'ADLs' - Independence versus Dependence

[Guest guest]

Hi folks:

This is a topic I do not recall seeing discussed here previously. It is relevant to everyone, but especially so for those planning/expecting/hoping to live to 100 years of age or more.

The subject line above refers to the difference between independence and dependance with respect to 'ADLs' - the acronym for 'activities of daily living'. In other words, the ability to look after oneself unaided as long as possible for all essential daily activities. Reading about this recently I have found to be a quite 'sobering' experience. In thirty years we will all be a lot older than we are now.

In one paper five ADLs were listed. They were:

Bathing

Dressing

Walking

Eating

Continence

Another paper refers to seven ADLs. But I do not know what that list's ADLs are as I do not have access to the full text. It would be nice to know what all seven are, if anyone is able to check - PMID: 7775716.

PMID: 11108417 - full text can be accessed at: http://ageing.oxfordjournals.org/cgi/reprint/29/5/441 - studied performance measures that could help predict approaching dependence. It found that: "..... even after controlling for age, sex and a number of chronic conditions, lower scores on each baseline performance measure showed increased risk for the onset of functional dependence. Maximum walking speed was most sensitive in predicting future dependence for those aged 65-74 years, while usual walking speed was most sensitive for people aged over 75 years." And that: "walking speed was the best physical performance measure for predicting the onset of functional dependence" for the subjects in their study.

The study has some very interesting data in Table 1.

PMID: 7775716 found that: "Eight of the 12 qualitative tests and all six of the timed tests were significantly associated (P < .05) with the onset of functional dependence." And that: "Four timed tests - chair stands, rapid gait, 360 degrees turn, and bending over - showed a threshold phenomenon, where the rate of new dependence increased slowly with worsening performance until a critical point (or threshold) was reached, at which the rate of dependence increased substantially. For timed chair stands, for example, the rates of functional dependence within quarters of worsening performance were 5.3%, 6.3%, 6.7%, and 16%."

The key question for us is what we can do to ensure we remain independent as long as possible. Avoiding obesity, CVD and diabetes are three issues that are closely related to dependence, which CRON itself goes a long way to fix.

Various types of exercise are also likely to be beneficial. One paper I read - which I can no longer locate - found that specific targeted exercises were likely to be more useful than generalized fitness activities.

But whatever the scientific consensus turns out to be for the best ways to delay the onset of dependence, papers focussing on this topic would, I think, be a helpful addition to the material already available at , especially for older members.

Rodney.