Díaz-Venegas Carlos, Reistetter Timothy A, Wang Ching-Yi, Wong Rebeca
a Rehabilitation Sciences Academic Division & Research Center , University of Texas Medical Branch , Galveston , TX , USA ;
b Department of Physical Therapy , University of Texas Medical Branch , Galveston , TX , USA ;
Disabil Rehabil. 2016 Oct;38(20):2016-27. doi: 10.3109/09638288.2015.1111435. Epub 2016 Jan 5.
This paper seeks to document the progression of disability in a developing country and to examine gender differences in this process.
The data come from the Mexican Health and Aging Study (MHAS), a nationally representative sample of older adults. An ordinal logistic regression (n = 3283) is used to measure the progression of disability that considers: (1) no disability, (2) mobility problems, (3) mobility problems with IADLs limitations, (4) mobility problems with ADLs limitations, (5) combinations of the latter three and (6) death.
Approximately 43% of the sample remained in the same level of disability after 2 years. The patterns of progression with two disabilities differ for men and women.
Our model reflects the importance of separating ADLs and IADLs in the study of disability progression in Mexico. Varying risk profiles and cultural differences might influence the divergent disability paths followed by each gender. Implications for Rehabilitation The disablement process involving transitions from mobility impairments to IADL and ADL limitations seen in developed countries differs for older adults in Mexico. Cultural differences may influence the progression from non-disabled to becoming disabled in different ways for females in developing countries like Mexico. One-fifth of individuals showed greater function and independence over time, suggesting that the disablement process is reversible. This finding highlights the need to focus on improving mobility, ADL, and IADL skills to facilitate successful aging. Although disability is often conceptualised as a combination of ADL and IADL limitations, gender differences seen in Mexico indicate the need to separate ADL and IADL when developing approaches to prevent or ameliorate disability.
本文旨在记录一个发展中国家的残疾进展情况，并研究这一过程中的性别差异。
数据来自墨西哥健康与老龄化研究（MHAS），这是一个具有全国代表性的老年人样本。采用有序逻辑回归（n = 3283）来衡量残疾进展情况，该模型考虑以下几种情况：（1）无残疾；（2）行动不便；（3）行动不便且有工具性日常生活活动受限；（4）行动不便且有日常生活活动受限；（5）后三种情况的组合；（6）死亡。
约43%的样本在两年后仍处于相同的残疾水平。男性和女性在两种残疾情况下的进展模式有所不同。
我们的模型反映了在墨西哥残疾进展研究中区分日常生活活动和工具性日常生活活动的重要性。不同的风险状况和文化差异可能会影响不同性别所经历的不同残疾路径。康复意义在墨西哥，老年人的残疾过程与发达国家不同，发达国家中从行动障碍到工具性日常生活活动和日常生活活动受限的转变在墨西哥并不相同。在像墨西哥这样的发展中国家，文化差异可能会以不同方式影响女性从非残疾到残疾的转变。五分之一的个体随着时间推移表现出了更好的功能和独立性，这表明残疾过程是可逆的。这一发现凸显了专注于提高行动能力、日常生活活动能力和工具性日常生活活动能力以促进成功老龄化的必要性。尽管残疾通常被概念化为日常生活活动和工具性日常生活活动受限的组合，但在墨西哥观察到的性别差异表明，在制定预防或改善残疾的方法时，需要区分日常生活活动和工具性日常生活活动。
