Md Sharif Shakirah, Jawahir Suhana, Fun Weng Hong, Tan Ee Hong, Md Razman Alif Haikal, Awang Halimah, Sararaks Sondi, Mansor Norma
Centre for Health Outcomes Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, Shah Alam, 40170, Selangor, Malaysia.
Centre for Health Equity Research, Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, Shah Alam, 40170, Selangor, Malaysia.
BMC Geriatr. 2025 Jul 2;25(1):447. doi: 10.1186/s12877-025-06076-4.
Population ageing is a global phenomenon that resulted from the demographic transition. Senescence leads to increasing dependency on carrying out Activities of Daily Living (ADL). Limitations in ADL impact not only the individual but also the society through higher demand for social and health care services. Thus, this study aims to describe the prevalence of ADL limitation and determine factors associated with transition from independence to ADL limitation among community-dwelling older adults in Malaysia.
A prospective cohort study using data from 2275 adults aged 60 and above from the Malaysia Ageing and Retirement Survey, was conducted. Respondents were categorised into independent and with ADL limitation, defined as the inability to carry out at least one ADL item, measured using items adapted from the Barthel's index. Those who were independent at baseline were followed up three years later to determine their ADL limitation status. Logistic regression analysis was conducted to assess whether sociodemographic and health factors such as age, sex, education attainment, multimorbidity, cognition, level of physical activity, health status, and body mass index (BMI) predicted the transition from independence to ADL limitation.
The baseline prevalence of ADL limitation was 15.7%. Among those who were independent at baseline, 8.2% developed ADL limitation at follow-up. Increasing age, female sex, poor health status, lower levels of physical activity, and abnormal BMI were predictors of transition from independence to ADL limitation at follow-up (AUC = 0.83).
The prevalence of ADL limitation among community-dwelling older adults in Malaysia was comparable to the other reported figures. Lower levels of physical activity and abnormal BMI were two modifiable predictors of transition to ADL limitation among independent older adults. As such, policy strategies to further enhance active lifestyles and maintain normal BMI levels, especially among independent older adults, should be explored.
人口老龄化是由人口转变导致的全球现象。衰老导致对开展日常生活活动（ADL）的依赖增加。ADL的限制不仅影响个人，还通过对社会和医疗服务的更高需求影响社会。因此，本研究旨在描述马来西亚社区居住的老年人中ADL限制的患病率，并确定与从独立状态转变为ADL限制相关的因素。
使用来自马来西亚老龄化与退休调查的2275名60岁及以上成年人的数据进行了一项前瞻性队列研究。受访者被分为独立组和有ADL限制组，ADL限制定义为无法完成至少一项ADL项目，使用改编自巴氏指数的项目进行测量。对基线时独立的受访者在三年后进行随访，以确定他们的ADL限制状态。进行逻辑回归分析，以评估年龄、性别、教育程度、多种疾病、认知、身体活动水平、健康状况和体重指数（BMI）等社会人口学和健康因素是否能预测从独立状态转变为ADL限制。
ADL限制的基线患病率为15.7%。在基线时独立的受访者中，8.2%在随访时出现了ADL限制。年龄增加、女性、健康状况差、身体活动水平较低和BMI异常是随访时从独立状态转变为ADL限制的预测因素（AUC = 0.83）。
马来西亚社区居住的老年人中ADL限制的患病率与其他报告数据相当。身体活动水平较低和BMI异常是独立老年人转变为ADL限制的两个可改变的预测因素。因此，应探索进一步促进积极生活方式和维持正常BMI水平的政策策略，特别是在独立老年人中。
