Department of Rehabilitation, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
Medicine (Baltimore). 2024 Mar 1;103(9):e37318. doi: 10.1097/MD.0000000000037318.
Due to the paucity of existing evidence, this study aims to investigate the relationship between chronic disease, sensory impairment, walking limitation, and difficulty in activities of daily living (ADLs) in community-dwelling older Indians. This cross-sectional study included data from 31,394 individuals aged ≥ 60 years from the 2017 to 2018 Longitudinal Ageing Study in India. Participants were divided into 2 groups: 12,993 with chronic disease, sensory impairment, and a walking limitation, and 18,401 healthy individuals without such conditions. Participants with any chronic disease were further divided into 2 groups: sensory impairment (n = 12,462), and a walking limitation (n = 4745). Self-reported close-ended questionnaires with yes or no were used to assess each chronic disease (such as hypertension, diabetes, lung disorders, joint disorders, or heart disease), sensory impairment (vision or hearing), and walking limitation. A walking limitation was defined as being when a person could only walk at their usual pace for less than 500 meters on a flat surface. ADLs were assessed and classified as physical ADLs including basic physical requirements like dressing. Instrumental ADLs (IADLs) included more complicated community-based tasks like meal preparation. Findings showed that older Indians with chronic disease, sensory impairment, and a walking limitation were more likely to be significantly associated with physical ADLs (adjusted odds ratio [aOR] = 1.85, 95% confidence interval [CI] = 1.34-1.57, P < .0001) and IADLs (aOR = 1.45, 95% CI = 1.70-2.03, P < .0001) than those without such conditions. Among older Indians with chronic disease, sensory impairment was more likely associated with physical ADLs (aOR = 1.98, 95% CI = 1.82-2.16, P < .0001) and IADLs (aOR = 1.26, 95% CI = 1.15-1.37, P < .0001) followed by a walking limitation (aOR = 1.53, 95% CI = 1.42-1.65, P < .0001; aOR = 1.27, 95% CI = 1.17-1.38, P < .0001, respectively). These findings suggest that older Indians with chronic disease, sensory impairment, and walking limitation, can experience increased difficulty in overall and individual physical ADL and IADL than those without these conditions. Older Indians with any chronic condition who had sensory impairment or a walking limitation were also more likely to have difficulty with physical ADLs and IADLs.
由于现有证据有限，本研究旨在探讨慢性病、感觉障碍、行走受限和日常生活活动（ADL）困难在印度社区居住的老年人中的关系。这项横断面研究包括来自印度 2017 年至 2018 年纵向老龄化研究的 31394 名年龄≥60 岁的个体的数据。参与者分为两组：12993 名患有慢性病、感觉障碍和行走受限的患者，以及 18401 名健康个体。有任何慢性疾病的参与者进一步分为两组：感觉障碍（n=12462）和行走受限（n=4745）。使用有或无的自我报告封闭式问卷来评估每种慢性疾病（如高血压、糖尿病、肺部疾病、关节疾病或心脏病）、感觉障碍（视力或听力）和行走受限。行走受限的定义为一个人在平坦表面上只能以正常速度行走不到 500 米。ADL 通过评估和分类进行，包括穿衣等基本身体需求的身体 ADL。工具性 ADL（IADL）包括更复杂的基于社区的任务，如准备膳食。研究结果表明，患有慢性病、感觉障碍和行走受限的印度老年人更有可能与身体 ADL（调整后的优势比[aOR]=1.85，95%置信区间[CI]=1.34-1.57，P<.0001）和 IADL（aOR=1.45，95%CI=1.70-2.03，P<.0001）显著相关，而没有这些条件的人则不太可能相关。在患有慢性病的印度老年人中，感觉障碍更可能与身体 ADL（aOR=1.98，95%CI=1.82-2.16，P<.0001）和 IADL（aOR=1.26，95%CI=1.15-1.37，P<.0001）相关，而行走受限则不太可能相关（aOR=1.53，95%CI=1.42-1.65，P<.0001；aOR=1.27，95%CI=1.17-1.38，P<.0001）。这些发现表明，患有慢性病、感觉障碍和行走受限的印度老年人在整体和个别身体 ADL 和 IADL 方面可能比没有这些条件的老年人更难。有任何慢性疾病的老年人，无论是感觉障碍还是行走受限，也更有可能难以进行身体 ADL 和 IADL。
