Middle-Aged and Impaired? More Common Than You Might Think
MONDAY, Nov. 13, 2017 -- As early as middle age, many Americans have problems with dressing, grocery shopping and otherwise caring for themselves -- and for some, it leads to a progressive decline, a new study finds.
The study, of nearly 6,900 middle-aged adults, found that roughly 1 in 5 developed a "functional impairment" before age 65. That meant they had difficulty with routine self-care or daily tasks such as bathing themselves and making meals.
Though those types of disabilities are common among elderly people, the new findings show that middle-aged people often have similar issues -- and they do not always recover.
That had been a big question going into the study, according to lead researcher Dr. Rebecca Brown: "Is functional impairment in middle age a temporary phenomenon, or does it have consequences later?" Brown is an assistant professor of medicine at the University of California, San Francisco.
For many people in the study, their impairment did have consequences. Overall, 16 percent of middle-aged participants with impairments got worse over the next 10 years, and 19 percent died.
The better news, Brown said, was that many people either remained stable or got better. In all, 28 percent regained their function and remained disability-free for the rest of the study period.
The findings are published in the Nov. 14 issue of Annals of Internal Medicine.
The study did not break down the specific causes of people's disabilities, but 43 percent of those who developed a disability had arthritis, and a similar percentage were obese.
Low-income adults also faced higher risks, Brown pointed out. There could be multiple reasons for that, she said -- from higher rates of chronic health conditions to less access to medical care.
What does it all mean?
For starters, any problems with self-care in middle age should probably be seen as a "red flag," said Dr. Thomas Gill, a professor of geriatrics at the Yale School of Medicine. "It's a sign that a person is potentially vulnerable," said Gill, who wrote an editorial published with the study.
His advice to people who've ever had a functional impairment: Talk to your doctor about whether you can better manage any chronic medical conditions.
"Ask your doctor, 'If I'm having difficulty with these tasks at the age of 60, what will happen when I'm 70?' " Gill said.
Lifestyle is a big issue, he pointed out. Regular exercise and, if needed, weight loss can help manage medical conditions like arthritis -- and possibly cut the risk for future disabilities.
In fact, Gill said, "losing weight is one of the most effective measures for arthritis."
As for exercise, Gill said he and his fellow researchers had found clear benefits in a recent trial of sedentary adults in their 70s and 80s. People who started an exercise program were less likely to develop a disability over the next several years than were those who remained inactive.
When the exercisers did suffer an impairment -- such as trouble walking -- they were a third more likely to recover.
It's not clear whether those findings would apply to middle-aged people, too, according to Gill. But in theory, he noted, they could be "even more responsive" to exercise than elderly adults.
In the new study, Brown said, sedentary people were at greater risk of developing a functional impairment. That hints that exercise would curb the risks, she added, though it's not proof.
Regular exercise is already recommended for most adults, for a variety of health reasons. That doesn't have to mean joining a gym and going all-out, according to Brown.
"Start with small steps," she said. "Go for a 15-minute walk. Do some light resistance exercise at home."
Brown also agreed that a functional impairment can act as a red flag for middle-aged adults.
"You could see it as an opportunity to talk to your doctor, and try some simple strategies, like exercise, to improve your health," she said.
The U.S. National Institute on Aging has advice on exercise and diet.
Posted: November 2017