Department of Public Health and Mortality Studies, International Institute for Population Sciences, Mumbai, India.
Department of Mathematical Demography and Statistics, International Institute for Population Sciences, Mumbai, India.
BMC Public Health. 2021 Aug 12;21(1):1541. doi: 10.1186/s12889-021-11591-1.
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.
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.
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.
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.
研究通过结合日常生活活动（ADL）和工具性日常生活活动（IADL）来研究老年人的功能障碍。本研究通过结合老年人的各种损伤，如听力、视力、行走、咀嚼、说话和记忆丧失，为 ADL 和 IADL 增加了另一个维度。本研究通过 ADL、IADL 以及各种损伤来检查印度老年人的功能障碍。
本研究利用了印度人口老龄化知识库建设（BKPAI）的数据，这是一项全国性调查，在印度七个邦进行。该研究使用了三个结果变量，即 ADL、IADL 和损伤。描述性和双变量分析以及多变量分析用于实现研究目标。计算了 ADL、IADL 和损伤的集中指数，并对 IADL 进行了分解分析。
研究结果表明，近 7.5%的老年人在 ADL 方面无法完全独立。超过一半（56.8%）的老年人在 IADL 方面无法完全独立，近四分之三（72.6%）的老年人报告有损伤。总体而言，80 岁以上的老年人、自我报告健康状况较差的老年人和患有慢性病的老年人的 ADL、IADL 和损伤程度更高。ADL（AOR=6.42，95%CI：5.1-8.08）、IADL（AOR=5.08，95%CI：4.16-6.21）和损伤（AOR=3.50，95%CI：2.73-4.48）的可能性在 80 岁以上的老年人中显著高于 60-69 岁的老年人。此外，自我报告健康状况较差和患有慢性病的老年人更有可能报告 ADL（AOR=2.95，95%CI：2.37-3.67 和 AOR=2.70，95%CI：2.13-3.43）、IADL（AOR=1.74，95%CI：1.57-1.92 和 AOR=1.15，95%CI：1.04-1.15）和损伤（AOR=2.36，95%CI：2.11-2.63 和 AOR=2.95，95%CI：2.65-3.30）。受教育程度和财富解释了老年人 IADL 患病率中大部分的社会经济不平等。
建议政府建议老年人采取促进健康的方法，这可能会有所帮助。此外，迫切需要为患有慢性病的老年人提供高质量的护理。
