Improvement and deterioration in physical functioning among israelis aged 60 and over
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Myers-JDC-Brookdale Institute. Center for Research on Aging. Improvement and Deterioration in Physical Functioning among Israelis Aged 60 and over. Jenny Brodsky, Tal Spalter , Yitschak Shnoor October 17, 2012. Outline. Background Study Purpose and Hypothesis Method of Analysis

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Improvement and Deterioration in Physical Functioning among Israelis Aged 60 and over

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Myers-JDC-Brookdale Institute

Center for Research on Aging

Improvement and Deterioration in Physical Functioning among Israelis Aged 60 and over

Jenny Brodsky, Tal Spalter, Yitschak Shnoor

October 17, 2012


  • Background

  • Study Purpose and Hypothesis

  • Method of Analysis

  • Findings

  • Discussion

Survival curves of morbidity, disability and mortality

Source: WHO 84576

The Nagi Disablement Model

The IoM Disability in America


Process is Dynamic-


IOM - Institute of Medicine report Disability in America (Pope and Tarlov 1991)

International Classification of Functioning, Disability and Health

WHO, 2001

Study Objectives

  • To examine the changes in physical functioning of older adults between two periods of time

  • To examine what variables predict the changes in function


  • Together with patterns of functional deterioration, we will also find patterns of improvement

  • Women, the old-old, minorities (Arabs), and those with low income and low education, are at higher risk of functional deterioration

  • Older adults suffering from multi-pathology, as well as individuals with cognitive and mental problems, are at higher risk of functional deterioration

Study Population

  • Individuals who were 60 and over in the first round of SHARE- Israel (2005-2006); they were 65 and over in the second round of SHARE-Israel (2009-2010)

  • N=982

Dependent Variables

  • Changes in mobility(walking 100 meters, sitting for two hours, getting up from a chair, climbing several floors or one floor without resting)

  • Changes in basic functions(pulling or pushing large objects; stooping, crouching, or kneeling; reaching or extending arms above shoulder level; handling small objects; carrying 5kg)

  • Changes in ADL (washing, dressing, eating, toileting, crossing a room, getting in and out of bed)

  • Changes in IADL(preparing a hot meal, buying groceries, using the telephone, taking drugs, financial management)

Dependent Variables cont.

  • Scales were built in the two rounds of SHARE by summing up items

  • Changes were calculated by taking round two minus round one

Independent Variables

  • Socio-demographic status (age, gender, living arrangements, education, income, population group)

  • Function and health (function in the first wave, No. of illnesses, change in the No. of illnesses between waves, mental health, cognitive function)

  • Social Activities(volunteering, participating in social, religious, political and educational activities)

  • Receipt of formal support (personal care and homemaking)

  • Receipt of informal support

Changes in Functioning1 N=982 (%)

1 The changes between rounds are significant by t-test for paired samples


Linear Regression to Predict Changes in Functioning: N=982

*p<0.05, **p<0.01

1Standardized coefficients-b; positive=improvement & negative=deterioration

Linear regression – prediction of changes in functioning

Linear regression – prediction of changes in functioning (cont.)

Major Findings and Implications

  • There is no single pattern of functional deterioration over time among older adults, there is also improvement

  • Arab older adults are at higher risk of deterioration in physical functioning over time

  • Physical health indicators, mainly multi-pathology, predict deterioration in functioning (according to the Disablement Model)

  • Mental and cognitive status predict deterioration in functioning

  • Receiving informal care and formal help (in homemaking) predict deterioration

Major Findings and Implications (cont.)

  • These findings do not lead to the conclusion that there is no need to help the elderly.

  • However, they imply that many times, instrumental assistance to the elderly, "save the hassle" of doing things by themselves and thus, weakens a potential functional rehabilitation process.


While Mr. Johns never did make it into the Olympics, he did however get full motion back in his knees

Improvement and Preservation of Functional Capabilities

  • Professional rehabilitation

  • Training of professional and non-professional staff (i.e., nurses and homecare workers)

  • Training of family caregivers

"My goal is to die before there's a technology breakthrough that forces me to live until one hundred and thirty"

Thank You

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