Predictors of ADL Disability in Culturally Diverse Older Adults

Abstract

Almost 42% of adults over 65 years of age live with at least one disability. Further, people of lower socioeconomic status and Blacks have greater risks for disability than individuals of higher socioeconomic status and Whites. The consequences of disability include loss of independence and institutionalization, among others. PURPOSE: To utilize the disablement process framework to examine the contribution of physical function, dyspnea, and pain to disability in activities-of-daily-living (ADL) in culturally diverse older adults. METHODS: Participants were 51 older adults (M age = 69.0 years, SD = 9.7) from an urban community center and an independent living housing facility for seniors with fixed incomes. Participants completed the Functional Status Index (FSI), the Continuous Scale Physical Functional Performance 10-item Test (CS-PFP10), and an analog dyspnea scale. RESULTS: The first hierarchical regression revealed that facility (β = −.37, p < .01) explained 13.4% of the variance in disability (FSIA). The addition of physical function (CS-PFP10 total score) explained another 19.5% of the variance in disability and it was the only significant predictor (β = −.49, p < .001). Finally, the addition of pain (FSIP) and dyspnea accounted for another 50.5% of the explained variance and pain (β = .43, p < .001) and physical function (β = −.39, p < .01) were the only significant predictors of disability. CONCLUSIONS: Overall, the disablement process model provides a valuable conceptual framework to the progression of disability in a sample of high-risk population. Based on these results, dyspnea is important for understanding physical function, and physical function and pain are crucial stages in the progression of disability.