Prevalence Of Activities Of Daily Living Disability Research Articles

Does a Reduction in Receiving Assistance With Daily Activities Among Older Adults in Mexico Indicate An Increase in Unmet Needs or a Decrease in Needs for Care?

The percentage of older adults in Mexico with difficulty completing activities of daily living (ADL) who receive assistance from family appears to be decreasing. We compared 2 birth cohorts of older adults in Mexico to investigate whether this trend reflects an increase in unmet caregiving needs or a decrease in the need for care. We selected Mexican Health and Aging Study participants aged 60-76 in 2001 (n = 4,805) and 2018 (n = 6,494). ADL tasks were dressing, walking, bathing, getting in and out of bed, and toileting. Participants who reported difficulty with an ADL were asked if anyone helped them with the task. Logistic regression was used to estimate adjusted odds ratios (aOR) for cohort differences in ≥1 ADL limitations and help with ≥1 ADL. We used a decomposition analysis to identify participant characteristics that mediated cohort differences in receiving help with ≥1 ADL. The 2018 cohort had higher odds for ≥1 ADL limitations (aOR = 1.85, 95% CI = 1.60-2.14) but lower odds for help with ≥1 ADL (aOR = 0.66, 95% CI = 0.49-0.89). Among participants with ADL disability, the 2018 cohort had fewer living children and a lower prevalence of probable dementia. The lower number of living children and lower prevalence of probable dementia explained 9.34% and 43.7% of the cohort effect on receiving help with ≥1 ADL, respectively. The declining percentage of older adults in Mexico with ADL disability receiving assistance may not reflect increasing unmet needs. However, the increased prevalence of ADL disability will increase the number of older adults needing informal care.

Association between disability in activities of daily living and phase angle in hemodialysis patients

BackgroundDisability in activities of daily living (ADL) significantly increases the risk of mortality among patients undergoing hemodialysis. Malnutrition and decreased exercise capacity are closely correlated with ADL disability. Phase angle (PhA) has been proposed as a measure of nutritional status and exercise capacity. This study aims to investigate the prevalence of ADL disability in hemodialysis patients and its association with PhA.MethodsA prospective, observational study was conducted, involving hemodialysis patients treated between November 2019 and January 2020 in an affiliated hospital of Chinese university. ADL was measured using both basic ADL (BADL) scales and instrumental ADL (IADL) scales. PhA measurements were obtained using a BIA device while the patients were in the supine position after dialysis.ResultsA total of 237 hemodialysis patients with a mean age of 60.01 ± 13.55 years were included in this study. The prevalence of disability in ADL was 43.5%. Multivariable analysis results showed a robust association between low PhA and disability in both BADL and IADL (for each unit decrease in PhA: odds ratio 4.83 [95% CI: 2.56–9.0], and 3.57 [95% CI: 2.14–5.95], respectively). The optimal cut-off values of PhA for disability in BADL and IADL were 4.8 and 5.4, with the area under the ROC curve (AUC) were 0.783 (0.727, 0.835) and 0.799 (0.743, 0.848), respectively.ConclusionsLow PhA is strongly associated with disability in ADL in hemodialysis patients. These findings suggest that PhA may serve as a potentially objective measure of ADL disability in hemodialysis patients.

Prevalence and Trends of Basic Activities of Daily Living Limitations in Middle-Aged and Older Adults in the United States.

Population-level surveillance of the prevalence and trends of basic self-care limitations will help to identify the magnitude of physical disablement in the rapidly growing older American demographic. We sought to evaluate the prevalence and trends of activities of daily living (ADL) limitations in the United States. The analytic sample included 30,418 Americans aged ≥50 years from the 2006-2018 waves of the Health and Retirement Study. ADLs were self-reported. Weighted prevalence estimates were presented, and trends analyses were performed. Although overall ADL disability prevalence was 16.5% (95% confidence interval: 15.8-17.2) in 2018, there were no changes in limitations during the study period (p = 0.52). Older adults had a greater ADL disability prevalence than middle-aged adults (p < 0.001). While older persons experienced a declining trend of ADL limitations (p < 0.001), middle-aged persons had an increasing trend (p < 0.001). Males had a lower ADL limitation prevalence than females (p < 0.001). Hispanic and non-Hispanic Black had a higher ADL disability prevalence than non-Hispanic White (p < 0.001). This investigation revealed that while the estimated prevalence of ADL limitations in the United States was substantial, changes in such limitations were not observed. Our findings can help guide ADL screening, target sub-populations with an elevated ADL limitation prevalence, and inform interventions.

