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The European Journal of Public Health Advance Access originally published online on July 13, 2005
The European Journal of Public Health 2005 15(5):494-497; doi:10.1093/eurpub/cki015
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© The Author 2005. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

Health Inequalities

Association between chronic diseases and disability in elderly subjects with low and high income: the Leiden 85-plus Study

Annetje Bootsma-van der Wiel1, Anton J.M. de Craen1, Eric Van Exel1, Peter W. Macfarlane2, Jacobijn Gussekloo1 and Rudi G.J. Westendorp1

1 Department of Gerontology and Geriatrics, Leiden University Medical Center, The Netherlands
2 Department of Medical Cardiology, Royal Infirmary, Glasgow, UK

Correspondence: Dr Anton J.M. de Craen, Dept. of Gerontology and Geriatrics, Leiden University Medical Centre, C2-R-133, PO Box 9600, 2300 RC Leiden, The Netherlands, tel: +31-71-526-6640, fax: +31-71-524-8159, e-mail: craen{at}lumc.nl

Background: Disability in activities of daily living (ADL) might be more prevalent among elderly with low income due to higher prevalence of chronic diseases and impairments, as well as stronger associations of these factors with ADL-disability. Methods: In the Leiden 85-plus Study, we defined disability as being unable to perform one or more basic ADL activities. Presence of chronic diseases was obtained from medical records, impairments were assessed with performance-tests. Results: Elderly with low income had higher prevalence of ADL-disability (23% versus 12%; odds ratio 2.0; 95% confidence interval 1.3–3.2), higher prevalence of impairments and equal prevalence of chronic diseases, except for dementia and co-morbidity. Associations of these factors with ADL-disability were not stronger. Conclusions: We conclude that ADL-disability is more prevalent in elderly with low income. Neither prevalence of chronic diseases nor the association with disability could explain this.

Keywords: chronic diseases, disability, elderly, income


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