Trends In Disability Research Articles

Estimates and trends in death and disability from atrial fibrillation/atrial flutter due to high sodium intake, China, 1990 to 2019

ObjectiveThe effect of sodium intake on atrial fibrillation (AF)/atrial flutter (AFL), with respect to sex and age, has yet to be elucidated. This study aims to compare long-term trends in AF/AFL death and disability due to high sodium intake in China from 1990 to 2019.MethodsWe utilized data from the Global Burden of Disease study to assess the mortality and disability burden of AF/AFL attributable to high sodium intake (> 5 g/d) in China from 1990 to 2019. Overtime trends and average annual percentage change (AAPC) were analyzed with adjustments for age, sex, period, and cohorts.ResultsIn 2019, the number of AF/AFL deaths and disability-adjusted life years attributable to high sodium intake were 4209.944 (95% UI: [1250.690-8718.238]) and 235484.586 (95% UI: [89136.783-428566.694]), with males comprising 44.81% and 51.95% of cases, respectively. The age-standardized mortality rates (ASMRs) and age-standardized disability rates (ASDRs) of AF/AFL attributable to high sodium intake exhibited downward trends from 1990 to 2019 in China. The AAPC was − 0.221(95% CI: -0.321–0.121)and − 0.631(95% CI: -0.816–0.446) for AF/AFL, respectively. An upward trend was observed in ASMRs for AF and AFL, attributable to high sodium intake due to high salt intake at ages 30–34, 35–39, and 40–44. With an increase in age, the AAPC for ASMRs increased correspondingly, and the AAPC for ASDRs exhibited a decreasing trend.ConclusionsOur findings provide strong evidence that high sodium levels in China significantly affect standard ASMRs and ASDRs for AF and AFL. Notably, different patterns of change are identified across various age groups, emphasizing the pronounced effect of salt reduction on AF and AFL.

Temporal trends in disability adjusted life year and mortality for colorectal cancer attributable to a high red meat diet in China from 1990 to 2021: an analysis of the global burden of disease study 2021

BackgroundHigh red meat consumption is a main modifiable risk factor for colorectal cancer mortality (CRC), but its attributable disease burden remains unclear in China. We aimed to analyze the temporal trends in CRC deaths and disability-adjusted life years (DALYs) attributable to high red meat consumption in China from 1990 to 2021 and to predict the disease burden in the next 15 years.MethodsData was obtained from the Global Burden of Disease (GBD) 2021 study. The Joinpoint regression model was used to calculate the annual percentage change (APC) and the average annual percentage change (AAPC). In addition, the age-period-cohort (APC) model was employed to explore the effects of age, period, and cohort on CRC mortality. The autoregressive integrated moving average (ARIMA) model was utilized to predict the disease burden in 2022–2036. We also compared the CRC burden attributed to high red meat in China with 204 countries worldwide.ResultsThe results showed that the number of CRC deaths in China due to high red meat consumption increased nearly 2.5 times, from 17,608 (95% UI: -3 to 36,613) in 1990 to 43,580 (95% UI: -16 to 92,083) in 2021. Male CRC deaths exhibited a more pronounced increase, rising from 9,800 in 1990 to 27,600 in 2021. Additionally, the number of DALYs increased from 518,213 (95% UI: -105,107 to 1,074,174) in 1990 to 1,091,788 (95% UI: -509 to 2,295,779) in 2021. Joinpoint regression analysis confirmed that the AAPC in ASDR and ASMR was − 0.20 (95% CI: -0.40 ∼ 0.00) and − 0.30 (95% CI: -0.40 ~ -0.10). When age, period, and cohort effects were examined as the reference group, the risk of CRC was found to increase with age. However, women experienced a marked decline in both period and cohort effects compared to men.ConclusionsCompared to global levels, the burden in China is heavier. In terms of mortality or DALY standardized rates, Chinese women show a similar downward trend to the overall trend, while Chinese men show a striking upward trend. This study provides valuable insights into enhancing CRC prevention and improving dietary patterns in China.

Functional outcomes and healthcare utilization trends in postsurgical and nonsurgical patients following high-frequency (10 kHz) spinal cord stimulation therapy.

