IDENTIFYING

PREDICTORS OF
FUNCTIONAL
DECLINE ‘-

By: Makayla Roma

Mentor: Dr. Sabrina Cassuci

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Effects of an ageing population :
• By 2030 it is estimated that every one in five
people will be of retirement age

• The U.S. spent 3.65 trillion on health care last ‘-

year with the elderly population being the largest
cost

• The onset of functional decline is one of the

largest contributors to this problem

(U.S. Census Bureau, 2018)

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Functional Decline
• Our study looks to identify predictors of functional decline
• Functional decline is the loss of independent function in elderly
• Functional Decline is usually measured by an overall ADL score
‘-

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(ShutterSchock, 2015) (NHAbuseGuide, 2015)
Predictors of functional decline
• Predictors of functional decline – any factor that have an impact on functional
decline (income, social network, residence)

• We focused on four main predictors: cognition, locomotion, sensory, and social

determinants of health ‘-

• Since these are measured by clinicians more often than ADL’s, they can be used
to to predict functional decline earlier

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Goal
• If we can see an enough amount of change in the predictors then we can change
services provided to patients to prolong/stop functional decline

Y: change in
ADL year to ‘-
year

X1: X2:change X4: change

X3:change in Social
change in in
in Sensory Determinan
Cognition Locomotio
year to ts of health
year to n year to
year year to
year year 5
year
Hypothesis

A change in one of these (cognitive, locomotive, sensory, SDH) health

scores can be a predictive measure used to determine a change in
‘-
functional decline

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NHATS

• National Health and Ageing Trend Study

• Annual, in-person interviews collect detailed information on the disablement
process and its consequences
‘- and answers,
• From this data set we were able to use the NHATS questions
mapping them to our four categories and to ADL

In the last month have you used a hearing aid?

Sensory In the last month have you used glasses?
In the last month have you used any other seeing device?

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Predictors Scoring system

• After mapping which questions belong to each category we then created a dichotomous
grading scale since the questions had different styles of answers

1 0 • Since we‘- want to see if a person will

have a decline in functional status we
Yes No must look at the change in each of the
scores from year to year and compare
with the change in ADL score from year
Excellent, Very Bad, Very bad to year
good, good

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 ADL score

• Mapped each of the question asked

by NHATS to the categories defined
by the KATZ index

‘-
• Then used the Katz index to
categorize answers dichotomously to
create an overall score for each
person

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https://slideplayer.com/slide/12897460/
 Model
• Multivariable regression

‘-

Change in ADL Score Change in Change in Change in Change in

cognitive locomotive cognitive SDH
score score score score

https://www.theanalysisfactor.com/link-functions-and-errors-in-logistic-
regression/ 10