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PubMed2006

Healthy lifestyle behaviors among older U.S. adults with and without disabilities, Behavioral Risk Factor Surveillance System, 2003.

INTRODUCTION: Little is known about the relationship between healthy behaviors and the prevalence of chronic diseases in older adults with disabilities. This study examines the prevalence of selected healthy lifestyle behaviors related to chronic diseases among adults aged 65 years and older with and without disabilities. METHODS: Data from the 2003 Behavioral Risk Factor Surveillance System (BRFSS) were used to assess having a healthy weight and six behaviors: current cigarette smoking status, consumption of at least one alcoholic beverage daily, consumption of at least five fruits or vegetables daily, physical activity during the average week, influenza immunization in the past year, and lifetime pneumococcal immunization. RESULTS: People with a disability were less likely than people without a disability to have a healthy weight (28.5% vs 37.2%) and to engage in the recommended level of weekly physical activity (14.7% vs 26.2%). However, people with a disability were more likely than those without a disability to be nonsmokers (91.8% vs 89.9%), to consume up to one alcoholic beverage daily (95.1% vs 91.5%), to have received their influenza immunization in the past year (72.7% vs 69.0%), and to have received a lifetime pneumococcal immunization (72.1% vs 63.0%). There was no difference between people with and without a disability in the prevalence rates of consuming at least five fruits or vegetables daily. CONCLUSION: The prevalence of having a healthy weight and six chronic-disease related behaviors among adults aged 65 years and older varies by disability status and by specific modifiable lifestyle behavior. Screening older adults with and without disabilities and counseling them about health behaviors should be integrated into every interaction between older adults and their health care providers to potentially lower the rates of morbidity and mortality related to chronic diseases in the later years.

Aged↗

PubMed1990

The Health and Activity Limitation Survey. Disabled aboriginal persons in Canada.

In 1986, out of a total of 711,725 Canadians of aboriginal ancestry, 86,505 reported having some level of disability. This article profiles disabled aboriginal persons living both on-and off-reserve, presenting data from Statistics Canada's 1986 Census of Population and the Health and Activity Limitation Survey (HALS), conducted in 1986 and 1987. Census data provide an overview of selected demographic and socio-economic characteristics of the disabled aboriginal population. HALS data provide details on the nature and number of disabilities, underlying causes of the disabilities, and the degree of assistance required for daily activities. Accidents were frequently cited as the underlying cause of disability among disabled aboriginal people living both on- and off-reserve. Most disabled original persons aged 15 and older were able to perform household duties such as preparation of meals, shopping and housework. On-reserve disabled aboriginal persons did, however, require and receive help more frequently than those who resided off-reserve.

Accidents↗

PubMed1990

Canada's disabled population in institutions.

One percent of Canada's population are long-term residents of health care institutions. Of this group an estimated 97% have a disabling condition. This article profiles disabled people living in institutions using data from the Health and Activity Limitation Survey (HALS) undertaken by Statistics Canada. HALS collected data on: the nature, number and severity of disabilities; the underlying causes of the disabilities; and the degree of assistance required for daily activities. For the institutional component of HALS, a sample of 19,000 disabled individuals from 1,100 institutions was used. The institutional survey indicated that almost 80% of the disabled population in institutions were aged 65 or older, while about 90% had mobility and/or agility-related disabilities. The most frequently cited underlying cause of disability for respondents living in both institutions and households was disease or illness. Among young adults in institutions, mental retardation was the main disabling condition. Among the elderly, diseases of the musculoskeletal system and connective tissue (including arthritis) were most common. Most respondents in institutions required daily help with personal care, shopping and personal finances.

Activities of Daily Living↗

PubMedDate not supplied

Disability index of hands and feet in patients attending an urban leprosy clinic.

