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New thinking and science on disability in mid- and late life

DOI: http://dx.doi.org/10.1093/eurpub/5.1.20 20-28 First published online: 1 January 1995


Disability refers to the impacts that chronic conditions have on people's ability to act in necessary, expected and personally desired ways in their society. Scientists are now working to trace trajectories of disability over time for individuals and identify factors that propel and slow disability's pace. Their work is guided by conceptual schemes that Include i) a main pathway linking pathology, impairments, functional limitations, disability, and social disadvantage and ii) predisposing risk factors, interventions and exacerbators that alter the pace of that pathway. Recent findings from 3 projects are presented on the disabling impact of various chronic conditions, dynamics of disability for individuals and successful interventions. The results show the importance of non-fatal conditions as causes of disability in late life, how chronic conditions Increase time spent by older persons on obligatory activities while reducing time spent on discretionary ones and the great efficacy of personal and (especially) equipment assistance in reducing disability. We discuss medicine's dreams of primary prevention, contrasted with the actual advances in secondary prevention in the past half century and how those advances now prompt needs for prevention strategies that maintain and restore function among persons with chronic conditions.

  • disability
  • dysfunction
  • gerontology
  • chronic conditions

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