scholarly journals Socio-economic inequality in functional disability and impairments with focus on instrumental activity of daily living: a study on older adults in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ratna Patel ◽  
Shobhit Srivastava ◽  
Pradeep Kumar ◽  
Shekhar Chauhan ◽  
Mani Deep Govindu ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Chronic Diseases ◽  
Daily Living ◽  
Functional Disability ◽  
Economic Inequality ◽  
National Level ◽  
Decomposition Analysis ◽  
Self Rated Health ◽  
The Government

Abstract Background Studies 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. Methods This 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. Results The 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. Conclusion It 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.

scholarly journals Socio-economic inequality in functional disability and impairments with focus on Instrumental Activity of Daily Living: A Study on Older Adults in India

2021 ◽  
Author(s):  
Ratna Patel ◽  
Shobhit Srivast ◽  
Pradeep Kumar ◽  
SHEKHAR CHAUHAN ◽  
Mani Deep Govindu ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Disability ◽  
Population Aging ◽  
Economic Inequality ◽  
National Level ◽  
Memory Loss ◽  
Decomposition Analysis ◽  
The Government

Abstract Background Studies 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. Methods This 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 fulfill the objectives of the study. The concentration index was calculated for ADL, IADL, and impairments, and further, decomposition analysis was carried out for IADL. Results The results observed that nearly 7.5 percent of older adults reported ADL, more than half (56.8%) reported IADL, and nearly three-fourths (72.6%) reported impairments. Overall, ADL, IADL, and impairments were higher among older adults aged 80 + years, older adults with poor self-rated health, and those suffering from chronic diseases. Educational status and wealth explained most of the socio-economic inequality in the prevalence of IADL among older adults. Conclusion It is recommended that the government advise older adults to adopt health-promoting approaches, which may be useful. Further, there is a pressing need to deliver quality care to older adults suffering from chronic conditions.

Potential associated factors of functional disability in Chinese older inpatients: A multicenter cross-sectional study

2020 ◽  
Author(s):  
Hongpeng Liu ◽  
Jing Jiao ◽  
Chen Zhu ◽  
Minglei Zhu ◽  
Xianxiu Wen ◽  
...  
Keyword(s):  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Disability ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Older Inpatients ◽  
Hospital Wards

Abstract Background: Older adults are vulnerable to a decline in physical functioning, including basic activities of daily living (ADL) and higher-level instrumental activities of daily living (IADL). The causes of functional disability in older adults are multifactorial. A comprehensive understanding of these factors will contribute toward future health service planning. However, studies of ADL and IADL in Chinese older adults are insufficient. The aim of this study is to describe the level of ADL and IADL in different age groups and explore the factors associated with functional disability in Chinese older inpatients. Methods: We conducted a cross-sectional study consisted of 9,996 Chinese older inpatients aged 65 years and older. Participants were recruited from six provinces or municipality city in southwest (Sichuan province), northeast (Heilongjiang), south central (Hubei province), northern (Beijing municipality city), northwest (Qinghai province), and eastern China (Zhejiang province) from October 2018 to February 2019. The levels of ADL and IADL were measured by scores of the Barthel index and Instrumental Activities of Daily Living Scale in consecutive intervals from 65 years of age. After controlling for the cluster effect of hospital wards, a mixed-effect generalized linear model was used to examine the association between functional disability and covariates. Results: The average ADL score was 27.68±4.59 and the mean IADL score 6.76±2.01 for all participants. A negative correlation between scores and age was observed, and there was a significant difference in ADL and IADL scores among different age groups. The top negatively influential factor in ADL and IADL was stair climbing and shopping, respectively. After controlling for the cluster effect of hospital wards, aging, emaciation, frailty, depression, falling accidents in past 12 months, hearing dysfunction, cognitive dysfunction, urinary dysfunction, and defecation dysfunction were associated with ADL and IADL. Patients transitioned from the emergency department and other hospitals were also affected by ADL disability. Former smoking was associated with lower IADL scores. Higher level of education, living in a building without elevators, and current alcohol consumption were correlated with better IADL performance. Conclusion: Decreased functional ability was associated with the increasing age. Sociodemographic characteristics (such as age), physical health variables (frailty, emaciation, hearing dysfunction, urinary dysfunction, defecation dysfunction, falling accidents in past 12 months), and mental health variables (cognitive dysfunction, depression) were associated with functional disability. These findings potentially have major importance for the planning of hospital services, discharge planning, and post-discharge care.

