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, yet appropriate methods are limited to 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 class subgroups, and restricted cubic spine was drawn to show the relationship between ADL disability with age and BMI. Results The overall participants (n = 8108) were divided into three ADL classes by LPA - ‘no BADL limitation- IADL impairment’ (Class one, n = 1526, 19%), ‘no BADL limitation-no IADL limitation’ (Class two, n = 6062, 75%) and ‘BADL impairment- IADL impairment’ (Class three, n = 520, 6%). Compared with the participants in Class two, the oldest-old, living without spouse, lacking exercise and social activity, having experience of falls, having comorbidity of diabetes, heart disease, stroke, decreased cognitive function, depression symptom were highly associated with BADL/IADL difficulties in Class one and Class three,. Additionally, malnutrition and asthma were associated with combined ADL/IADL impairment (Class three), and illiteracy only was associated with IADL impairment (Class one). Furthermore, a significant U-shape relation was detected between age and BMI with ADL disability. The elderly with IADL impairment was less likely to evolve combined BADL/IADL impairment aged at 80–90, and the elderly with underweight or obese may have higher risk of combined BADL/IADL impairment. Conclusion A novel ADL assessment was explored using LPA, by which elderly people could be defined as three distinct classes of combined ADL/IADL. The predictors identified in the ADL classes could enlighten targeted intervention to address the onset of functional disability and consequent problems with the elderly.

Intergenerational support and subjective wellbeing among oldest-old in China: the moderating role of economic status

“…Following extant researches [ 5 , 6 , 23 ], in combination with the design of the CLHLS questionnaire, a set of variables were chosen for data analysis (Table 1 ).…”

“…Psychological health of the older adults is measured by the depression symptom. The 10-item Center for Epidemiologic Studies Short Depression Scale (CES-D) was adopted to measure the depression symptom, scoring from 0 to 30 with a cutoff point of 10, to distinguish depressive (0) and normal groups (1) [ 23 ].…”