1
|
Raina P, Ali MU, Joshi D, Gilsing A, Mayhew A, Ma J, Sherifali D, Thompson M, Griffith LE. The combined effect of behavioural risk factors on disability in aging adults from the Canadian Longitudinal Study on Aging (CLSA). Prev Med 2021; 149:106609. [PMID: 33984371 DOI: 10.1016/j.ypmed.2021.106609] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/19/2021] [Accepted: 05/09/2021] [Indexed: 11/28/2022]
Abstract
The objective of this study was to explore how behavioural risk factors (smoking, physical activity, and nutrition) cluster together and assess how clusters of behavioural risk factors are associated with functional disability by age and sex at the individual and population level. We used currently available baseline cross-sectional data from the Canadian Longitudinal Study on Aging (CLSA). The CLSA is a national, population-based longitudinal study established to understand and examine health of an aging population. This study included 51,338 Canadian men and women aged 45 to 85 years residing in the community in 10 Canadian provinces. Behavioural risk factors included smoking, physical activity, and nutrition. The main outcome used in the study was functional disability, which was assessed using a questionnaire adapted from the Older Americans Resources and Services Multidimensional Assessment Questionnaire. In this analyses of unique combinations of the risk factors of smoking, physical activity, and nutritional risk, the magnitude of the association of the behavioural risk factors with functional disability was dependent on which risk factors were included and differed by age and sex strata. Of the risk factors, physical activity accounted for between 70% to 90% of the total population level risk in individuals with all three risk factors, suggesting it is a key driver of the population burden of disability. Together, these results show that considering unique clusters of risk factors, as well as age and sex, is essential for tailoring public health strategies to reduce the burden of disability among aging populations.
Collapse
Affiliation(s)
- Parminder Raina
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada.
| | - Muhammad Usman Ali
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada; School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Divya Joshi
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Anne Gilsing
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Alexandra Mayhew
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Jinhui Ma
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| | - Diana Sherifali
- McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada; School of Nursing, McMaster University, Hamilton, Ontario, Canada; Population Health Research Institute, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Mary Thompson
- Department of Statistics & Actuarial Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada; Labarge Centre for Mobility in Aging, McMaster University, Hamilton, Ontario, Canada; McMaster Institute for Research on Aging, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
2
|
Gondek D, Bann D, Ning K, Grundy E, Ploubidis GB. Post-war (1946-2017) population health change in the United Kingdom: A systematic review. PLoS One 2019; 14:e0218991. [PMID: 31269039 PMCID: PMC6608959 DOI: 10.1371/journal.pone.0218991] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 06/10/2019] [Indexed: 11/18/2022] Open
Abstract
We systematically reviewed the evidence on secular trends in main chronic conditions, disability and self-assessed general health among adults in the United Kingdom, as reported in primary/secondary care databases and population-based surveys. Searches were conducted separately for: (1) trends in age-standardised or age-specific prevalence of major non-communicable diseases, disability, and self-reported general health; (2) trends in health expectancy. The databases searched were MEDLINE, EMBASE/EMBASE Classic and Web of Science (all from 1946/7). The evidence was synthesised narratively. There were 39 studies reporting trends in prevalence of health conditions and 15 studies in health expectancy. We did not find evidence for improvement in the age-standardised or age-specific prevalence of any of the studied major chronic conditions over the last few decades, apart from Alzheimer's disease and other dementias. Both increasing or stable prevalence rates with simultaneous rising life expectancy support the expansion of morbidity theory, meaning that people are expected to spend a greater number of years with chronic condition(s). The evidence on disability-expressed as prevalence or health expectancy-was mixed, but also appeared to support the expansion of morbidity among those aged 65 or over. The evidence on trends in disability for younger age is lacking. Across the studied period (1946-2017), the UK population endured more years with chronic morbidity and disability, which may place a serious strain on the health care system, the economy and the society.