Change in functional disability and its trends among older adults in Korea over 2008–2020: a 4-year follow-up cohort study

BackgroundThe prevalence of functional disabilities, including difficulties in performing activities of daily living (ADLs) and instrumental activities of daily living (IADLs), increased significantly in recent years and burdened the healthcare system.MethodsWe analysed data from Korean Longitudinal Study of Aging (KLOSA) surveys, including participants aged 65 or older at baseline (2008), and participated in all 4-year follow-up periods in 2012, 2016, and 2020. A 4-year follow-up cohort study was applied to specify the change in functional disability and its trend over time among older adults. The generalized estimation equation (GEE) model was used to verify the uptrend of functional disability. Logistic regression analyses were applied to examine the influence of demographic and health parameters on the change in functional disability.ResultsThe prevalence of ADL disability was 2.24% at baseline, increased to 3.10% after four years, 6.42% after eight years, and reached 11.12% after 12 years, five times higher than that at baseline. For IADL disability, they were 10.67%, 10.61%, 18.18%, and 25.57%, respectively. The uptrend of ADL disability in persons aged 65–74 (1.77% at baseline, increased to 7.65% in 2020, 12-year change of 5.88%) was slower than in those aged 75 or older (4.22% at baseline, increased to 25.90% in 2020, 12-year change of 21.68%). IADL disability were consistent with this. The high ADL/IADL disability rate was also present among persons with poor health status, physical inactivity, depression, dementia, and multiple chronic diseases. The relative risk of ADL/IADL disability in persons with a history of functional disability was significantly higher than in those without historical disabilities.ConclusionThe study verified the change in functional disability and its upward trend over time by older adults’ demographic and health parameters. Functional disability was relatively flat tending to increase slowly during the early years but increased rapidly in the following years. Factors that strongly influenced the change in prevalence and the uptrend of functional disability were advanced age, living alone, being underweight or obese, poor health status, physical inactivity, depression, dementia, having multiple chronic diseases, and especially having a historical disability.

The relationship between sleep duration and activities of daily living (ADL) disability in the Chinese oldest-old: A cross-sectional study.

To investigate the relationship between sleep duration and activities of daily living (ADL) disability, and to explore the optimal sleep duration among oldest-old Chinese individuals. In this cross-sectional study, 1,798 participants (73.2% female) were recruited from Dongxing and Shanglin in Guangxi Zhuang Autonomous Region, China in 2019. The restricted cubic spline function was used to assess the dose-response relationship between sleep duration and ADL disability, and the odds ratios (ORs) of the associations were estimated by logistic regression models. The overall prevalence of ADL disability was 63% (64% in females and 58% in males). The prevalence was 71% in the Han population (72% in females and 68% in males), 60% in the Zhuang population (62% in females and 54% in males) and 53% in other ethnic population (53% in females and 53% in males). A nonlinear relationship between sleep duration and ADL disability was observed. Sleep duration of 8-10 hours was associated with the lowest risk of ADL disability. Sleep duration (≥12 hours) was associated with the risk of ADL disability among the oldest-old individuals after adjusting for confounding factors (OR = 1.47, 95% CI [1.02, 2.10], p<0.05). Sleep duration more than 12 hours may be associated with an increased risk of ADL disability in the oldest-old individuals, and the optimal sleep duration among this population could be 8-10 h.

Associations of Heavy Metals with Activities of Daily Living Disability: An Epigenome-Wide View of DNA Methylation and Mediation Analysis.

