Validation of the global activity limitation indicator in Taiwan

An exploratory study on the application of screening of activity limitation and safety awareness (SALSA) scale for evaluation of activity limitation among elderly

BACKGROUND

Aging poses a significant risk for activity and functional limitations. Problems among aged populations are interrelated, and these problems can lead to other disorders and finally leave a negative impact on the quality of life (QoL) This study used the screening of activity limitation and safety awareness (SALSA) scale to screen and measure activity limitations among the elderly.

MATERIALS AND METHODS

A community-based descriptive cross-sectional study was conducted among 928 elderly from the three districts of Tamil Nadu, India. The SALSA scale was administered via a door-to-door interview, and data analysis was carried out. Simple random sampling was used to obtain the study subjects in the selected study area. Chi-square tests and binary logistic regression were performed to find the association between selected risk factors.

RESULTS

Among the 928 elderly, 53.7% of them were males, 84.9% were between the age of 60 and 69 years, and 31% were 70 years and above. The study found that 66.5% of the elderly have mild activity limitations, 15.7% of them had moderate limitations, 4.8% of them had severe limitations, around 3% of them had extreme limitations, and 10.3% of them had no significant limitations. The binary logistic regression found people of age 65 and above (OR = 3.80), female gender (OR = 2.90), with hypertension (OR = 1.95), vision problem (OR = 1.92), decreased sensation of the foot (OR = 3.41), as the significant independent risk factors for activity limitation among the elderly.

CONCLUSION

The study found self-reported activity limitations among the elderly to be nearly 90%. The SALSA scale may be used as a handy tool to identify the activity limitation in community-based geriatric checkups.

Trends in inequalities in disability in Europe between 2002 and 2017

BACKGROUND

Monitoring socioeconomic inequalities in population health is important in order to reduce them. We aim to determine if educational inequalities in Global Activity Limitation Indicator (GALI) disability have changed between 2002 and 2017 in Europe (26 countries).

METHODS

We used logistic regression to quantify the annual change in disability prevalence by education, as well as the annual change in prevalence difference and ratio, both for the pooled sample and each country, as reported in the European Union Statistics on Income and Living Conditions (EU-SILC) and the European Social Survey (ESS) for individuals aged 30-79 years.

RESULTS

In EU-SILC, disability prevalence tended to decrease among the high educated. As a result, both the prevalence difference and the prevalence ratio between the low and high educated increased over time. There were no discernible trends in the ESS. However, there was substantial heterogeneity between countries in the magnitude and direction of these changes, but without clear geographical patterns and without consistency between surveys.

CONCLUSIONS

Socioeconomic inequalities in disability appear to have increased over time in Europe between 2002 and 2017 as per EU-SILC, and have persisted as measured by the ESS. Efforts to further harmonise disability instruments in international surveys are important, and so are studies to better understand international differences in disability trends and inequalities.

Association of the global activity limitation indicator with specific measures of disability in adults aged below 65

BACKGROUND

health measures as the global activity limitation indicator (GALI) or self-rated health (SRH) allow to quantify and monitor the health of the population. The GALI is widely used in the European Union; however, evidence of its construct validity is still limited. We examine whether the GALI reflects disability in specific living contexts such as self-care, domestic life and work activity, whether it does so consistently across gender and age and its added value concerning SRH.

METHODS

We used the subsample of adults aged 16-64 years (N = 15 934) from the 2009 European Health Interview Survey in Spain and analyzed the data with logistic regression models using the GALI and SRH as response variables.

RESULTS

The GALI was strongly and significantly associated with the three measures of disability: self-care (OR = 22.8, 95% CI: 15.9-32.7), domestic life (OR = 16.3, 95% CI: 13.6-19.5) and work activity (e.g. impossibility to work: OR = 41.9, 95% CI: 30.3-57.8; prolonged sick leave: OR = 10.7, 95% CI: 9-12.7). There were significant interactions with age on all three disability measures and with the gender on one (domestic life), although they were small. SRH was also strongly associated with all three disability measures, but to a lesser extent than the GALI.

CONCLUSIONS

The GALI reflects well and better than SRH, disability in self-care, domestic life and work activity. It is unknown whether the GALI performs equally in other living contexts such as social relations and community life.

Are We Living Longer and Healthier?

Objective: To examine whether we live healthier as we live longer in Hong Kong, which has one of the highest life expectancies in the world. Methods: Sullivan's method was used to evaluate the chronic disease-free life expectancy (CDFLE), life expectancy in good self-perceived health (GPHLE), and impairment-free life expectancy (IFLE) among population aged 50 years and older in Hong Kong in 2007-2016. Results: In spite of the marked improvement in life expectancy in Hong Kong, the increase in GPHLE was much smaller, while CDFLE and IFLE even declined for both genders. The situation was more severe among older population. Discussion: People in Hong Kong live longer but with worsening health. The expansion of chronic diseases, self-perceived poor health, and impairments among older adults calls for more fiscal investments, government attention, and public health policies.

Prospects of activity limitations among older adults in 23 low and middle income countries

Increasing life expectancy and a growing share of older people around the world spotlight the issue of health during additional years of life. Research on trends of proportions of older people with activity limitations for low and middle income countries is sparse. We use data from the World Health Survey and the UN World Population Prospects to predict prevalence of activity limitations for 23 low and middle income countries for the upcoming 30 years. Our projections highlight huge variation in the proportion of older adults with limitations across investigated countries and this variation is not expected to diminish. However, these countries are facing considerable demographic changes and even though prevalence rates appear almost constant, absolute numbers are changing which require policy interventions. Furthermore, variations across countries reflect not only disparities in health conditions, but also differences in cultural peculiarities of reporting and historical perception of health.