Collapse
Affiliation(s)
- Dawid Gondek
- Centre for Longitudinal Studies, Department of Social Science, UCL Institute of Education, University College London, London, United Kingdom
| | - David Bann
- Centre for Longitudinal Studies, Department of Social Science, UCL Institute of Education, University College London, London, United Kingdom
| | - Ke Ning
- Centre for Longitudinal Studies, Department of Social Science, UCL Institute of Education, University College London, London, United Kingdom
| | - Emily Grundy
- Institute for Social and Economic Research, University of Essex, Colchester, United Kingdom
| | - George B. Ploubidis
- Centre for Longitudinal Studies, Department of Social Science, UCL Institute of Education, University College London, London, United Kingdom
| |
Collapse
|
3
|
Artaud F, Sabia S, Dugravot A, Kivimaki M, Singh-Manoux A, Elbaz A. Trajectories of Unhealthy Behaviors in Midlife and Risk of Disability at Older Ages in the Whitehall II Cohort Study. J Gerontol A Biol Sci Med Sci 2016; 71:1500-1506. [PMID: 27034508 PMCID: PMC5055647 DOI: 10.1093/gerona/glw060] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 03/06/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Most of the evidence on the association between unhealthy behaviors and disability comes from studies in the elderly, where reverse causation and selection bias may distort associations; thus, studies based on midlife trajectories of health behaviors are needed. We examined the association of trajectories of four health behaviors (physical activity, fruit and vegetable consumption, smoking, alcohol), starting in midlife and over 20 years, with subsequent disability risk in early old age (range = 54-84 years) in the Whitehall II cohort study. METHODS Disability was assessed three times over 3 years. A hierarchical disability indicator was constructed; participants were considered disabled if they reported difficulties with mobility and instrumental activities of daily living or with mobility and instrumental and basic activities of daily living. Behavior trajectories were defined using group-based trajectory models. Multivariable generalized estimating equations logistic models were used to examine their independent associations with disability. RESULTS Of 6,825 participants, 19.2% reported being disabled at least once. In mutually adjusted models, participants with persistent inactivity or declining physical activity, recent ex- or current smokers, and persistent/recent abstainers or persistent heavy drinkers had a higher disability risk, whereas fruit and vegetable consumption was not associated with disability. Disability risk increased progressively with the number of unhealthy behavior trajectories: the odds ratio of disability for 2-3 unhealthy trajectories was 2.69 (95% confidence interval = 2.26-3.19); these associations remained after adjustment for a wide range of covariates. CONCLUSIONS Unhealthy behavior trajectories in midlife are associated with greater disability risk later in life.
Collapse
Affiliation(s)
- Fanny Artaud
- INSERM, U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France. .,University Versailles St-Quentin, UMRS-1018, Versailles, France
| | - Séverine Sabia
- INSERM, U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France.,Department of Epidemiology and Public Health, University College London, UK.,University Paris-Sud, UMRS-1018, Villejuif, France
| | - Aline Dugravot
- INSERM, U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France.,University Paris-Sud, UMRS-1018, Villejuif, France
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, UK
| | - Archana Singh-Manoux
- INSERM, U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France.,Department of Epidemiology and Public Health, University College London, UK.,University Paris-Sud, UMRS-1018, Villejuif, France
| | - Alexis Elbaz
- INSERM, U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France.,University Paris-Sud, UMRS-1018, Villejuif, France
| |
Collapse
|
4
|
Modig K, Virtanen S, Ahlbom A, Agahi N. Stable or improved health status in the population 65 years and older in Stockholm, Sweden – an 8-year follow-up of self-reported health items. Scand J Public Health 2016; 44:480-9. [DOI: 10.1177/1403494816636248] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/04/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Karin Modig