Background:Exposure to heavy metals has been reported to be associated with multiple diseases. However, direct associations and potential mechanisms of heavy metals with physical disability remain unclear.Objectives:We aimed to quantify associations of heavy metals with physical disability and further explore the potential mechanisms of DNA methylation on the genome scale.Methods:A cross-sectional study of 4,391 older adults was conducted and activities of daily living (ADL) disability were identified using a 14-item scale questionnaire including basic and instrumental activities to assess the presence of disability (yes or no) rated on a scale of dependence. Odds ratios (ORs) and 95% confidence intervals (CI) were estimated to quantify associations between heavy metals and ADL disability prevalence using multivariate logistic regression and Bayesian kernel machine regression (BKMR) models. Whole blood–derived DNA methylation was measured using the HumanMethylationEPIC BeadChip array. An ADL disability-related epigenome-wide DNA methylation association study (EWAS) was performed among 212 sex-matched ADL disability cases and controls, and mediation analysis was further applied to explore potential mediators of DNA methylation.Results:Each 1-standard deviation (SD) higher difference in -transformed manganese, copper, arsenic, and cadmium level was significantly associated with a 14% (95% CI: 1.05, 1.24), 16% (95% CI:1.07, 1.26), 22% (95% CI:1.13, 1.33), and 15% (95% CI:1.06, 1.26) higher odds of ADL disability, which remained significant in the multiple-metal and BKMR models. A total of 85 differential DNA methylation sites were identified to be associated with ADL disability prevalence, among which methylation level at cg220000984 and cg23012519 (annotated to IRGM and PKP3) mediated 31.0% and 31.2% of manganese-associated ADL disability prevalence, cg06723863 (annotated to ESRP2) mediated 32.4% of copper-associated ADL disability prevalence, cg24433124 (nearest to IER3) mediated 15.8% of arsenic-associated ADL disability prevalence, and cg07905190 and cg17485717 (annotated to FREM1 and TCP11L1) mediated 21.5% and 30.5% of cadmium-associated ADL disability prevalence (all ).Discussion:Our findings suggested that heavy metals contributed to higher prevalence of ADL disability and that locus-specific DNA methylation are partial mediators, providing potential biomarkers for further cellular mechanism studies. https://doi.org/10.1289/EHP10602

Vision and Hearing Impairments Affecting Activities of Daily Living among Malaysian Older Adults by Gender.

Vision and hearing impairments are common among older adults and can cause undesirable health effects. There are limited studies from low- and middle-income countries exploring gender differences between vision and hearing impairment with Activities of Daily Living (ADL) disability. Therefore, this study aimed to investigate gender differences between vision and hearing impairments with ADL disability among older adults in Malaysia. Cross-sectional data from 3977 respondents aged 60 and above from the Malaysian National Health and Morbidity Survey 2018 were used. We used logistic regression analysis to measure associations between vision and hearing impairments with ADL disability, adjusted for covariates. The prevalence of ADL disability was higher among females than males (p < 0.001). The adjusted associations between vision impairment and ADL disability were significant among males (aOR 3.79; 95%CI 2.26, 6.38) and females (aOR 2.66; 95%CI 1.36, 5.21). Similarly, significant adjusted associations were found between hearing impairment and ADL disability among males (aOR 5.76; 95%CI 3.52, 9.40) and females (aOR 3.30; 95%CI 1.17, 9.33). Vision and hearing impairments were significantly associated with ADL disability, with no gender differences identified. Early detection and effective management of vision and hearing impairments are important to prevent ADL disability and improve older adults’ level of independence.