189 leprosy patients including 20 from a leprosy colony having disabilities and deformities were graded by the WHO (1960) classification and their disability indices were calculated. Disabilities occurred more frequently in males and the disability index was significantly higher in those with longer duration of the disease and in multibacillary patients. Majority of the disabled patients (82.5%) were manual workers, but the highest disability index was observed in beggars. Irregularly treated and untreated patients had significantly higher disability indices (DI 2.40 and DI 1.40) than those taking regular treatment (DI 1.09). No correlation was found between severity of disability and occurrence of type I and type II reactions. Disabilities of hands and feet occurred with equal frequency.

Adolescent↗

PubMed1990

[Use of the disability classification "Residual work capacity for part-time work" in an area of Croatia].

A retrospective evaluation of disability was carried out in a group of workers with residual work capacity for part-time work from the region of Slavonski Brod over a ten-year period. The evaluation comprised disability assessment, estimation of the reliability of primary diagnosis with respect to disability assessment, and determination of the period between the assessment of residual work ability for part-time work and retirement due to disability. The disability category "residual work capacity for part-time work" was assigned to 1,029 persons, and was most frequently caused by cardiovascular diseases. Disability pension was based mostly on the diagnoses of mental disorders and cardiovascular diseases and was received by 1,365 persons. With part-time workers who had their residual work ability assessed on the basis of cardiovascular diseases and mental disorders, working part-time was only a temporary, short-term solution, because as soon as within a year, after a regular check-up, they were given disability pension owing to deterioration of primary disease. On the other hand, workers with diseases of the locomotor system as primary diagnosis, who had worked part-time for several years, often had disability pension granted because of some other disease. A detailed analysis among 426 still active workers with residual work capacity showed disability to have been assessed mostly on the ground of diseases of the locomotor system. Functional disorders were usually light to moderate, and working conditions often inappropriate. It is considered that the categories "residual work capacity with full-time work at a more appropriate workplace", with a change of occupation or without it, and "altered work capacity" would have been better applicable in the majority of cases.

Adult↗

PubMed1989

Pattern of leprosy disabilities in Gorakhpur (Uttar Pradesh).

Out of 514 leprosy cases studied, 229(44.56%) had disability. Disability was most commonly seen in lepromatous leprosy. There was an increasing trend in disability with increasing age of patient and duration of disease. Disability rate was higher in males as compared to females. Nerve thickening and reactional states were more common in disabled cases. Dapsone treated group showed a disability rate of 63.8% as compared to 30.0% in untreated group. Hand was the most commonly affected site and mobile claw hand was the single most common disability. The overall disability index-D.I. (2) of Bachelli was 1.25 and lepromatous cases had highest D.I. (1.89). Disability index was higher in males and was found to increase with increasing age of patient and duration of disease.

Adolescent↗

PubMed1987

Long-term disability programs in selected countries.

In 1985, the Social Security Administration commissioned an 18-month research project to study disability in eight industrialized countries: Austria, Canada, Finland, the Federal Republic of Germany, Israel, the Netherlands, Sweden, and the United Kingdom. The study focused on three key areas: (1) the initial determination of disability, (2) the methods of monitoring disability, and (3) the incentives to return to work. Although the study revealed great variations among the countries in the definition of long-term disability, the approach followed in providing benefits, and the organization and features of the programs, some basic similarities were also found. Among the similarities are: (1) most countries have several income-maintenance programs to protect workers in the event that they are disabled, and (2) the disability test to determine whether a person is eligible for a disability benefit is ambiguous in that the various programs each have different eligibility criteria, different definitions of disability, different considerations given to labor-market conditions, and so forth. This article examines the diversity among the countries and attempts to highlight unique approaches to adjudicating disability, providing linkages to rehabilitation, and creating incentives for returning to work.

Austria↗

PubMed1985

Prevalence of disability observed in an Oxfordshire practice.

A register was compiled of disabled patients in an Oxfordshire practice; patients were considered to be disabled when an impairment appreciably affected their day-to-day life. The rates of disability rose with age. Three-quarters of the disabled patients had one disability, 21% two and 5% three or more disabilities. The most common source of disability was disorders of the nervous system followed by circulatory and musculoskeletal conditions. More than two-thirds of the disabilities were capable of amelioration and 4% could be completely resolved. Most patients had come to terms with their disability, only 8% finding adjustment difficult.

