Geriatric Syndromes and Incident Disability in Older Women: Results from the Women's Health Initiative Observational Study

Objectives: To determine how the number of geriatric syndromes is associated with incident disability in community-based populations of older adults. Design: Longitudinal analysis from the Women's Health Initiative Observational Study (WHI-OS). Setting: Community. Participants: Twenty-nine thousand five hundred forty-four women aged 65 and older enrolled in the WHI-OS and free of disability in activities of daily living (ADLs) at baseline. Measurements: Geriatric syndromes (high depressive symptoms, dizziness, falls, hearing or visual impairment, osteoporosis, polypharmacy, syncope, sleep disturbance, and urinary incontinence) were self-reported at baseline and 3-year follow-up. Disability was defined as dependence in any ADL and was assessed at baseline and follow-up. Chronic diseases were measured according to a modified Charlson Index. Results: Geriatric syndromes were common in this population of women; 76.3% had at least one syndrome at baseline. Greater number of geriatric syndromes at baseline was significantly associated with greater risk of incident ADL disability at follow-up (P ? .001). Adjusted risk ratios were 1.21 (95% confidence interval (CI) = 0.78�1.87) for a single syndrome and 6.64 (95% CI = 4.15�10.62) for five or more syndromes compared with no syndromes. These results were only slightly attenuated after adjustment for number of chronic diseases or pain. Conclusion: Geriatric syndromes are significantly associated with onset of disability in older women; this association is not simply a result of chronic disease or pain. A better understanding of how these conditions contribute to disablement is needed. Geriatric syndrome assessment should be considered along with chronic disease management in the prevention of disability in older women