Prevalence of disability in a composite ≥75 year-old population in Spain: A screening survey based on the International Classification of Functioning

Abstract

BackgroundThe prevalence and predictors of functional status and disability of elderly people have been studied in several European countries including Spain. However, there has been no population-based study incorporating the International Classification of Functioning, Disability and Health (ICF) framework as the basis for assessing disability. The present study reports prevalence rates for mild, moderate, and severe/extreme disability by the domains of activities and participation of the ICF.MethodsNine populations surveyed in previous prevalence studies contributed probabilistic and geographically defined samples in June 2005. The study sample was composed of 503 subjects aged ≥75 years. We implemented a two-phase screening design using the MMSE and the World Health Organization-Disability Assessment Schedule 2nd edition (WHO-DAS II, 12 items) as cognitive and disability screening tools, respectively. Participants scoring within the positive range of the disability screening were administered the full WHO-DAS II (36 items; score range: 0-100) assessing the following areas: Understanding and communication, Getting along with people, Life activities, Getting around, Participation in society, and Self-care. Each disability area assessed by WHO-DAS II (36 items) was reported according to the ICF severity ranges (No problem, 0-4; Mild disability, 5-24; Moderate disability, 25-49; Severe/Extreme disability, 50-100).ResultsThe age-adjusted disability prevalence figures were: 39.17 ± 2.18%, 15.31 ± 1.61%, and 10.14 ± 1.35% for mild, moderate, and severe/extreme disability, respectively. Severe and extreme disability prevalence in mobility and life activities was three times higher than the average, and highest among women. Sex variations were minimal, although life activities for women of 85 years and over had more severe/extreme disability as compared to men (OR = 5.15 95% CI 3.19-8.32).ConclusionsDisability is highly prevalent among the Spanish elderly. Sex- and age-specific variations of disability are associated with particular disability domains.

Funcionalidade de idosos cadastrados em uma unidade da Estratégia Saúde da Família segundo categorias da Classificação Internacional de Funcionalidade

“…Ressaltam-se os achados de um dos raros estudos 29 semelhantes a este que também utilizaram a CIF para classificar a funcionalidade de idosos acima de 75 anos de idade, porém baseando-se apenas nas ABVDs. Na ocasião, a maioria dos idosos estudados também foi codificada com qualificador 0, embora mais de 10% da amostra referiram dificuldade completa para realização das atividades e para participação, talvez justificada pela faixa etária mais elevada.…”

The burden of generalized anxiety disorder in Canada

“…The sociodemographic characteristics we studied included sex (women, men); age (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)30-49, 50+ years and mean age); marital status (single, divorced/separated/ widowed, married/common law); respondent's highest level of education (less than secondary, secondary graduate, some post-secondary, post-secondary graduate); adjusted household income quintiles; employment status in the previous week (student, did not work including permanently disabled and elderly, worked); immigrant status (yes, no); Aboriginal status (yes, no); and geography (urban, rural).…”

The emerging pattern of disability in Rwanda

“…First, it is known that there is a stigma attached to disability in Rwandan society that may have inhibited some households from declaring members with a disability [7,10]. Second, the government relied on self-identification of disability [4] and third, disability was ill defined [6].…”

“…In Rwanda, the definition of disability is legislated by the national government [8] and defined as ''the condition of a person's impairment of health ability he or she should have been in possession, and consequently leading to deficiency compared to others'' [6]. In the 2002 national census in Rwanda, persons with disabilities (PWDs) were defined as: ''Persons who were born without physical, mental or psychological ability like that of others or who were deprived of it due to illness, accident, war or old age'' [9].…”

“…In addition, the questions of a census do not capture the richness of human functioning inherent in current definitions of disability and models of disability -either by type of disability (physical, mental, sensory, and psychological) or by functional domain (body structure/function, activities, and participation). This is especially true in a social model of disability where disability arises from the interaction between functional status and the environment [6]. A further disadvantage of census data is the focus on physical disability resulting in an underestimate of disability due to mental health [2].…”