Skip to main content
Log in

Determinants of locomotor disability in people aged 55 years and over: The Rotterdam study

  • Published:
European Journal of Epidemiology Aims and scope Submit manuscript

Abstract

Locomotor disability, as defined by difficulties in activities of daily living related to lower limb function, can be the consequence of diseases and impairments of the cardiovascular, pulmonary, nervous, sensory and musculoskeletal system. We estimated the associations between specific diseases and impairments and locomotor disability, and the proportion of disability attributable to each condition, controlling for age and comorbidity. The Rotterdam Study is a prospective follow-up study among people aged 55 years and over in the general population. Locomotor disability in 1219 men and 1856 women was assessed with the Stanford Health Assessment Questionnaire. Diseases and impairments were radiological osteoarthritis, pain of the hips and knees, morning stiffness, fractures, hypertension, vascular disease, ischemic heart disease, stroke, heart failure, chronic obstructive pulmonary disease (COPD), depression, Parkinson's disease, osteoporosis, diabetes mellitus, overweight, and low vision. Adjusted odds ratios, etiologic and attributable fractions were calculated for locomotor disability. The occurrence of locomotor disability can partly be ascribed to joint pain, COPD, morning stiffness, diabetes and heart failure in both men and women. In addition in women osteoarthritis, osteoporosis, low vision, fractures, stroke and Parkinson's disease are significant etiologic fractions. In men with morning stiffness, joint pain, heart failure, diabetes mellitus, and COPD a significant proportion of their disability is attributable to this impairment. In women this was the case for Parkinson's disease, morning stiffness, low vision, heart failure, joint pain, diabetes, radiological osteoarthritis, stroke, COPD, osteoporosis, and fractures of the lower limbs, in that order. We conclude that locomotor complaints, heart failure, COPD and diabetes mellitus contribute considerably to locomotor disability in non-institutionalized elderly people.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Odding E, Valkenburg HA, Algra D, Vandenouweland FA, Grobbee DE, Hofman A. The association of locomotor complaints and disability in the Rotterdam Study. Ann Rheum Dis 1995; 54: 721–725.

    Google Scholar 

  2. Odding E, Valkenburg HA, Algra D, Vandenouweland FA, Grobbee DE, Hofman A. The association of abnormalities on physical examination of the hip and knee with locomotor disability in the Rotterdam Study. Br J Rheumatol 1996; 35: 884–890.

    Google Scholar 

  3. Odding E, Valkenburg HA, Algra D, Vandenouweland FA, Grobbee DE, Hofman A. Associations of radiological osteoarthritis of the hip and knee with locomotor disability in the Rotterdam Study. Ann Rheum Dis 1998; 57: 203–208.

    Google Scholar 

  4. Burger H, van Daele PL, Odding E, et al. Association of radiographically evident osteoarthritis with higher bone mineral density and increased bone loss with age. The Rotterdam Study. Arthritis Rheum 1996; 81–86.

  5. Guccione AA, Felson DT, Anderson JJ, et al. The effects of speci.c medical conditions on the functional limitations of elders in the Framingham Study. Am J Public Health 1994; 84: 351–358.

    Google Scholar 

  6. Pinsky JL, Jette AM, Branch LG, Kannel WB, Feinleib M. The Framingham Disability Study: Relationship of various coronary heart disease manifestations to disability in older persons living in the community. Am J Public Health 1990; 80: 1363–1368.

    Google Scholar 

  7. Pinsky JL, Branch LG, Jette AM, et al. KR. Framingham Disability Study: Relationship of disability to cardiovascular risk factors among persons free of diagnosed cardiovascular disease. Am J Epidemiol 1985; 122: 644–656.

    Google Scholar 

  8. Hofman A, Grobbee DE, Dejong PTVM, Vandenouweland FA. Determinants of disease and disability in the elderly: The Rotterdam Elderly Study. Eur J Epidemiol 1991; 7: 403–422.

    Google Scholar 

  9. Odding E. Locomotor disability in the elderly. An epidemiological study of its occurrence and determinants in a general population of 55 years and over. Thesis Erasmus University Rotterdam, the Netherlands, 1994; 51–74.

    Google Scholar 

  10. Stolk RP, Hoes AW, Pols HAP, et al. Insulin, hypertension and antihypertensive drugs in elderly patients: The Rotterdam Study. J Hypertens 1996; 14: 237–242.

    Google Scholar 

  11. Meijer WT, Hoes AW, Rutgers D, Bots ML, Hofman A, Grobbee DE. Peripheral arterial disease in the elderly: The Rotterdam Study. Arterioscler Thromb Biol 1998; 18: 185–192.

    Google Scholar 

  12. Bots ML, Looman SJ, Koudstaal PJ, Hofman A, Hoes AW, Grobbee DE. Prevalence of stroke in the general population. The Rotterdam Study. Stroke 1996; 27: 1499–1501.

    Google Scholar 

  13. Mosterd A, Deckers JW, Hoes AW, et al. Classification of heart failure in population based research: An assessment of six heart failure scores. Eur J Epidemiol 1997; 13: 491–502.

    Google Scholar 

  14. Egberts AC, Leufkens HG, Hofman A, Hoes AW. Incidence of antidepressant drug use in older adults and association with chronic diseases: The Rotterdam Study. Int Clin Psychopharmacol 1997; 12: 217–223.

    Google Scholar 

  15. de Rijk MC, Breteler MM, Graveland GA, et al. Prevalence of Parkinson's disease in the elderly: The Rotterdam Study. Neurology 1995; 45: 2143–2146.

    Google Scholar 

  16. Stolk RP, Pols HA, Lamberts SWJ, de Jong PTVM, Hofman A, Grobbee DE. Diabetes mellitus, impaired glucose tolerance, and hyperinsulinemia in an elderly population. The Rotterdam Study. Am J Epidemiol 1997; 145: 24–32.

