Original article
The Boston Rehabilitative Impairment Study of the Elderly: A Description of Methods

https://doi.org/10.1016/j.apmr.2012.08.217Get rights and content

Abstract

Objectives

To describe the methods of a longitudinal cohort study among older adults with preclinical disability. The study aims to address the lack of evidence guiding mobility rehabilitation for older adults by identifying those impairments and impairment combinations that are most responsible for mobility decline and disability progression over 2 years of follow-up.

Design

Longitudinal cohort study.

Setting

Metropolitan-based health care system.

Participants

Community-dwelling primary care patients aged ≥65 years (N=430), with self-reported modification of mobility tasks because of underlying health conditions.

Interventions

Not applicable.

Main Outcome Measures

Late Life Function and Disability Instrument (LLFDI) (primary outcome); Short Physical Performance Battery and 400-m walk test (secondary outcomes).

Results

Among 7403 primary care patients identified as being potentially eligible for participation, 430 were enrolled. Participants have a mean age of 76.5 years, are 68% women, and have on average 4.2 chronic conditions. Mean LLFDI scores are 55.5 for Function and 68.9 and 52.3 for the Disability Limitation and Frequency domains, respectively.

Conclusions

Completion of our study aims will inform development of primary care–based rehabilitative strategies to prevent disability. Additionally, data generated in this investigation can also serve as a vital resource for ancillary studies addressing important questions in rehabilitative science relevant to geriatric care.

Section snippets

Study design

Boston RISE is a prospective cohort study based at Spaulding Rehabilitation Hospital (SRH) in Boston, Massachusetts. SRH is part of Partners HealthCare, a not-for-profit system of affiliated hospitals throughout eastern Massachusetts. The Boston RISE cohort includes 430 primary care patients 65 years and older. Recruitment was initiated in December 2009 and was completed in January 2012. Study operations are centralized at the SRH Cambridge site. All study procedures were approved by the

Results

Among the 7403 primary care patients identified, 5333 (72%) were approved by primary care providers to receive communication about the study (see fig 2). In total, 4495 people received recruitment letters, and 47 people contacted study staff independently after seeing recruitment materials in a primary care office or hearing about the study from a friend or family member. Study staff conducted phone screenings with 1349 people, of whom 712 (56%) were eligible for the final screening at the

Discussion

While a number of longitudinal cohort studies of older adults have examined functional decline and disability (InCHIANTI, Health Aging and Body Composition Study, Women’s Health and Aging Study, and MOBILIZE Boston), to the best of our knowledge ours is the first purposely designed around the context of rehabilitative care.5, 6, 7, 8, 9 The aim of this report is to demonstrate the feasibility of successfully developing this unique cohort study in order to facilitate replication for other

Conclusions

Boston RISE represents a unique investigation that will advance geriatric rehabilitative research. This clinically based methodological approach provides the opportunity to address important knowledge gaps in the care of older adults and allows the resulting findings to be readily applied within both rehabilitative and primary care settings. Additionally, it can serve as a template for other studies addressing important questions in aging and rehabilitation science.

Acknowledgments

We thank the staff of the Massachusetts General Hospital Clinical Research Center for their assistance with data collection.

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    Supported by the National Institute on Aging (grant no. 5 R01 AG032052-03) and the National Center for Research Resources in a grant to the Harvard Clinical and Translational Science Center (grant no. 1 UL1 RR025758-01).

    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.

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