scholarly journals Rural-Urban Inequalities in Poor Self-Rated Health, Self-reported Functional Disabilities and Depression Among Chinese Older Adults: Evidence From the China Health and Retirement Longitudinal Study 2011 and 2015

2020 ◽  
Author(s):  
Haiting Jiang ◽  
Bo Burström ◽  
Jiaying Chen ◽  
Kristina Burström
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Activities Of Daily Living ◽  
Educational Level ◽  
Daily Living ◽  
Household Registration ◽  
Registration System ◽  
Chinese Older Adults ◽  
Self Rated Health ◽  
Functional Disabilities

Abstract BackgroundRural-urban inequalities in health among older adults in China have not been extensively studied from the national perspective. In particular, studies have not taken into account combinations of Hukou (household registration system in China) and actual residence, which may be important so as not to underestimate rural-urban differences. This study investigates rural-urban inequalities in prevalence of poor self-rated health, self-reported functional disabilities and depression among Chinese older adults in 2011 and 2015, and analyses sociodemographic determinants of rural-urban inequalities in self-reported health outcomes. MethodsData from the nationwide China Health and Retirement Longitudinal Study (CHARLS), on older adults aged 60 years and above in CHARLS 2011 and CHARLS 2015 were used. Only rural residents with rural Hukou and urban residents with urban Hukou were included. Sociodemographic factors, including age, sex, marital status, living arrangement, living near children, educational level and income were studied. Self-Rated Health (SRH) was assessed with a single question. Basic Activities of Daily Living (BADLs) and Instrumental Activities of Daily Living (IADLs) were used to measure self-reported functional abilities. The 10-item version of the Center for Epidemiologic Studies Depression Scale was used to measure self-reported depression. ResultsRural respondents had poorer socioeconomic status and higher prevalence of poor SRH, functional disabilities and depression than urban respondents. The levels of functional disabilities, both BADLs and IADLs, were similar in 2011 and 2015, while the prevalence of poor SRH and self-reported depression was lower in 2015, both among rural and urban respondents. Impairments increased with age and appeared at younger age among rural respondents compared to urban respondents. Being female, unmarried, with low educational level and low income increased the odds ratios of reporting poor SRH, functional disabilities and depression. Sensitivity analyses using only Hukou registration resulted in underestimation of rural-urban differences. ConclusionsThere were large rural-urban inequalities in poor SRH, self-reported functional disabilities and depression that were closely related to rural-urban differences in educational level and income. Key words : China; depression; functional ability; health inequalities; household registration system; older adults; rural-urban; self-rated health; social determinants of health

scholarly journals Caregiving, Recovery, and Death After Incident ADL/IADL Disability Among Older Adults in the United States

2019 ◽  
Vol 39 (4) ◽  
pp. 393-397 ◽  
Author(s):  
Claire K. Ankuda ◽  
Deborah A. Levine ◽  
Kenneth M. Langa ◽  
Katherine A. Ornstein ◽  
Amy S. Kelley
Keyword(s):  
United States ◽  
Older Adults ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Disability ◽  
The United States ◽  
Levels Of Care ◽  
Iadl Disability ◽  
And Function ◽  
At Home

This study assesses patterns of caregiving, death, and recovery after incident disability in older adults. We used the Health and Retirement Study to follow of a cohort of adults age ≥65 years in the United States with incident disability in activities of daily living (ADLs) or instrumental activities of daily living (IADLs; n = 8,713). Rates of care and function state were assessed biennially: deceased, nursing home dwelling, at home with paid help, at home with both paid and unpaid help, at home with unpaid help, at home with no assistance and recovered. In the 2 years after incident disability, 22.1% recovered and 46.8% died. Transitions between care and function states occurred frequently, with more than 20% of the cohort living at home with no assistance despite disability at least once. This study demonstrates the high levels of care and function state fluctuation and unmet needs after functional disability.

