Predictors of ADL Disability Trajectories Among Low-Income Frail Elders in the Community

Abstract

In this study, the author examined the effects of psychosocial and health factors on the ADL disability trajectory of low-income frail elders living in the community. She analyzed three-year longitudinal data with a maximum of 15 repeated observations from a cohort of elderly participants in Michigan’s Medicaid Waiver Program ( N=3,161), using the hierarchical linear modeling approach. Baseline data of this cohort were taken in 1999; a reassessment was conducted about every three months. The analysis shows that major risk factors for a poor activity of daily living (ADL) disability trajectory include being Black, older, living with nonspouse others, and no confidence in functional improvement. Presence of arthritis, cancer, and cognitive limitation had significant and modest effects on ADL disability trajectories. The findings have implications to community-based intervention programs for frail elderly persons in the community.