Functional Limitations and Disability Among Middle-Aged Adults

Project: Research project

Project Details


The burden of functional limitations (restrictions in basic physical actions) and disability (problems with daily activities and life participation) may be more common in middle-aged US adults than previously recognized. However, studies of younger populations have not typically included functional assessments. The Coronary Artery Risk Development in Young Adults (CARDIA) study provides a unique opportunity to study functional status in a diverse, aging cohort. The Year 35 in-person exam is scheduled for 2020 and 2021, at which time, participants will be 53 to 65 years old. We propose a CARDIA ancillary study to obtain measures of function by self-report and physical performance to be paired with the existing data collected from early adulthood through middle age to address the following aims: 1. To quantify the burden of functional limitations and disability and assess the degree to which this can be attributed to multimorbidity rather than individual catastrophic health events, 2. To assess domains of functional limitations and disability captured by physical performance versus self-report, 3. To identify risk factors in early adulthood for functional limitations and disability in middle-age, 4. To determine the association of functional limitations and disability with measures of cardiovascular health. We will add measures of self-reported functional limitations (from the Patient-Reported Outcomes Measurement Information System [PROMIS] Physical Function tool) and disability measures (basic and instrumental activities of daily living including level of difficulty) to the CARDIA Year 35 exam (projected N=3,270). Physical performance will be assessed with measures of fast and usual gait speed, single leg balance, timed chair stands, 6-minute walk test, and grip strength. Ignoring functional limitations and disability in middle-age adults may neglect an important window of opportunity to intervene and minimize the long-term burden and costs associated with functional decline. As studies of younger populations have not often included functional assessments, the conceptualization, measurement approaches, risk factors, and implications of functional limitations and disability are poorly understood. Filling this knowledge gap by adding appropriate functional measures to an ongoing population based cohort, that represents the next wave of aging US adults will lead to new approaches to prevent functional decline and support health promotion among those with reduced function.
Effective start/end date1/15/2012/31/23


  • Duke University (A033130//5R01AG062502-02)
  • National Institute on Aging (A033130//5R01AG062502-02)


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