Disability in instrumental activities of daily living among older adults: gender differences

OBJECTIVE To analyze gender differences in the incidence and determinants of disability regarding instrumental activities of daily living among older adults. METHODS The data were extracted from the Saúde, Bem-Estar e Envelhecimento (SABE – Health, Wellbeing and Ageing) study. In 2000, 1,034 older adults without difficulty in regarding instrumental activities of daily living were selected. The following characteristics were evaluated at the baseline: sociodemographic and behavioral variables, health status, falls, fractures, hospitalizations, depressive symptoms, cognition, strength, mobility, balance and perception of vision and hearing. Instrumental activities of daily living such as shopping and managing own money and medication, using transportation and using the telephone were reassessed in 2006, with incident cases of disability considered as the outcome. RESULTS The incidence density of disability in instrumental activities of daily living was 44.7/1,000 person/years for women and 25.2/1,000 person/years for men. The incidence rate ratio between women and men was 1.77 (95%CI 1.75;1.80). After controlling for socioeconomic status and clinical conditions, the incidence rate ratio was 1.81 (95%CI 1.77;1.84), demonstrating that women with chronic disease and greater social vulnerability have a greater incidence density of disability in instrumental activities of daily living. The following were determinants of the incidence of disability: age ≥ 80 and worse perception of hearing in both genders; stroke in men; and being aged 70 to 79 in women. Better cognitive performance was a protective factor in both genders and better balance was a protective factor in women. CONCLUSIONS The higher incidence density of disability in older women remained even after controlling for adverse social and clinical conditions. In addition to age, poorer cognitive performance and conditions that adversely affect communication disable both genders. Acute events, such as a stroke, disables elderly men more, whereas early deficits regarding balance disable women more.

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Association of Blood Chemistry Quantifications of Biological Aging With Disability and Mortality in Older Adults

The Journals of Gerontology Series A ◽

10.1093/gerona/glz219 ◽

2019 ◽

Vol 75 (9) ◽

pp. 1671-1679 ◽

Cited By ~ 1

Author(s):

Daniel C Parker ◽

Bryce N Bartlett ◽

Harvey J Cohen ◽

Gerda Fillenbaum ◽

Janet L Huebner ◽

...

Keyword(s):

Older Adults ◽

African American ◽

Activities Of Daily Living ◽

Daily Living ◽

Rate Ratio ◽

Incidence Rate Ratio ◽

Blood Chemistry ◽

Biological Age ◽

Biological Aging ◽

Reference Samples

Abstract Quantification of biological aging has been proposed for population surveillance of age-related decline in system integrity and evaluation of geroprotective therapies. However, methods of quantifying biological aging have been little studied in geriatric populations. We analyzed three clinical-biomarker-algorithm methods to quantify biological aging. Klemera–Doubal method Biological Age and homeostatic dysregulation algorithms were parameterized from analysis of U.S. National Health and Nutrition Examination Surveys (NHANES) data (N = 36,207) based on published methods. Levine method Biological Age was adapted from published analysis of NHANES data. Algorithms were applied to biomarker data from the Duke Established Populations for Epidemiologic Studies of the Elderly (Duke-EPESE) cohort of older adults (N = 1,374, aged 71–102 years, 35% male, 52% African American). We tested associations of biological aging measures with participant reported Activities of daily living (ADL), instrumental activities of daily living (IADL) dependencies, and mortality. We evaluated the sensitivity of results to the demographic composition of reference samples and biomarker sets used to develop biological aging algorithms. African American and white Duke-EPESE participants with more advanced biological aging reported dependence in more ADLs and IADLs and were at increased risk of death over follow-up through 2017. Effect sizes were similar across algorithms, but were strongest for Levine method Biological Age (per-quintile increase in ADL incidence rate ratio = 1.25, 95% confidence interval [1.17–1.37], IADL incidence rate ratio = 1.23 [1.15–1.32], mortality hazard ratio = 1.12 [1.08–1.16]). Results were insensitive to demographic composition of reference samples, but modestly sensitive to the biomarker sets used to develop biological aging algorithms. Blood-chemistry-based quantifications of biological aging show promise for evaluating the effectiveness of interventions to extend healthy life span in older adults.

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126271 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6271

Author(s):

Yee Mang Chan ◽

Norhafizah Sahril ◽

Ying Ying Chan ◽

Nor’ Ain Ab Wahab ◽

Norliza Shamsuddin ◽

...

Keyword(s):

Older Adults ◽

Gender Differences ◽

Activities Of Daily Living ◽

Hearing Impairment ◽

Daily Living ◽

Hearing Impairments ◽

Cross Sectional ◽

Middle Income ◽

Middle Income Countries ◽

Adl Disability

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.

