Gender, childhood and adult socioeconomic inequalities in functional disability among Chinese older adults

Zhong, Yaqin; Wang, Jian; Nicholas, Stephen

doi:10.1186/s12939-017-0662-3

Cited by 68 publications

(70 citation statements)

References 42 publications

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“…Among our participants, older women seemed more vulnerable to accumulated deficits than older men, as another study also found [37]. Women's tendency to become severely frail in later life could be explained by their higher probability of functional disability, which is a main measure of physical deficits [38]. Our results also suggested that participants with lower educational attainment were more likely to be severely frail, which was in agreement with a previous study that older adults with lower educational attainment were at increased risk of worsening frailty over a 2-year period [39].…”

Section: Discussionsupporting

confidence: 55%

Frailty index–predicted mortality is moderated by health-related behaviors: a 4-year community-based longitudinal-cohort study

Huang¹,

Chen

Bo³

et al. 2020

Preprint

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To explore the separate and joint associations between frailty and long-term, all-cause mortality with health-related behaviors in older adults. We enrolled a total of 4050 community residents age ≥60 years from Songjiang District, Shanghai, China, and followed up with them every year from 2015 to 2018.Based on the standard procedure for creating an FI, we developed one containing 28 measured variables. Survival analyses were used to examine the risk ratios (RRs) between frailty and 4-year mortality; hazard ratios (HRs) were obtained and adjusted for gender and age. Over an average follow-up time of 1107.56 ± 144.43 days, 216 (5.4%) participants died. Of all participants, 71.7% were non-frail (FI = 0–0.1), 23.2% were pre-frail (FI = 0.1–0.2), and 5.1% were frail (FI ³0.2). Multivariate HRs (with 95% confidence intervals [CIs]) for all-cause mortality were 1.58 (1.06–2.34) and 2.63 (1.52 –4.55) for moderate (FI 0.1–0.2) and severe (FI >0.2) frailty, respectively, compared with mild frailty (<0.1). Risk of death for severely frail participants who were physically inactive (HR = 3.40; 95% CI, 1.78–6.50; P < 0.001) was 105%, much higher than for severely frail participants who performed physical exercise (HR = 2.34; 95% CI, 1.35–4.09; P < 0.01). Similarly, among severely frail participants, those who were socially inactive (HR = 5.77; 95% CI, 2.69–12.38; P < 0.01) were 344% more likely to die than those who regularly participated in social activities (HR = 2.33; 95% CI, 1.42–3.86; P < 0.01).

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Section: Discussionsupporting

confidence: 55%

Frailty index–predicted mortality is moderated by health-related behaviors: a 4-year community-based longitudinal-cohort study

Huang¹,

Chen

Bo³

et al. 2020

Preprint

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“…Besides, a series of independent variables included in CHARLS dataset were taken into account based on a comprehensive literature review [3,5,8,[19][20][21][22][23][24][25][26]. A set of variables were included to identify the long-term effect of childhood environment and health.…”

Section: Other Covariatesmentioning

confidence: 99%

Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective

2020

IJERPH

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Background: China has the largest number of aging people in need of long-term care, among whom 70% have chronic diseases. For policy planners, it is necessary to understand the different levels of needs of long-term care and provide long-term care insurance to ensure the long-term care needs of all people can be met. Methods: This study combines the 2013 wave of CHARLS survey and the Life Course Survey of 2014. The combination allows us to factor in both childhood and adulthood data to provide life-course analysis. We identified 7,734 older adults with chronic diseases for analysis. The need for long-term care is defined by the presence of functional limitations based on the performance of basic activities of daily living (ADLs) and of instrumental activities of daily living (IADLs). Two dummy variables, ADLs disability and IADLs disability, and two count variables, ADLs score and IADLs score, were defined to measure incidence and severity of long-term care need, respectively. The concentration index was used to capture the inequality in long-term care need, and a decomposition method based on Probit Regression and Negative Binomial Regression was exploited to identify the contribution of each determination. Results: At least a little difficulty was reported in ADLs and IADLs in 20.44% and 19.25% of respondents, respectively. The concentration index of ADLs disability, ADLs score, IADLs disability, IADLs score were −0.085, −0.109, −0.095 and −0.120, respectively, all of which were statistically significant, indicating the pro-poor inequality in the incidence and severity of long-term care need. Decomposition analyses revealed that family income, education attainment, aging, and childhood experience played a significant role in explaining the inequalities. Conclusions: The long-term care need among older adults with chronic disease is high in China and low socioeconomic groups had a higher probability of needing long-term care or need more long-term care. It is urgent to implement long-term care insurance, especially for the individuals from lower socioeconomic groups.

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“…Based on previous literature (26,(34)(35)(36)(37)(38)(39)(40)(41)(42), several socio-demographic and clinical characteristics were included in the analyses as covariates because they have shown associations with ADL and/or different aspects of housing in people with PD or older adults.…”

Section: Other Covariatesmentioning

confidence: 99%

Longitudinal association between housing accessibility and activities of daily living: the role of self-efficacy and control in people ageing with Parkinson’s disease

Gefenaitė¹,

Björk

Iwarsson³

et al. 2020

Preprint

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Background External housing-related control beliefs (HCB) and general self-efficacy (GSE) influence different health outcomes in the general ageing population, but there is no information of their role in people ageing with Parkinson’s disease (PD). This study aimed to longitudinally assess the role of external HCB and GSE on the association between housing accessibility and activities of daily living (ADL) among people ageing with PD.Methods Baseline and 3-year follow-up data on 130 community-living participants from the Swedish project ‘Home and Health in People Ageing with PD’ were collected. Assessments addressed housing accessibility, external HCB, GSE, generic ADL and ADL specific to PD. The moderating effects of external HCB and GSE were assessed by including an interaction term in multivariable logistic regression. Results There were statistically significant interactions between housing accessibility and GSE on ADL (p=0.03), and housing accessibility and external HCB on PD specific ADL (p=0.03). After stratifying the analyses by GSE, housing accessibility problems led to more dependence and difficulty in ADL in participants with low GSE (OR 1.14; 95% CI 1.02-1.28). After stratifying by external HCB, housing accessibility increased dependence and difficulty in PD specific ADL in participants with low external HCB (OR 1.35; 95% CI 1.03-1.76). Discussion The results suggest that housing accessibility predicts ADL in people with PD with GSE and external HCB playing a moderating role for generic ADL and ADL specific to PD, respectively. Further longitudinal studies should validate these findings and explore their potential application in PD-related care and rehabilitation.

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Gender, childhood and adult socioeconomic inequalities in functional disability among Chinese older adults

Cited by 68 publications

References 42 publications

Frailty index–predicted mortality is moderated by health-related behaviors: a 4-year community-based longitudinal-cohort study

Frailty index–predicted mortality is moderated by health-related behaviors: a 4-year community-based longitudinal-cohort study

Decomposing Inequality in Long-Term Care Need Among Older Adults with Chronic Diseases in China: A Life Course Perspective

Longitudinal association between housing accessibility and activities of daily living: the role of self-efficacy and control in people ageing with Parkinson’s disease

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