Abstract
BackgroundNo previous study has evaluated disability in older persons according to the International Classification of Functioning, Disability and Health Framework guidelines. We conducted a more comprehensive investigation of disability and associated factors among older adults receiving home-based care in rural Dongguan, a city in the central Guangdong Province of Southern China.MethodsA total of 819 individuals aged ≥60 years were recruited from Dongguan home-based care system of via a two-stage selection process. We interviewed participants and assessed their ability level using the Ability Assessment for Older Adults, which defined by a combination of activity of daily living, sensory perception, mental status and social involvement. Conditional probability and Logistic regression approaches were used to assess the strength of association between each pair of conditions. Factors significantly associated with disability were identified via χ2 tests and multinomial ordinal logistic regression.ResultsOf the 819 included participants (mean age 87 ±4.7 years), 75.5% were female, 76.7% had any disability, and 62.3% had a mild disability. The occurrence of any deficits significantly increased the likelihood of the co-occurrence of other deficits (odds ratio [OR] > 1, P < 0.05), with the lowest prevalence odds ratio observed among individuals with sensory and communication deficiency (OR: 2.99; 95% confidence interval [CI]: 2.21–4.05). Multivariable ordinal logistic regression analysis indicated that physical activity (OR: 0.96; 95% CI: 0.93–0.99), sedentary behavior (OR: 1.25; 95% CI: 1.13–1.38), not watching television (OR: 1.7; 95% CI: 1.07–2.72) and age (OR: 1.09; 95% CI: 1.02–1.17) were significantly associated with disability.ConclusionsImpairment of ADL, sensory perception, mental status or social involvement increased the likelihood of risk of the co-occurrence of other deficits. Comprehensive disability among older adults receiving home-based care is associated with age, sedentariness, physical activity and TV viewing.
Highlights
No previous study has evaluated disability in older persons according to the International Classification of Functioning, Disability and Health Framework guidelines
The provision of home-based care for older citizens is a public service in China that is delivered by social workers and includes provision of care to older adults who live alone, who are unable to care for themselves or who are aged 80 years or older
We evaluated the mental status of participants by Mini-Cog assessment [19], in combination with aggressive behavior and depressive symptoms
Summary
No previous study has evaluated disability in older persons according to the International Classification of Functioning, Disability and Health Framework guidelines. A growing incidence of chronic disease and functional impairment places increased demands on home-based care services for the older adults [2, 3]. As stated by the World Health Organization (WHO), disability is an umbrella term that considers impairment and limitations in activity and in participation [6], all of which are associated with a reduction in the QOL of older adults [7, 8]. A recent systematic review concluded that no study has evaluated the disability through a questionnaire covered all essential dimensions proposed by International Classification of Functioning, Disability, and Health framework [9]. What we seriously lack is more comprehensive data about disability covering impairments, activity limitations, and participation restrictions
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