Evidence map›Paper›PMID 36511646›Full record

ArticleJournal of the American Geriatrics Society2023

The devil's in the details: Variation in estimates of late-life activity limitations across national cohort studies.

Claire K Ankuda, Kenneth Covinsky, Vicki A Freedman, Kenneth Langa, Melissa D Aldridge, Cynthia Yee, Amy S Kelley

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Claire K AnkudaBrookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.ORCID 0000-0003-1371-8524
Kenneth CovinskyDivision of Geriatrics, University of California San Francisco, San Francisco, California, USA.
Vicki A FreedmanMichigan Center on the Demography of Aging, University of Michigan, Ann Arbor, Michigan, USA.
Kenneth LangaDepartment of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.
Melissa D AldridgeBrookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Cynthia YeeBrookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Amy S KelleyBrookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.ORCID 0000-0002-6345-9834

Funding

HRS Yrs29-34: Y33 SSA CoFundingU01AG009740 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Jessica Faul, KENNETH M LANGA · 1990 to 2026
$555.8M
The National Health and Trends StudyU01AG032947 · NIA · JOHNS HOPKINS UNIVERSITY · PI VICKI A. FREEDMAN, JENNIFER ANN SCHRACK · 2008 to 2026
$169.4M
Residing in the Community with Dementia at the End of Life: Understanding Hospice Use and Residential SettingP30AG028741 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI ORNA INTRATOR · 2010 to 2026
$21.9M
Unnecessary and Harmful Medication Use in Older Adults with DementiaP01AG066605 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI MELISSA Diane ALDRIDGE · 2020 to 2026
$17.7M
Health Care Use After Functional Disability: Opportunities to Improve the Care of Older AdultsK76AG064427 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI ANKUDA, CLAIRE KATHRYN · 2020 to 2024
$1.3M
Improving Care for Older Adults with Serious IllnessK23AG040774 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KELLEY, AMY STEVES · 2012 to 2016
$785k
Midcareer Investigator Award for Patient-Oriented Research in Dementia and Serious IllnessK24AG062785 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI KELLEY, AMY STEVES · 2019 to 2022
$581k
NIA NIH HHS K23 AG040774NIA NIH HHS K24 AG062785NIA NIH HHS K76 AG064427NIA NIH HHS L30 AG064691NIA NIH HHS P01 AG066605NIA NIH HHS P30 AG028741NIA NIH HHS U01 AG009740NIA NIH HHS U01 AG032947
6 · The paper itself

Abstract

backgroundAssessing activity limitations is central to aging research. However, assessments of activity limitations vary, and this may have implications for the populations identified. We aim to compare measures of activities of daily living (ADLs) and their resulting prevalence and mortality across three nationally-representative cohort studies: the National Health and Aging Trends Study (NHATS), the Health and Retirement Survey (HRS), and the Medicare Current Beneficiary Survey (MCBS).

methodsWe compared the phrasing and context of questions around help and difficulty with six self-care activities: eating, bathing, toileting, dressing, walking inside, and transferring. We then compared the prevalence and 1-year mortality for difficulty and help with eating and dressing.

resultsNHATS, HRS, and MCBS varied widely in phrasing and framing of questions around activity limitations, impacting the proportion of the population found to experience difficulty or receive help. For example, in NHATS 12.4% [95% confidence interval (CI) 11.5%-13.4%] of the cohort received help with dressing, while in HRS this figure was 6.4% [95% CI 5.7%-7.2%] and MCBS 5.3% [95% CI 4.7%-5.8%]. When combined with variation in sampling frame and survey approach of each survey, such differences resulted in large variation in estimates of the older population of older adults with ADL disability.

conclusionsIn order to take late-life activity limitations seriously, we must clearly define the measures we use. Further, researchers and clinicians seeking to understand the experience of older adults with activity limitations should be careful to interpret findings in light of the framing of the question asked.

Indexed as

Activities of Daily LivingPersons with DisabilitiesAgedCohort StudiesHumansMedicareSelf CareUnited Statesfunctional impairmentgeriatricspublic health

Identifiers

PMID36511646
PMCPMC10023348

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.