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Suvi Virtanen
- Department of Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anders Ahlbom
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Neda Agahi
- Aging Research Center, Karolinska Institutet & Stockholm University, Stockholm, Sweden
| |
Collapse
|
5
|
Jagger C, Matthews FE, Wohland P, Fouweather T, Stephan BCM, Robinson L, Arthur A, Brayne C. A comparison of health expectancies over two decades in England: results of the Cognitive Function and Ageing Study I and II. Lancet 2016; 387:779-86. [PMID: 26680218 PMCID: PMC4761658 DOI: 10.1016/s0140-6736(15)00947-2] [Citation(s) in RCA: 110] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Whether rises in life expectancy are increases in good-quality years is of profound importance worldwide, with population ageing. We investigate how various health expectancies have changed in England between 1991 and 2011, with identical study design and methods in each decade. METHODS Baseline data from the Cognitive Function and Ageing Studies in populations aged 65 years or older in three geographically defined centres in England (Cambridgeshire, Newcastle, and Nottingham) provided prevalence estimates for three health measures: self-perceived health (defined as excellent-good, fair, or poor); cognitive impairment (defined as moderate-severe, mild, or none, as assessed by Mini-Mental State Examination score); and disability in activities of daily living (defined as none, mild, or moderate-severe). Health expectancies for the three regions combined were calculated by the Sullivan method, which applies the age-specific and sex-specific prevalence of the health measure to a standard life table for the same period. FINDINGS Between 1991 and 2011, gains in life expectancy at age 65 years (4·5 years for men and 3·6 years for women) were accompanied by equivalent gains in years free of any cognitive impairment (4·2 years [95% CI 4·2-4·3] for men and 4·4 years [4·3-4·5] for women) and decreased years with mild or moderate-severe cognitive impairment. Gains were also identified in years in excellent or good self-perceived health (3·8 years [95% CI 3·5-4·1] for men and 3·1 years [2·7-3·4] for women). Gains in disability-free years were much smaller than those in excellent-good self-perceived health or those free from cognitive impairment, especially for women (0·5 years [0·2-0·9] compared with 2·6 years [2·3-2·9] for men), mostly because of increased mild disability. INTERPRETATION During the past two decades in England, we report an absolute compression (ie, reduction) of cognitive impairment, a relative compression of self-perceived health (ie, proportion of life spent healthy is increasing), and dynamic equilibrium of disability (ie, less severe disability is increasing but more severe disability is not). Reasons for these patterns are unknown but might include increasing obesity during previous decades. Our findings have wide-ranging implications for health services and for extension of working life. FUNDING UK Medical Research Council.
Collapse
Affiliation(s)
- Carol Jagger
- Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, UK; Newcastle University Institute for Ageing, Newcastle University, Newcastle, UK.
| | - Fiona E Matthews
- Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, UK; Newcastle University Institute for Ageing, Newcastle University, Newcastle, UK; Medical Research Council (MRC) Biostatistics Unit, Cambridge Institute of Public Health, Cambridge, UK
| | - Pia Wohland
- Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, UK; Newcastle University Institute for Ageing, Newcastle University, Newcastle, UK
| | - Tony Fouweather
- Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, UK
| | - Blossom C M Stephan
- Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, UK; Newcastle University Institute for Ageing, Newcastle University, Newcastle, UK
| | - Louise Robinson
- Institute of Health and Society, Faculty of Medicine, Newcastle University, Newcastle, UK
| | - Antony Arthur
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Carol Brayne
- Department of Public Health and Primary Care, Cambridge Institute of Public Health, Cambridge University, Cambridge, UK
| |
Collapse
|
6
|
