Associations between chronic conditions, body functions, activity limitations and participation restrictions: a cross-sectional approach in Spanish non-clinical populations

Abstract

ObjectivesTo analyse the relationships between chronic conditions, body functions, activity limitations and participation restrictions in the International Classification of Functioning, Disability and Health (ICF) framework.DesignA cross-sectional study.Setting2 geographical areas in the Autonomous Region of Aragon, Spain, namely, a rural area, Cinco Villas, and an urban area in the city of Zaragoza.Participants864 individuals selected by simple random sampling from the register of Social Security card holders, aged 50 years and over, positive to disability screening.Main outcome measuresICF Checklist—body function domains, WHO Disability Assessment Schedule 2.0 (WHODAS 2.0, 36-item (WHODAS-36)) global scores and medical diagnoses (chronic conditions) from primary care records.ResultsMild disability (WHODAS-36 level 5–24%) was present in 51.5% of the sample. In the adjusted ordinal regression model with WHODAS-36 as the dependent variable, disability was substantially associated with moderate-to-complete impairment in the following functions: mental, OR 212.8 (95% CI 72 to 628.9); neuromusculoskeletal, OR 44.8 (24.2 to 82.8); and sensory and pain, OR 6.3 (3.5 to 11.2). In the relationship between health conditions and body function impairments, the strongest links were seen for: dementia with mental functions, OR 50.6 (25.1 to 102.1); cerebrovascular disease with neuromusculoskeletal function, OR 5.8 (3.5 to 9.7); and chronic renal failure with sensory function and pain, OR 3.0 (1.49 to 6.4). Dementia, OR 8.1 (4.4 to 14.7) and cerebrovascular disease, OR 4.1 (2.7 to 6.4) were associated with WHODAS-36 scores.ConclusionsBody functions are heterogeneously linked to limitations in activities and restrictions on participation, with the highest impact being due to mental and musculoskeletal functions. This may be relevant for disability assessment and intervention design, particularly if defined on a body function basis. Control of specific health conditions, such as dementia and cerebrovascular disease, appears to be paramount in reducing disability among persons aged 50 years and over.

Effectiveness of Integration and Re-Integration into Work Strategies for Persons with Chronic Conditions: A Systematic Review of European Strategies

“…The answer to this question is straightforward: because persons with chronic conditions experience considerable disability in daily life, ranging from problems in body functions such as problems with pain, the level of energy or muscle power, to limitations in activities such as doing housework or walking, and important restrictions in their participation in society, such as keeping a job and raising a family. This fact has been corroborated by diverse studies [ 2 , 39 ] and is also reinforced by the Global Burden of Disease Study, which overwhelmingly identified NCDs, many times chronic conditions, as the ones mostly associated to disability [ 40 ]. A recent article on disability, NCDs and health information stresses that it is very unfortunate that action plans for NCDs, and their corresponding monitoring frameworks, continue to heavily focus on mortality and to neglect the adequate measurement of both morbidity and disability [ 41 ].…”

“…People with chronic diseases face a variety of important problems in performing their every-day lives and in participating in society, being work one of the major areas affected [ 1 , 2 ]. Chronic diseases, also known as non-communicable diseases (NCDs), are defined by the World Health Organization (WHO) as diseases that are not passed from person to person, that have generally a long duration and slow progression [ 3 ].…”

Analysis of Chronic Illnesses and Disability in a Community-Based Sample of Elderly People in South-Eastern Poland

“…These people with a severe or extreme disability will require occasional or regular assistance in their everyday life. Similarly, a study involving a Spanish population revealed that 51.5% of the elderly had moderate disability, which was significantly associated with cognitive impairment, cerebrovascular diseases, and locomotor diseases [ 41 ]. In contrast, a study conducted in the United States reported a lower incidence of disability among the elderly (25.4%) [ 42 ].…”

Physical activity, body functions and disability among middle-aged and older Spanish adults

“…The selected individuals were double screened for disability and cognitive function by trained research assistants, and those with comprehensive assessments were included in the analysis [15]. Screening involved two stages: firstly, we selected individuals with at least one positive answer in a disability questionnaire, the WHODAS 2.0 12-item [14].…”