Abstract
BackgroundsLittle is known about the role of frailty in the recovery process of disability among older adults. We examined the association between frailty and recovery from activities of daily living (ADL) and instrumental ADL (IADL) disability among community-dwelling Chinese older adults.MethodsData were from the China Health and Retirement Longitudinal Study. Three waves were used. Participants ≥60 years, had frailty assessment at baseline, and had incident disability in ADL or IADL in 2013, and had disability assessment in 2015 were included. Recovery from ADL and IADL disability were used as outcome measure. Multivariable logistic regression was used to evaluate the potential association between frailty and recovery from ADL or IADL.ResultsWe included 516 and 598 participants in the ADL and IADL analysis, respectively. In total, 237 participants recovered from ADL disability and 293 recovered from IADL disability. Nearly half of the non-frail persons recovered from ADL disability, while less than one-quarter of the frail persons had recovery. Over half of the non-frail persons had IADL disability recovery, while only 30% of the frail recovered. After adjustment, the odds of recovery from ADL disability were 59% (95% confidence interval [CI]: 1, 83%) lower among frail participants than those who were non-frail; the odds of recovery from IADL disability were 52% lower among frail persons than those who were non-frail and the association did not reach statistical significance.ConclusionsFrailty is an independent predictor of poor recovery from disability among nondisabled community-dwelling older adults in China.
Highlights
The prevalence of disability in activities of daily living (ADLs) and instrumental ADL (IADLs) has declined during the past several decades in China [1,2,3]
We examined the association between frailty and recovery from ADL and IADL disability among community-dwelling Chinese older adults without pre-existing disability from the China Health and Retirement Longitudinal Study (CHARLS)
The distribution of sociodemographic, lifestyle, and health characteristics was similar among persons included in the IADL analysis
Summary
The prevalence of disability in activities of daily living (ADLs) and instrumental ADL (IADLs) has declined during the past several decades in China [1,2,3]. ADL includes basic and core self-care tasks (e.g., eating, dressing, bathing), while IADL represents more complicated and higher-level tasks that are necessary for independently adapting to the living environment (e.g., cooking, shopping, taking medication) [17, 18]. Both theory and empirical evidence suggest a hierarchical relationship between IADL and ADL, with older persons first declining in IADL function [19]. Identification of factors associated with IADL recovery is critical for designing effective interventions in the early stage of the recovery process among the disabled persons
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