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 1,297 records · Page 72Linked to original sources

PubMed2006

Role of knee kinematics and kinetics on performance and disability in people with medial compartment knee osteoarthritis.

BACKGROUND: Although gait characteristics have been well documented in people with knee osteoarthritis, little is known about the relationships between gait characteristics and performance or disability. Our purpose was to examine the role of knee kinematics and kinetics on walking performance and disability in people with knee osteoarthritis. We also examined whether pain mediated the relationship between the knee adduction moment and performance or disability. METHODS: Three-dimensional gait analysis was conducted on 54 people with medial compartment knee osteoarthritis. Performance was quantified with the Six Minute Walk test and disability was self-reported on the Short Form-36. The pain subscale of the Western Ontario McMaster Universities Osteoarthritis Index and the functional self-efficacy subscale of the Arthritis Self-Efficacy scale were completed. FINDINGS: A step-wise linear regression demonstrated that the variance in Six Minute Walk test scores was explained by functional self-efficacy (50%) and the range of knee motion (8%). The variance in Short Form-36 was explained by pain (36%), the peak extension angle (19%) and the range of knee motion (4%). Pain was unrelated to the knee adduction moment so analyses of pain as a mediator of the adduction moment on either performance or disability were halted. INTERPRETATION: Kinematic output from the motor control system is useful in understanding some variance in current performance and disability in people with knee osteoarthritis. The knee adduction moment was unrelated to these variables and pain did not mediate between the knee adduction moment and performance or disability. Therefore this moment does not explain current clinical status in people with knee osteoarthritis based on the measures of performance and disability used in this study.

Aged↗

PubMed2005

Nondisease factors affected trajectories of disability in a prospective study.

OBJECTIVE: To examine nondisease factors, including sociodemographic variables, health behaviors and psychosocial factors as determinants of trajectories of disability. STUDY DESIGN AND SETTING: We used a classification of 10 trajectories of disability based on a multiround prospective study design; nine trajectories grouped survivors with a similar level and time course of disability, one included all deaths. Multinomial logistic regression was used to assess associations between these trajectories and a wide range of nondisease factors. RESULTS: Correcting for age, sex, and four chronic diseases, we found that sociodemographic factors (education and income), health behaviors (leisure-time physical activity and BMI), and psychosocial factors (locus of control, neuroticism, and active problem focusing) were significantly associated with the trajectories of disability. Moreover, our results pointed to factors associated with disability trajectories that were characterized by sudden increase (external locus of control and, to a lesser extent, BMI), strong fluctuations (neuroticism, BMI, external locus of control), or high severity (leisure-time physical inactivity) of disability. CONCLUSION: A wide range of nondisease factors is associated with the trajectories of disability. Preventing obesity, developing a more internal locus of control, and increasing physical activity could contribute to preventing trajectories characterized by rapid decline, large fluctuations or severe disability. Understanding the role of these factors should receive high priority.

Adolescent↗

PubMed2004

Disability induced by hand osteoarthritis: are patients with more symptoms at digits 2-5 interphalangeal joints different from those with more symptoms at the base of the thumb?

BACKGROUND: The contribution of osteoarthritis (OA) at the base of the thumb (BT) and digits 2-5 interphalangeal joints (IP) to disability in the hand has never been assessed. OBJECTIVES: To evaluate and compare disability in patients with clinical hand OA and more severe symptoms at BT or IP. DESIGN: Observational, prospective, correlational. SETTING: Rheumatology and rehabilitation departments in two tertiary care teaching hospitals. PARTICIPANTS: One hundred and sixteen patients (107 women, mean age 62+/-7 years) fulfilling the American College of Rheumatology criteria for OA in the hand, with more symptomatic BT (67 patients) or IP (49 patients). MAIN OUTCOME MEASURE: Disability assessment with Cochin hand functional scale (CHFS) was the primary outcome. Assessment of impairment by the visual analog scale of pain (VAS pain), Ritchie articular index (RAI), modified Kapandji index (mKI), Kallman radiological classification and handicap assessment with visual analog scale (VASHd) was the secondary outcome. Group comparisons were assessed by use of Student's t-test for quantitative variables and Chi-square test for categorical variables. Results of the CHFS analysis were assessed by factorial analysis followed by Varimax rotation. Correlation between scores of disability, impairment, and handicap measures were calculated with use of Spearman rank correlation coefficient. RESULTS: Demographic data, disease duration, and level of global pain were similar between the BT and IP groups. The BT and IP groups did not differ significantly according to disability and handicap level (P=0.42 and P=0.94 for CHFS total score and VASHd, respectively). Factor analysis of the CHFS revealed similar results for the two groups of patients, especially for the first extracted factor. Disability scores correlated best with global hand pain (r=0.65) in the BT group and with RAI scores (r=0.71) in the IP group. CONCLUSIONS: Disability and perceived handicap levels are comparable in clinical hand OA patients with more symptomatic BT or IP. These two groups should not be considered different during trials assessing treatments for hand OA when the primary outcome measure assesses disability.

