Relationship of Gait Speed and Sedentary Behavior with Instrumental Activities of Daily Living in Older People using a Daycare Center in Japan

BackgroundQuality of life is an important health outcome for older persons. It predicts the adverse outcomes of institutionalization and premature death. The aim of this cross-sectional study was to determine the influence of both disability in activities of daily living (ADL) and instrumental activities of daily living (IADL) on physical and mental dimensions of quality of life.MethodsA total of 377 Dutch people aged 75 years and older completed a web-based questionnaire. This questionnaire contained the Groningen Activity Restriction Scale (GARS) for measuring ADL and IADL and the Short-Form Health Survey (SF-12) for measuring quality of life. The SF-12 distinguishes two dimensions of quality of life, a physical and mental dimension.ResultsAll ADL disability items combined and all IADL disability items combined explained a significant part of the variance of the physical and the mental dimension of quality of life. Only ADL item “stand up from sitting in a chair”, and IADL items “do “heavy” household activities” and “do the shopping” were negatively associated with both quality of life dimensions after controlling for all the variables in the model.DiscussionThis study showed that disability in ADL and IADL is negatively associated with quality of life in older people. Therefore, it is important for health care professionals to carry out interventions aimed to prevent and diminish disability or the adverse outcomes of disability such as a lower quality of life. In order to be effective these interventions should be inexpensive, feasible, and easy to implement.

During the life cycle of human beings, various evolutionary processes take place in a constant and irreversible way, aging is characterized by a progressive loss of functionality and adaptability; this process involves functional changes and a greater degree of dependence, gradually affecting their health and performance of daily activities, leaving a negative impact in the lives of older people. Objective: Evaluate the dependence level in basic and instrumental activities of daily living in older adults. Materials and Methods: A descriptive, cross-sectional study with a quantitative approach and simple random sampling, the sample size consisted of 84 older adults, residents of Tepic Nayarit. Mexico. The Katz Index instruments were used to assess the functional dependence of the basic activities of daily living and the Lawton-Brody Instrumental Activities of Daily Living (IADL) scale to measure the level of independence in the instrumental activities of daily living. Results: The mean age of older adults was 74.58 ± 12.4 years. In regards to gender, 58% were female and 42% were male. The dependency classification according to the Katz index for basic activities of daily living determined that 50% had a significant prevalence of mild disability, 35.72% had moderate disability and 14.28% had severe disability. The Lawton-Brody (IADL) scale contributed evaluating the dependence level in instrumental activities of daily living, the results showed that 17% of older adults were independent, 21% had mild dependence, 25% had moderate dependence, 29% had severe dependence, and 5.9% had total dependence. Conclusions: The level of dependence is related to the health and age of persons and they are a constraint to be self-sufficient in managing the care they require daily, therefore, it is important to carry out interventions to promote independence and functionality in older adults.

An increasingly aging population, accompanied by a shortage of residential aged care homes and workforce and consumer feedback, has driven a growing interest in enabling older people to age in place through home-based care. In this context, smart home technologies for remote health monitoring have gained popularity for supporting older people to live in their own homes. This study aims to investigate the impact of smart home monitoring on multiple outcomes, including quality of life, activities of daily living, and depressive symptoms among older people living in their own homes over a 12-month period. We conducted an open-label, parallel-group randomized controlled trial. The control group continued to receive their existing care from aged care service providers. Meanwhile, the intervention group, in addition to receiving their usual aged care services, had their activities of daily living monitored using a smart home platform. Surveys including the Adult Social Care Outcomes Toolkit (ASCOT), EuroQol-5 Dimensions-5 Levels (EQ-5D-5L), Katz Index of Independence in Activities of Daily Living (Katz ADL), Lawton Instrumental Activities of Daily Living Scale (IADL), and Geriatric Depression Scale (GDS) were conducted at baseline and 6 and 12 months from baseline. Linear mixed-effects models were used to compare the difference between the intervention and control groups, with the ASCOT as the primary outcome measure. Data from 130 participants were used in the analysis, with no significant differences in baseline characteristics between the control group (n=61) and the intervention group (n=69). In comparison to the control group, the intervention group had a higher ASCOT score at the 6-month assessment (mean difference 0.045, 95% CI 0.001 to 0.089; Cohen d=0.377). However, this difference did not persist at the 12-month assessment (mean difference 0.031, 95% CI -0.014 to 0.076; Cohen d=0.259). There were no significant differences in EQ-5D-5L, Katz ADL, IADL, and GDS observed between the intervention and control groups at the 6-month and 12-month assessments. The study demonstrates that smart home monitoring can improve social care-related quality of life for older people living in their own homes. However, the improvement was not sustained over the long term. The lack of statistically significant findings and diminished long-term improvements may be attributed to the influence of the COVID-19 pandemic during the later stage of the trial. Further research with a larger sample size is needed to evaluate the effect of smart home monitoring on broader quality-of-life measures. Australian New Zealand Clinical Trials Registry ACTRN12618000829213; https://tinyurl.com/2n6a75em. RR2-10.2196/31970.

