Predictors of ADL Disability in Culturally Diverse Older Adults

Abstract

Int J Exerc Sci 2(3) : 202-214, 2009. The purpose of this study was to utilize the disablement pathway model to examine the contribution of physical function, dyspnea, and pain to disability in activities-of-daily-living (ADL) in culturally diverse older adults. Participants were 51 older adults (age = 69.0 years ± 9.7; 76.5% African-American, 51.0% < high school education, 52.9% < $20,000 annual income) from an urban community center and an independent living housing facility for seniors. Participants completed the Functional Status Index (FSI), which provides ratings of need for assistance (FSIA) and pain (FSIP) with ADL, the Continuous Scale Physical Functional Performance 10-item Test (CS-PFP10), and an analog dyspnea scale. Hierarchical multiple regression analyses revealed that facility, physical function, pain, and dyspnea accounted for 50.5% of the variance in disability and that pain (β = .43, p < .01) and physical function (β = -.39, p < .01) were the only significant predictors. In the second model, facility, dyspnea, and pain explained 27.6% of the variance in physical function, and facility (β = .39, p < .01) and dyspnea (β = -.26, p = .05) were the only significant predictors. Based on the disablement pathway model, physical functional improvement and pain prevention and management should be targeted when designing culturally appropriate strategies for delaying disability and maintaining independent life.

Disparities in Disability Among Non-Hispanic Black Elders: Results From the National Interview Survey 2001–2003

“…As expected, respondents age 75 and older were more likely to report ADL and IADL disability than respondents 65-74; however, there was a higher disability rate for NHWs than NHBs for the two age groups. It's possible that this is indicative of the racial crossover effect that is seen at 85+ years (Holton, 2007). Reported disability decreased in NHBs as level of education increased.…”

“…This reversal is known as the crossover effect (Johnson, 2000). Survival of the fittest underlies the pattern of NHB crossover effect; the less healthy and more disabled NHBs die in youngold age (<85 years), leaving healthier and functional older adults, who are mostly women (Holton, 2007). Yet both the validity and the rationale of the crossover effect have been in question.…”