Aged↗

PubMed2004

Voxel-based morphometry of comorbid schizophrenia and learning disability: analyses in normalized and native spaces using parametric and nonparametric statistical methods.

We employed voxel-based morphometry (VBM) to compare the distributions of grey matter found in structural magnetic resonance imaging (MRI) brain scans of patients with comorbid learning disability with schizophrenia, schizophrenia alone, learning disability alone, and normal controls. Our primary aim was to replicate a previous region of interest (ROI) finding that comorbids and schizophrenics belong to the same population. Nonparametric analysis in normalized space showed no significant differences in grey matter distribution between the comorbid and schizophrenia groups. Furthermore, this analysis showed significant grey matter reductions in the comorbid and schizophrenia groups when compared to the learning-disabled or the normal controls. Parametric analysis localized the significant grey matter reductions between the normal controls and the comorbid and schizophrenia groups to the prefrontal and temporal lobes. It also identified an area of increased grey matter, on the inferior aspect of the postcentral gyrus, in the learning-disabled alone compared to the other groups. Native space parametric and nonparametric analyses, based on modulation of the normalized scans, confirmed the similarity in grey matter distribution of the comorbid and schizophrenia groups. Results confirm the ROI finding that in native space the learning-disabled group possesses the least and normal controls the most grey matter for the cohort. An increase in the basal ganglia of patients with schizophrenia vs. the learning-disabled, probably attributable to antipsychotic medication, was identified in the native space analysis. The native space results did not however register statistically significant temporal lobe reductions found under normalized analysis between schizophrenics and normal controls. This may be attributable to minor physical anomalies (MPA) in the schizophrenic cranium. Overall, these VBM results replicate previous ROI findings and are compatible with the view that comorbid learning disability with schizophrenia is a severe form of schizophrenia, rather than a consequence of learning disability. VBM has the facility to compare grey matter distributions in this structurally diverse cohort.

Adult↗

PubMed2004

Spousal congruence on disability, pain, and spouse responses to pain.

We examined congruence between chronic pain patients and their spouses on their reports of patient pain severity, patient disability, and spouse responses to pain. Patients reported that they were more physically and psychosocially disabled than their spouses reported them to be. However, spouses reported that the patients' pain was more severe than patients reported. Depressive disorders in the patient and gender interacted with patient-spouse ratings. For physical and psychosocial disability, depressed patient couples reported significantly larger differences in disability ratings than non-depressed patient couples. In addition, female patients' disability was rated as more severe by the female patients than by their husbands. Male patient couples did not report differences on physical disability. Findings relating to other forms of disability and to spouse responses are also described. The results are discussed in the context of an interpersonal perspective of chronic pain and have implications for the assessment of pain and disability.

Adult↗

PubMed2006

Does sleep quality predict pain-related disability in chronic pain patients? The mediating roles of depression and pain severity.

Disrupted sleep has long been associated with physical functioning and disability in chronic pain populations and recent research shows that patterns of sleep and rest can predict physical disability, independent of depression and pain levels in this group. However, it is unknown whether sleep quality may independently predict disability in this way. The aim of the present study was to examine the self-reported relationship between sleep and disability in 155 chronic pain patients attending a pain management service. The sample had an average age of 52.9 years and 69% were female with mean pain duration of 10.5 years. Disrupted sleep and rest patterns and poor sleep quality were positively correlated with depression and pain-related disability. Hierarchical regression analyses showed that sleep quality did not predict pain-related disability when depression and pain severity were taken into consideration. Separate mediation analyses of depression and pain severity revealed that both variables were important partial mediators of the relationship between sleep quality and disability. Depression was found to be a stronger mediator than pain severity. These findings highlight the important role of sleep in chronic pain suffering. However, due to the cross sectional nature of this study, the mediation pathways proposed require testing by further research adopting a prospective design. Ideally, future research should evaluate whether targeted interventions to improve sleep can reduce pain severity, depression and ultimately, pain-related disability.