Objective: To identify the prevalence and factors associated with functional disability for Instrumental Activities of Daily Living (IADL) among older people in a Brazilian capital. Methods: This is a cross-sectional study carried out on 927 older people in the city of Goiânia, Goiás, Brazil. Lawton’s scale was used to assess IADL. Functional disability was characterized as difficulty in performing at least one activity. Multiple logistic regression was employed for the analysis of association. Results: A 58.2% prevalence of disability was identified, and the most compromised activities were doing manual work, doing the laundry, and ironing. There was an association between disability and old age, poor/very poor self-rated health, cerebrovascular accident, widowhood, cognitive impairment, musculoskeletal disorder, and living alone. Conclusions: The prevalence of functional disability for IADL was higher than that of national and international studies. We verified associated factors that can be modified by health promotion initiatives, which are configured as priority areas for interventions.

This study investigated the efficacy of donepezil treatment on activities of daily living (ADLs) and social functioning in patients with moderate to severe Alzheimer's disease (AD) and the possible benefits of this treatment on caregiving time and stress levels. Randomized, double-blind, placebo-controlled, multinational study. Patients resided in the community or in assisted living facilities who did not require skilled 24-hour nursing care. Two hundred ninety patients with moderate to severe AD (baseline standardized Mini-Mental State Examination score of 5-17). Donepezil (5 mg/d for 4 weeks and 10 mg/d per clinician's judgment thereafter) or placebo for 24 weeks. ADLs were assessed using the Disability Assessment for Dementia (DAD), the modified instrumental activities of daily living (IADL) scale (IADL+), and the modified Physical Self Maintenance Scale (PSMS+). Caregiver time spent assisting patients with basic and instrumental ADLs was recorded as part of the IADL+ and PSMS+ scales. Patients' social behavior was evaluated through the use of a caregiver diary that captured observations of patients' motivation, interactions, and engagement. Caregivers were evaluated for their levels of caregiver stress with a modified, multiple-item Caregiver Stress Scale (CSS). For each outcome measure, the mean change from baseline at Week 24 using a last observation carried forward (LOCF) analysis was calculated. IADL+ and PSMS+ mean change from baseline scores for donepezil-treated patients showed a slower decline during the study than placebo-treated patients (Week 24 LOCF mean treatment differences: IADL+ = 6.83, P <.0001; PSMS+ = 1.32, P =.0015). Significant differences between the groups in favor of donepezil were observed on the DAD for instrumental and basic ADLs and on the three components required for the completion of each ADL: initiation, planning and organization, and effective performance. At baseline, caregivers of patients treated with donepezil (n = 141) did not differ significantly from caregivers of patients treated with placebo (n = 146) with respect to demographics or mean total scores on the CSS. At Week 24 LOCF, the overall distribution of caregiver ratings on each of the three caregiver diary items favored donepezil-treated patients over placebo-treated patients (P <.005). At Week 24 LOCF, mean change from baseline scores for CSS total and individual domain scores (all domains except caregiving competence, personal gain, and management of distress) were better for caregivers of donepezil-treated patients than for those of placebo-treated patients (CSS total, mean treatment difference = 1.82). Caregivers of donepezil-treated patients reported spending less time assisting with ADLs than caregivers of placebo-treated patients (mean difference = 52.4 min/d). Donepezil demonstrated a significantly slower decline than placebo in instrumental and basic ADLs in these patients with moderate to severe AD. The ADL benefits in AD patients treated with donepezil were associated with less caregiving time and lower levels of caregiver stress.

