Abstract
BackgroundThe prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. The present study investigated the epidemiology of physical disability and functional limitation among older people in Malaysia and compares findings to other countries.MethodsA population-based cross sectional study was conducted in Alor Gajah, Malacca. Seven hundred and sixty five older people aged 60 years and above underwent tests of functional limitation (Tinetti Performance Oriented Mobility Assessment Tool). Data were also collected for self reported activities of daily living (ADL) using the Barthel Index (ten items). To compare prevalence with other studies, ADL disability was also defined using six basic ADL's (eating, bathing, dressing, transferring, toileting and walking) and five basic ADL's (eating, bathing, dressing, transferring and toileting).ResultsTen, six and five basic ADL disability was reported by 24.7% (95% CI 21.6-27.9), 14.4% (95% CI 11.9-17.2) and 10.6% (95% CI 8.5-13.1), respectively. Functional limitation was found in 19.5% (95% CI 16.8-22.5) of participants. Variables independently associated with 10 item ADL disability physical disability, were advanced age (≥ 75 years: prevalence ratio (PR) 7.9; 95% CI 4.8-12.9), presence of diabetes (PR 1.8; 95% CI 1.4-2.3), stroke (PR 1.5; 95% CI 1.1-2.2), depressive symptomology (PR 1.3; 95% CI 1.1-1.8) and visual impairment (blind: PR 2.0; 95% CI 1.1-3.6). Advancing age (≥ 75 years: PR 3.0; 95% CI 1.7-5.2) being female (PR 2.7; 95% CI 1.2-6.1), presence of arthritis (PR 1.6; 95% CI 1.2-2.1) and depressive symptomology (PR 2.0; 95% CI 1.5-2.7) were significantly associated with functional limitation.ConclusionsThe prevalence of physical disability and functional limitation among older Malaysians appears to be much higher than in developed countries but is comparable to developing countries. Associations with socio-demographic and other health related variables were consistent with other studies.
Highlights
The prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia
Even though significant progress has been made in establishing an extensive health care delivery system for Malaysian rural population, the recent National Health and Morbidity Survey III in 2006 revealed that prevalence of hypertension, hypercholesterolemia, being underweight and smoking is much higher among the rural population than their urban counterparts[3]
Significant independent associations for physical disability were found for advanced age, (≥ 75 years: prevalence ratio (PR) 7.9; 95% CI 4.8-12.9), presence of diabetes (PR 1.8; 95% CI 1.4-2.3), presence of stroke (PR 1.5; 95% CI 1.1-2.2), having depressive symptomology
Summary
The prevalence and correlates of physical disability and functional limitation among older people have been studied in many developed countries but not in a middle income country such as Malaysia. In 2000, 8% of Malaysian rural population comprised older people age 60 years and above as compared to only 5% in the urban population[2]. Even though significant progress has been made in establishing an extensive health care delivery system for Malaysian rural population, the recent National Health and Morbidity Survey III in 2006 revealed that prevalence of hypertension, hypercholesterolemia, being underweight and smoking is much higher among the rural population than their urban counterparts[3]. A World Health Organization (WHO) study revealed that Malaysian elderly residing in rural areas experienced greater financial hardship and express more need for health services than those in urban areas[4]
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