Culture Matters in Assessment of Daily Activities: An example from Turkey in a large community sample

Abstract

AbstractBackgroundDemographic variables such as gender and age, within their own cultural context, might play a role in the instrumental activities of daily living (IADL). Functional evaluation of the elderly requires acknowledgement of the cultural context. In this study we aimed to determine the functional activities of cognitively normal Turkish elderly in a large community sample.Method1909 people over the age of 55, with no known diagnosis of neuropsychiatric/ developmental disorder, representing Turkey’s demographic structure were recruited. Modified Mini Mental State (3MS) was used as the cognitive assessment method. MMSE scores were estimated from 3MS. Participants with an MMSE score of over 25 and over 20 for educated and undereducated population respectively were determined as cognitively normal. Lawton‐Brody Instrumental Activities of Daily Living and Functional Activities Questionnaire were used to assess instrumental activities of daily living. Ordinal logistic regression analysis was used to assess the relation between the demographic variables and IADL.ResultThe data of 1503 individuals were assessed. 28.7% of the sample were over the age of 80, females comprised 52%, and 33.5% of the individuals were undereducated. Age, gender and education were asociated with IADL. Overall, individuals over 80 years of age were less independent in all instrumental acitivities. Regarding gender, male individuals were more independent on transportation, shopping, using phone, keeping track of current events and paying attention/discussing media, while females reported more independence on food preparation, housekeeping and laundry. The level of education was associated with dependence on phone use, shopping, travelling and finance, individuals with less than 5 years of education were significantly less independent on Transportation, shopping, using phone and finance management when compared with higher educated individuals.ConclusionThe activities of daily living differed at different age, gender and education levels in Turkish population. Our results displayed differences from previous studies representing various cultures. The assessment of functional activities of daily living requires appreciation of the cultural context.