Activities of Daily Living↗

PubMedDate not supplied

CBCL in the assessment of psychopathology in Finnish children with intellectual disability.

Structured checklists have been used to supplement psychiatric assessment of children with normal intelligence, but for children with intellectual disability, only a few checklists exist. We evaluated the Child Behavior Checklist (CBCL) in the assessment of psychopathology in Finnish children with intellectual disability. The CBCL was completed by parents or other carers of 90 children aged 6-13 years. Of the 118 CBCL problem items, the lowest scores were for 'Suicidal talks' and 'Alcohol, drugs', and the highest score for 'Acts too young'. Total Problem, Internalizing, and Externalizing scores were highest among children with moderate intellectual disability and lowest among those with profound intellectual disability. Externalizing scores were significantly higher among children with mild or moderate intellectual disability than among those with severe or profound intellectual disability. Compared with the original normative samples, Total Problem scores were higher in the present study. With a T-score cut-off point of 60, the rated frequency of psychiatric disorders was 43%. We conclude that, despite certain limitations, the CBCL can be used in the assessment of psychopathology among children with mild intellectual disability but is less reliable for those with moderate, severe, or profound intellectual disability.

Adolescent↗

PubMed2006

The impact of disability transitions on social inclusion.

As the extent of disability increases in society, there is an increasing need to understand its consequences for many aspects of social inclusion. Using the Living in Ireland Survey 1995-2001 (n=2727 adults), we provide a rigorous analysis of the transitions into and out of disability and the related consequences for various characteristics of social inclusion. We compare the effect of onset, exit and persistent disability on household income and the probability of being in poverty. We also look at the impact on daily societal participation for individuals with varying durations of disability. Results show that people with disabilities have much lower levels of social inclusion and imply that related policy should focus on the heterogeneity of disabled people, depending on their respective transitions into disability and the duration of their disability.

Adolescent↗

PubMed2000

Assessing joint pain complaints and locomotor disability in the Rotterdam study: effect of population selection and assessment mode.

OBJECTIVE: To assess the prevalence of self-assessed and physician-assessed disability and joint pain, their association, and the effect of cohort reduction and mode of assessment. DESIGN: Cross-sectional population survey. SETTING: General population, age 55 years and older. SUBJECTS: Independently living participants of the Rotterdam Study, including 1,156 men and 1,739 women. OUTCOME MEASURES: Self-reported and physician-assessed joint complaints. Patients' self-assessment of locomotor disability was by response to questions from the Stanford Health Assessment Questionnaire; physicians assessed patients' disability by administering activity tests. RESULTS: Reduction of the study cohort because of nonresponse and missing data had no influence on the frequency and effect measures. The physician-assessed prevalence of pain of the hips, knees, or feet was significantly lower than the self-assessed prevalence, with the percentage agreement being 83% for men and 74% for women, with kappa-values of approximately .40. The prevalence of physician-assessed locomotor disability was also significantly lower than the self-assessed disability, with the percentage agreement being 83% for men and 78% for women, with kappa values of .41 and .47, respectively. The associations of joint complaints with disability were similar for both modes of assessment. CONCLUSION: Cohort reduction caused by nonresponse and missing data had no influence on estimates of frequency and association. Self-assessment gives higher prevalences of joint complaints and locomotor disability than physician assessment, but the associations between complaints and disability were the same.

Aged↗

PubMed1998

Pre-AIDS physical disability: data from the AIDS Time-Oriented Health Outcome Study.