Activities of Daily Living↗

PubMedDate not supplied

An epidemiological study of leprosy disability in a leprosy endemic rural population of Pondicherry (south India).

The disability rate in this study was 16.23%. The highest disability rate of 30.76% was found in those aged 45 years and above. Disabilities were found to be more common among male leprosy patients with a disability rate of 21.05% compared to that of 11.45% found among female leprosy patients. None of the indeterminate leprosy patients showed any disabilities, whereas all the neuritic and lepromatous leprosy cases showed disabilities. The disability rate among tuberculoid leprosy patients and borderline leprosy patients were found to be 3.25% and 35% respectively. Persons whose monthly per capita income was less than Rs. 200/- constituted 93.50% of the cases with disabilities. Anaesthesia of the hand was seen in 67.4% of the cases. The mean disability index (DI-2 type) was 0.927.

Adolescent↗

PubMed1995

Disability problem in a rural area of Bangladesh.

For prevalence and pattern of disability as well as the socio-economic effects of disability, a community based study was carried out in a rural area of Bangladesh. A trained physician conducted a house to house survey in a population of 1906. An overall prevalence of disability of 8.5 percent was found. Major forms of disability were hearing disability (23%), visual disability (21%) and movement disability (15%). Disability was found to have considerable effects on educational attainment, employment and marriage. Many of these disabilities could be prevented by simple measures such as immunization, vitamin A supplementation and improving referral systems for early treatment. A substantial proportion could also benefit from relatively simple rehabilitatory measures.

Adolescent↗

PubMed1994

Migraine heterogeneity. Disability, pain intensity, and attack frequency and duration.

Data from population-based studies are summarized to characterize the full range and variability of the impact migraine has on the individual. Despite differences in methods and data collection in population-based studies describing disability, pain intensity, and attack frequency as well as the duration of migraine and other headaches, several patterns emerge. On average, migraine headaches are more disabling, more painful, and longer in duration than other types of headaches. Females report more pain and disability with headache than do males. Although disability measurements are important in demonstrating the effect of headache on both the individual and society, actual measurements often fall short. Most studies use only workdays lost as the sole measure of disability. Most migraineurs do not miss work while experiencing a headache; instead, they attempt to function on the job, with considerably reduced effectiveness. Computing only workdays lost does not account for impairment at work nor does it show the impact of migraine on other aspects of life. In addition, evidence suggests the presence of a pain intensity threshold for disability. Headache-related pain intensity below the threshold is not associated with disability. Despite the threshold of pain intensity for disability, a significant proportion of migraine sufferers report levels of pain intensity above the threshold in the absence of work-related disability. The grading of headache severity should be a composite that would permit a more complete image of the heterogeneity of migraine's effects and a more accurate idea of the need for healthcare services. This composite should include two areas: (1) more complete measures of life impact, encompassing daily activities in a number of domains, including work, family, and social activities; and (2) an assessment of pain intensity and attack frequency.

Adolescent↗

PubMed1993

The relationship between the St. Thomas and Oswestry disability scores and the severity of low back pain.

OBJECTIVE: To investigate the relationship between the two disability questionnaires and low back pain severity using the visual analog scale (VAS). DESIGN: One hundred sixty-two chiropractic patients with low back pain were interviewed using an interactive microcomputer system. The sources of data were the St. Thomas and Oswestry disability questionnaires for disability and a VAS for pain severity. All were inherent in the computer interview system. SETTING: The computer review system was set up in the Anglo-European College of Chiropractic outpatient clinic. PATIENTS, PARTICIPANTS: One hundred sixty-two consenting new patients from the general community suffering from low back pain who attended the Anglo-European College of Chiropractic outpatient clinic were asked to participate. MAIN OUTCOME MEASURES: Main outcome measures were the St. Thomas and Oswestry disability questionnaires for disability and the VAS for low back pain severity. RESULTS: There was a moderate correlation between the scores from the St. Thomas and Oswestry disability questionnaires (r = .77, p < .0001). A low but significant correlation score was found when comparing the St. Thomas and Oswestry disability score with pain severity (0.38, p < .0001, and 0.47, p < .0001, respectively). CONCLUSION: The consequence of pain (disability) appears to have a weak relationship to pain severity. Despite the moderate correlation between the two disability questionnaires, it is suggested that they are not interchangeable.

