Functional Impairments Associated With Patient Activation Among Community-Dwelling Older Adults.
Ling Na, Pui L Kwong, Dawei Xie and 3 others
PMID 29894313WHAT IT FOUND
Older adults with greater limitations in basic self-care or household tasks reported lower confidence managing their own care and poorer communication with doctors.
Health information-seeking was less consistent, especially with basic self-care limitations.
Key findings
01In adjusted models, self-care efficacy decreased with higher ADL and IADL limitation stages.
02In adjusted models, patient-doctor communication decreased with higher ADL stages and declined across IADL stages I through III.
03Health information-seeking decreased with higher IADL stages, while ADL limitations showed less consistent associations.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study is cross-sectional, so it cannot show that activity limitations caused lower patient activation. It included only community-dwelling older adults and excluded people living in long-term care facilities, so it may not apply to more dependent patients. The most severe stage had a very small sample, so effects at that stage were hard to detect. Health information-seeking was limited to written sources such as the internet, newspapers, doctors and medication labels, not information from family, friends, television or radio. Patient activation was self-reported, and people with severe cognitive impairment may not be represented. The survey allowed proxy responses for some variables, although patient activation required self-report.
Declared interests
The study was supported by National Institutes of Health grants R01AG040105 and R01HD074756. The authors reported no personal conflicts of interest, no disclosures beyond funding, and no party with a direct interest in the results conferring a benefit. They also stated that their opinions and conclusions are not necessarily those of the sponsoring agency.
The easy way to misread this
Do not conclude that reducing activity limitations will improve patient activation. The study is cross-sectional and did not test any treatment, so it shows association rather than cause.