Disability prevalence in midlife (aged 55\u201365 years): Cross-Country comparisons of gender differences and time trends

BackgroundPrior literature on disability has centered on disability prevalence among older adults ages 65 and older, providing only limited insight to potential gender differences in disability prevalence in mid-life. Midlife is, however, a critical time to be examined, as it is typically the time in the life course when large inequalities in physical health first emerge.MethodsUsing the Harmonized data files provided by the Gateway to Global Aging Data, we estimate disability prevalence of nationally representative adults ages 55–65 from 23 countries (N = 79,465). We examine gender differences in two disability indicators, limitations in instrumental activities of daily living (IADLs) and activities of daily living (ADLs) in two time periods, 2004/05 and 2014/15.ResultsThere are substantial cross-country variations in IADL and ADL disability prevalence in midlife. Within countries, we find that women have higher IADL prevalence than men in only one out of five countries. Similarly, for ADL prevalence, women have higher ADL prevalence than men in only one out of ten countries. Further, comparing disability prevalence in two time periods, we observe different country-specific time trends.ConclusionsIn the majority of mid and high-income countries, there is no significant gender difference in IADL and ADL prevalence, but there are few countries where women show higher prevalence of disability than men in mid-life. This finding calls for future research into what contributes to cross-country variations.

Gender Differences in Disability Life Expectancy Among Older Adults in Colombia Age 60 and Older

Life expectancy has increased rapidly in Colombia but it is unclear whether these added years of life are healthy years. The objective of this paper is to estimate gender differences in disability life expectancy for older adults. We use data from the first nationally representative survey of adults ages 60 and over in Colombia, the 2015 Survey of Aging, Health and Wellbeing (SABE) (N=23,694) to determine age- and gender-specific prevalence. Mortality data come from the Latin American Mortality Database. We created prevalence base life tables using the Sullivan′s method to calculate disability life expectancy. We define disability as having any reported difficulty with any of the following activities of daily living (ADL): eating, dressing, bathing, toileting, getting out of bed, and walking across a room. The age-adjusted prevalence of ADL disability was 8.7% for men and 12.4% for women. Life expectancy at age 60 for women was 20.6 years, of which 3.0 years (14%) were lived with disability. In contrast, men’s life expectancy at age 60 was 18.2 years, of which 1.7 years (10%) were lived with disability. Women have lower mortality rates than men at older ages, but because they have higher disability prevalence, they live proportionately more years with disability relative to men. We also investigated patterns at different ages, and functional limitations, and found similar gender differences. This study provides new insights into how mortality and disability patterns at older ages contribute to the gender health disparity in older Colombians.

Activities of daily living, life orientation, and health-related quality of life among older people in nursing homes: a national cross-sectional study in China.

This study aimed to explore the current status of activities of daily living (ADLs), life orientation, and health-related quality of life (HRQoL) among older people in nursing homes and to further examine the mediating role of life orientation in the impact of ADLs on HRQoL. A national cross-sectional study was conducted among older people aged 60 and above in nursing homes by the randomly stratified cluster sampling method. The status of ADLs, life orientation and HRQoL were measured using an ADL scale, a life orientation scale and the SF-12v2 scale, respectively. Multiple linear regression models were used to identify explanatory factors associated with ADLs, life orientation, and HRQoL. The potential mediating role of life orientation in the relationship between ADL and HRQoL was explored by mediation analysis. The overall prevalence of ADL disability was 52.67%, and 84.37% of older people in nursing homes had a negative life orientation. The mean scores of physical health and mental health among older people in nursing homes were 45.44 ± 6.46 and 42.67 ± 8.48, respectively. Some sociodemographic characteristics were associated with poor physical health and mental health. After adjustments were made for covariates, the life orientation score mediated 13.81% of the total effect of the ADL score on physical component score of HRQoL and mediated 45.33% of the mental component score of HRQoL. A sizeable proportion of older people had ADL disability and negative life orientation, and HRQoL was poor among older Chinese people in nursing homes. Life orientation partially mediates the relationship between ADLs and HRQoL.