Disability Evaluation↗

PubMedDate not supplied

Americans With Disabilities Act.

The Americans with Disabilities Act gives all Americans with disabilities a chance to achieve the same quality of life that individuals without disabilities enjoy. This act prohibits discrimination on the basis of disabilities in employment, public services, privately operated public accommodations, services, and telecommunications. The Americans with Disabilities Act is divided into five titles. Title I of the act pertains to discrimination against the disabled in the workplace. Title II prevents discrimination against persons with a disability in state and local government services. Title III prohibits discrimination against persons with disabilities in places of public accommodations and commercial facilities. Title IV ensures that companies offering telephone services to the general public provide special services for individuals with hearing and speech impairments. Under the enforcement provisions of the Americans with Disabilities Act, stringent penalties will be implemented for failure to comply with its provisions.

Commerce↗

PubMed1997

[Predictive factors of physical disability in a cohort of retired persons in Paris followed during 10 years].

OBJECTIVE: The objective of the present study was to examine predictors of physical disability in a survey of retired men and women living in the Paris area followed-up longitudinally for 10 years. METHODS: Subjects were randomly selected in a supplementary retirement pension fund. In all 627 subjects took part in the first phase of the survey (1982-83) and 392 in the follow-up phase (1992-93). At the 10-year follow-up, there were 185 confirmed deaths and 50 subjects refused to participate or could not be traced. Physical disability was measured by difficulties reported by the subjects for seven basic activities of daily life. Possible predictors, socio-demographic, impairments, physical activities, working conditions during working life were explored at T1. RESULTS: The incidence of physical disability was 41.4% for men and 57.6% for women. For disability in mobility, the incidence was 37.1% for men and 54.7% for women. In multivariate analysis, predictors of physical disability were social category (clerks), no physical activities, use of medicine, mental impairment. The predictors of disability in mobility were sex (women), social category (clerks), use of medicine, cardio-respiratory and sensory impairments. On the contrary, subjects with mental impairment had a lower incidence of disability in mobility than subjects without mental impairment. CONCLUSION: The results confirm the two poles of disability: biomedical and social. Working conditions during working life do not seem to play a direct part in incidence of disability at ten years follow-up.

Activities of Daily Living↗

PubMed1998

[Internal consistency and validity of work disability duration].

In this study results of a survey taken of persons insured under the public health care system were presented. The main objective of the survey was to determine the health of the insured on the basis of their subjective data, as well as to assess their prevention behaviour and their wish that the health insurance should offer prevention programmes. In addition, the health insurance provided data on how often the insured persons were unable to work for health reasons during a period of seven years. The data of work absenteeism are used to divide the group of respondents according to their health. To determine internal consistency it was first investigated whether persons with periods of disablement during one year (cross-section) also had long periods of disablement in the years before or after (longitudinal section). It was found that in the cross-section, persons with serious health problems (more than six weeks of disablement) differed little from those with average disablement periods (from one to six weeks) in the long-term development of disablement. The study also examined the correlation of periods of disablement and subjective data (validity). A mean correlation was found between the respondents' subjective assessment of their health and the length of disablement periods. There was also a significant negative correlation between internal health locus of control beliefs and the length of disablement. The results are discussed, and the ways and limits of using periods of disablement for empirical studies are presented.

Absenteeism↗

PubMed1998

Psychosocial adjustment among Central American immigrants with disabilities: an exploratory study.

