Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.
Department of Health and Nursing Science, Inland Norway University of Applied Sciences, Elverum, Norway.
Front Public Health. 2023 Oct 4;11:1215417. doi: 10.3389/fpubh.2023.1215417. eCollection 2023.
Maintaining independence in activities of daily living (ADL) is essential for the well-being of older adults. This study examined the relationship between demographic and living situation factors and ADL independence among community-dwelling older adults in Norway.
Data was collected in Norway between 2017 and 2019 as part of the fourth wave of the ongoing Trøndelag Health Study (HUNT) survey, sent to all citizens in Trøndelag county over 20 years of age, which is considered representative of the Norwegian population. Included in the current cross-sectional study were 22,504 community-living individuals aged 70 years or older who completed the survey and responded to all items constituting the ADL outcome measure. Group differences in ADL independence were examined with Chi Square tests, while crude and adjusted associations with ADL independence were examined with logistic regression analyses. Statistical significance was set at < 0.05.
The participants reported a high degree of independence in primary ADL and slightly lower in instrumental ADL. In the fully adjusted analyses, ADL independence was associated with lower age, female gender, higher levels of education and income, higher subjective well-being, having no chronic or disabling disease, and having someone to talk to in confidence. Surprisingly, women who were married had higher likelihood of ADL independence than unmarried women, whereas married men had lower likelihood of ADL independence than unmarried men.
In addition to known demographic and disease-related factors, the social context affects independence in ADL even in a society that offers advanced health and homecare services to all older adults equally. Furthermore, the same social setting can have differential effects on men and women. Despite the healthcare system in Norway being well-developed, it does not completely address this issue. Further improvements are necessary to address potential challenges that older adults encounter regarding their social connections and feelings of inclusion. Individuals with limited education and income are especially susceptible to ADL dependency as they age, necessitating healthcare services to specifically cater to this disadvantaged demographic.
维持日常生活活动（ADL）的独立性对于老年人的幸福至关重要。本研究探讨了挪威社区居住的老年人的人口统计学和生活状况因素与 ADL 独立性之间的关系。
数据于 2017 年至 2019 年期间在挪威收集，作为正在进行的特隆赫姆健康研究（HUNT）调查的第四波，该调查发送给特隆赫姆县所有 20 岁以上的公民，被认为是挪威人口的代表。本横断面研究包括 22504 名年龄在 70 岁或以上的社区居住者，他们完成了调查并回答了构成 ADL 结果测量的所有项目。使用卡方检验检查 ADL 独立性的组间差异，同时使用逻辑回归分析检查 ADL 独立性的粗关联和调整关联。统计显著性设为<0.05。
参与者报告在主要 ADL 方面具有高度独立性，在工具性 ADL 方面略低。在完全调整的分析中，ADL 独立性与较低的年龄、女性性别、较高的教育和收入水平、较高的主观幸福感、没有慢性或致残性疾病以及有可以倾诉的人有关。令人惊讶的是，已婚女性比未婚女性更有可能具有 ADL 独立性，而已婚男性比未婚男性更不可能具有 ADL 独立性。
除了已知的人口统计学和与疾病相关的因素外，社会环境甚至在一个向所有老年人平等提供先进的医疗和家庭护理服务的社会中，也会影响 ADL 的独立性。此外，相同的社会环境对男性和女性可能会产生不同的影响。尽管挪威的医疗保健系统发达，但它并没有完全解决这个问题。需要进一步改进，以解决老年人在社会联系和包容感方面遇到的潜在挑战。受教育程度和收入有限的人随着年龄的增长特别容易依赖 ADL，因此医疗保健服务需要专门针对这一弱势群体。
