Fong Joelle H, Selvamani Y
Lee Kuan Yew School of Public Policy, National University of Singapore, 469C Bukit Timah Road, Singapore, 259771, Singapore.
School of Public Health, SRM Institute of Science and Technology, Kattankulathur, Chennai, India.
BMC Geriatr. 2024 Jul 23;24(1):626. doi: 10.1186/s12877-024-05198-5.
To examine the prevalence of toileting disability among older adults in India and its association with broad aspects of the physical and social environment.
We use data from the inaugural wave of the Longitudinal Ageing Study in India and focus on adults aged 65 and older (N = 20,789). We draw on the disablement process model and existing frameworks to identify environmental factors and other risk factors that may be associated with toileting disability. Hierarchical logistic regressions are implemented to analyze the health impacts from physical and social environment characteristics.
One in five older Indian adults had difficulties with toileting, and the prevalence rate of this functional disability varied across sub-national regions. We find that low neighborhood trust was associated with an increased likelihood of toileting disability, as was the use of assistive mobility devices. The negative effects of these social and external environment characteristics hold when we stratified the sample by rural and urban residency. Also, older adults in urban areas without access to toilets and using shared latrines had higher odds of being disabled in terms of toileting. Other factors important in explaining toileting disability among older adults included poor self-rated health, arthritis, currently working, living in the East or West region, and having functional limitations.
Poor person-environment fit can compromise older adults' ability to perform self-care tasks. Policymakers need to look beyond the physical environment (e.g., dedicating resources to construct toilet facilities) to adopt a more holistic, multi-faceted approach in their sanitation policies. Improving the safety of neighborhood surroundings in which shared latrines are located and the availability of accessible toilets that cater to those with mobility impairments can help improve independence in toileting among older adults.
研究印度老年人如厕障碍的患病率及其与身体和社会环境广泛方面的关联。
我们使用印度纵向老龄化研究首波的数据，重点关注65岁及以上的成年人（N = 20789）。我们借鉴残疾过程模型和现有框架来识别可能与如厕障碍相关的环境因素和其他风险因素。实施分层逻辑回归分析身体和社会环境特征对健康的影响。
五分之一的印度老年成年人存在如厕困难，这种功能障碍的患病率在各邦之间有所不同。我们发现邻里信任度低与如厕障碍的可能性增加有关，使用辅助移动设备也是如此。当我们按城乡居住地对样本进行分层时，这些社会和外部环境特征的负面影响依然存在。此外，城市中无法使用厕所且使用共享厕所的老年人在如厕方面残疾的几率更高。其他在解释老年成年人如厕障碍方面重要的因素包括自我健康评价差、患有关节炎、目前正在工作、居住在东部或西部地区以及存在功能限制。
人与环境适配性差会损害老年人进行自我护理任务的能力。政策制定者需要超越物理环境（例如投入资源建设厕所设施），在其卫生政策中采取更全面、多方面的方法。改善共享厕所所在邻里环境的安全性以及提供适合行动不便者使用的无障碍厕所，有助于提高老年人在如厕方面的独立性。
