International Institute for Population Sciences, Mumbai, Maharashtra, India.
International Institute for Population Sciences, Mumbai, Maharashtra, India
BMJ Open. 2022 Apr 29;12(4):e054661. doi: 10.1136/bmjopen-2021-054661.
OBJECTIVES: This study investigates the gender disparities in difficulty in activities of daily living (ADL) and instrumental activities of daily living (IADL) and explores its contributing factors among older adults in India. DESIGN: A cross-sectional study was conducted using country representative survey data. SETTING AND PARTICIPANTS: The present study uses the data from the Longitudinal Ageing Study in India, 2017-2018. Participants included 15 098 male and 16 366 female older adults aged 60 years and above in India. PRIMARY AND SECONDARY OUTCOME MEASURES: Difficulty in ADL and IADL were the outcome variables. Descriptive statistics and bivariate analysis were carried out to present the preliminary results. Multivariate decomposition analysis was used to identify the contributions of covariates that explain the group differences to average predictions. RESULTS: There was a significant gender differential in difficulty in ADL (difference: 4.6%; p value<0.001) and IADL (difference: 17.3%; p value<0.001). The multivariate analysis also shows significant gender inequality in difficulty in ADL (coefficient: 0.046; p value<0.001) and IADL (coefficient: 0.051; p value<0.001). The majority of the gender gap in difficulty in ADL was accounted by the male-female difference in levels of work status (18%), formal education (15% contribution), marital status (13%), physical activity (9%), health status (8%) and chronic morbidity prevalence (5%), respectively. Equivalently, the major contributors to the gender gap in difficulty in IADL were the level of formal education (28% contribution), marital status (10%), alcohol consumption (9%), health status (4% contribution) and chronic morbidity prevalence (2% contribution). CONCLUSION: Due to the rapidly increasing ageing population, early detection and prevention of disability or preservation of daily functioning for older adults and women in particular should be the highest priority for physicians and health decision-makers.
目的:本研究旨在调查印度老年人日常生活活动(ADL)和工具性日常生活活动(IADL)困难方面的性别差异,并探讨其影响因素。 设计:这是一项使用具有全国代表性的调查数据进行的横断面研究。 地点和参与者:本研究使用了 2017-2018 年印度纵向老龄化研究的数据。参与者包括印度 15098 名男性和 16366 名女性 60 岁及以上的老年人。 主要和次要结果测量:ADL 和 IADL 困难是结果变量。进行了描述性统计和双变量分析以呈现初步结果。使用多元分解分析来确定解释群体差异对平均预测的协变量的贡献。 结果:ADL(差异:4.6%;p 值<0.001)和 IADL(差异:17.3%;p 值<0.001)方面存在显著的性别差异。多元分析还显示,ADL(系数:0.046;p 值<0.001)和 IADL(系数:0.051;p 值<0.001)方面存在显著的性别不平等。ADL 困难方面的性别差距主要归因于工作状态(18%)、正规教育(15%)、婚姻状况(13%)、身体活动(9%)、健康状况(8%)和慢性病患病率(5%)的男女差异。同样,IADL 困难方面的主要贡献因素是正规教育水平(28%)、婚姻状况(10%)、饮酒(9%)、健康状况(4%)和慢性病患病率(2%)。 结论:由于人口老龄化迅速增加,医生和卫生决策者应将早期发现和预防残疾或维持老年人特别是妇女的日常功能作为最高优先事项。
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