Introduction: Population aging and increasing long-term care needs call for designing and implementing better tools for assessing functional ability. In Chile, the Lawton and Brody (L&B) scale is used for identifying limitations with instrumental activities. This study compared the costs and acceptability of the L&B with a new instrument to measure instrumental activities of daily living (IADL): the Instrument for the Assessment of Functionality Stages (Instrumento de Evaluación de Estadios de Funcionalidad; IDEEF). Methods: Phone surveys were carried out to apply the L&B and the IDEEF to a sample of 200 older people (60+) participating in public programs for older people in the Metropolitan Region, Chile. Besides the items assessed by each scale, the survey captured completion times and included a short questionnaire on acceptability, data that allowed comparisons between instruments. Results: On average, the L&B takes around 4 min to be applied; the completion times for the IDEEF are 4 times longer. However, the IDEEF performs better in terms of acceptability and has neither gender bias nor dependency bias. Conclusion: Both instruments have pros and cons, but the IDEEF appears as a feasible alternative to the L&B to improve the assessment of IADL in the country.

Introduction: Chronic pain in older people is a global health problem not only in terms of a negative subjective feeling, but also as a social and economic factor. Deterioration of functional capacity is one of the main symptoms of chronic pain; therefore, it should be assessed as a basic parameter in the life of older people. The aim of the study was to analyze the factors which have an impact on the functional capacity of older people with chronic pain. Material and methods: The study was conducted among 181 people over 65 suffering from chronic pain lasting more than 6 months. The study used a questionnaire that included questions about demographic and social characteristics and the following scales: Abbreviated Mental Score (AMTS), Personal Activities of Daily Living (PADL) by Katz, Instrumental Activities of Daily Living (IADL) by Lawton, Geriatric Pain Measure-24 (GPM-24). Results: In the study group, a positive correlation was found between: coexisting diseases and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A positive correlation was also found between the Geriatric Depression Scale (GDS) and withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of the total GPM-24 score. A significantly negative correlation was found between: AMTS, ADL, IADL performance and: withdrawal due to pain, pain intensity, pain resulting from walking or from the effort from other activities, and in terms of total GPM-24 score. Conclusions: Chronic pain is more common in people with disabilities in basic and complex activities of daily living, with limited efficiency in cognitive functions and an increased sense of depression. The standard in everyday practice and clinical trials should be taking a history of chronic pain in every older person, monitoring the pain’s intensity and accompanying characteristics by using a multidimensional scale for assessing pain in older people.

BackgroundActivities of Daily Living (ADL) are crucial for assessing older adult’s ability to live independently. Physical exercise has a positive impact on ADL. During the COVID-19 pandemic, the reduction of social interaction and the limited use of exercise facilities led some older adults to reduce regular exercise and show more sedentary behavior. This study aimed to examine the influence of physical exercise on the Activities of Daily Living (ADL) among older adults during the COVID-19 pandemic.MethodsUsing the China Longitudinal Aging Social Survey (CLASS) data, propensity score matching (PSM) was performed on the sample, with the interaction between participation in physical exercise and observation year as the core independent variables, and instrumental activities of daily life (IADL) and basic activities of daily life (BADL) as the dependent variables for difference-in-differences (DID) regression analysis. Verify age heterogeneity through grouped regression, and use mediation effect analysis to examine the role of retirement.ResultsIn the context of COVID-19, participation in physical exercise had a positive impact on the IADL and BADL of older adults. The IADL and BADL of older adults who participated in physical exercise were 0.189 and 0.119 units higher than those who did not participate in physical exercise. This positive impact also varied by age, for older adults aged 75 years and above, participation in physical exercise exerted a significant positive impact on both IADL and BADL. In contrast, among those under 75 years of age, no significant effects of physical exercise on IADL or BADL were detected. The analysis further revealed retirement status emerged as a significant masking variable that amplifies observed differences in ADL outcomes when controlled analytically.ConclusionDuring the pandemic, physical exercise still has a positive impact on the IADL and BADL of the older adults. The older adults aged 75 and above are more reliant on physical exercise to improve their IADL and BADL. Due to the survivor effect, the relative negative effect of retirement on the IADL and BADL of the older adults who engage in physical exercise is more pronounced.

