adult↗

PubMed2005

Multilevel analysis of couple congruence on pain, interference, and disability.

Couple congruence on ratings of pain severity and disability were examined using hierarchical linear modeling. Older community Individuals with Chronic Pain (ICPs) and their spouses completed the Multidimensional Pain Inventory (pain severity, interference, negative spouse responses to pain), Sickness Impact Profile (physical disability, psychosocial disability), and the Mood and Anxiety Symptom Questionnaire (psychological distress). Both spouses reported on ICPs' pain and disability as well as their own psychological distress. Spousal incongruence was observed on interference and physical disability such that ICPs reported greater disability than their spouses reported for them. No significant incongruence was observed in pain severity or psychosocial disability. Predictors of couples' mean ratings of pain and disability were identified. Specifically, couples in which the ICP was female reported higher couples' ratings of pain severity and interference. ICP distress was related to higher couples' ratings of all pain and disability variables whereas spouse distress was related to higher psychosocial disability ratings. ICPs' perceptions of negative spouse responses were also positively associated with couples' ratings of physical and psychosocial disability. In terms of congruence, ICP distress was associated with incongruence on interference, physical disability, and psychosocial disability whereas spouse distress predicted incongruence on pain severity, and interference. This study suggests that understanding couples' pain outcome ratings involves an awareness of factors that might influence their perceptions and behaviors.

Aged↗

PubMedDate not supplied

A longitudinal study of employment and skill acquisition among individuals with developmental disabilities.

Recent legislation, especially the Americans with Disabilities Act in 1990, generated the closure of institutions for people with disabilities and inclusion into community residences and employment. It has been well documented that individuals with developmental disabilities often experience difficulties with employment including both obtaining and maintaining jobs, and many researchers have looked for ways to make employment more successful [McConkey, R. & Mezza F. (2001). Employment aspirations of people with learning disabilities attending day centers. Journal of Learning Disabilities, 5(4), 309-318; Stevens, G. (2002). Employers' perceptions and practice in the employability of disabled people: a survey of companies in south east UK. Disability and Society, 17(7), 779-796; Capella, M., Roessler, R., & Hemmeria, K. (2002). Work-related skills awareness in high-school students with disabilities. Journal of Applied Rehabilitation Counseling, 33(2), 17-23; Ingraham, K., Rahimi, M., Tsang, H., Chan, F., & Oulvey, E. (2001). Work support groups in state vocational rehabilitation agency settings: a case study. Psychiatric Rehabilitation Skills, 5(1), 6-21; Gosling, V. & Cotterill, L. (2000). An employment project as a route to social inclusion for people with learning difficulties? Disability and Society, 15(7), 1001-1018; Neitupski, J. & Hamre-Nietupski, S. (2000). A systematic process for carving supported employment positions for people with severe disabilities. Journal of Developmental and Physical Disabilities, 12(2), 103-119]. While research has accumulated that has examined predictors of successful employment, this research assessed longitudinal outcomes of employment. Data were obtained from an existing data set of all known persons receiving services from the Developmental Disabilities Division of the Oklahoma Department of Human Services (N=2760). Results indicated that as people moved to employment, scores on adaptive skills increased, that as people moved from employment, adaptive skills decreased, and that as employment status remained constant, adaptive skills also remained unchanged. No consistent impact was found on challenging behaviors. Type of employment (sheltered, supported, and competitive) was then examined, and the same pattern of changes in adaptive skills was found; i.e., changes in employment to more/less competitive was accompanied by more/less adaptive skills. This suggests that employment itself, especially work in the competitive workforce, may be a significant source of enhancing adaptive skills for people with developmental disabilities and, thus, greatly adding to the success of community living.

Adult↗

PubMed1997

Breast and cervical cancer screening among women with physical disabilities.