Chronic low back pain (CLBP) is the leading cause of disability in the United States and is associated with a steadily increasing burden of healthcare expenditures. Given this trend, it is essential to evaluate interventions aimed at reducing disability and optimizing healthcare utilization (HCU) in affected populations. This study investigates the impact of prior spinal surgery on functional outcomes and HCU patterns following high-frequency (10 kHz) spinal cord stimulation (SCS) therapy. This retrospective observational study included 160 subjects who underwent implantation of a 10 kHz SCS device. Participants were divided into surgical and non-surgical cohorts for comparative analysis. Pain relief was assessed using the Numeric Rating Scale (NRS), while disability levels were evaluated using the Oswestry Disability Index (ODI). HCU was examined through the frequency of emergency department (ED) visits, outpatient visits for interventional pain procedures, and opioid consumption measured in morphine milliequivalents (MME). No statistically significant differences were observed between the surgical and non-surgical groups regarding pain relief and disability outcomes. Additionally, ED visits and outpatient visits for interventional pain procedures did not show significant differences between the two cohorts. This study represents the first comparative analysis of pain, disability, and HCU trends between surgical and non-surgical populations following 10 kHz SCS therapy. The results suggest that prior spinal surgery may not substantially affect the efficacy of 10 kHz SCS therapy in terms of pain relief, disability reduction, or HCU patterns.

Disability trends in Spain by sex: An Age-Period-Cohort analysis

ObjectivesDisability is a complex concept, and generally refers to a situation where the carrying out of daily routines and social interactions is made more difficult for people. Despite research suggesting an increase in disability worldwide, there are few studies that afford a longitudinal perspective, with most focused exclusively on older populations. This study takes a generational perspective with the aim of analyzing the trend of disability in Spain Study designAge-period-cohort analysis. MethodTo address a gap in the existing research, this study carries out an Age-Period-Cohort analysis to examine disability time-trends in Spain by sex, using data from various cross-sectional surveys conducted in 1999 (n = 218,185), 2008 (n = 258,187), and 2020 (n = 164,254). ResultsThe results of this study contribute to knowledge of disability time-trends, and provide overall-population scope and sex differentials. While age was found to be the primary factor in an increase in disability, this study afforded insight into a decline in disability over period, observed after removing the age effect. Further, after controlling for age and period, significant differences in the prevalence of disability by cohort were observed. Differences by sex were found, with differing patterns of disability observed for female and male cohorts. This study also found an increase in the prevalence of disability in the youngest cohort, despite a general decrease in disability for generations born after 1960. ConclusionsBetween generational cohorts, there are differing patterns for the prevalence of disability which cannot be explained by age, or by the period through which the cohort has lived.

Trends in disability adjusted life years of anxiety disorders from 1990 to 2019 in Indonesia: Evidence from joinpoint regression analysis.

In 2019, anxiety disorders constituted a significant share of the disability adjusted life years (DALYs) lost as a result of mental disorders. This study sought to examine the gender and age-specific distribution pattern and the trends of DALYs in anxiety disorders. Using descriptive methods, the study examined the trends in the DALYs of anxiety disorders in Indonesia from 1990 to 2019. The initial step was to extract age-standardized DALYs rates (ASR) data from the Global Health Data Exchange (GHDx) covering the period from 1990 to 2019. Trend data analysis used the joinpoint regression analysis. The results indicate that DALYs rate due to anxiety were higher in women as compared to men. The highest anxiety rate in Indonesia in both 1990 and 2019 was between 25-49 years old. Anxiety rates are important to monitor for stakeholders, particularly for women and those in the reproductive age groups.

Trends in disability adjusted life years of anxiety disorders from 1990 to 2019 in Indonesia: Evidence from joinpoint regression analysis

In 2019, anxiety disorders constituted a significant share of the disability adjusted life years (DALYs) lost as a result of mental disorders. This study sought to examine the gender and age-specific distribution pattern and the trends of DALYs in anxiety disorders. Using descriptive methods, the study examined the trends in the DALYs of anxiety disorders in Indonesia from 1990 to 2019. The initial step was to extract age-standardized DALYs rates (ASR) data from the Global Health Data Exchange (GHDx) covering the period from 1990 to 2019. Trend data analysis used the joinpoint regression analysis. The results indicate that DALYs rate due to anxiety were higher in women as compared to men. The highest anxiety rate in Indonesia in both 1990 and 2019 was between 25-49 years old. Anxiety rates are important to monitor for stakeholders, particularly for women and those in the reproductive age groups.