Up to 60% of older adults have a lifestyle characterized by low physical activity (PA) and high sedentary behavior (SB). This can amplify age-related declines in physical and cognitive functions and may therefore affect the ability to complete basic and instrumental activities of daily living (ADL and IADL, respectively), which are essential for independence. This systematic review aims to describe the association of objectively measured PA and SB with ADL and IADL in community-dwelling older adults. Six databases (PubMed, Embase, the Cochrane library, CINAHL, PsychINFO, SPORTDiscuss) were searched from inception to 21/06/2020 for articles meeting our eligibility criteria: 1) observational or experimental study, 2) participants’ mean/median age ≥60 years, 3) community-dwelling older adults, 4) PA and SB were measured with a(n) accelerometer/pedometer, 5) PA and SB were studied in relation to ADL and/or IADL. Risk of bias was assessed in duplicate using modified versions of the Newcastle–Ottawa scale. Effect direction heat maps provided an overview of associations and standardized regression coefficients (βs) were depicted in albatross plots. Thirty articles (6 longitudinal; 24 cross-sectional) were included representing 24,959 (range: 23 to 2749) community-dwelling older adults with mean/median age ranging from 60.0 to 92.3 years (54.6% female). Higher PA and lower SB were associated with better ability to complete ADL and IADL in all longitudinal studies and overall results of cross-sectional studies supported these associations, which underscores the importance of an active lifestyle. The median [interquartile range] of βs for associations of PA/SB with ADL and IADL were, respectively, 0.145 [0.072, 0.280] and 0.135 [0.093, 0.211]. Our strategy to address confounding may have suppressed the true relationship of PA and SB with ADL or IADL because of over-adjustment in some included studies. Future research should aim for standardization in PA and SB assessment to unravel dose–response relationships and inform guidelines.

Background Functional abilities start to decelerate after the age of 70 and causes need for assistance to do their basic activities of daily living (BADL) as well as instrumental activities of daily living (IADL).&#x0D; Objective To find out the functional status of senior citizens of a Metropolitan city in Morang.&#x0D; Method A descriptive cross-sectional study was carried out at Biratnagar Metropolitan City among 254 senior citizens receiving old age allowance using cluster sampling technique. Data were collected through face to face interview and measuring height and weight by researcher herself for the period of four weeks. Basic activities of daily living and instrumental activities of daily living were assessed using Katz Index of Basic Activities of Daily Living and Lawton Instrumental Activities of Daily Living tool with some modifications. Chi square test was used to assess the association between variables.&#x0D; Result About 48.4% and 90.6% of senior citizens had dependency in Basic Activities of Daily Living and Lawton Instrumental Activities of Daily Living respectively. The most common dependency for Basic Activities of Daily Living and Instrumental Activities of Daily Living was control of urination and defecation (31.9%) and using telephones (75.2%) respectively. Basic activities of daily living was significantly associated with age (p=0.0017), sex (p=0.013), literacy status (p=0.001), years of smoking (p=0.0029), social participation (0.0029) and history of fall within 1 year (p=0.038). Likewise Instrumental Activities of Daily Living was significantly associated with age (p=0.03), sex (p=0.035), literacy status (p=0.002), exercise (p=0.033) and social participation (p= 0.001).&#x0D; Conclusion It is concluded that about half of the senior citizens are dependent in Basic Activities of Daily Living and almost all of them are dependent in Instrumental Activities of Daily Living. So senior citizen clubs/ groups are suggested to be strengthened which may be effective in promoting independence, extending an active and healthy ageing.

