Trends in Incidence of Disability in Activities of Daily Living in Chinese Older Adults: 1993–2006

Abstract

BACKGROUND A decline in prevalence of disability in activities of daily living (ADL) among Chinese elderly people has been reported, but data on secular trends of incidence of ADL disability are sparse. OBJECTIVES We seek to investigate the time trends in incidence of ADL disability among Chinese older adults, and further, to explore factors potentially contributing to the trends. DESIGN A population-based prospective study. SETTING Participants were selected from nine provinces of China through a multistage, randomized, cluster sampling process. PARTICIPANTS We identified three consecutive cohorts of people aged ≥60 years within China Health and Nutrition Survey: cohort 1993-2000 (n=831), cohort 1997-2004 (n=1,091), and cohort 2000-2006 (n=1,152). MEASUREMENTS Disability in ADL was defined as inability to perform at least one of the five self-care activities, i.e., transferring, dressing, toileting, bathing, and feeding. Data were analyzed with Cox and generalized estimating equation models. RESULS The incidence (per 1,000 person-years) of ADL disability significantly decreased from 35.3 in 1993-2000 and 28.9 in 1997-2004 to 24.3 in 2000-2006 in Chinese older adults (Ptrend<.001). The incidence of ADL disability significantly decreased in both men and women, in young-old adults (aged 60-74 years), and in those living in rural area (Ptrend<.02) after controlling for multiple potential influential factors. Of the five ADL items, the decline in incidence of disability was significant in transferring (Ptrend<.001) and bathing (Ptrend=.002) and marginally significant in toileting (Ptrend=.061), but the incidence was stable in dressing (Ptrend=.384) and feeding (Ptrend=.258). CONCLUSION The incidence of ADL disability decreased from 1993 to 2006 among older adults in China, especially in transferring and bathing, independent of socio-demographics, lifestyles, and chronic health conditions.

Efeito da idade, período e coorte de nascimento na incapacidade de idosos residentes na comunidade: Coorte de Idosos de Bambuí (1997-2012)

“…O aumento da prevalência de incapacidade com a idade e a maior proporção dessas limitações entre as mulheres, resultados observados no presente estudo, são consistentemente reportados na literatura 17,18 . Em relação aos domínios da incapacidade, a maior prevalência foi para dificuldades na execução das atividades de mobilidade, seguida das limitações em AIVD e ABVD, também de forma semelhante ao observado entre adultos mais velhos americanos, acompanhados entre 1996 e 2010 19 .…”

“…As tendências temporais da incapacidade ao longo do tempo apresentam grandes variações entre populações, indicando não haver um padrão claramente definido 20 . Alguns estudos evidenciaram aumento 5,10,19,21 e outros redução das taxas 18,22,23,24 . A análise das pensões por incapacidade na população adulta da Noruega mostrou ainda que esse indicador apresentou comportamento cíclico, com variações importantes no período analisado (entre 1970 e 1999) 25…”

“…Por outro lado, corroborando as tendências descritas na presente análise, um estudo anterior na mesma população mostrou redução das taxas de incidência de incapacidade para ABVD, sobretudo a partir da oitava onda 27 , o que coincide com o período a partir do qual há consistente redução seguida de estabilização nas taxas de prevalência deste desfecho. Pode-se supor que essa redução da incidência também tenha ocorrido de forma semelhante para AIVD e mobilidade, levando ao perfil descrito no presente estudo, dada a importância da incidência na determinação da prevalência desses eventos 18 . Adicionalmente, a redução da prevalência de incapacidade pode ser devido à recuperação dos idosos para realizar as atividades avaliadas, dada a possível natureza transitória deste evento 28,29 .…”

Age-Related Changes in Instrumental and Basic Activities of Daily Living Impairment in Older Adults with Very Mild Alzheimer’s Disease

“…Aging is associated with decreases in the degree of independence in instrumental and basic activities of daily living (IADL and BADL, respectively) in community-dwelling older adults. Impairments in IADL, such as using public transportation, shopping, preparing meals, paying bills, and managing deposits, tend to appear earlier than impairments in BADL (e.g., transferring or bathing) among normally aging individuals [1][2][3].…”

Index of Healthy Aging in Chinese Older Adults: China Health and Retirement Longitudinal Study

“…[2][3][4] As population aging has become a prominent policy and public health issue, research on aging has proliferated in China over the past decade, with a focus on the mechanisms, epidemiology, and interventions for noncommunicable diseases, disability, and frailty. [5][6][7][8][9][10][11][12] In contrast, little is known about Chinese older adults who are on the other end of the continuum-persons who maintain a high level of health and function in late life. Identifying older adults with exceptional health and characterizing their sociodemographic, lifestyle, and physiological profiles may help uncover healthy aging-and longevity-associated factors, which may be useful for clinical, epidemiological, and policy applications.…”