Disability trajectories prior to death for ten leading causes of death among middle-aged and older adults in Taiwan

BMC Geriatrics

Meng-Ling Li¹  Maw Pin Tan²  Chia-Ming Chang³  Ching-Ju Chiu⁴  Chih-Hsing Wu⁵ 

[1] Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan;Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia;Division of Geriatrics and Gerontology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan City, Taiwan;Institute of Gerontology, College of Medicine, National Cheng Kung University, No. 1 University Road, 701, Tainan, Taiwan;Institute of Gerontology, College of Medicine, National Cheng Kung University, No. 1 University Road, 701, Tainan, Taiwan;Department of Family medicine, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan;

关键词: ten leading causes of death;    functional impairment;    disability trajectory;    longitudinal study;    Asia;   

DOI  :  10.1186/s12877-021-02300-z

来源: Springer

【 摘 要 】

BackgroundProlonged life expectancy is associated with increased prevalence of chronic diseases. The aim of this study was to determine the different disability trajectories for the top ten leading causes of death in Taiwan .MethodsA total of 2,431 participants aged 50–96 in 1996 from the Taiwan longitudinal study on aging (TLSA) who died from 1996 to 2016 were analyzed. Integration of Cause of Death Data and TLSA helped sort out participants who had died from the ten leading causes of death. The level of physical disability was evaluated with the Activities of Daily Living Scale (ADLs), ranging from 0 to 6 points, in 1996, 1999, 2003, 2007, and 2011. A multilevel model was used to investigate the levels and rates of change in disability development before death.ResultsThe outcome of the research showed that the earliest group to experience physical limitation was individuals living with diabetes. The groups with the highest ADL scores were participants with diabetes, cerebrovascular disease, and hypertension-related diseases. Most groups reach ADL scores ≥ 1 (mild-level) during 4–6 years before death except chronic hepatitis and cirrhosis and injury.ConclusionsPeople who had died from the ten leading causes of death experienced different disability trajectories before death. The trajectory of the participants who had died from diabetes showed a unique pattern with the earliest occurrence and more severe deterioration in terms of development of disabilities. Disability trajectories provide a prediction of survival status for middle-aged and older adults associated with the ten leading causes of death.

【 授权许可】

CC BY