School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA.
School of Nursing, University of Michigan, Ann Arbor, Michigan, USA.
J Gerontol A Biol Sci Med Sci. 2024 Jul 1;79(7). doi: 10.1093/gerona/glae104.
The development of disability related to activities of daily living (ADL) is of great concern in the aging population, particularly for Hispanic and Non-Hispanic (NH) Black older adults, where disability prevalence is greater compared to NH Whites. ADL-disability is typically measured across many functional tasks without differentiating upper- versus lower-limb limitations, hindering our understanding of disability burden. Despite the importance of the upper limbs for completing ADL and known age-related declines in function, racial/ethnic differences in upper limb function remain largely unknown.
We identified 4 292 NH White, NH Black, and Mexican American older adults (≥65) from the 2011-2018 waves of the National Health and Nutrition Examination Survey (NHANES). We classified participants as having a limitation based on their ability to complete 5 upper-limb tasks (preparing meals, eating, dressing, reaching overhead, and grasping small objects) and compared limitation rates across racial/ethnic groups.
Compared to NH Whites, NH Black older adults had significantly greater odds of reporting difficulties preparing meals (odds ratio [OR]: 1.36, 95% confidence interval [95% CI]: 1.01, 1.86) and dressing (OR: 1.55, 95% CI: 1.19, 2.02), while Mexican Americans had greater difficulty preparing meals (OR: 1.70, 95% CI: 1.12, 2.58), dressing (OR: 1.63, 95% CI: 1.12, 2.36), and grasping small objects (OR: 1.48, 95% CI: 1.06, 2.07).
Our results demonstrate differences in self-reported upper limb ADL-disability across racial/ethnic groups, particularly for Mexican American older adults. Such findings underscore the need for routine monitoring of upper limb function throughout adulthood to identify limitations and target therapeutic interventions before independence is compromised.
日常生活活动（ADL）相关残疾的发展是老龄化人口中非常关注的问题，特别是对于西班牙裔和非西班牙裔（NH）黑种人老年人，他们的残疾患病率高于 NH 白种人。ADL 残疾通常通过许多功能任务进行测量，而不区分上下肢限制，这阻碍了我们对残疾负担的理解。尽管上肢对于完成 ADL 很重要，并且已知功能随着年龄的增长而下降，但上肢功能的种族/民族差异在很大程度上仍未被发现。
我们从 2011-2018 年全国健康和营养检查调查（NHANES）的多个波次中确定了 4292 名 NH 白种人、NH 黑种人和墨西哥裔美国老年人（≥65 岁）。我们根据他们完成 5 项上肢任务的能力将参与者分类为有或无限制，并比较了不同种族/民族群体的限制率。
与 NH 白人相比，NH 黑人老年人在准备膳食（优势比[OR]：1.36，95%置信区间[95%CI]：1.01，1.86）和穿衣（OR：1.55，95%CI：1.19，2.02）方面报告困难的可能性显著更高，而墨西哥裔美国人在准备膳食（OR：1.70，95%CI：1.12，2.58）、穿衣（OR：1.63，95%CI：1.12，2.36）和抓握小物体（OR：1.48，95%CI：1.06，2.07）方面报告困难的可能性更高。
我们的结果表明，不同种族/民族群体的自我报告上肢 ADL 残疾存在差异，特别是对于墨西哥裔美国老年人。这些发现强调了在整个成年期常规监测上肢功能的必要性，以识别限制并在独立性受损之前针对治疗干预。
