Garcia-Davis Sandra, Hlaing WayWay M, Vidot Denise C, Feaster Daniel J, Hansen Jared, Brintz Ben J, Intrator Orna, Leykum Luci K, Bouldin Erin D, Trivedi Ranak B, Noel Polly H, Dang Stuti
Miami VA Healthcare System, Geriatric Research, Education & Clinical Center GRECC, Miami, FL 33125, USA.
Department of Public Health Sciences, University of Miami, Miami, FL 33136, USA.
J Clin Med. 2025 Jun 13;14(12):4219. doi: 10.3390/jcm14124219.
Veterans differ in sociodemographic composition and experience higher frequencies of disability than non-Veterans of the same age. Yet the epidemiology of the long-term care needs of Veterans, specifically activities of daily living (ADLs) and instrumental activities of daily living (IADLs), remains an important gap in the literature. The objectives of this study were to (1) characterize Veterans across levels of hierarchy of ADL and IADL support needs; (2) compare Veterans across the degree of need for help, from those who can still "self-manage" to those with an "unmet need"; and (3) identify the types and prevalence of ADL and IADL need combination patterns. This study used cross-sectional data from the 2021 administration of the HERO CARE survey. We included Veterans ages 65+ in our analyses (N = 7424). We calculated the overall weighted descriptive statistics across a hierarchy of ADL and IADL problems and the degree of need for help. One-way ANOVA for continuous variables and Rao-Scott chi-square tests for categorical variables were conducted to examine associations between groups, followed by post hoc pairwise comparisons, as appropriate. Veteran respondents mean age was 82.3 (SD: 8.2 years), and most were male, non-Hispanic White, and married. In weighted analyses, more Veterans with both ADL and IADL problems compared to only ADL problems reported food insecurity, missed appointments, low health literacy, and depression. Among Veterans with ADL or IADL problems, 32.3% reported an unmet need for help. Almost a quarter of Veterans with ADL problems reported difficulties performing all eight ADLs (23.9%), and over a quarter of Veterans with IADL problems reported difficulties performing all seven IADLs (31.3%). Our findings show that Veterans are demographically and clinically different based on their hierarchy of impairment and degree of need for help. Identifying the patterns and prevalence of ADL and IADL needs among Veterans provides valuable information to align the Veterans Affairs (VA) programs and services with Veterans' needs.
退伍军人在社会人口构成方面存在差异，且与同龄非退伍军人相比，残疾发生率更高。然而，退伍军人长期护理需求的流行病学情况，特别是日常生活活动（ADL）和工具性日常生活活动（IADL）方面，在文献中仍是一个重要空白。本研究的目的是：（1）描述退伍军人在ADL和IADL支持需求层次水平上的特征；（2）比较不同需求程度的退伍军人，从仍能“自我管理”的到有“未满足需求”的；（3）确定ADL和IADL需求组合模式的类型和患病率。本研究使用了2021年HERO CARE调查管理的横断面数据。我们在分析中纳入了65岁及以上的退伍军人（N = 7424）。我们计算了ADL和IADL问题层次以及帮助需求程度的总体加权描述性统计数据。对连续变量进行单因素方差分析，对分类变量进行Rao-Scott卡方检验以检查组间关联，随后根据情况进行事后两两比较。退伍军人受访者的平均年龄为82.3岁（标准差：8.2岁），大多数为男性、非西班牙裔白人且已婚。在加权分析中，与仅有ADL问题的退伍军人相比，同时存在ADL和IADL问题的退伍军人报告有粮食不安全、错过预约、健康素养低和抑郁的情况更多。在有ADL或IADL问题的退伍军人中，32.3%报告有未满足的帮助需求。几乎四分之一有ADL问题的退伍军人报告在执行所有八项ADL时存在困难（23.9%），超过四分之一有IADL问题的退伍军人报告在执行所有七项IADL时存在困难（- 31.3%）。我们的研究结果表明，退伍军人根据其损伤层次和帮助需求程度在人口统计学和临床方面存在差异。确定退伍军人中ADL和IADL需求的模式和患病率为使退伍军人事务（VA）计划和服务与退伍军人需求相匹配提供了有价值的信息。