A study on disability in terms of activities of daily living among elderly in Palam village of west Delhi

Background: Aging, an integral part of living, typically is accompanied by gradual but progressive physiological changes and an increased prevalence of acute and chronic illness. Although neither a disease nor disability per se, aging nonetheless is associated with a high incidence of physical impairment as well.The objective of the present study was to assess the prevalence of activities of daily living (ADL) disability in elderly living in Palam village of Delhi.Methods: A community based cross-sectional study was carried out to assess the prevalence of ADL disability in elderly living in Palam village of Delhi using Barthel ADL index. It uses ten variables describing ADL and mobility. The sample size was estimated to be 350 and systematic random sampling was used to choose the study subjects.Results: The prevalence of ADL disability was found to be 20.3% in the study population. This was found to be 16.3% in males and 23.9% in females.Conclusions: After obtaining adequate data on elderly having difficulty in performing their routine activities of daily living, appropriate steps needs to be taken to mitigate its ill effects which should also address their health care needs and help them to live a healthy and good quality life.

Disabilities in activities of daily living and in instrumental activities of daily living among older adults in China, 2011–15: a longitudinal cohort study

BackgroundWith global population ageing, the population of older adults (aged ≥60 years) is rapidly growing, and most such individuals are in need of health care and assistance. We aimed to assess changes in disability in basic activities of daily living (ADL), and in instrumental activities of daily living (IADL) among older Chinese individuals. MethodsWe used data from three surveys of the China Health and Retirement Longitudinal Study, conducted in 2011 (n=7380), 2013 (n=8328), and 2015 (n=9594). Data on six ADL measures (dressing, bathing, eating, walking, toileting, and urination and defecation) and six IADL measures (doing housework, shopping, cooking, managing money, taking medicine, and telephoning) were collected through interviews. We defined disability as need of assistance or inability to perform any of the ADLs or IADLs. Generalised estimating equation models were used to assess the time trend in the prevalence of disabilities in ADL and IADL. FindingsThe prevalence of disability in IADLs increased from 1496 (20·96%, weighted) of 7330 participants in 2011 to 2584 (26·51%, weighted) of 9348 in 2015, with a relative annual increase of 1·92% in the total sample (ptrend<0·0001). The trend was statistically significant (ptrend<0·001) in all subgroups by age, sex, and living region. The prevalence of disability in ADLs showed little change from 2011 (759 [11·40%, weighted] of 7354) to 2015 (983 [10·03%, weighted] of 9554), with a relative annual change of 0·12% in the total sample (ptrend=0·2429), and in all subgroups by age, sex, and living region (ptrend>0·10). After controlling for various confounding factors, functional capacities in ADLs and IADLs were substantially worse in women than in men. InterpretationThe prevalence of IADL disability increased among older Chinese adults during 2011–15, whereas the prevalence of ADL disability remained stable. Improvements in lifestyle, socioeconomics, and health care might reduce disabilities in ADL, but lifespan extension might expand IADL disability as more frail and older individuals survive with health problems. FundingNational Natural Science Foundation of China (grant number 81573262).

Changes in the morbidity prevalence and morbidity-free life expectancy of the elderly population in China from 2000 to 2010

Abstract This paper explores the changes in the prevalence of morbidity, morbidity-free life expectancy and its related factors in China from 2000 to 2010. The analysis uses health status data from three waves of the Sample Survey of the Aged Population in Urban/Rural China (SSAPUR). To explore the changes, three types of morbidity-free life expectancy (MFLE) are estimated using the Sullivan method. To identify the influencing factors of morbidity, we use regression models that consist of social and economic variables to identify these factors. Our results show that between 2000 and 2010, the prevalence of moderate morbidity based on activities of daily living (ADLs) declined across most age groups; however, the prevalence for instrumental activities of daily living (IADLs) and severe morbidity both increased, especially in the oldest old age group. Furthermore, the ratio of the MFLE to the total remaining life expectancy suggests the occurrence of a trend toward morbidity expansion. Our regression results suggest that age is the main factor in morbidity and impairment; however, education, health care, income and urbanisation play important roles in reducing the scores for IADLs and the prevalence of ADLs disability. Our findings imply that health care policy should assume a greater focus on healthy ageing, especially when people are expected to live longer. The findings also suggest that the government should prepare for the increasing demand for long-term care in the near future.