ObjectivesHandgrip strength (HGS) and muscle mass are strong predictors for dependency in Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL) in community dwelling older adults. Whether this also applies to older hospitalized patients is yet unknown. We studied the association between HGS and muscle mass with ADL and IADL dependency at admission and change of ADL and IADL dependency at three months after discharge in older hospitalized patients.DesignObservational longitudinal inception cohort (EMPOWER) including 378 patients aged 70 years and older.SettingFour different clinical wards of a university teaching hospital, The Netherlands.MeasurementsHGS and muscle mass were measured within 48 hours after admission using hand dynamometry and Bio-electrical Impedance Analysis respectively. ADL dependency was assessed using the Katz score (0-6 points) and IADL dependency using the Lawton and Brody score (0-8 points) within 48 hours after admission and three months after discharge.ResultsAt admission, lower HGS was associated with ADL dependency in both males and females. Lower muscle mass was associated with ADL dependency in males. Lower HGS was associated with IADL dependency, but only in males. Lower HGS at admission in males was associated with an increase in ADL dependency three months after discharge.ConclusionIn hospitalized older patients, HGS is associated with ADL and IADL and muscle mass measures with ADL in male patients only. HGS should be explored as predictive marker for outcome of hospitalized older patients after discharge.

To the Editor: Apolipoprotein E (APOE) gene is one of the genes with a huge impact on longevity and successful aging. The APOE polymorphism has been associated with lipid or cognitive disorders, which may result in cardiovascular disease or Alzheimer’s disease.1 In older adults, stroke and cognitive impairment are all risk factors for physical disability. Thus more researches have been conducted to examine whether the APOE genotype is independently associated with physical limitations in the older population. While these studies 2–5 do improve our knowledge on the relationship between APOE gene and physical function in older adults, no attention has been paid to investigating the role of this gene in the development of functional decline at different stages. The progressive decline of physical function in older adults usually begins with the limitation of mobility function, continues to deteriorate into difficulty in coping with complex household works, and finally results in inability to complete self-care tasks.6 We conducted a prospective nested case-control study of genetic variation in the APOE gene and risk of deterioration in physical functioning in Taiwan, with a particular interest in the transitions of mobility, Instrumental Activities of Daily Living (IADL), and Activities of Daily Living (ADL) decline. Samples were from 924 study participants of the Social Environment and Biomarkers of Aging Study (SEBAS) in 2000.7 SEBAS included an in-home interview and a physical examination at the hospital. The in-home interview collected information on self-reports of physical limitations, demographic and social variables, and cognitive measures. Mobility includes 9 tasks involving general mobility function of upper and lower extremities. IADL covers six tasks involving living environment. ADL incorporates six personal care tasks. Mobility decline was defined as having no difficulty in all 21 tasks in 2000 but experiencing difficulty in at least one of the 9 mobility tasks in 2003. IADL decline was defined as having difficulty in at least one mobility task but no difficulty in all ADL and IADL tasks in 2000, but experiencing difficulty in at least one mobility and one IADL task but no difficulty in all ADL tasks in 2003. ADL decline was defined as having difficulty in at least one mobility and one IADL task but no difficulty in all ADL tasks in 2000, and experiencing difficulty in at least one mobility, one IADL, and one ADL task in 2003. The APOE genotyping was conducted using DNA extract obtained from whole blood. During the three years of follow-up, there were 91, 79, and 35 participants identified as having mobility, IADL, and ADL decline, respectively. For each subject with mobility, IADL, or ADL decline, one control subject without the specific decline was matched for age and sex. For example, one subject with only mobility difficulty in both the 2000 and the 2003 interviews was age- and sex- matched to the subject with IADL decline. Odds ratios (ORs) for subjects carrying e2 or e4 allele were estimated using conditional logistic regression adjusting for risk factors relevant to functional decline,8,9 including body mass index (BMI), heart disease, stroke, arthritis, cognitive impairment, and physical activity. Updated information of these covariates obtained from the 2003 interview was used in the adjusted models. Because physical function of cases at baseline had not deteriorated, the prevalence of disability-related diseases and factors including BMI, cognitive impairment, and physical activity was similar and tested without statistically significant differences between cases and controls. The distribution of all sixAPOE genotypes (e2/e2, e2/e3, e2/e4, e3/e3, e3/e4, and e4/e4) and frequencies of the three APOE alleles (e2, e3, and e4) were statistically insignificant between cases with controls for all three groups. Table 1 shows the risks of developing mobility, IADL, or ADL limitations for older adults with the e2 or e4 allele. The presence of APOEe2 or e4 allele was not related to the declines of physical functioning. Table 1 Associations between APOE alleles and risk of mobility, IADL, or ADL decline This lack of association is in agreement with findings from three similar studies using ADL tasks, 3 a mobility task only, 10 or a combination of mobility, IADL, and ADL as the measures of physical limitations. 4 The e4 allele has been linked with decreased longevity through developing cognitive impairment and cardiovascular disease, whereas the e2 allele increases longevity and promotes successful aging. 1 Although APOE plays an important role in aging process, both e2 and e4 alleles, based on our study results, do not have a direct link with the decline of physical function at different stages. It is possible that APOE may affect physical function indirectly through cognitive impairment and cardiovascular disease, and the association disappears when cardiovascular disease and cognitive function are all considered.