OBJECTIVE: This article reports findings from the National Study of Women with Physical Disabilities about rates of screening for breast and cervical cancer and factors associated with regular screening in a large sample of women with a variety of physical disabilities and a comparison group of women without disabilities. DESIGN: Case-comparison study using written survey. Data were analyzed using measures of central tendency, chi 2 analysis, logistic regression, and risk using odds ratios. SETTING: General community. PARTICIPANTS: A total of 843 women, 450 with disabilities and 393 of their able-bodied friends, aged 18 to 65, who completed the written questionnaire. The most common primary disability type was spinal cord injury (26%), followed by polio (18%), neuromuscular disorders (12%), cerebral palsy (10%), multiple sclerosis (10%), and joint and connective tissue disorders (8%). Twenty-two percent had severe functional limitations, 52% had moderate disabilities, and 26% had mild disabilities. MAIN OUTCOME MEASURES: Outcomes were measured in terms of frequency of pelvic exams and mammograms. RESULTS: Women with disabilities tend to be less likely than women without disabilities to receive pelvic exams on a regular basis, and women with more severe functional limitations are significantly less likely to do so. No significant difference was found between women with and without disabilities, regardless of severity of functional limitation, in receiving mammograms within the past 2 years. Perceived control emerged as a significant enhancement factor for mammograms and marginally for pelvic exams. Severity of disability was a significant risk factor for noncompliance with recommended pelvic exams, but not mammograms. Race was a significant risk factor for not receiving pelvic exams, but not mammograms. Household income and age did not reach significance as risk factors in either analysis. CONCLUSIONS: Women with physical disabilities are at a higher risk for delayed diagnosis of breast and cervical cancer, primarily for reasons of environmental, attitudinal, and information barriers. Future research should focus on the subpopulations that were not surveyed adequately in this study, women with disabilities who have low levels of education or income, or who are of minority status.

Adolescent↗

PubMed2000

Predictors of admission to a high-security hospital of people with intellectual disability with and without schizophrenia.

Admission to secure hospital facilities is a rare outcome for people with intellectual disability with or without concomitant psychosis. The present study compares people with mild intellectual disability with and without schizophrenia resident in the Scottish and Northern Irish State Hospital, Carstairs, to matched mild intellectual disability controls, also with and without schizophrenia, in the community. It is hoped that this study may identify socio-demographic, clinical or historical predictors which may lead to admission to secure hospital facilities for people with mild intellectual disability. One hundred and eight subjects were identified from two previous studies which concerned State Hospital patients and patients with intellectual disability with and without schizophrenia. Four experimental groups were derived: (1) 14 individuals with comorbid intellectual disability and schizophrenia who had been resident in the State Hospital; (2) 34 comorbid community control subjects; (3) 33 individuals with intellectual disability and no psychosis who had been resident in the State Hospital; and (4) 27 community control subjects with mild intellectual disability. The four groups were compared on a range of socio-demographic, historical and clinical variables obtained from case records and subject interviews. Relative to community controls, people with intellectual disability and no psychosis in the State Hospital are likely to be single, to have a later age of first psychiatric hospital admission, and to have a history of previous suicide attempts, alcohol abuse or drug misuse. Subjects with comorbid intellectual disability and schizophrenia in the State Hospital are more likely to be male, to have an early age of first psychiatric admission, and to have no family history of either schizophrenia or intellectual disability. Strategies aimed at addressing suicidal behaviour, alcohol and drug misuse amongst people with intellectual disability may facilitate a reduction in the number of admissions to high-security hospitals in the UK. In people with comorbid intellectual disability and schizophrenia, males with an early age of onset and no known family history are more likely to require care and treatment in a secure psychiatric setting. Such comorbid subjects may be suffering from a particular malignant form of schizophrenia, manifesting in childhood as cognitive impairment prior to the early onset of psychosis in teenage years.

Adolescent↗

PubMed2002

Underestimation of disability in community-living older persons.

OBJECTIVES: When ascertaining the occurrence of disability, long assessment intervals may be problematic because they do not account for the possibility of recovery or for deaths or losses to follow-up. Our objective was to compare the rates of disability obtained from single follow-up assessments with those obtained from monthly assessments for intervals up to 24 months. DESIGN: Prospective cohort study. SETTING: General community. PARTICIPANTS: Seven hundred fifty-four nondisabled persons, aged 70 and older, categorized into three groups according to their risk for disability (low, intermediate, and high). MEASUREMENTS: Participants were followed with monthly telephone interviews to determine the occurrence of disability in one or more of four key activities of daily living (ADLs). RESULTS: For each risk group, the rates of disability obtained from monthly assessments of ADL function (cumulative disability) were considerably greater than those obtained from single follow-up assessments (prevalent disability). These differences in rates increased progressively as the length of the assessment interval increased. For example, the cumulative and prevalence rates of disability in participants in the intermediate risk group were 0.24 and 0.11 at 6 months, 0.36 and 0.20 at 12 months, 0.46 and 0.16 at 18 months, and 0.53 and 0.20 at 24 months, respectively. Although the overall rates were lower, the results for persistent disability, defined as a new disability that was present for at least 2 consecutive months, were similar. Although these differences in rates were attributable almost exclusively to recovery from disability in the first 6 months, they were due increasingly to deaths and losses to follow-up over the next 18 months, particularly in participants in the high-risk group. CONCLUSIONS: The occurrence of disability is substantially underestimated by longitudinal studies with long assessment intervals. More frequent assessments of functional status could lead to an improved understanding of the course and overall burden of disability in community-living older persons.