Angleman SB, Santoni G, Von Strauss E, Fratiglioni L. Temporal Trends of Functional Dependence and Survival Among Older Adults From 1991 to 2010 in Sweden: Toward a Healthier Aging. J Gerontol A Biol Sci Med Sci 2014; 70:746-52. [DOI: 10.1093/gerona/glu206] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 09/30/2014] [Indexed: 01/05/2023] Open
|
7
|
Guay M, Dubois MF, Corrada M, Lapointe-Garant MP, Kawas C. Exponential increases in the prevalence of disability in the oldest old: a Canadian national survey. Gerontology 2014; 60:395-401. [PMID: 24818716 DOI: 10.1159/000358059] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 12/17/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND As most studies generally treat all 85+ year-olds as a homogeneous group, little is known about the specific disabilities of the oldest old population, those aged 90 and older. OBJECTIVE To estimate age-specific prevalence of disability in activities of daily living for older Canadians, including the oldest old, those aged 90 and older. METHODS Cross-sectional national survey with a representative sample of noninstitutionalized Canadians aged between 50 and 104 years old (n = 28,406). Disability was self-reported and defined as needing assistance to perform self-care and domestic life activities. RESULTS The prevalence of disability increased with age, and the rise appeared exponential when considering the oldest old. At age 90, the highest estimated rates of disability were reported for housekeeping (50%), shopping (45%) and transportation (44%), and 21% reported requiring assistance for washing themselves. Compared to the 85-89 age group, the estimated proportion of people reporting disability in the 95+ age group approximately triples for self-care activities and doubles for domestic life activities. CONCLUSION Even if we knew that disability increases with age, we can now state that it increases at an accelerated rate beyond age 85. Grouping people aged 85+ into one category leads to substantial underestimates of disability in the oldest old. Accurate estimates are necessary for adequate allocation of care and rehabilitation resources for a rapidly expanding age group.
Collapse
Affiliation(s)
- Manon Guay
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Qué., Canada
| | | | | | | | | |
Collapse
|
8
|
Oksuzyan A, Jeune B, Juel K, Vaupel JW, Christensen K. Changes in hospitalisation and surgical procedures among the oldest-old: a follow-up study of the entire Danish 1895 and 1905 cohorts from ages 85 to 99 years. Age Ageing 2013; 42:476-81. [PMID: 23531440 DOI: 10.1093/ageing/aft031] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE to examine whether the Danish 1905 cohort members had more active hospital treatment than the 1895 cohort members from ages 85 to 99 years and whether it results in higher in-hospital and post-operative mortality. METHODS in the present register-based follow-up study the complete Danish birth cohorts born in 1895 (n = 12,326) and 1905 (n = 15,477) alive and residing in Denmark at the age of 85 were followed from ages 85 to 99 years with regard to hospitalisations and all-cause and cause-specific surgical procedures, as well as in-hospital and post-operative mortality. RESULTS the 1905 cohort members had more frequent hospital admissions and operations, but they had a shorter length of hospital stay than the 1895 cohort at all ages from 85 to 99 years. The increase in primary prosthetic replacements of hip joint was observed even within the 1895 cohort: no patients were operated at ages 85-89 years versus 2.2-3.6% at ages 95-99 years. Despite increased hospitalisation and operation rates, there was no increase in post-operative and in-hospital mortality rates in the 1905 cohort. These patterns were similar among men and women. CONCLUSIONS the observed patterns are compatible with more active treatment of the recent cohorts of old-aged persons and reduced age inequalities in the Danish healthcare system. No increase in post-operative mortality suggests that the selection of older patients eligible for a surgical treatment is likely to be based on the health status of old-aged persons and the safety of surgical procedures rather than chronological age.
Collapse
Affiliation(s)
- Anna Oksuzyan
- Institute of Public Health, University of Southern Denmark, J.B. Winsløwsvej 9B, Odense, Denmark.
