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Warning Signs along the Road to Functional Dependency

David B. Reuben, MD
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University of California, Los Angeles; Los Angeles, CA 90095-1687 Requests for Reprints: David B. Reuben, MD, Multicampus Program in Geriatric Medicine and Gerontology, University of California, Los Angeles, 10945 Le Conte Avenue, Los Angeles, CA 90095-1687.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1998;128(2):138-139. doi:10.7326/0003-4819-128-2-199801150-00010
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In the general community-dwelling population of older persons, dependence in basic self-care tasks, the “activities of daily living” (ADL), is uncommon. According to most studies, fewer than 10% of these persons need assistance with such tasks as bathing, dressing, transferring from bed to chair, feeding, grooming, and using a toilet [1]. Nevertheless, older persons with such functional dependency incur high health care costs [2]. Older persons with ADL dependency are also costly to society in other respects; for example, they place a burden on their families, who must use personal resources and often relinquish other responsibilities to care for them.

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