Abstract
BackgroundDisability in aged people became one of the major challenges in China due to the acceleration of population aging. Nevertheless, there were limited methods to appropriately discriminate the degree of combined basic activity of daily living (BADL) and instrumental activity of daily living (IADL). The present study explored an empirical typology of the activity of daily living (ADL) and its association with health status among the elderly in China.MethodsData throughout the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was retrieved and Latent profile analysis (LPA) was conducted to identify the subgroups of ADL for included elderly subjects. Multinomial regression was performed to detect the effect of identified characteristics with ADL subgroups, and the restricted cubic spine was drawn to show the changes in the relationship between age-specific ADL disability and BMI.ResultsThe overall participants (n=8108) were divided into three ADL classes by LPA - ‘no BADL limitation-no IADL limitation’ (Class one, n=6062, 75%), ‘no BADL limitation- IADL impairment’ (Class two, n=1526, 19%), and ‘BADL impairment- IADL impairment’ (Class three, n=520, 6%). Compared with the participants in Class one, the oldest-old, living without spouse, lacking of exercise, short in social activities, having experience of falls, having comorbidity of diabetes, heart disease, stroke, decreased cognitive function, depression symptom were highly associated with Class two and Class three. Additionally, malnutrition and asthma were associated with combined BADL/IADL impairment (Class three), while illiteracy was only associated with IADL impairment (Class two). Furthermore, a statistically significant U-shape association was detected between age and BADL/IADL disability (Class three vs. Class two) as well as BMI and BADL/IADL disability (Class three vs. Class one). The elderly aged 80–90 with IADL impairment were less likely to evolve into combined BADL/IADL impairment, and the elderly who were underweight or obese may have higher risk of combined BADL/IADL impairment.ConclusionA novel functional assessment was explored based on LPA, by which elderly people could be classified into three distinct classes of combined BADL/IADL. The predictors identified with particular IADL/BADL classes could draw early attention to the onset of functional disability and enlighten targeted interventions to address consequent problems of aged people.
Highlights
Disability in aged people became one of the major challenges in China due to the acceleration of population aging
Mini Mental State Examination (MMSE) test showed that 78.48% (n=6363) of the subjects were declined in cognition, and Epidemiologic Studies Short Depression Scale (CES-D) test showed that 26.63% (n=2159) of subjects had depression symptoms
Latent profile analysis (LPA) clustering in our study showed that the basic activity of daily living (BADL)/ instrumental activity of daily living (IADL) dependence (Class three) was about 6%, and IADL
Summary
Disability in aged people became one of the major challenges in China due to the acceleration of population aging. The present study explored an empirical typology of the activity of daily living (ADL) and its association with health status among the elderly in China. Aging of population, giving rise to the prevalence of chronic diseases, financial burden and labor shortage, emerging as public health concerns, has caused a considerable concern and become a great challenge to the public health in China [1]. It was unoptimistic that the healthy life expectancy of Chinese was documented from 64.5 to 66.6 years for males and 67.5 to 69.7 years for females during2013to 2017 [2]. The functional ability of the elderly was usually measured with the basic ADL (BADL) and instrumental ADL (IADL). In order to assess the ADL of the elderly in modern society, Lawton et al designed the IADL scale, which represented individual’s adaption to surrounding environment, such as making calls, shopping, cooking and doing housework [7]
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