ObjectiveImpaired Activities of Daily Living (ADL) can have a negative impact on the psychological well-being of older adults. This study categorises ADL into Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL). By utilising nationally representative cross-sectional data, we explore the association between ADL and BADL limitations and depressive symptoms among the elderly population in China. In addition, this study explored the relationships between BADL, IADL and depression risk in elderly people at the individual and provincial levels and in rural and urban subgroups.MethodsThe China Health and Retirement Longitudinal Study(CHARLS) survey used a multistage probability‒proportional‒to-size (PPS) sampling technique. Province-level socioeconomic characteristics were merged with microdata for respondents over 60 years of age from the 2020 China Health and Retirement Longitudinal Study (CHARLS 2020) Wave 5 (n = 10,036) by the author. The respondents were asked whether their BADL and IADL were limited. The risk of depression was assessed using the 10-item Centre for Epidemiological Studies Depression Scale (CES-D 10). The chi-squared test was used to explore whether having a disability that limits BADL and IADL was associated with mental health status. A binary logistic regression model was used to evaluate this association further after controlling for confounding factors.ResultsOverall, 27.5% (2759/10036) and 25.7% (2776/10036) of the participants over 60 years of age were limited in their BADL and IADL, respectively. Regression analyses revealed that older adults whose BADL were not limited (OR = 1.942, 95% CI: 1.638–2.303, P <.001) and whose IADL were not limited (OR = 1.775, 95% CI: 1.485–2.122, P <.001) had a lower risk of depression than older adults whose BADL and IADL were limited. In addition, older adults who were female (P <.001), were 60–69 years (P <.005), had a partner (P <.001), were literate (P <.001), lived in a rural area (P <.001), had a retirement pension (P <.001), had three or more children (P <.001), did not have any chronic diseases (P <.001), had a fair SRH score (P <.001), drank alcohol (P <.001), exercised (P <.005), did not participate in social activities (P <.001), or had an above average per capita household consumption (P <.001) lived in provinces with the first quartile of GDP per capita (P <.001) and lived in provinces with the second quartile of the number of beds in medical institutions per 10,000 persons (P <.001) were more likely to experience depressive symptoms, while smoking had no effect. In a binary logistic regression, older adults who were single (OR = 0.669, 95% CI = 0.551, 0.812), illiterate (OR = 0.646, 95% CI = 0.504, 0.828), living in rural areas (OR = 1.485, 95% CI = 1.270, 1.735), without retirement pensions (OR = 0.671, 95% CI = 0.582, 0.819) and with very bad SRH scores (OR = 0.411, 95% CI = 0.311, 0.544) had a greater risk of depressive symptoms. In the binary logistic regression analysis of the urban and rural subgroups separately, the results indicated that old people whose BADL or IADL were not limited were associated with a risk of depression, especially rural (P <.001) and urban (P <.001) participants.ConclusionsThe present study provides evidence of an association between BADL, IADL and depression in older Chinese adults. This study revealed that individuals with limited BADL and limited IADL were predominantly depressed older adults. Binary logistic regression models suggested that disabilities limiting BADL and IADL were more likely to be associated with depressive symptoms in rural Chinese older adults. Findings underscore the need for targeted rural interventions (e.g., subsidised mobility aids and caregiver training) to mitigate depression risk.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40359-025-03223-9.