Trends in disability in activities of daily living among Chinese older adults, 1997-2006: the China Health and Nutrition Survey.

A decline in prevalence of late-life disability in activities of daily living (ADLs) has been reported in Western countries. We investigate the time trend of disability in basic ADLs among Chinese older people in 1997-2006, and explore the potential contribution of cardiometabolic diseases to the trend. The study included 7,845 participants (age ≥ 60 years) in the China Health and Nutrition Survey who were examined in 1997, 2000, 2004, and 2006. Data on ADLs were collected through interviews. Disability in basic ADLs was defined as need of assistance or inability to perform at least one of the five self-care activities of bathing, dressing, toileting, feeding, and transferring. Generalized estimating equation models were used to test the time trend in ADL disability and its association with cardiometabolic diseases. Prevalence of ADL disability decreased from 13.2% in 1997 to 9.9% in 2006; the trend was statistically evident among people aged 60-69 years, women, and rural residents (p trend < .05). From 1997 to 2006, the prevalence of ADL disability decreased at a relative annual rate of 3.1% in total sample; the decline was statistically more evident in young-olds than older-olds, in men than women, and in rural than urban residents. The disabling effect decreased over time for stroke (p trend = .032) and multiple cardiometabolic diseases (p trend = .014). The prevalence of disability in basic ADLs among Chinese older adults decreased from 1997 to 2006. Stroke and multiple cardiometabolic diseases appear to become less disabling over time, which may partly contribute to the favorable trend in ADL disability.

Time trends in prevalence of activities of daily living (ADL) disability and survival: Comparing two populations (aged 78+ years) living in a rural area in Sweden

The aim was to study time trends in prevalence of disability in ADL and survival among men and women 78 years and older comparing two cohorts. The study was a time trend study based on two population-based community cohorts, the Nordanstig Project (NP), collected 1995–1998 and the Swedish National Study on Aging and Care in Nordanstig (SNAC-N), collected 2001–2003. The participants were people aged 78 years and older from the NP cohort (N=303) and from the SNAC-N cohort (N=406). All were clinically examined by physicians and nurses using standardized protocols. Disability was defined as a need for assistance in one or more ADL activities. The prevalence of disability and survival were compared using logistic and Cox models. The prevalence of ADL disability was stable for men, while women became more disabled in ADL during the time period, OR 2.36 (1.12–4.94). There was no significant difference in survival time between the cohorts in either ADL disabled persons or non-disabled persons. There was a tendency for increased survival for non-disabled persons in SNAC-N compared with NP, although not significant; this was particularly true for women. In general, women survived longer than men did regardless of whether they were ADL disabled or not. The time trends for ADL disability found in the study show that ADL disability had increased in women but not in men. More studies are needed to identify risk factors for ADL disability with a view to preventing it in time.

Disability occurrence and proximity to death

Purpose. This paper aims to assess whether disability occurrence is related more strongly to proximity to death than to age.Method. Self reported disability and vital status were available from six annual waves and a subsequent 12-year mortality follow-up of the Dutch GLOBE longitudinal study. Logit and Poisson regression methods were used to study associations of disability occurrence with age and with proximity to death.Results. For disability in activities of daily living (ADL), regression models with proximity to death had better goodness of fit than models with age. With approaching death, the odds for ADL disability prevalence and incidence rates increased 20.0% and 18.9% per year, whereas severity increased 4.1% per year. For the ages younger than 60, 60–69 and older than 70 years, the odds for ADL disability prevalence increased 6.4%, 16.0% and 23.0% per year. Among subjects with asthma/chronic obstructive pulmonary disease, heart disease and diabetes increases were 25.1%, 19.5% and 22.7% per year. Functional impairments were more strongly related to age.Conclusions. The strong association of (ADL) disability occurrence with proximity to death implies that a substantial part of the disability burden may shift to older ages with further increases in life expectancy.