scholarly journals Socioeconomic inequality in psychological distress among older adults in India: a decomposition analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shobhit Srivastava ◽  
Naina Purkayastha ◽  
Himanshu Chaurasia ◽  
T. Muhammad
Keyword(s):  
Older Adults ◽  
Psychological Distress ◽  
Older People ◽  
Activities Of Daily Living ◽  
Living Arrangements ◽  
Daily Living ◽  
General Health Questionnaire ◽  
Decomposition Analysis ◽  
Economic Benefits ◽  
Cross Sectional Survey

Abstract Background Older people coming from a lower wealth gradient are more vulnerable to have stressful life events further adding more risk for common mental health disorders and psychological distress situations. The present study explores the associations between socioeconomic and health-related variables and psychological distress among older adults in India and the contribution of such factors to the inequalities in psychological distress. Methods A cross-sectional survey of 9181 older adults conducted as ‘Building a Knowledge Base on Population Ageing in India’ was assessed. Logistic regression and decomposition models were used to analyze the data. Psychological distress was measured from General Health Questionnaire (GHQ-12). The value of Cronbach's alpha was 0.90. It was having a scale of 0 to 12 on the basis of experiencing stressful symptoms and was re-coded as 0 (representing 6+ stressful symptoms) and 1 (representing 5 and fewer symptoms). Results Older adults from the poored, suffering from multi-morbidity, disabled, with low activities of daily living and low instrumental activities of daily living and poor cognitive ability were suffering from high psychological distress in India. Further, factors such as religion, caste, education, living arrangements, and self-worth in the family were major contributors to the concentration of psychological distress in older adults from poor households (concentration index: − 0.23). Conclusion The study suggests that among older people, there is a wide disparity of experiencing psychological distress across different socio-economic groups with significant factors being responsible for inequality in psychological distress. There is a need to build a “win-win” circumstance across sectors, including a broad spectrum of health, social and economic benefits to the vulnerable older population.

scholarly journals Dependence in instrumental activities of daily living and its implications for older adults’ oral health

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249275
Author(s):  
Maria Vieira de Lima Saintrain ◽  
Suzanne Vieira Saintrain ◽  
July Grassiely de Oliveira Branco ◽  
José Manuel Peixoto Caldas ◽  
Caroline Barbosa Lourenço ◽  
...  
Keyword(s):  
Older Adults ◽  
Oral Health ◽  
Activities Of Daily Living ◽  
General Health ◽  
Daily Living ◽  
Functional Disability ◽  
Functional Dependence ◽  
Northeastern Brazil ◽  
Poor General Health ◽  
Instrumental Activities

We aimed to assess the association between dependence in instrumental activities of daily living (IADL) and oral health in older adults. We conducted a cross-sectional study of 280 people aged ≥60 years served at public primary health care centers in Northeastern Brazil. Sociodemographic, oral discomfort and general health data were collected. The Lawton and Brody scale were used to assess IADL. This research adheres to the STROBE checklist. Most participants were married (n = 139; 49.6%), women (n = 182; 65.0%) and retired (n = 212; 75.7%). A total of 37 (13.2%) older adults had some degree of dependence in IADL. Dependence in IADL was associated with: retirement (p<0.040), poor general health (p = 0.002), speech problems (p = 0.014), use of medications (p = 0.021), difficulty chewing and swallowing food (p = 0.011), voice changes (p = 0.044), edentulism (p = 0.011), use of toothbrush (p<0.001), use of toothpaste (p<0.001), and visit to the dentist in the previous year (p = 0.020). Functional disability was associated with older age, cardiovascular diseases, speech problems, chewing and swallowing difficulties, use of medication and brushing deficiency. The functional dependence in IADL can be considered an indicator of oral health status in older adults.

scholarly journals Early Cognitively Based Functional Limitations Predict Loss of Independence in Instrumental Activities of Daily Living in Older Adults