Disability trends among elderly Ukrainians in war conditions: a 10-year retrospective study

AimNon-communicable diseases (NCDs) in elderly are a significant problem in Ukraine. It is expected that the ongoing war will augment this problem. The study aimed to analyze the trends of disability due to NCDs s in newly-diagnosed elderly patients between 2013 and 2023.MethodsThis retrospective study included data obtained from the official document “Report on the Causes of Disability and Indications for Medical, Professional, and Social Rehabilitation” commissioned by the Ministry of Health of Ukraine. The data on disability due to NCDs s were obtained from for 2013–2023.ResultsDuring the 2013–2021 the average number of disabled elderly patients due to NCDs per 10,000 elderly persons was significantly lower in compare with working-age. During the first year of full-scaled war the average number of disabled elderly patients due to NCDS s per 10,000 elderly persons dramatically increased by 2-fold, and in 2023 – by 2.8-fold against 2013 value (p < 0.05), while in working-age the disability rate increased significantly only in 2023 by 1.4-fold compared to the pre-war level. In 2013–2021 the main causes of disability among those related to NCDs in elderly were cardiovascular diseases, followed by cancer. In 2022 compared to the pre-war level, the indicators of disability of the elderly due to CVD increased by 1.5 times, due to cerebrovascular diseases - by 2.2 times, due to cancer - by 1.7 times, due to musculoskeletal diseases - by 2 times (p < 0.05). The most significant increase in the number of elderly people with disabilities during the full-scale war occurred due to coronary artery disease - by 55.1%, and osteoarthritis - by 83.4% from baseline in 2013. It estemated the differences in indicators of disability of elderly between regions of Ukraine, significantly higher indicators of disability of the elderly due to cardiovascular diseases, cancer, cerebrovascular diseases, musculoskeletal diseases were noted in the frontline regions.ConclusionsData on primary disability among elderly Ukrainians indicates a significant increase in NCDs-related disability during the war in compare with working population, especially in frontline regions and regions with a high concentration of displaced persons. In this structure of NCDs-related increasing disability, CVD, oncology and musculoskeletal diseases system prevailed.

Global, regional, and national temporal trends in metabolism-related ischemic stroke mortality and disability from 1990 to 2021

BackgroundStroke ranks as the second leading cause of mortality and the third leading cause of disability worldwide. Nonetheless, the evolving burden of ischemic stroke attributable to various metabolic risk factors remains inadequately elucidated. A thorough grasp of these trends is crucial for a nuanced comprehension of stroke epidemiology and the formulation of effective preventive and interventional measures. MethodBased on the Global Burden of Disease, Injury, and Risk Factors Study 2021 (GBD), we analyzed national temporal trends in the burden of metabolism-associated ischemic stroke in 204 countries and territories globally from 1990-2021, as measured by the average annual percentage change (AAPC), using join-point regression models. The burden of disease was assessed using age-standardized (ASR) mortality rates and disability-adjusted life years (DALY) per 100 000 population. Cross-country inequalities in ischemic stroke burden were quantified using standard health equity methods and changes in ischemic stroke burden were projected to 2045. ResultsGlobally, the ASR for ischemic stroke mortality linked to overall dietary metabolic risk declined by an average of 1.6% annually, while the ASR for disability-adjusted life years saw an average annual decrease of 1.3%. High systolic blood pressure remained a primary contributor to metabolism-related ischemic stroke, accounting for 57.9% of deaths and 58.0% of disability in 2021. Disparities associated with the sociodemographic index (SDI) diminished, with the gap in DALYs between countries with the highest and lowest SDIs narrowing from 592.2 (95% CI: 440.2-744.4) to 480.4 (95% CI: 309.7-651.2) in 2021. Projections indicate a continued decline in overall metabolism-related ischemic stroke deaths, mortality rates, and ASRs through 2045, although an increase in DALYs and ASRs is anticipated within the male population. ConclusionThe global burden of metabolic risk-associated ischemic stroke has generally been decreasing from 2019 to 2021. This study highlights significant challenges in controlling and managing metabolic risk-associated ischemic stroke, including an increase in the number of cases in certain countries and regions, as well as an uneven distribution worldwide. These findings may provide valuable insights for the development of improved public health policies and the rational allocation of healthcare resources.

