Abstract
BackgroundRecovery from functionally disabled status is an important target of public health measures for older adults. This study aimed to examine socioeconomic inequalities in the improvement of functional ability among older adults stratified by the level of disability at baseline.MethodsIn the Japan Gerontological Evaluation Study, we conducted a mail survey of community-dwelling older adults (1937 men and 2212 women) who developed functional impairment during 2010–2014. The survey data were individually linked to the longitudinal records of changes in the levels of functional disability based on the Public Long-Term Care Insurance System.ResultsThe mean (standard deviation) follow-up period was 316 (269) days. During follow-up, 811 participants (19.5%) showed improved functional ability. Among those with severe disabilities at baseline, men with 13 or more years of education were more likely to improve functional ability than men with 9 or fewer years of education (hazard ratio: 1.97, 95% confidence interval: 1.12–3.45). A similar association was observed among women (hazard ratio: 2.16, 95% confidence interval: 1.03–4.53). Neither income nor occupation was statistically associated with improved functional ability.ConclusionsThere are education-related inequalities in the improvement of functional ability, especially among older adults with severe disabilities. Health policy makers and practitioners should consider the educational background of individuals with reduced functionality in formulating strategies to improve their functional ability.
Highlights
Recovery from functionally disabled status is an important target of public health measures for older adults
Study population The analyses were based on the Japan Gerontological Evaluation Study (JAGES) linked to the LTC insurance (LTCI) database of Japan
The characteristics of the cohort stratified by gender and disability group at the time of the initial assessment are shown in Additional file 3: Table S2
Summary
Recovery from functionally disabled status is an important target of public health measures for older adults. This study aimed to examine socioeconomic inequalities in the improvement of functional ability among older adults stratified by the level of disability at baseline. The improvement of functional ability is considered important because of its impact on the quality of life of older adults and the demand for long-term care (LTC) services [2]. In Japan, 6.0 million individuals were certified as eligible to use public LTC insurance (LTCI) benefits in 2015. The majority of disabilities were progressive in the long-term, 1 in 10 individuals had improved functional ability within a year [4]. The trajectory of functional ability among older adults may improve if they receive adequate health care [2]
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