Geriatric syndromes and incident disability in older women: results from the women’s health initiative observational study

Rosso AL, Eaton CB, Wallace R, Gold R, Stefanick ML, Ockene JK, Curb JD, Michael YL.
J Am Geriatr Soc. 2013 Mar;61(3):371-9. doi: 10.1111/jgs.12147. Epub 2013 Mar 1.

SOURCE:  Department of Epidemiology, Center for Aging and Population Health, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

OBJECTIVES: To determine how the number of geriatric syndromes is associated with incident disability in community-based populations of older adults.

DESIGN:  Longitudinal analysis from the Women’s Health Initiative Observational Study (WHI-OS).

SETTING:   Community.

PARTICIPANTS:  Twenty-nine thousand five hundred forty-four women aged 65 and older enrolled in the WHI-OS and free of disability in activities of daily living (ADLs) at baseline.

MEASUREMENTS:  Geriatric syndromes (high depressive symptoms, dizziness, falls, hearing or visual impairment, osteoporosis, polypharmacy, syncope, sleep disturbance, and urinary incontinence) were self-reported at baseline and 3-year follow-up. Disability was defined as dependence in any ADL and was assessed at baseline and follow-up. Chronic diseases were measured according to a modified Charlson Index.

RESULTS:  Geriatric syndromes were common in this population of women; 76.3% had at least one syndrome at baseline. Greater number of geriatric syndromes at baseline was significantly associated with greater risk of incident ADL disability at follow-up (P ≤ .001). Adjusted risk ratios were 1.21 (95% confidence interval (CI) = 0.78-1.87) for a single syndrome and 6.64 (95% CI = 4.15-10.62) for five or more syndromes compared with no syndromes. These results were only slightly attenuated after adjustment for number of chronic diseases or pain.

CONCLUSION:  Geriatric syndromes are significantly associated with onset of disability in older women; this association is not simply a result of chronic disease or pain. A better understanding of how these conditions contribute to disablement is needed. Geriatric syndrome assessment should be considered along with chronic disease management in the prevention of disability in older women.