| | | | | | | | | |
Collapse
|
9
|
Litwin H, Shrira A, Shmotkin D. Self-reported functional status among the old-old: a comparison of two Israeli cohorts. J Aging Health 2012; 24:846-62. [PMID: 22422761 PMCID: PMC3538843 DOI: 10.1177/0898264312436714] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To examine differences in functional status among two successive cohorts. METHOD The study was a comparative analysis of Jewish respondents aged 75 to 94 from two nationwide random samples: the Cross-Sectional and Longitudinal Aging Study (1989-1992; N = 1,200) and the Survey of Health, Ageing, and Retirement in Europe (2005-2006; N = 379). Self-reported functional limitation and disability were compared by means of logistic regressions and MANCOVA, controlling for age, gender, origin, education, marital status, income, self-rated health, and home care receipt. RESULTS Reported functional limitation decreased in the later cohort (SHARE-Israel), but activities of daily living (ADL) and instrumental activities of daily living (IADL) disability increased. Receipt of home care moderated these effects. ADL and IADL disability increased among home care-receiving respondents in the later cohort whereas functional limitation decreased among respondents not in receipt of home care. DISCUSSION The findings suggest that different measures used to assess the disablement process capture different aspects and that contextual factors influence how older people rate their own functional capacity.
Collapse
Affiliation(s)
- Howard Litwin
- The Hebrew University of Jerusalem, Jerusalem, Israel.
| | | | | |
Collapse
|
10
|
Chen YC, Chou YC, Lin LP, Wu CL, Lin JD. Long term trend analysis of geographical disparity in aging and disability: Taiwanese population approach. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:350-356. [PMID: 22119680 DOI: 10.1016/j.ridd.2011.10.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 10/14/2011] [Indexed: 05/31/2023]
Abstract
Purposes of the present paper were to describe the overtime change of disability prevalence among the elderly (65 years and older), and to analyze the geographic disparity of the disability prevalence during the year 2000-2010 in Taiwan. Study data mainly come from two public web-access information: (1) The physically and mentally disabled population by age and grade, 2000-2010; (2) Taiwan general population by age, 2000-2010. We used statistical methods include number, percentage and geographical information system (GIS) to describe the disability prevalence among the elderly people by year and administrative area, and a trend test was conducted to examine the overtime change of disability prevalence in the elderly people. The results found that the mean of disability prevalence rate in the elderly population was 14.8% and it was significantly increased during the past 11 years (R(2) = 0.901; p < 0.0001). With regards to the elderly disability prevalence disparity in administrative areas, those areas of higher elderly disability prevalence were more likely to occur in east-mountain areas-Taitung County (24.2%), Yilan County (21.0%), Hualien County (20.3%), and central-agricultural counties such as Yunlin County (21.8%), Nantou County (17.6%) and Chiayi County (17.3%). The most relative change areas of disability prevalence rate in the elderly population during the past 11 years were more likely to occur in central or east areas in Taiwan. The present study highlights the authorities should pay much attention to increasing rate and the geographical disparity of disability prevalence in the elderly population, to allocate appropriate health and welfare resources for this vulnerable population.
Collapse
Affiliation(s)
- Yong-Chen Chen
- Graduate Institute of Life Sciences, National Defense Medical Center, Taiwan
| | | | | | | | | |
Collapse
|
11
|
Maierhofer S, Almazán-Isla J, Alcalde-Cabero E, de Pedro-Cuesta J. Prevalence and features of ICF-disability in Spain as captured by the 2008 National Disability Survey. BMC Public Health 2011; 11:897. [PMID: 22122806 PMCID: PMC3280204 DOI: 10.1186/1471-2458-11-897] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Accepted: 11/28/2011] [Indexed: 11/25/2022] Open
Abstract