This is an exploratory study that investigated factors influencing the psychosocial adjustment of Central American immigrants with disabilities. The relationships between stress, and perception of disability severity and (a) depression and (b) anxiety were assessed. Furthermore, this study investigated whether social support moderated the impact of stress and severity of disability on depression and anxiety. Stress, severity of disability, and social support explained a high percentage (54%) of the variance in depression. High levels of stress, increased perceptions of severity of disability, and low social support were associated with increased depression. The interactions between support and stress and between support and disability severity did not significantly add to the original model which predicted depression. Main effects were found for stress, disability severity, and the interaction between support and disability severity. Stress and social support significantly accounted for 31% of the variance in anxiety. Increased stress and decreased social support were associated with greater levels of anxiety. The interaction between support and stress did not significantly predict anxiety. Implications of the study in terms of future research and intervention programs targeting mental health outcomes for Latino immigrants with disabilities are discussed.

Acculturation↗

PubMed2001

Correlates of functional disability in essential tremor.

The decision to treat patients with essential tremor (ET) is based primarily on the functional impact of the tremor. Correlates of functional disability, apart from the severity of the tremor itself, have not been studied. The objective of this work was to study correlates of functional disability in ET, and to present data on the extent of functional disability in community-dwelling ET cases. ET cases and age-matched control subjects were ascertained from a tertiary referral center at Columbia-Presbyterian Medical Center and a community in northern Manhattan, N.Y. Subjects underwent a 2.5-hour evaluation, including a tremor disability questionnaire, a videotaped tremor examination rated by a neurologist, a performance-based test of function, quantitative computerized tremor analysis, the Hamilton Anxiety Rating Scale, and the depression module of the Structured Clinical Interview for DSM-IV. Seventy-six (85.4%) of 89 cases reported disability on > or =1 item on the disability questionnaire. In multivariate linear regression analyses, current major depression, Hamilton Anxiety Rating Scale score, age, and tremor severity were independently correlated with performance-based test scores. Twenty-seven (73.0%) of 37 community cases reported disability on > or =1 (mean = 8.4) item on the questionnaire, and 25 (67.6%) demonstrated moderate or greater difficulty on > or =1 (mean = 4.2) task in a performance-based test. Depression, anxiety, and age, independent of the severity of tremor, were associated with greater functional disability in ET, so that these factors must be considered when assessing the impact of new treatments in ET. Among a group of community-dwelling cases, approximately three-quarters reported disability, suggesting that the number of individuals who might receive some benefit from advances in the treatment of ET is probably a great deal larger than previously thought.

Activities of Daily Living↗

PubMed2005

Hand disability and related variables in patients with rheumatoid arthritis.

OBJECTIVE: To carry out a cross-sectional study of patients with rheumatoid arthritis (RA) for hand disability, articular damage and to define their relation with demographic, laboratory and clinical parameters. METHODS: The study included 105 RA patients with a mean age of 49.4 years. Demographic parameters of the patients were recorded. Clinical parameters including disease duration, duration of morning stiffness, pain assessed by visual analog scale, Ritchie Articular Index, grip strength, lateral, tip and three-fingered pinch, and laboratory parameters comprising C-reactive protein, erythrocyte sedimentation rate and rheumatoid factor were evaluated in all patients. The Rheumatoid Arthritis Articular Damage (RAAD) score was used to assess the irreversible articular damage and deformities of the hand. Hand disability was assessed by the special hand disability index of Standford Health Assessment Questionnaire (HAQ). RESULTS: Hand disabilities of various levels were detected in 81% of the patients. Disease duration, grip strength, pinch measurements, clinical and laboratory activity parameters were strongly correlated with hand disability (p<0.01). Hand disability was more related to disease activity parameters than articular damage (p<0.01 and p<0.05, respectively). Grip strength and pinch measurements were the most related parameters with hand disability. The disability scores were significantly higher in female patients (p<0.01). The RAAD score was correlated with disease duration and grip strength (p<0.01). The clinical and laboratory parameters and seropositivity were not correlated with articular damage assessed by RAAD score (p>0.05). CONCLUSION: Our data suggest that grip strength and pinch measurements seem to be the most related variables with hand disability and articular damage. Therefore, grip strength and pinch measurement should be included in the evaluation and follow-up of the patients with RA in hand rehabilitation units.

Adult↗