BackgroundStudies have examined functional disability among older adults by combining Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). This study adds another dimension to ADL and IADL by combining various impairments such as hearing, vision, walking, chewing, speaking, and memory loss among older adults. This study examines functional disability among older adults in India as measured by ADL, IADL, along with various impairments.MethodsThis study utilized data from Building a Knowledge Base on Population Aging in India (BKPAI), a national-level survey and conducted across seven states of India. The study utilized three outcome variables, namely, ADL, IADL, and Impairments. Descriptive and bivariate analyses were used along with multivariate analysis to fulfil the objectives of the study. The concentration index was calculated for ADL, IADL, and impairments, and further, decomposition analysis was carried out for IADL.ResultsThe results observed that nearly 7.5% of older adults were not fully independent for ADL. More than half (56.8%) were not fully independent for IADL, and nearly three-fourths (72.6%) reported impairments. Overall, ADL, IADL, and impairments were higher among older adult’s aged 80+ years, older adults with poor self-rated health, and those suffering from chronic diseases. The likelihood of ADL (AOR = 6.42, 95% CI: 5.1–8.08), IADL (AOR = 5.08, 95% CI: 4.16–6.21), and impairment (AOR = 3.50, 95% CI: 2.73–4.48) were significantly higher among older adults aged 80+ years compared to 60–69 years. Furthermore, older adults who had poor self-rated health and suffered from chronic diseases were more likely to report ADL (AOR = 2.95, 95% CI: 2.37–3.67 and AOR = 2.70, 95% CI: 2.13–3.43), IADL (AOR = 1.74, 95% CI: 1.57–1.92 and AOR = 1.15, 95% CI: 1.04–1.15), and impairment (AOR = 2.36, 95% CI: 2.11–2.63 and AOR = 2.95, 95% CI: 2.65–3.30), respectively compared to their counterparts. Educational status and wealth explained most of the socio-economic inequality in the prevalence of IADL among older adults.ConclusionIt is recommended that the government advise older adults to adopt health-promoting approaches, which may be helpful. Further, there is a pressing need to deliver quality care to older adults suffering from chronic conditions.

Background: Vietnam currently has a rapidly aging population, while formal social protection has only covered a small fraction of older people. Therefore, many older people with insufficient income or poor health must rely on their children's support.Method: This study uses the Vietnam National Aging Survey 2011 to determine whether the quality of children's education/employment and the number of children in a family impact older people's life satisfaction and health.Results: We find that the number of children has no effect on parents' life satisfaction but is adversely related to parents' health across a range of physical and mental health measures. In contrast, children's education has beneficial impacts on the well-being of elderly parents. Parents with better-educated children are more satisfied with their lives and report better health and fewer illness issues. Among other factors, income and wealth are strong and consistent predictors of older people's life satisfaction and self-perceived physical and mental health.Conclusion: To the best of our knowledge, this is the first study to explore the relationship between quantity and quality of children and the well-being of elderly parents. Our results show that the number of children has an adverse effect on older people's self-reported health and life satisfaction in Vietnam. Meanwhile, parental health and life satisfaction are significantly related to children's education. The findings of this study provide several practical implications. Most importantly, investment in education for children will have long-lasting impacts on the health and well-being of elderly adults. In addition, our paper indicates that the government program for reducing fertility has contributed to the longer-term health of people.