Updated trends in disability, diversity, and corporate social responsibility

BACKGROUND: Disability holds a unique position in employment, including corporate social responsibility (CSR) and diversity, equity and inclusion efforts. Furthermore, contextual shifts in employment, such as the COVID-19 pandemic, make it critical to explore how disability is considered within company strategies. OBJECTIVE: Authors reviewed 2020/2021 CSR reports to observe organizational disability inclusion practices and shifts in company approaches to workplace and community initiatives. This analysis helps illuminate what disability inclusion strategies businesses publicize and prioritize, contributing to the growing knowledge of disability inclusion. METHODS: Building from a previous analysis completed in 2018 (Gould et al., 2020), the current review involved content analysis of 129 CSR reports from companies recognized for their disability inclusion efforts. RESULTS: Results showed a substantial increase in organizations that participated in disability inclusion activities and illuminated potential contextual changes. Additional findings highlight primary disability inclusion strategies as well as emerging practices. CONCLUSION: Although there is an increasing interest in including disability within business efforts, there continues to be distinct challenges to advancing disability inclusion overall. By providing insights into disability inclusion approaches, the current study sets a foundation for future research to explore the efficacy and long-term impacts of inclusive practices to enhance disability employment outcomes.

Does Pain Explain Trends in Disability? An Analysis of Middle-Aged and Older U.S. Adults, 2002-2018.

This article investigates the role of pain in disability trends in the United States, within the context of recent unfavorable disability trends and the concurrent rise in pain. We conducted a 2-part analysis using National Health Interview Survey data from 2002 to 2018 for U.S. adults aged 45-84. First, we assessed how changes in the prevalence of 5 site-specific types of pain (headaches/migraines, joint, low back, neck, and facial/jaw pain) associated with disability trends. Second, we used self-reported causes of disability and examined whether there has been a change in the proportion of individuals who attribute their disability to 1 of 5 chronic or acute painful conditions. The 5 site-specific types of pain, individually and collectively, were significantly associated with increases in disability. If site-specific chronic pain had not increased during the study period, the trend for functional limitations would have been 40% lower, and that for activity limitations would have shown a slight decline instead of an increase. Attributions of functional limitations to painful conditions increased by 23% during the 2002-2018 period, representing an additional 9.82 million Americans experiencing pain-attributable disability. Arthritis/rheumatism, back/neck problems, and other musculoskeletal/connective conditions were the primary sources of pain-related disability. Our research provides the first systematic, national examination of how pain is contributing to disability trends in the United States. The findings have implications for disability reduction policies and shed light on the far-reaching consequences of pain for overall population health.

Trends in Disability and Limitations among U.S. Adults Age 18-44, 2000-2018.

Understanding disability trends is critical for health care and social policy. Although trends in disability and limitations have been studied extensively among older and middle-aged adults, little is known about trends in younger Americans, despite their importance for current and future population health. We present the first comprehensive evidence on disability trends among U.S. adults age 18-44. We analyze 20 measures of disability and limitations collected in the nationally representative National Health Interview Survey 2000-2018 (N=261,505). Robust Poisson models estimate age- and sex-adjusted trends and their covariates. Over one quarter (27.4%) reported at least one disability or limitation; the age-adjusted prevalence increased by 5% from 2000 to 2018. However, trends for specific disabilities and limitations varied tremendously. ADL and IADL limitations, cognitive, and social disabilities increased steeply (by 65-89% over the study period). Mobility limitations were generally unchanged or increased modestly. Hearing and 'other' limitations decreased significantly (25-48% decrease). The trends are only partly explained by education, health behaviors, chronic conditions, and other covariates. Disability trends research must not be limited to older adults. Researchers and policy makers interested in health care policy, planning, and caregiving should pay attention to disability trends among young adults in the United States.

Global trends in heart failure from 1990 to 2019: An age-period-cohort analysis from the Global Burden of Disease study.

