Functional decline in older adults

Am Fam Physician. 2013 Sep 15;88(6):388-94.


Functional disability is common in older adults. It is often episodic and is associated with a high risk of subsequent health decline. The severity of disability is determined by physical impairments caused by underlying medical conditions, and by external factors such as social support, financial support, and the environment. When multiple health conditions are present, they often result in greater disability than expected because the patient's ability to compensate for one problem may be affected by comorbid conditions. Evaluation of functional disability is most effective when the physician determines the course of the disability, associated symptoms, effects on specific activities, and coping mechanisms the patient uses to compensate for the functional problem. Underlying health conditions, impairments, and contextual factors (e.g., finances, social support) should be identified using validated screening tools. Interventions should focus on increasing the patient's capacity to cope with task demands and reducing the demands of the task itself. Interventions for functional decline in older adults are almost always multifactorial because they must address multiple conditions, impairments, and contextual factors.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Accidental Falls / prevention & control
  • Activities of Daily Living*
  • Aged, 80 and over
  • Cognitive Dysfunction / diagnosis
  • Cognitive Dysfunction / therapy
  • Comorbidity*
  • Depression / diagnosis
  • Depression / therapy
  • Disabled Persons*
  • Education, Medical, Continuing
  • Female
  • Frail Elderly*
  • Geriatric Assessment / methods*
  • Health Status*
  • Humans
  • Hypertension / diagnosis
  • Hypertension / therapy
  • Macular Degeneration / diagnosis
  • Osteoarthritis / diagnosis
  • Osteoarthritis / therapy
  • Peripheral Nervous System Diseases / diagnosis
  • Peripheral Nervous System Diseases / therapy
  • Quality of Life*
  • Risk Assessment
  • Self Care*
  • Sleep Initiation and Maintenance Disorders / diagnosis
  • Sleep Initiation and Maintenance Disorders / therapy
  • Social Support
  • Urinary Incontinence / diagnosis
  • Urinary Incontinence / therapy
  • Visually Impaired Persons