    Google Scholar 

  17. Klaver CC, Wolfs RC, Vingerling JR, Hofman A, de Jong PTVM. Age-specific prevalence and causes of blindness and visual impairment in an older population: The Rotterdam Study. Arch Ophthalmol 1998; 116: 653–658.

    Google Scholar 

  18. WHO. International Classification of Impairments, Disabilities, and Handicap. A manual of classification relating to the consequences of disease (reprint 1989). World Health Organisation Geneva, 1980.

    Google Scholar 

  19. Fries JF, Spitz PW, Kraines RG, Holman HR. Measurement of patient outcome in arthritis. Arthritis Rheum 1980; 23: 137–145.

    Google Scholar 

  20. Fries JF, Spitz PW, Young DY. The dimensions of health outcomes: The Health Assessment Questionnaire, Disability and Pain Scales. J Rheumatol 1982; 9: 789–793.

    Google Scholar 

  21. Siegert CEH, Vleming LJ, Vandenbroucke JP, Cats A. Measurement of disability in Dutch rheumatoid arthritis patients. Clin Rheumatol 1984; 3: 305–309.

    Google Scholar 

  22. Thompson PW. Functional outcome in rheumatoid arthritis. Br J Rheumatol 1988; 27(Suppl I): 37–43.

    Google Scholar 

  23. Kellgren JH, Jeffrey MR, Ball J (eds). The Epidemiology of Chronic Rheumatism. Volume II: Atlas of Standard Radiographs of Arthritis. Oxford: Blackwell Scientific Publications, 1963.

  24. Joint National Committee on High Blood Pressure. 1988 report of the Joint National Committee on detection, evaluation, and treatment of high blood pressure. Arch Intern Med 1988; 148: 1023–1038.

    Google Scholar 

  25. Vogt MT, Wolfson SK, Kuller LH. Lower extremity arterial disease and the ageing process: A review. J Clin Epidemiol 1992; 45: 529–542.

    Google Scholar 

  26. Fowkes FGR, Houseley E, Cawood EHH, et al. Edinburgh artery study: Prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population. Int J Epidemiol 1991; 20: 384–392.

    Google Scholar 

  27. Schroll M, Munck O. Estimation of peripheral arteriosclerotic disease by ankle blood pressure measurements in a population of 60 year old men and women. J Chronic Dis 1981; 34: 261–269.

    Google Scholar 

  28. Rose GA, Blackburn H, Gillum RF, Prineas RJ. Cardiovascular Survey Methods. World Health Organisation, Geneva 1982.

    Google Scholar 

  29. Remes J, Miettinen H, Reunanen A, Puörälä K. Validity of clinical diagnosis of heart failure in primary health care. Eur Heart J 1991; 12: 315–321.

    Google Scholar 

  30. VanderLende R, Rijcken B, Scaf-klomp W, Schouten JP. Epidemiology of chronic obstructive pulmonary disease (COPD) Eur J Respir Dis Suppl 1986; 146: 49–60.

    Google Scholar 

  31. Kleinbaum DG, Kupper LL, Morgenstern H, (eds). Epidemiologic research. Principles and quantitative methods. New York: Van Nostrand Reinhold, 1982: 160–164.

    Google Scholar 

  32. Greenland S. Bias in methods for deriving standardized morbidity ration and attributable fraction estimates. Stat Med 1984; 3: 131–141.

    Google Scholar 

  33. Hopman-Rock M, Odding E, Hofman A, Kraaimaat FW, Bijlsma JWJ. Physical and psychosocial disability in elderly subjects in relation to pain in the hip and/or knee. J Rheumatol 1996; 23: 1037–1044.

    Google Scholar 

  34. Hubert HB, Bloch DA, Fries JF. Risk factors for physical disability in an aging cohort: The NHANES I Epidemiologic Followup Study. J Rheumatol 1993; 20: 480–488.

    Google Scholar 

  35. Jette AM, Pinsky JL, Branch LG, Wolf PA, Feinleib M. The Framingham Disability Study: Physical disability among community-dwelling survivors of stroke. J Clin Epidemiol 1988; 41: 719–726.

    Google Scholar 

  36. Kelly-Hayes M, Jette AM, Wolf PA, D'Agostino, Odell PM. Functional limitations and disability among elders in the Framingham Study. Am J Public Health 1992; 82: 841–845.

    Google Scholar 

  37. Keil JE, Gazes PC, Sutherland SE, Rust PF, Branch LG, Tyroler HA. Predictors of physical disability in elderly blacks and whites of the Charleston Heart Study. J Clin Epidemiol 1989; 42: 521–529.

    Google Scholar 

  38. Harris T, Kovar MG, Suzman R, Kleinman JC, Feldman JJ. Longitudinal study of physical ability in the oldest old. Am J Public Health 1989; 79: 698–702.

    Google Scholar 

  39. Lammi UK, Kivela SL, Nissinen A, Punsar S, Puska P, Karvonen M. Predictors of disability in elderly Finnish men – a longitudinal study. J Clin Epidemiol 1989; 42: 1215–1225.

    Google Scholar 

  40. Schultz-Larsen K, Avlund K, Kreiner S. Functional ability of community dwelling elderly. Criterion-related validity of a new measure of functional ability. J Clin Epidemiol 1992; 45: 1315–1326.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Odding, E., Valkenburg, H.A., Stam, H.J. et al. Determinants of locomotor disability in people aged 55 years and over: The Rotterdam study. Eur J Epidemiol 17, 1033–1041 (2001). https://doi.org/10.1023/A:1020006909285

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1020006909285

Navigation