This study aimed to analyse the global prevalence and disability trends of heart failure (HF) from 1990 to 2019, considering both sexes and country-specific economic strata. This study conducted a secondary analysis employing data from the Global Burden of Disease (GBD) study. The analysis is stratified by sex and Socio-demographic Index (SDI) levels. Through age-period-cohort and Joinpoint regression analyses, we investigated the temporal trends in HF prevalence and years lived with disability (YLDs) during this period. Between 1990 and 2019, the global prevalence of HF surged by 106.3% (95% uncertainty interval: 99.3% to 114.3%), reaching 56.2 million cases in 2019. While all-age prevalence and YLDs increased over the 30year span, age-standardized rates decreased by 2019. Countries with higher SDI experienced a more pronounced percentage decrease compared with those with lower SDI. Longitudinal analysis revealed an overall improvement in both prevalence and YLDs for HF, albeit with notable disparities between SDI quintiles and sexes. Ischaemic heart disease and hypertensive heart disease emerged as the most rapidly increasing and primarily contributing causes of HF, albeit with variations observed across different countries. The average annual percentage change for prevalence and YLDs over the period was -0.26% and -0.25%, respectively. This study offers valuable insights into the global burden of HF, considering factors such as population aging, regional disparities, sex differences and aetiological variations. The findings hold significant implications for healthcare planning and resource allocation. Continued assessment of these trends and innovative strategies for HF prevention and management are crucial for addressing this pressing global health concern.

Cohort Differences in Physical Health and Disability in the United States and Europe.

Declines in mortality have historically been associated with improvements in physical health across generations. While life expectancy in most high-income countries continues to increase, there is evidence that younger generations, particularly in the United States, are less healthy than previous generations at the same age. We compared generational trends in physical health in the United States, England, and continental Europe to explore whether other regions have experienced a similar pattern of worsening health across cohorts. Using data from nationally representative studies of adults aged ≥50 years from the United States (Health and Retirement Study, n = 26,939), England (English Longitudinal Study of Ageing, n = 14,992) and 11 continental European countries (Survey of Health, Ageing and Retirement in Europe, n = 72,595), we estimated differences in the age-adjusted prevalence of self-reported chronic disease and disability and observer-measured health indicators across pseudo-birth cohorts (born <1925, 1925-1935, 1936-1945, 1946-1954, 1955-1959). Age-adjusted prevalence of doctor-diagnosed chronic disease increased across successive cohorts in all regions. Trends in disability prevalence were more regionally varied. Still, in both the United States and Europe, we observed a structural break in disability trends, with declines observed in prewar cohorts slowing, stalling, or reversing for cohorts born since 1945. In all regions, we found evidence for worsening health across cohorts, particularly for those born since 1945. While more chronic disease in younger cohorts need not necessarily translate to worse quality of life or higher rates of functional limitation, there is some suggestion that worsening chronic disease morbidity may be spilling over into worsening disability.

Temporal trends in prevalence and disability of chronic kidney disease caused by specific etiologies: an analysis of the Global Burden of Disease Study 2019.

The prevalence of disability in CKD is high. In this context the aim of the present study wasto assess the temporal trends of prevalence and disability progression for chronic kidney disease (CKD) caused by specific etiologies. Using data from the Global Burden of Diseases Study (GBD) 2019, we examined the age-standardized rates of CKD prevalence and disability-adjusted life-years for different etiologies, including Type 1/2 diabetes mellitus (T1DM/T2DM), glomerulonephritis, and hypertension. We also calculated the average annual percentage changes to assess trends. Additionally, we utilized the joinpoint regression model to identify significant shifts over time. From 1990 to 2019, the global prevalence of CKD due to various etiologies exhibited an overall increasing trend, albeit with fluctuations. Notably, CKD due to T1DM, glomerulonephritis, and hypertension consistently demonstrated a significant upward trend across all continents, while the prevalence of CKD due to T2DM varied across continents. In terms of disability-adjusted life-years, CKD due to T2DM and hypertension exhibited a significant rising trend over the past 30 years. However, changes in age standardized disability-adjusted life-years for CKD due to different etiologies were not consistent across continents, with an upward trend observed in The Americasand a contrasting trend in Asia. Furthermore, both age-standardized prevalence rate and age standardized disability-adjusted life-year trends for CKD varied significantly across 204 countries and territories. Additionally, a negative association was observed between the Socio-demographic Index and the disability progression of CKD. The prevalence and disability burden of CKD caused by specific etiologies show substantial heterogeneity worldwide, highlighting significant disparities in the distribution of CKD. It is crucial to implement geographic and personalized strategies in different regions to alleviate the burden of CKD effectively.

Global, regional, and national temporal trends of diet-related ischemic stroke mortality and disability from 1990 to 2019.

