The Association Between Activity Limitation Stages and Admission to Facilities Providing Long-term Care Among Older Medicare Beneficiaries.

This was an observational survey analysis, so it shows association and not that activity limitation stages caused admission to long-term care. Activity limitation stage was based on self or proxy reported difficulty, which may introduce recall or perception bias. Cognition was not included as a covariate because it was unavailable. Caregiver availability, willingness, and burden were not accounted for, although these may affect admission. The long-term care definition was broad and combined many facility types, and short and long stays were not distinguished. The sample was community-dwelling Medicare beneficiaries aged 65 years and older, so results may not apply to younger people, nursing home residents, or people without Medicare. A small number of beneficiaries were excluded from the models because covariate information was missing. Dual eligibility was adjusted, but state-level Medicare or Medicaid eligibility requirements and admissions due to them were not adjusted.

The authors reported no personal conflicts of interest and no disclosures beyond the funding source.

Do not read these results as evidence that treating an ADL or IADL limitation will prevent admission to long-term care. The study observed associations in survey records and did not test therapy or interventions.