Samenvatting

Objective: To predict mortality by disability in a sample of 479 Dutch community-dwelling
people aged 75 years or older.
Methods: A longitudinal study was carried out using a follow-up of seven years. The
Groningen Activity Restriction Scale (GARS), a self-reported questionnaire with good
psychometric properties, was used for data collection about total disability, disability in
activities in daily living (ADL) and disability in instrumental activities in daily living
(IADL). The mortality dates were provided by the municipality of Roosendaal (a city in
the Netherlands). For analyses of survival, we used Kaplan–Meier analyses and Cox regression analyses to calculate hazard ratios (HR) with 95% confidence intervals (CI).
Results: All three disability variables (total, ADL and IADL) predicted mortality, unadjusted and adjusted for age and gender. The unadjusted HRs for total, ADL and IADL
disability were 1.054 (95%-CI: [1.039;1.069]), 1.091 (95%-CI: [1.062;1.121]) and 1.106
(95%-CI: [1.077;1.135]) with p-values <0.001, respectively. The AUCs were <0.7, ranging
from 0.630 (ADL) to 0.668 (IADL). Multivariate analyses including all 18 disability items
revealed that only “Do the shopping” predicted mortality. In addition, multivariate analyses
focusing on 11 ADL items and 7 IADL items separately showed that only the ADL item
“Get around in the house” and the IADL item “Do the shopping” significantly predicted
mortality.
Conclusion: Disability predicted mortality in a seven years follow-up among Dutch community-dwelling older people. It is important that healthcare professionals are aware of
disability at early stages, so they can intervene swiftly, efficiently and effectively, to maintain
or enhance the quality of life of older people.