Background Since 1986, the study of disability in Spain has been mainly addressed by National Disability Surveys (NDSs). While international attempts to frame NDS designs within the International Classification of Functioning, Disability and Health (ICF) have progressed, in general, the ICF has hardly been used in either the NDS or epidemiological studies. This study sought to identify ICF Activity- and Participation-related content in the most recent Spanish NDS, the 2008 Survey on Disabilities, Independence and Dependency Situations (Encuesta sobre discapacidades, autonomía personal y situaciones de Dependencia - EDAD 2008), and estimate the prevalence of such ICF-framed disability. Methods EDAD 2008 methods and questions were perused. Of the 51 EDAD items analysed, 29 were backcoded to specific d2-d7 domains of the ICF Checklist and, by rating the recorded difficulty to perform specific tasks with or without help, these were then taken as performance and capacity respectively. A global ICF score was also derived, albeit lacking data for d1, "Learning and applying knowledge", d8, "Major Life Areas" and d9, "Community, Social and Civic Life". Data were grouped by sex, age, residence and initial positive screening, and prevalence figures were calculated by disability level both for the general population, using the originally designed weights, and for the population that had screened positive to disability. Data for institutionalised persons were processed separately. Results Crude prevalence of ICF severe/complete and moderate disability among the community-dwelling population aged ≥6 years was 0.9%-2.2% respectively, and that of severe/complete disability among persons living in sheltered accommodation was 0.3%. Prevalence of severe/complete disability was: higher in women than in men, 0.8% vs. 0.4%; increased with age; and was particularly high in domains such as "Domestic Life", 3.4%, "Mobility", 1.8%, and "Self-care", 1.9%, in which prevalence decreased when measured by reference to performance. Moreover, global scores indicated that severe/complete disability in these same domains was frequent among the moderately disabled group. Conclusions The EDAD 2008 affords an insufficient data set to be ICF-framed when it comes to the Activity and Participation domains. Notwithstanding their unknown validity, ratings for available ICF domains may, however, be suitable for consideration under the ADL model of functional dependency, suggesting that there are approximately 500,000 persons suffering from severe/complete disability and 1,000,000 suffering from moderate disability, with half the latter being severely disabled in domains capable of benefiting from technical or personal aid. Application of EDAD data to the planning of services for regions and other subpopulations means that need for personal help must be assessed, unmet needs ascertained, and knowledge of social participation and support, particularly for the mentally ill, improved. International, WHO-supported co-operation in ICF planning and use of NDSs in Spain and other countries is needed.
Collapse
Affiliation(s)
- Sarah Maierhofer
- Department of Applied Epidemiology, National Centre of Epidemiology-Consortium for Biomedical Research in Neurodegenerative Diseases (Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas - CIBERNED), Carlos III Institute of Health, Av, Monforte de Lemos 5, 28029 Madrid, Spain.
| | | | | | | |
Collapse
|
12
|
van Gool CH, Picavet HSJ, Deeg DJH, de Klerk MMY, Nusselder WJ, van Boxtel MPJ, Wong A, Hoeymans N. Trends in activity limitations: the Dutch older population between 1990 and 2007. Int J Epidemiol 2011; 40:1056-67. [PMID: 21324941 DOI: 10.1093/ije/dyr009] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND It is not clear whether recent increases in life expectancy are accompanied by a concurrent postponement of activity limitations. The objective of this study was to give best estimates of the trend in the prevalence of activity limitations among the non-institutionalized population aged 55-84 years over the period 1990-2007 in The Netherlands. METHODS We examined self-reports on 12 measures of moderate or severe activity limitations in stair climbing, walking and getting dressed as assessed by OECD long-term disability questionnaire or Short Form-36 (SF-36) items, using original data from five population-based cross-sectional and longitudinal surveys (n = 54,847 respondents). To account for heterogeneity between surveys, we used meta-analyses to study time trends. RESULTS Time trends of 10 out of the 12 activity limitation variables studied were stable. The prevalence of at least moderate activity limitations in stair climbing [odds ratio (OR) = 1.03)] and getting dressed (OR = 1.04) based on OECD items increased over the study period. Age- and gender-stratified time trend analyses showed consistent patterns. CONCLUSIONS No declines were observed in the prevalence of activity limitations in the Dutch older population over the period 1990-2007. The increase in life expectancy in this period is accompanied by a stable prevalence of most activity limitations.
Collapse
Affiliation(s)
- Coen H van Gool
- Center for Public Health Forecasting, National Institute for Public Health and Environment, Bilthoven, The Netherlands
| | | | | | | | | | | | | | | |
Collapse
|