Activities of Daily Living↗

PubMed2005

Has the Disability Discrimination Act closed the employment gap?

STUDY OBJECTIVE: To investigate whether the disparity in employment rates between people with a limiting long-term illness or disability and those without has decreased since the implementation of the Disability Discrimination Act in the UK. DESIGN: National cross-sectional data on employment rates for people with and without a limiting long-term illness or disability were obtained from the General Household Survey for a twelve-year period (1990-2002; 10 surveys). Representative population samples were analysed. The sample size for the GHS over the study period ranged from 19,193 to 24,657 and the average response rate ranged from 72% to 82%. MAIN OUTCOME MEASURE: The relative employment rates of men and women of working age (18-60/65 years). Compares people with a limiting long-term illness or disability ('disabled') with people with no limiting long-term illness or disability ('not disabled'). RESULTS: Age standardised employment rates remained relatively stable from 1990 to 2001 for people defined as 'not disabled'. However, the employment rates of people defined as 'disabled' have decreased since 1990, and were at their lowest following the implementation of the employment aspects of the DDA in 1996 (1998-2002). In addition the gap between the employment rates of people defined as 'disabled' and 'not disabled' was most marked after the DDA between 1998-2002 (p < 0.05). CONCLUSIONS: This appraisal of routine population data pre- and post- the Disability Discrimination Act indicates that the legislation may not have been effective in closing the employment gap that exists in the UK between people with a limiting long-term illness or disability and those without.

Adult↗

PubMed1998

Psychopathology as a predictor of disability: a population-based follow-up study in Baltimore, Maryland.

To determine whether psychopathology is associated with disability as a result of underlying physical illness or whether such psychopathology antedates disability and is an independent determinant of disability, the authors conducted a nested case-control study within the Epidemiologic Catchment Area Follow-up Study in Baltimore, Maryland. From a 1981 random sample of 3,481 persons from Baltimore interviewed for psychopathology, disability, and other comorbidity, 1,920 who were alive in 1993 were traced and were reinterviewed with a similar instrument. Within the study population, 168 new cases of disability were identified as occurring between 1981 and 1993, as measured by the inability to perform activities of daily living. These cases were compared with 1,715 controls who reported no disability. The sociodemographic factors that were significantly related to incident disability in this analysis were age, female gender, and less than a high school education. These comparisons revealed associations of incident disability in activities of daily living with almost all antecedent chronic physical illnesses. Significant age- and gender-adjusted associations were observed between incident disability in activities of daily living and antecedent (in 1981) alcohol abuse and dependence (odds ratio (OR)=2.5, 95% confidence interval (CI) 1.5-4.2), major depressive disorder (OR=4.2, 95% CI 2.2-8.3), and phobia (OR=1.9, 95% CI 1.3-2.8). The adjusted odds ratio for the joint effect of antecedent depression and chronic physical illness on incident disability in activities of daily living was 17.0 (95% CI 6.9-41.7). There was a significant independent effect of antecedent major depression on activities of daily living disability. The effect of psychopathology on incident disability is nonspecific as to type of baseline chronic physical illness. Such a finding has important implications for defining strategies to prevent disability.

Adolescent↗

PubMed2006

Balance disability after stroke.

BACKGROUND AND PURPOSE: Balance disability is common after stroke, but there is little detailed information about it. The aims of this study were to investigate the frequency of balance disability; to characterize different levels of disability; and to identify demographics, stroke pathology factors, and impairments associated with balance disability. SUBJECTS: The subjects studied were 75 people with a first-time anterior circulation stroke; 37 subjects were men, the mean age was 71.5 years (SD=12.2), and 46 subjects (61%) had left hemiplegia. METHODS: Prospective hospital-based cross-sectional surveys were carried out in 2 British National Health Service trusts. The subjects' stroke pathology, demographics, balance disability, function, and neurologic impairments were recorded in a single testing session 2 to 4 weeks after stroke. RESULTS: A total of 83% of the subjects (n=62) had a balance disability; of these, 17 (27%) could sit but not stand, 25 (40%) could stand but not step, and 20 (33%) could step and walk but still had limited balance. Subjects with the most severe balance disability had more severe strokes, impairments, and disabilities. Weakness and sensation were associated with balance disability. Subject demographics, stroke pathology, and visuospatial neglect were not associated with balance disability. DISCUSSION AND CONCLUSION: Subjects with the most severe balance disability had the most severe strokes, impairments, and disabilities. Subject demographics, stroke pathology, and visuospatial neglect were not associated with balance disability.

Adult↗