The activity of daily living (ADL) subgroups and health impairment among Chinese elderly: a latent profile analysis

Abstract

Background Disability in aged people became one of the major challenges in China due to the acceleration of population aging. Nevertheless, there were limited methods to appropriately discriminate the degree of combined basic activity of daily living (BADL) and instrumental activity of daily living (IADL). The present study explored an empirical typology of the activity of daily living (ADL) and its association with health status among the elderly in China. Methods Data throughout the Chinese Longitudinal Healthy Longevity Survey (CLHLS) was retrieved and Latent profile analysis (LPA) was conducted to identify the subgroups of ADL for included elderly subjects. Multinomial regression was performed to detect the effect of identified characteristics with ADL subgroups, and the restricted cubic spine was drawn to show the changes in the relationship between age-specific ADL disability and BMI. Results The overall participants (n=8108) were divided into three ADL classes by LPA - ‘no BADL limitation-no IADL limitation’ (Class one, n=6062, 75%), ‘no BADL limitation- IADL impairment’ (Class two, n=1526, 19%), and ‘BADL impairment- IADL impairment’ (Class three, n=520, 6%). Compared with the participants in Class one, the oldest-old, living without spouse, lacking of exercise, short in social activities, having experience of falls, having comorbidity of diabetes, heart disease, stroke, decreased cognitive function, depression symptom were highly associated with Class two and Class three. Additionally, malnutrition and asthma were associated with combined BADL/IADL impairment (Class three), while illiteracy was only associated with IADL impairment (Class two). Furthermore, a statistically significant U-shape association was detected between age and BADL/IADL disability (Class three vs. Class two) as well as BMI and BADL/IADL disability (Class three vs. Class one). The elderly aged 80–90 with IADL impairment were less likely to evolve into combined BADL/IADL impairment, and the elderly who were underweight or obese may have higher risk of combined BADL/IADL impairment. Conclusion A novel functional assessment was explored based on LPA, by which elderly people could be classified into three distinct classes of combined BADL/IADL. The predictors identified with particular IADL/BADL classes could draw early attention to the onset of functional disability and enlighten targeted interventions to address consequent problems of aged people.

Association between social capital and sleep duration among rural older adults in China

“…The measure of self-reported sleep quality was dichotomized into very good/good versus other (fair/bad/very bad), and was treated as a binary outcome. The 10-item Center for Epidemiologic Studies Short Depression Scale (CES-D) was adopted to measure the depression symptom, scoring from 0 to 30 [43,44]. ADL was based on whether the respondent could be independent in feeding, bathing, dressing, toilet hygiene, continence and indoor transferring, each item was scored from 1 to 3 (1 score representing complete independence; 2 scores representing partially dependence; 3 scores representing complete dependence), and lower scores indicating better functional independence.…”

Approaching person‐centered long‐term care: The trajectories of intrinsic capacity and functional decline in Taiwan

“…3 For example, previous studies showed three subgroups of disability trajectories. [8][9][10] However, Fuente et al identified four classes of health trajectories in an English Longitudinal Study of Aging sample, 11 and another study by Daskalopoulou et al reported four healthy aging trajectories, including high-stable, moderate-stable, low-stable, and decliners in a Mexican Health and Aging Study sample. 12 Also, the Taiwan Longitudinal Study on Aging (2017) regarding healthy aging identified four health profiles among the aging population.…”

Social Interaction, Lifestyle, and Depressive Status: Mediators in the Longitudinal Relationship between Cognitive Function and Instrumental Activities of Daily Living Disability among Older Adults

“…Information on IADL disability drew on the data in the 2014 survey, including visiting neighbors, shopping, preparing meals, washing clothes, and taking public transportation. The participants were asked whether they could complete these tasks by themselves (1 = Yes, I can do it independently; 2 = Yes, but I need some help; 3 = No, I cannot do it) [ 24 ]. The total IADL disability score ranged from 5 to 15.…”