Stroke is the second leading cause of death and the third leading cause of disability in the general population worldwide. However, the changing trend of ischemic stroke burden attributable to various dietary risk factors has not been fully revealed and may contribute to a better understanding of stroke epidemiology. Our article aimed to evaluate the temporal trend of diet-related ischemic stroke burden to inform future research and policy-making. This analysis was based on the data from the Global Burden of Disease (GBD) Study 2019 (spanning years 1990 to 2019), and we used the joinpoint regression to model temporal trends in diet-related ischemic stroke burden across countries and regions of the world during the study period. Six specific dietary factors known to influence stroke risk, including sodium, red meat, fiber, vegetables, whole grains, and fruits, were evaluated in the GBD study to determine their individual and joint impact on ischemic stroke. The changing trend was primarily measured by the average annual percent change (AAPC). Age-standardized rates (ASRs) of mortality and years lived with disability (YLD) per 100,000 population were used to evaluate disease burden. Finally, the socioeconomic background, which was quantified as sociodemographic index (SDI), and its association with diet-related ischemic stroke burden were also explored with the Pearson correlation coefficient. During the study period, the ischemic stroke ASR of mortality attributable to overall dietary risk decreased by an average of 1.6% per year, while the ASR of YLD decreased by an average of 0.2% per year. High sodium diet was still a key driver of diet-related ischemic stroke, accounting for 8.4% and 11.0% of deaths and disabilities, respectively, in 2019. In addition, we found a negative association between temporal evolution of stroke burden and socioeconomic background (r = -0.6603 for mortality and r = -0.4224 for disability, P < 0.001), which suggested that the developing countries with weak social and economic foundation faced greater challenges from the ongoing burden of diet-related strokes compared with developed countries. Our study found declining trends and revealed the current status of diet-related ischemic stroke mortality and disability. Interdisciplinary countermeasures involving the development of effective food policies, evidence-based guidelines, and public education are needed in the future to combat this global epidemic. The data used for analysis were open-access and can be obtained from https://vizhub.healthdata.org/gbd-results/.

Trends in disability in activities of daily living and instrumental activities of daily living among Chinese older adults from 2011 to 2018

AimThis study aimed to assess the trends in disabilities in activities of daily living (ADL) and instrumental activities of daily living (IADL) among older Chinese adults and explore the influence of multimorbidity and unhealthy behaviors on ADL/IADL disability over time.MethodsData were obtained from four waves (2011–2018) of the China Health and Retirement Longitudinal Study. Disability in ADL/IADL was defined as inability to perform any ADL/IADL task. Latent class analysis was used to identify multimorbidity patterns. The generalized estimating equation was used to test disability trends. Logistic regression was used to investigate the factors influencing disability.ResultsThe prevalence of IADL and ADL disability showed significant increasing trends among older Chinese adults from 2011 to 2018 (ptrend < 0.001). The negative association between alcohol intake more than once per month and IADL disability strengthened over time (ptrend < 0.05). The influence of the “arthritis/digestive diseases” pattern, “cardiometabolic disease” pattern and “high multimorbidity” pattern on ADL disability weakened over time (ptrend < 0.05).ConclusionsThe prevalence of IADL and ADL disability among Chinese older adults increased over time. The “arthritis/digestive diseases” pattern, “cardiometabolic disease” pattern and “high multimorbidity” pattern appeared to be less disabling in ADL over time. Improving the prevention and treatment of multimorbidity and developing age-friendly living conditions could be helpful to reduce the risks of disability.

Single-centre prospective cohort study investigating the associations and one-year trends of frailty, cognition, disability and quality of life pre- and post-intervention for chronic limb-threatening ischaemia