OBJECTIVE: To document the severity and correlates of perceived physical disability in a group of persons with HIV infection before an AIDS-defining illness, and to compare disability levels with a group of adults not infected with HIV. DESIGN: Observational cross-sectional study. SETTING: Community-based sample in California recruited through the AIDS Time-Oriented Health Outcome Study. PARTICIPANTS: Five hundred thirty-one asymptomatic and 345 symptomatic persons with HIV infection, primarily Caucasian, well-educated, homosexual and bisexual men. The control group consisted of 2,567 persons evaluated in the National Health and Nutrition Examination Survey and Epidemiologic Follow-up Study, a national probability sample of civilian, noninstitutionalized persons between ages 1 and 74 years living in the United States. MAIN OUTCOME MEASURE: Perceived physical disability measured by the HIV Health Assessment Questionnaire, a self-administered questionnaire that measures perceived disability in eight areas of mobility and activities of daily living. RESULTS: There were few significant differences between the asymptomatic and symptomatic groups. Total disability scores demonstrated a moderately strong relationship to number of symptoms, overall health status, employment, and Medical Outcomes Study-HIV fatigue index (r = -.39 to .59; p < .001). With few exceptions, less than 10% of the cohort perceived limitations to any degree and no more than 2% reported being "unable to perform" in a given functional category. However, both groups demonstrated somewhat higher levels of physical dysfunction than an age-, race-, and education-matched comparison group of adults without HIV infection. CONCLUSIONS: Persons with HIV infection before an AIDS-defining illness demonstrate relatively low levels of physical dysfunction. When present, deficits tend to occur among instrumental activities of daily living. Despite the relatively low levels, perceived disability among the pre-AIDS sample is somewhat higher than that of the general population. Implications for functional assessment, disability screening, and future HIV disability research are discussed.

Activities of Daily Living↗

PubMed1984

Current status of the neuromaturational examination as an index of learning disability.

To further define the role of the neuromaturational examination in determining the presence of learning problems, we examined 104 boys, ages 9.5 to 14.1 years, representing three populations of school children: normal (32 boys), gifted (37), and learning disabled (35). Information concerning each child's behavior and development was obtained through a parent questionnaire; cognitive ability and academic achievement were measured by the Wechsler Intelligence Scales for Children (revised) and Woodcock -Johnson Psychoeducational Battery, respectively. Significant relationships emerged between the number of neuromaturational signs and data group membership (LD greater than N greater than G,P less than 0.05). The number of neuromaturational signs decreased with age for normal (P less than 0.05) and gifted (P less than 0.05) children, but not for the learning-disabled group. Tasks that differentiated the normal and learning disabled were entered into a stepwise discriminant analysis, with a resulting classification accuracy of 93.1% and 100% for the normal and learning-disabled boys, respectively. Analysis of covariance indicated that differences in performance of the three groups may reflect IQ differences among the populations. Learning disabled boys were more likely to exhibit synkinesis than normal boys, but gifted boys did not differ from the learning disabled in the frequency of synkinesis. Our data indicate that, although a composite set of neuromaturational tasks can discriminate normal and learning-disabled boys with a high level of accuracy, caution is urged because the findings may be more related to overall intelligence than to a specific learning disability.

Adolescent↗

PubMed2000

Maltreatment and disabilities: a population-based epidemiological study.

OBJECTIVES: To assess the prevalence of abuse and neglect among a population of children identified as a function of an existing disability, relate specific types of disabilities to specific types of abuse, and to determine the effect of abuse and neglect on academic achievement and attendance rates for children with and without disabilities. METHOD: An electronic merger of school records with Central Registry, Foster Care Review Board, and police databases was followed by a detailed record review of the circumstances of maltreatment. RESULTS: Analyses of the circumstances of maltreatment and the presence of disabilities established a 9% prevalence rate of maltreatment for nondisabled children and a 31% prevalence rate for the disabled children. Thus, the study established a significant association between the presence of an educationally relevant disability and maltreatment. CONCLUSIONS: Children with disabilities are 3.4 times more likely to be maltreated than nondisabled peers. School professionals need to be cognizant of the high base rate of maltreatment among the children they serve. Disability status needs to be considered in national incidence studies of maltreatment.

Adolescent↗

PubMed2003

Prevalence and outcomes for parents with disabilities and their children in an Australian court sample.