2015 ◽  
Vol 21 (9) ◽  
pp. 688-698 ◽  
Author(s):  
Karen M. Lau ◽  
Mili Parikh ◽  
Danielle J. Harvey ◽  
Chun-Jung Huang ◽  
Sarah Tomaszewski Farias
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Disability ◽  
Neuropsychological Functioning ◽  
Functional Limitations ◽  
Instrumental Activities ◽  
Increased Risk ◽  
Iadl Disability

AbstractOlder adults with early forms of neurodegenerative disease are at risk for functional disability, which is often defined by the loss of independence in instrumental activities of daily living (IADLs). The current study investigated the influence of mild changes in everyday functional abilities (referred to as functional limitations) on risk for development of incident functional disability. A total of 407 participants, who were considered cognitively normal or diagnosed with mild cognitive impairment (MCI) at baseline, were followed longitudinally over an average 4.1 years (range=0.8–9.2 years). Informant-based ratings from the Everyday Cognition (ECog; Farias et al., 2008) and the Instrumental Activities of Daily Living (Lawton & Brody, 1969) scales assessed the degree of functional limitations and incident IADL disability, respectively. Cox proportional hazards models revealed that more severe functional limitations (as measured by the Total ECog score) at baseline were associated with approximately a four-fold increased risk of developing IADL disability a few years later. Among the ECog domains, functional limitations in Everyday Planning, Everyday Memory, and Everyday Visuospatial domains were associated with the greatest risk of incident functional disability. These results remained robust even after controlling for participants’ neuropsychological functioning on tests of executive functions and episodic memory. Current findings indicate that early functional limitations have prognostic value in identifying older adults at risk for developing functional disability. Findings highlight the importance of developing interventions to support everyday abilities related to memory, executive function, and visuospatial skills in an effort to delay loss of independence in IADLs. (JINS, 2015,21, 688–698)

scholarly journals Rural-urban inequalities in poor self-rated health, functional disabilities and depression among Chinese older adults: Evidence from the China Health and Retirement Longitudinal Study 2011 and 2015

2020 ◽  
Author(s):  
Haiting Jiang ◽  
Bo Burström ◽  
Jiaying Chen ◽  
Kristina Burström
Keyword(s):  
Older Adults ◽  
Longitudinal Study ◽  
Health Outcomes ◽  
Activities Of Daily Living ◽  
Educational Level ◽  
Daily Living ◽  
Living Arrangement ◽  
Chinese Older Adults ◽  
Self Rated Health ◽  
Functional Disabilities

Abstract Background: The demand for healthcare and social services increases with the aging of the population and functional disabilities among older adults. Rural-urban inequalities in health have not been extensively studied previously from the national perspective, especially after classifying the effects of Hukou (household registration system in China) and residence. This study investigates rural-urban inequalities in prevalence of poor self-rated health, functional disabilities and self-reported depression among Chinese older adults and analyses determinants of rural-urban inequalities in self-reported health outcomes. Methods: The data originate from the China Health and Retirement Longitudinal Study (CHARLS), which started in 2011 and collects data every two years, a representative sample in 28 provinces in China. Older adults aged 60 years and above in CHARLS 2011 and CHARLS 2015 were studied. Sociodemographic factors were studied, including age, sex, marital status, living arrangement, living near children, educational level and income. Self-Rated Health (SRH) was assessed with a single question. Basic Activities of Daily Living (BADLs) and Instrumental Activities of Daily Living (IADLs) were used to measure self-reported functional abilities. The 10-item version of the Center for Epidemiologic Studies Depression Scale was used to measure self-reported depression. Results: Rural respondents had poor socioeconomic status and higher prevalence of poor SRH, functional disabilities and depression than urban respondents. The levels of functional disabilities, both BADLs and IADLs, were similar in 2011 and 2015, while the prevalence of poor SRH and self-reported depression were lower in 2015, both among rural and urban respondents. Impairments increased with age, and appeared at younger age among rural respondents compared to urban respondents. Being female, unmarried, with low educational level and low income increased the odds ratios of reporting poor SRH, functional disabilities and depression. Living arrangement and living near children did not have significant impacts on health outcomes. Conclusions: Rural-urban inequalities in poor SRH, functional disabilities and depression were mainly related to educational level and income.

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