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Fatigue as a long-term risk factor for limitations in instrumental activities of daily living and/or mobility performance in older adults after 10 years

Clinical Interventions in Aging ◽

10.2147/cia.s116741 ◽

2016 ◽

Vol Volume 11 ◽

pp. 1579-1587 ◽

Cited By ~ 7

Author(s):

Sigrid Mueller-Schotte ◽

Nienke Bleijenberg ◽

Yvonne T. van der Schouw ◽

Marieke J. Schuurmans

Keyword(s):

Older Adults ◽

Risk Factor ◽

Activities Of Daily Living ◽

Daily Living ◽

Mobility Performance ◽

Instrumental Activities

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Trajectories of Limitations in Instrumental Activities of Daily Living in Frail Older Adults With Vision, Hearing, or Dual Sensory Loss

The Journals of Gerontology Series A ◽

10.1093/gerona/gly155 ◽

2018 ◽

Vol 74 (6) ◽

pp. 936-942 ◽

Cited By ~ 4

Author(s):

Sigrid Mueller-Schotte ◽

Nicolaas P A Zuithoff ◽

Yvonne T van der Schouw ◽

Marieke J Schuurmans ◽

Nienke Bleijenberg

Keyword(s):

Older Adults ◽

Activities Of Daily Living ◽

Daily Living ◽

Sensory Loss ◽

Frail Older Adults ◽

Instrumental Activities ◽

Dual Sensory Loss

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ASSESSMENT OF INSTRUMENTAL ACTIVITIES OF DAILY LIVING IN OLDER ADULTS WITH SUBJECTIVE COGNITIVE DECLINE USING THE VIRTUAL REALITY FUNCTIONAL CAPACITY ASSESSMENT TOOL (VRFCAT)

Journal of Prevention of Alzheimer's Disease ◽

10.14283/jpad.2018.28 ◽

2018 ◽

pp. 1-9

Author(s):

A.S. Atkins1 ◽

A. Khan ◽

D. Ulshen ◽

A. Vaughan ◽

D. Balentin ◽

...

Keyword(s):

Older Adults ◽

Virtual Reality ◽

Activities Of Daily Living ◽

Cognitive Decline ◽

Functional Capacity ◽

Daily Living ◽

Assessment Tool ◽

Subjective Cognitive Decline ◽

Capacity Assessment ◽

Instrumental Activities

Background: Continuing advances in the understanding of Alzheimer’s disease progression have inspired development of disease-modifying therapeutics intended for use in preclinical populations. However, identification of clinically meaningful cognitive and functional outcomes for individuals who are, by definition, asymptomatic remains a significant challenge. Clinical trials for prevention and early intervention require measures with increased sensitivity to subtle deficits in instrumental activities of daily living (IADL) that comprise the first functional declines in prodromal disease. Validation of potential endpoints is required to ensure measure sensitivity and reliability in the populations of interest. Objectives: The present research validates use of the Virtual Reality Functional Capacity Assessment Tool (VRFCAT) for performance-based assessment of IADL functioning in older adults (age 55+) with subjective cognitive decline. Design: Cross-sectional validation study. Setting: All participants were evaluated on-site at NeuroCog Trials, Durham, NC, USA. Participants: Participants included 245 healthy younger adults ages 20-54 (131 female), 247 healthy older adults ages 55-91 (151 female) and 61 older adults with subjective cognitive decline (SCD) ages 56-97 (45 female). Measures: Virtual Reality Functional Capacity Assessment Tool; Brief Assessment of Cognition App; Alzheimer’s Disease Cooperative Study Prevention Instrument Project – Mail-In Cognitive Function Screening Instrument; Alzheimer’s Disease Cooperative Study Instrumental Activities of Daily Living – Prevention Instrument, University of California, San Diego Performance-Based Skills Assessment – Validation of Intermediate Measures; Montreal Cognitive Assessment; Trail Making Test- Part B. Results: Participants with SCD performed significantly worse than age-matched normative controls on all VRFCAT endpoints, including total completion time, errors and forced progressions (p≤0001 for all, after Bonferonni correction). Consistent with prior findings, both groups performed significantly worse than healthy younger adults (age 20-54). Participants with SCD also performed significantly worse than controls on objective cognitive measures. VRFCAT performance was strongly correlated with cognitive performance. In the SCD group, VRFCAT performance was strongly correlated with cognitive performance across nearly all tests with significant correlation coefficients ranging from 0.3 to 0.7; VRFCAT summary measures all had correlations greater than r=0.5 with MoCA performance and BAC App Verbal Memory (p<0.01 for all). Conclusions: Findings suggest the VRFCAT provides a sensitive tool for evaluation of IADL functioning in individuals with subjective cognitive decline. Strong correlations with cognition across groups suggest the VRFCAT may be uniquely suited for clinical trials in preclinical AD, as well as longitudinal investigations of the relationship between cognition and function.

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