OBJECTIVE: The purpose of this study was to obtain sound prevalence and outcomes data on parents with disabilities and their children in statutory child protection proceedings. METHOD: The court files of all care and protection matters initiated by the statutory child protection authority and finalized in a 9-month period (n=285) at two Children's Courts in NSW, Australia were reviewed. RESULTS: Parents with disabilities featured in almost one-third of the cases (29.5%). Parental psychiatric disability was most prevalent at 21.8% followed by parental intellectual disability (mental retardation) at 8.8%. Significant associations were found between parental disability and court outcome with a disproportionately large number of children of parents with intellectual disability being made wards of the state. CONCLUSIONS: The findings demonstrate that parents with disabilities are significantly over-represented in statutory child protection proceedings and that the outcomes of these proceedings vary according to disability type.

Child↗

PubMed2003

Disability and a sense of community belonging. A study among tetraplegic spinal-cord-injured persons in France.

This article presents a study of the identity of persons with motor impairments with regard to the community of disabled persons. The authors used the Tetrafigap survey on the long-term outcome of Tetraplegic Spinal-cord-injured (TSCI) persons, in France, to study the sense of belonging to the community of disabled persons among 1356 TSCI persons in relation to factors of social participation (both sociological and disability-related) and subjective factors (subjective well-being, social perception of disability, perceived disability). The results show that 44% of TSCI persons felt that disabled persons do not constitute a community (the "no-community" group). Of those who recognised the existence of such a community, 34% said they belonged to it (the "in-community" group) and 22% declared they did not (the "out-community" group). People in the "no-community" group tended to be more socially integrated, whilst those in the "in-community" group tended to have greater social and clinical difficulties. The "out-community" group was more diverse, being made up of both autonomous persons and dependent persons suffering from complications. Factors related to the sense of community belonging were identified using bivariate analysis and multiple logistic regression. Subjective well-being appeared to be independent of any sense of community belonging. However, the authors found a gender difference: women in the "in-community" group described themselves as having a poorer level of well-being than women in the other two groups. The results are discussed in terms of two views on the social treatment of disabilities: universalism and assimilation vs. particularism and positive identity and the growth of the disability movement.

Activities of Daily Living↗

PubMed1997

Gender differences in correlates of disablement among the elderly in Egypt.

The purpose of this paper is to examine gender-specific models to determine whether different combinations of correlates are associated with male and female disablement, using a sample of noninstitutionalized elderly persons in Egypt. Because women and men have different work, family, and household roles, as well as different health risks, it is reasonable to assume that there may be differing correlates for disablement for elderly males and females. The dichotomous dependent variable indicates problems, or the inability, in performing at least one of six activities of daily living (ADL). Of interest is the association of health, economic, and family variables, controlling for age. Logistic regression models are estimated for the total, male, and female samples. The results indicate that for males, having to stop working due to illness and having an unattended medical need are associated with higher odds for disablement as compared with females. Additionally, illiteracy increases the odds for male disablement, yet it has no effect on female disablement. Having experienced an injury in the past year is associated with disability for females, as is spending a lifetime in a rural setting and currently living in a fair to poor residence. Also for the females, increased number of living children significantly increases the odds for functional disability. Separate male and female models were estimated for each of the six ADL items. The trends indicated that the model covariates were more useful in modeling female disabilities in personal care activities, rather than problems with eating and mobility. The health variables were significantly associated with most of the specific ADL problems for the males.

Activities of Daily Living↗

PubMed2002

Adolescent sexuality and disability.

