Socio-Demographic Determinants, Physical Health Status, and Depression Associated with Functional Limitations Among Older Chinese Adults

Abstract

Using data from a nationally representative sample of older Chinese adults, we aimed to explore the factors associated with functional limitations. We used a national sample of people aged 60 years or older collected as part of the China Health and Retirement Longitudinal Study (CHARLS) survey. Functional limitations, including physical functions, basic activities of daily living (BADLs), and instrumental ADL (IADLs) were evaluated using a functional limitation scale. The 10-item version of the Center for Epidemiological Studies Depression Scale (CES-D) was used to evaluate the presence of depressive symptoms. Compared with healthy controls, adults with functional limitations tended to be older; to be female; to have less education; to reside in rural areas; to be widowed; to have fewer earnings in the previous year; to have less coverage in medical insurance; and to have a greater number of comorbid chronic medical conditions, perceived pain, and depression (P < 0.05). Age was the only demographic risk factor for functional limitations (odds ratios [ORs] ranging from 1.05 to 1.10, P < 0.05). The presence of multiple chronic physical diseases (ORs ranging from 2.72 to 4.15, P < 0.05), perceived pain (ORs ranging from 2.49 to 3.26, P < 0.05), and depression (ORs ranging from 3.42 to 4.06, P < 0.05) consistently influenced physical, basic, and instrumental daily activities. When adjusted for socio-demographic factors, the associations among physical health status, pain, depression, and functional decline remained significant. In addition to age, multi-comorbidity involving chronic medical conditions, pain, and depression was associated with functional limitations among older Chinese adults.