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Predictors of functional change: a longitudinal study of nondemented people aged 65 and older
Wang L, van Belle G, Kukull WB, Larson EB.. Journal of the American Geriatrics Society, 2002-09-01
Topic: Risk, prevention and care in population studies
Objectives To identify factors associated with functional change in an older population and investigate interactions among selected potential risk factors. Design A population-based prospective cohort study. Setting A random sample was selected from the Group Health Cooperative members in the Seattle area from 1994 to 1996 and followed biennially. Participants Two thousand five hundred eighty-one people aged 65 and older, cognitively intact at baseline. Measurements Functional status was measured by activities of daily living, instrumental activities of daily living, and performance-based physical function testing. Results The cohort status at the time of these analyses was: deceased, 391; withdrawn, 179; dementia, 152; and on study, 1,873. The mean follow-up time was 3.4 years. Using linear regressions with Generalized Estimating Equation, selected medical conditions (diabetes mellitus, hypertension, coronary heart disease, cerebrovascular disease (CVD), osteoporosis, arthritis, and cancer), low cognitive function, depression, and smoking were associated with worse functional outcomes. Exercise and moderate alcohol use were associated with better functional outcomes. Over the follow-up period, coronary heart disease, CVD, and depression were associated with increased rates of functional decline. Exercise and moderate alcohol consumption were associated with decreased rates of functional decline. Significant interactions were observed between exercise and coronary heart disease, moderate alcohol use and CVD, and cognition and CVD. Conclusions Our study has identified not only risk factors associated with functional decline but also the interactions among these factors. These observations, along with other published research, add to the growing understanding of the underlying process of functional change and could provide a basis to design effective strategies to delay functional decline.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Wang, L., van Belle, G., Kukull, W. B., & Larson, E. B. (2002). Predictors of functional change: a longitudinal study of nondemented people aged 65 and older. Journal of the American Geriatrics Society. https://doi.org/10.1046/j.1532-5415.2002.50408.x
Vancouver
Wang L, van Belle G, Kukull WB, Larson EB. Predictors of functional change: a longitudinal study of nondemented people aged 65 and older. Journal of the American Geriatrics Society. 2002. doi:10.1046/j.1532-5415.2002.50408.x. PMID: 12383150.
BibTeX
@article{wang2002-12383150,
author = {Wang, L. and van Belle, G. and Kukull, W. B. and Larson, E. B.},
title = {{Predictors of functional change: a longitudinal study of nondemented people aged 65 and older}},
journal = {Journal of the American Geriatrics Society},
year = {2002},
doi = {10.1046/j.1532-5415.2002.50408.x},
pmid = {12383150},
url = {https://doi.org/10.1046/j.1532-5415.2002.50408.x}
}
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Key findings
- Objectives To identify factors associated with functional change in an older population and investigate interactions among selected potential risk factors.
- Results The cohort status at the time of these analyses was: deceased, 391; withdrawn, 179; dementia, 152; and on study, 1,873.
- Using linear regressions with Generalized Estimating Equation, selected medical conditions (diabetes mellitus, hypertension, coronary heart disease, cerebrovascular disease (CVD), osteoporosis, arthritis, and cancer), low cognitive function, depression, and smoking were associated with worse functional outcomes.
- Exercise and moderate alcohol use were associated with better functional outcomes.
- Over the follow-up period, coronary heart disease, CVD, and depression were associated with increased rates of functional decline.
Why it matters
In this cohort of older people without dementia, conditions like diabetes, hypertension, heart disease, and depression were linked to worse functional outcomes, while exercise and moderate alcohol use were linked to better ones. It did not test any treatment for Alzheimer's disease.
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Study details
- Study designcohort study
- Evidence strengthModerate
How this study scored 64/100
Published in a peer-reviewed journal, and it is a randomised controlled trial. Scored zero for sample size and effect reported because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of the American Geriatrics Society) |
| Journal's citation record | 3 / 4 | Journal of the American Geriatrics Society: journal h-index 344 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2002 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (pubmed indexes it as a clinical or observational study) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 6 / 7 | Cited 327 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 12.6 citations a year over 26 year(s) since 2002 |
| Impact for its field and year | 4 / 6 | Cited 8.4× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 5 other studies in this library |
| Still being cited | 2 / 4 | Cited 15 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Eric B. Larson: h-index 63 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 12383150) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 64 / 100 | — |
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