Regardless of what our beliefs about sex and disability may be, as health care providers we can promote the health and well being of our patients with disabilities in several ways. First and perhaps foremost, physical and programmatic barriers to accessing general health care including routine gynecologic care must be dramatically reduced. The promise of Title III of the Americans with Disabilities Act must be aggressively extended to our health care system to ensure equal access to routine health care for all. Second, knowledge of community resources that can support the healthy development and exercise of responsible and satisfying sexuality is critical. For example, health care providers should know about adaptive and assistive technologies as well as the use of personal care assistants to support the healthy although sometimes nontypical expression of one's sexuality. Centers for Independent Living are community resources that are often underutilized by the medical profession. These centers--run by and for people with disabilities--are likely resources and allies for providing education, role models, and peer mentoring around relationships, intimacy, sexuality, sexual expression, and parenting with a disability. Finally, sex education is a must and should include the following: Basic facts of life, reproduction, and sexual intercourse; Human growth and development Human reproduction and anatomy Self-pleasuring/masturbation and the use of sexual aids Intimacy and privacy Pregnancy and child birth Contraception and abortion Family life and parenthood Sexual response and consensual sex Sexual orientation Sexual abuse HIV/AIDS and other sexually transmitted diseases. The question should not be whether sex education is provided to persons with disabilities, but rather how it is most effectively provided. Health sex education must include the development of effective communication skills, decision-making skills, assertiveness, and the ability to say "no." It must also include ways to create satisfying relationships. For more information about sex education as it relates to people with disabilities, the following abbreviated resource list may be helpful: http://www.sexualhealth.com http://www.lookingglass.com Ludwig S, Hingsburger, D. Being sexual: an illustrated series on sexuality and relationships. SIECCAN, 850 Coxwell, Aven., East York, Ontario, M4C 5R1 Tel: 416-466-5304; Fax: 416-778-0785. Sexuality Information and Education Council of the United States (SIECUS), 130 West 42nd Street, Suite 350, New York, NY 10036. Tel: 212-819-9770. National Information Center for Children and Youth with Disabilities (NICHCY), P.O. Box 1492, Washington, DC 20013; Tel/TTY: 800-695-0285; Fax: 202-884-8641; Internet: www.nichcy.org Non-Latex Supplies (Ask your pharmacist if not available) Trojan-Supra: http://www.trojancondoms.com Durex-Avanti: http://www.durex.com Female Health Company-FC Female Condom http://www.femalehealth.com Pasante--EzOn http://www.postalcondoms.co.uk (available in Canada and U.K.).

Adolescent↗

PubMed2004

Life dissatisfaction and subsequent work disability in an 11-year follow-up.

BACKGROUND: Mental disorders are associated with disability, but the long-term effects of low subjective well-being on work ability in general population are not known. In this study we investigated whether self-reported life dissatisfaction predicts work disability. METHOD: A nationwide sample of Finnish twins aged 18-54 years (N = 22,136), unselected for health status responded to a health questionnaire with a four-item life satisfaction scale (range 4-20) covering interest, happiness, easiness and loneliness of life in 1975 and 1981. Cox regression for all subjects and conditional logistic regression for discordant twin pairs were used to compare the risk of subsequent work disability (N = 1200) (Nationwide Disability Register) between the dissatisfied and satisfied. RESULTS: Life dissatisfaction predicted subsequent (1977-87) work disability pension due to psychiatric and non-psychiatric causes among the healthy at baseline, and that due to psychiatric causes among the ill. After controlling for age, marital status, social class and health behaviour, these risks remained significant. Repeatedly reported (1975 and 1981) life dissatisfaction was strongly associated with increased (age-adjusted) risk of subsequent (1982-87) work disability due to psychiatric and also that due to non-psychiatric causes among the healthy. When twin pairs discordant for end-point disability status were analysed, risk differences related to life satisfaction were only slightly decreased, but they did not differ significantly between monozygotic and dizygotic pairs. CONCLUSION: Life dissatisfaction predicts subsequent work disability especially among the healthy.

Adolescent↗

PubMed2004

The effects of depressed affect on functional disability among rural older adults.

This study investigates functional disability among some of the nation's most vulnerable older adults: rural Medicaid recipients. Data were provided by 221 older adults (mean age = 75.9 years; 82% women) who were receiving community-based long-term care services through Medicaid. Participants self-reported functional ability involving the completion of six basic activities of daily living (BADLs), three cognitive instrumental activities of daily living (IADLS), and four physical IADLs. Self-reports of depressed affect and the number of physical health conditions were also obtained. Path analysis was used to examine all of the associations among age, gender, number of chronic health conditions, depressed affect and functional disability. The tested model was significant [chi2 (DF = 3, n = 221) = 5.052, p = 0.168; TLI = 0.945; CFI = 0.992; RMSEA = 0.056] and explained 45.1% of the variance in BADL disability. Depressed affect significantly predicted disability in cognitive IADLs and physical IADLs, which predicted disability in BADLs. Age and gender had indirect effects on BADL, through their association with cognitive IADLs and physical IADLs. The number of chronic health conditions exerted both indirect and direct effects on BADL disability. Results are discussed within the context of the growing literature that suggests the importance of psychological variables as predictors of functional disability. Moreover, we discuss whether community-based long-term care is appropriate for older adults with high levels of functional disability.

Activities of Daily Living↗