Chronic medical conditions as predictors of functional disability in an older population in Taiwan

Abstract

Objective: As there is little understanding of disability processes in Taiwanese elders, the present study aimed to identify medical predictors of the incidence of activities of daily living (ADL) disability. Method: A total of 903 subjects were studied over a 4‐year period (1994–1998). The measurement instrument was the Chinese‐version Multidimensional Functional Assessment Questionnaire (CMFAQ). Only the subjects free of ADL disability at baseline were included in separate logistic regression models to predict disability in physical and instrumental ADL. Results: The hypothesised associations between chronic conditions and future functional disability were cross‐nationally confirmed. Arthritis, diabetes and hypertension were significantly predictive of the onset of physical ADL (PADL) disability; diabetes was the only medical predictor of instrumental ADL (IADL) disability. Age and educational level were significant predictors of PADL and IADL. Conclusions: Prevention programs for chronic disease need to pay more attention not only to the disabled population, but also to secondary prevention among those elders who have higher medical risk of developing disability.

Gender and incidence of functional disability in the elderly: a systematic review

“…Of these, two observed higher incidence of functional disability in women 5,22 and 12 found no difference in the incidence between genders 8,21,23,24,25,26,28,29,30,31,32,33 . Disability in instrumental activities of daily living was examined in three studies 29,30,32 ; one found a higher incidence of functional disability in women 30 and two found no difference in incidence between the genders 29,32 . Mobility disability was evaluated in nine studies 4,5,7,8,27,29,33,34,35 , four of which 4,5,34,35 observed higher incidence of functional disability in women, while five 7,8,27,29,33 found no difference in incidence between genders.…”

“…5 ; Dunlop et al 22 Strawbridge et al 8 6,32 and living in rental housing 6,33 were risk factors for incidence of functional disability, regardless of gender. Table 3 Incidence of functional disability in the elderly according to gender and adjustment of analyses (N = 30) in 21 selected studies.…”

“…Diabetes was a risk factor for functional disability according to two studies, regardless of gender 23,32 . Arthritis was a risk factor for functional disability in three studies: two that did not evaluate gender as a predictor of functional disability 26,32 and one study only in women 9 . Visual impairment was a risk factor for functional disability in two studies 7,23 , regardless of gender.…”

“…As shown in this Table, functional disability in basic activities of daily living was evaluated in 14 studies 5,8,21,22,23,24,25,26,28,29,30,31,32,33 . Of these, two observed higher incidence of functional disability in women 5,22 and 12 found no difference in the incidence between genders 8,21,23,24,25,26,28,29,30,31,32,33 . Disability in instrumental activities of daily living was examined in three studies 29,30,32 ; one found a higher incidence of functional disability in women 30 and two found no difference in incidence between the genders 29,32 .…”

“…5 ; Dunlop et al 22 Instrumental activities of daily living Peek & Coward 30 Mobility Beckett et al 5 ; Leveille et al 4 ; Avlund et al 34 ; Nilsson et al 35 Basic activities of daily living + Mobility Tas et al 9 Higher in men Basic activities of daily living + Mobility Grundy & Glaser 6 No difference between genders Stawbridge et al 8 ; Ferucci et al 24 ; Jagger et al 31 Instrumental activities of daily living Murtagh & Hubert 29 ; Chiu et al 32 Mobility Melzer et al 27 Strawbridge et al 8 …”