Oh Eunmi, Moon SeolHwa, Hong Gwi-Ryung Son
Research Institute of Nursing Science, Hanyang University, Seoul, Republic of Korea.
Department of Nursing, Hoseo University, Cheonan-si, Republic of Korea.
Front Public Health. 2024 Dec 13;12:1485732. doi: 10.3389/fpubh.2024.1485732. eCollection 2024.
As life expectancy increases, the number of older adults with functional limitations is also increasing. Functional limitations are associated with adverse health outcomes such as reduced independence, diminished quality of life (QoL), and disability. Therefore, identifying which activities of daily living (ADLs) are limiting and understanding the influencing factors are crucial for developing tailored interventions. Although various factors influence ADL limitations, few studies have identified the longitudinal factors associated with each ADL. This study explores the longitudinal trends and factors associated with the ADL total score and functional limitations with each ADL among older adults in Korea.
Using data from the Korean Longitudinal Study of Aging (KLoSA) from 2006 to 2020, we analyzed 1,388 people aged 65 and older who had no ADL limitations in 2006. An ADL limitation was defined as partial or complete dependence in any of the following ADLs: getting dressed, washing face and hands, bathing, eating, transferring, toileting, and continence. We used repeated measures analysis of variance and multivariate logistic regression to investigate the trends and predictors of ADL limitations over a 14-year period.
In 2006, the mean age of the participants was 69.88 years (SD = ±4.11), and 60.20% were female. The prevalence of total ADL limitations and limitations in each of the seven ADLs increased gradually during the 14 years of follow up. In 2020, the ADL items with the highest prevalence of limitations were bathing, getting dressed, and washing face and hands. The common significant predictors for total ADL limitations and limitation in the top three ADLs were age and cognitive function.
ADL limitations among Korean older adults significantly increase over time, which highlights the need for integrated early intervention and continuous support for bathing limitations, including the application of integrated assistive technologies. In particular, because age and cognitive function were identified as the major predictors for limitations in both total ADLs and the top three ADLs, early assessment and appropriate intervention strategies need to consider those factors to prevent ADL limitations in older adults or to meet the immediate needs of those already experiencing ADL limitations. This approach could enhance the QoL for older adults and contribute to the development of long-term healthcare plans.
随着预期寿命的增加，功能受限的老年人数量也在上升。功能受限与不良健康后果相关，如独立性降低、生活质量（QoL）下降和残疾。因此，确定哪些日常生活活动（ADL）具有限制作用并了解其影响因素对于制定针对性干预措施至关重要。尽管多种因素影响ADL受限情况，但很少有研究确定与每项ADL相关的纵向因素。本研究探讨了韩国老年人ADL总分及每项ADL功能受限情况的纵向趋势和相关因素。
利用韩国老龄化纵向研究（KLoSA）2006年至2020年的数据，我们分析了2006年时无ADL受限的1388名65岁及以上老年人。ADL受限定义为在以下任何一项ADL中存在部分或完全依赖：穿衣、洗脸洗手、洗澡、进食、转移、如厕和大小便控制。我们使用重复测量方差分析和多变量逻辑回归来研究14年间ADL受限的趋势和预测因素。
2006年，参与者的平均年龄为69.88岁（标准差=±4.11），女性占60.20%。在14年的随访期间，ADL总受限情况以及七项ADL中每项的受限情况患病率逐渐上升。2020年，受限患病率最高的ADL项目是洗澡、穿衣和洗脸洗手。ADL总受限以及前三项ADL受限的常见显著预测因素是年龄和认知功能。
韩国老年人的ADL受限情况随时间显著增加，这凸显了对洗澡受限情况进行综合早期干预和持续支持的必要性，包括应用综合辅助技术。特别是，由于年龄和认知功能被确定为ADL总受限以及前三项ADL受限的主要预测因素，早期评估和适当的干预策略需要考虑这些因素，以预防老年人的ADL受限或满足那些已经存在ADL受限者的迫切需求。这种方法可以提高老年人的生活质量，并有助于制定长期医疗保健计划。