Abstract Background: Half of people with chronic limb-threatening ischaemia (CLTI) have frailty. This study aimed to describe the associations of frailty with cognition, disability and quality of life (QoL) among CLTI patients over 1 year following surgical or endovascular procedures. Methods: A single-centre prospective cohort study was undertaken. Patients undergoing a procedure for CLTI between May 2019 and May 2021 were eligible (minimum age &gt;65 initially; &gt;50 from November 2019). Participants underwent preoperative assessments for frailty, physical and cognitive function, disability, mood, disease-specific QoL (Vascular QoL questionnaire (VascuQoL)) and generic health-related QoL (EuroQoL EQ-5D-5L). Follow-up was at 3 months (clinic or telephone) and 12 months (telephone). Baseline frailty was assessed using both the Edmonton frail scale (EFS) and the clinical frailty scale (CFS). Frailty during follow-up was re-assessed at 3 and 12 months using the CFS as it can be performed via telephone. Associations of baseline frailty with disability, QoL and mood scores during follow-up were investigated using repeated measures mixed models. Results: Ninety-nine patients completed the baseline assessments. Forty-five (45%) were classified as frail by the EFS. Frailty was associated with a higher prevalence of cognitive impairment based on the Montreal cognitive assessment (52% vs 17%; p&lt;0.001). Eighty-seven patients were eligible for follow-up. Baseline frailty (EFS) was associated with worse QoL scores at all timepoints (VascuQoL p=0.001; EQ-5D-5L p&lt;0.001). Both those with and without frailty at baseline (EFS) had modest improvement in QoL scores at 12 months (VascuQoL p&lt;0.001; EQ-5D-5L p=0.001). Barthel index (disability) scores were lower for those with frailty at baseline (EFS) (p&lt;0.001) and decreased slightly over 12 months for both groups (p=0.007). Five patients (12%) transitioned from frailty to non-frailty at 12 months based on the CFS. However, 10 patients (23%) transitioned from non-frailty to frailty. Conclusions: CLTI patients with frailty have worse QoL and greater disability both pre- and post-intervention. However, they demonstrate similar QoL benefit to those without frailty at 1 year following intervention. Baseline frailty assessment is important to inform prognostic discussions, expectations and shared decision making in CLTI.

Tendencies in disability of the population as a result of malignant neoplasms in Ukraine (on the example of the Poltavia region).

Aim: To study the dynamics of the prevalence and structure of primary disability, including due to cancer, among the population of the Poltava region. Materials and Methods: The study used a retrospective analysis - the depth of the research search was six years (2019-2023); a comparative analysis - to establish the differences in disability indicators. Determining the trends of disability: analyzing the dynamic series. Results: The rate of initial disability due to neoplasms (including malignant) for 2019-2023 in Ukraine population is generally stable with a slight downward trend, in the Poltava region, there is a slight downward trend during the years 2019-2021, starting from 2022, begins to increase sharply, while throughout Ukraine the indicator remains stable. Among the able-bodied population of the Poltava region: if until 2021 the picture is identical to the indicators among the adult population, then starting from 2022 the disability of this contingent in the Poltava region begins to increase, while in Ukraine - to decrease. In 2023 among the population of the Poltava region, diseases of the musculoskeletal system became the cause of disability in 20.5 per 10,000 working-age population (І rank place) ; from circulatory system diseases was 12.3 (ІІ rank place); the rate of disability from a neoplasm is 16.1(ІІІ rank place). Conclusions: Analysis of the dynamics and structure of disabling pathology is important and necessary, as it allows to identify diseases that lead to permanent disability, as well as to develop medical and social measures to prevent disability.

EXPANDING INSIGHTS INTO LATE-LIFE DISABILITY USING OBJECTIVE ASSESSMENTS IN NHATS

Abstract The National Health and Aging Trends Study (NHATS) is a NIA-funded national panel study that conducts annual in-home interviews with a representative sample of US Medicare beneficiaries ages 65 years and older. Designed as a platform for the scientific study of late life disability trends and trajectories, NHATS fosters research to guide efforts to maximize health, promote independent functioning, and enhance quality of life at older ages. NHATS has collected performance-based measures of physical function since its inception (2011). In 2021 NHATS responded to expanded interest in objective measures of sensory loss and physical activity, by adding measures of vision (visual acuity, contrast sensitivity), hearing (pure tone audiometry), and physical activity (accelerometry). This symposium will introduce these measures and demonstrate their scientific application to answer key research questions related to physical and cognitive health. Dr. Schrack will present an overview of the accelerometry data collection procedures, as well as results by key demographic and health-related features. Dr. Twardzik will examine the association between features of participants’ social and physical environments and patterns of accelerometry-based physical activity. Dr. Martinez-Amezcua will examine the association between hearing and phenotypic frailty. Dr. Davoudi will present evidence on the links among sensory and motor function and risk of dementia. Finally, Dr. Wanigatunga will describe the association between measures of hand and leg strength and dementia incidence. Collectively, these presentations will highlight population-level associations of objective measures of health and function with physical and cognitive outcomes to advance the science of disability in older adults.

A propsective cohort study to determine association of complications with the disability trends in tuberculous meningitis (TBM)

A propsective cohort study to determine association of complications with the disability trends in tuberculous meningitis (TBM)