Risk factors for disability in older persons over 3-year follow-up

the identification of modifiable risk factors for preventing disability in older individuals is essential for planning preventive strategies. to identify cross-sectional correlates of disability and risk factors for the development activities of daily living (ADL) and instrumental ADL (IADL) disability in community-dwelling older adults. the study population consisted of 897 subjects aged 65-102 years from the InCHIANTI study, a population-based cohort in Tuscany (Italy). Factors potentially associated with high risk of disability were measured at baseline (1998-2000), and disability in ADLs and IADLs were assessed both at baseline and at the 3-year follow-up (2001-03). the baseline prevalence of ADL disability and IADL disability were, respectively, 5.5% (49/897) and 22.2% (199/897). Of 848 participants free of ADL disability at baseline, 72 developed ADL disability and 25 of the 49 who were already disabled had a worsening in ADL disability over a 3-year follow-up. Of 698 participants without IADL disability at baseline, 100 developed IADL disability and 104 of the 199 who already had IADL disability had a worsening disability in IADL over 3 years. In a fully adjusted model, high level of physical activity compared to sedentary state was significantly associated with lower incidence rates of both ADL and IADL disability at the 3-year follow-up visit (odds ratio (OR): 0.30; 95% confidence intervals (CI) 0.12-0.76 for ADL disability and OR: 0.18; 95% CI 0.09-0.36 for IADL disability). After adjusting for multiple confounders, higher energy intake (OR for difference in 100 kcal/day: 1.09; 95% CI 1.02-1.15) and hypertension (OR: 1.91; 95% CI 1.06-3.43) were significant risk factors for incident or worsening ADL disability. higher level of physical activity and lower energy intake may be protective against the development in ADL and IADL disability in older persons.

Disability Occurrence and Proximity to Death

Purpose This paper aims to assess whether disability occurrence is related more strongly to proximity to death than to age. Method Self reported disability and vital status were available from six annual waves and a subsequent 12-year mortality follow-up of the Dutch GLOBE longitudinal study. Logit and Poisson regression methods were used to study associations of disability occurrence with age and with proximity to death. Results For disability in activities of daily living (ADL), regression models with proximity to death had better goodness of fit than models with age. With approaching death, the odds for ADL disability prevalence and incidence rates increased 20.0% and 18.9% per year, whereas severity increased 4.1% per year. For the ages younger than 60, 60-69 and older than 70 years, the odds for ADL disability prevalence increased 6.4%, 16.0% and 23.0% per year. Among subjects with asthma/COPD, heart disease and diabetes increases were 25.1%, 19.5% and 22.72% per year. Functional impairments were more strongly related to age. Conclusions The strong association of (ADL) disability occurrence with proximity to death implies that a substantial part of the disability burden may shift to older ages with further increases in life expectancy.

Disability Trends in Hong Kong Community-Dwelling Chinese Older Adults

This article examines the trends of disability in six activities of daily living (ADLs) among Hong Kong community-dwelling older adults during the period from 1996 to 2004 by using three independent cross-sectional surveys of representative samples. Logistic regression was performed to assess the association between the year of survey and the presence of any ADL limitation with a wide range of covariates. We found that older adults in 2004 were more likely to report ADL disability than their counterparts in 1996, and the results would remain valid after considering the prevalence of ADL disability in nursing home residents. In addition, we found that age, education, the use of proxy, and the presence of six medical conditions were significantly related to ADL limitation. In general, public health efforts to prevent ADL limitation should be supported to reduce the demand for long-term care services in the coming decades.

Gender Differences in Activity of Daily Living of the Elderly in Rural China: Evidence from Chaohu

ABSTRACT Using data from a sample survey, “Well-being of the elderly in Anhui province, China,” this paper studies the effects of health, economic and family factors on the activities of daily living (ADLs) as measures of disability for elderly men and women. The objective is to explore reasons for gender differences in ADLs in rural China. Our results suggest that higher incidence rates of chronic diseases, lower cognitive ability, as well as heavier household and daily care burdens of females, are the main factors leading to a higher prevalence of ADL disability for the female elderly.